臺灣健保癌症用藥事前審查實作指引
1.0.8 - STU1.0.8

臺灣健保癌症用藥事前審查實作指引 - Downloaded Version 1.0.8 See the Directory of published versions

## Resource Profile: ClaimTWPAS - Detailed Descriptions

Active as of 2025-09-26

Definitions for the Claim-twpas resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. Claim
Definition | A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
Short | Claim, Pre-determination or Pre-authorization
Comments | The Claim resource fulfills three information request requirements: Claim - a request for adjudication for reimbursement for products and/or services provided; Preauthorization - a request to authorize the future provision of products and/or services including an anticipated adjudication; and, Predetermination - a request for a non-bind adjudication of possible future products and/or services.
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Adjudication Request, Preauthorization Request, Predetermination Request
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) sequence-1: diagnosis.sequence一定會有一個「1」，且只能出現一次。 (`diagnosis.where(sequence = 1).count() = 1`) supportingInfo: 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查報備)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。 (`(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'))`) applType: 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。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.exists())`)
2. Claim.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 10..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Claim.meta.profile
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Short | Profiles this resource claims to conform to
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Control | 10..1*
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Pattern Value | `https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Claim.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Claim.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Claim.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. Claim.extension:encounter
Slice Name | encounter
Definition | 就醫科別
Short | 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】
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(ClaimEncounter) (Extension Type: Reference(就醫科別-Encounter TWPAS))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Claim.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
14. Claim.identifier
Definition | A unique identifier assigned to this claim.
Short | 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填寫原送核案件之受理編號。Business Identifier for claim
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | false
Requirements | Allows claims to be distinguished and referenced.
Alternate Names | Claim Number
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Claim.status
Definition | The status of the resource instance.
Short | active | cancelled | draft | entered-in-error
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/fm-status|4.0.1` ) A code specifying the state of the resource instance.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.
Pattern Value | `active`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Claim.type
Definition | The category of claim, e.g. oral, pharmacy, vision, institutional, professional.
Short | Category or discipline
Comments | The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ClaimTypeCodes http://hl7.org/fhir/ValueSet/claim-type|4.0.1 (extensible to `http://hl7.org/fhir/ValueSet/claim-type|4.0.1` ) The type or discipline-style of the claim.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Claim type determine the general sets of business rules applied for information requirements and adjudication.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/claim-type", "code" : "institutional" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Claim.subType
Definition | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
Short | 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。More granular claim type
Comments | This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.
Control | 10..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-申報類別值集 http://hl7.org/fhir/ValueSet/claim-subtype|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | Some jurisdictions need a finer grained claim type for routing and adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Claim.subType.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..1*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Claim.subType.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. Claim.subType.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 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填寫原送核案件之受理編號。Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Claim.use
Definition | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
Short | claim | preauthorization | predetermination
Control | 1..1
Binding | The codes SHALL be taken from Use http://hl7.org/fhir/ValueSet/claim-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/claim-use|4.0.1` ) The purpose of the Claim: predetermination, preauthorization, claim.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This element is required to understand the nature of the request for adjudication.
Pattern Value | `preauthorization`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Claim.patient
Definition | The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.
Short | 病人資訊The recipient of the products and services
Control | 1..1
Type | Reference(病人資訊-Patient TWPAS, Patient)
Is Modifier | false
Must Support | true
Summary | true
Requirements | The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. Claim.created
Definition | The date this resource was created.
Short | 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。Resource creation date
Comments | This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to record a timestamp for use by both the recipient and the issuer.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. Claim.enterer
Definition | Individual who created the claim, predetermination or preauthorization.
Short | 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。Author of the claim
Control | 10..1
Type | Reference(醫事人員-Practitioner TWPAS, Practitioner, PractitionerRole)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Some jurisdictions require the contact information for personnel completing claims.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. Claim.provider
Definition | The provider which is responsible for the claim, predetermination or preauthorization.
Short | 醫事機構代碼，必須存在於醫事機構基本資料檔內。Party responsible for the claim
Comments | Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.
Control | 1..1
Type | Reference(醫事機構-Organization TWPAS, Practitioner, PractitionerRole, Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Claim.priority
Definition | The provider-required urgency of processing the request. Typical values include: stat, routine deferred.
Short | 申請案件類別，1:一般事前審查申請 | 3:自主審查報備 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。Desired processing ugency
Comments | If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-申請案件類別值集 http://hl7.org/fhir/ValueSet/process-priority|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-tmhb-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Claim.supportingInfo
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 20..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Claim.supportingInfo`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ category
42. Claim.supportingInfo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
44. Claim.supportingInfo.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Claim.supportingInfo.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. Claim.supportingInfo:weight
Slice Name | weight
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 病人體重Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Claim.supportingInfo:weight.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
52. Claim.supportingInfo:weight.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Claim.supportingInfo:weight.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "weight" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Claim.supportingInfo:weight.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Claim.supportingInfo:weight.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Quantity, boolean, string, Reference(Resource), Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Claim.supportingInfo:weight.value[x].value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | 體重，整數至多3位數及小數至多2位數。Numerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 10..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) HTWT: 整數至多3位數及小數至多2位數 (`value.toString().matches('^[0-9]{1,3}(.[0-9]{1,2})?$')`)
62. Claim.supportingInfo:weight.value[x].comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. Claim.supportingInfo:weight.value[x].system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 10..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Claim.supportingInfo:weight.value[x].code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Pattern Value | `kg`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Claim.supportingInfo:height
Slice Name | height
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 病人身高Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 10..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Claim.supportingInfo:height.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
72. Claim.supportingInfo:height.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Claim.supportingInfo:height.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "height" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Claim.supportingInfo:height.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Claim.supportingInfo:height.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Quantity, boolean, string, Reference(Resource), Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. Claim.supportingInfo:height.value[x].value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | 身高(cm)，整數至多3位數及小數至多2位數。Numerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 10..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) HTWT: 整數至多3位數及小數至多2位數 (`value.toString().matches('^[0-9]{1,3}(.[0-9]{1,2})?$')`)
82. Claim.supportingInfo:height.value[x].comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Claim.supportingInfo:height.value[x].system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 10..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Claim.supportingInfo:height.value[x].code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Pattern Value | `cm`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. Claim.supportingInfo:pregnancy
Slice Name | pregnancy
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 是否懷孕或哺乳Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. Claim.supportingInfo:pregnancy.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
92. Claim.supportingInfo:pregnancy.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. Claim.supportingInfo:pregnancy.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "pregnancyBreastfeedingStatus" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. Claim.supportingInfo:pregnancy.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. Claim.supportingInfo:pregnancy.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | boolean, string, Reference(Resource), Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Claim.supportingInfo:imagingReport
Slice Name | imagingReport
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 影像報告Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Claim.supportingInfo:imagingReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
104. Claim.supportingInfo:imagingReport.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. Claim.supportingInfo:imagingReport.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "imagingReport" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. Claim.supportingInfo:imagingReport.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Claim.supportingInfo:imagingReport.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 影像報告Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(影像報告-DiagnosticReport Image TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. Claim.supportingInfo:cancerStage
Slice Name | cancerStage
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 癌症分期量表Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Claim.supportingInfo:cancerStage.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
116. Claim.supportingInfo:cancerStage.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. Claim.supportingInfo:cancerStage.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "cancerStage" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. Claim.supportingInfo:cancerStage.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
122. Claim.supportingInfo:cancerStage.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 癌症分期量表Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(癌症分期量表-Observation Cancer Stage TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. Claim.supportingInfo:examinationReport
Slice Name | examinationReport
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 檢查報告Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. Claim.supportingInfo:examinationReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
128. Claim.supportingInfo:examinationReport.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. Claim.supportingInfo:examinationReport.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "examinationReport" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Claim.supportingInfo:examinationReport.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Claim.supportingInfo:examinationReport.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 檢查報告Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(檢查報告-DiagnosticReport TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. Claim.supportingInfo:geneInfo
Slice Name | geneInfo
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 基因資訊Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. Claim.supportingInfo:geneInfo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
140. Claim.supportingInfo:geneInfo.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. Claim.supportingInfo:geneInfo.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "geneInfo" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. Claim.supportingInfo:geneInfo.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Claim.supportingInfo:geneInfo.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 基因資訊Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(基因資訊-Observation Diagnostic TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Claim.supportingInfo:tests
Slice Name | tests
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 檢驗(查)Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Claim.supportingInfo:tests.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
152. Claim.supportingInfo:tests.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
154. Claim.supportingInfo:tests.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "tests" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
156. Claim.supportingInfo:tests.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. Claim.supportingInfo:tests.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 檢驗(查)Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(檢驗檢查-Observation Laboratory Result TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. Claim.supportingInfo:patientAssessment
Slice Name | patientAssessment
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 病人狀態評估Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
162. Claim.supportingInfo:patientAssessment.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
164. Claim.supportingInfo:patientAssessment.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. Claim.supportingInfo:patientAssessment.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "patientAssessment" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. Claim.supportingInfo:patientAssessment.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Claim.supportingInfo:patientAssessment.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 病人狀態評估Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(病人狀態評估-Observation Patient Assessment TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
172. Claim.supportingInfo:medicationRequest
Slice Name | medicationRequest
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 用藥品項Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. Claim.supportingInfo:medicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
176. Claim.supportingInfo:medicationRequest.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. Claim.supportingInfo:medicationRequest.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "medicationRequest" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
180. Claim.supportingInfo:medicationRequest.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
182. Claim.supportingInfo:medicationRequest.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 用藥品項Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(用藥品項-MedicationRequest Treat TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
184. Claim.supportingInfo:radiotherapy
Slice Name | radiotherapy
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 放射治療Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
186. Claim.supportingInfo:radiotherapy.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
188. Claim.supportingInfo:radiotherapy.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
190. Claim.supportingInfo:radiotherapy.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "radiotherapy" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
192. Claim.supportingInfo:radiotherapy.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. Claim.supportingInfo:radiotherapy.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 放射治療Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(放射治療-Procedure TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
196. Claim.supportingInfo:carePlanDocument
Slice Name | carePlanDocument
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 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PDFSupporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
198. Claim.supportingInfo:carePlanDocument.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
200. Claim.supportingInfo:carePlanDocument.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
202. Claim.supportingInfo:carePlanDocument.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "carePlanDocument" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
204. Claim.supportingInfo:carePlanDocument.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. Claim.supportingInfo:carePlanDocument.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 治療計畫文件Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(文件參照-DocumentReference TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
208. Claim.supportingInfo:medicalRecord
Slice Name | medicalRecord
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 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。Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
210. Claim.supportingInfo:medicalRecord.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
212. Claim.supportingInfo:medicalRecord.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
214. Claim.supportingInfo:medicalRecord.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "medicalRecord" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
216. Claim.supportingInfo:medicalRecord.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
218. Claim.supportingInfo:medicalRecord.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(文件參照-DocumentReference TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
220. Claim.supportingInfo:treatmentAssessment
Slice Name | treatmentAssessment
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 結果資訊Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
222. Claim.supportingInfo:treatmentAssessment.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
224. Claim.supportingInfo:treatmentAssessment.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。Information instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
226. Claim.supportingInfo:treatmentAssessment.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-補充資訊類別值集 http://hl7.org/fhir/ValueSet/claim-informationcategory|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "treatmentAssessment" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
228. Claim.supportingInfo:treatmentAssessment.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..01
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
230. Claim.supportingInfo:treatmentAssessment.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 結果資訊Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 10..1
Type | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS, Resource), boolean, string, Quantity, Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
232. Claim.diagnosis
Definition | Information about diagnoses relevant to the claim items.
Short | sequence=1時為主要疾病；sequence>=2代表共病。Pertinent diagnosis information
Control | 10..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | Required for the adjudication by provided context for the services and product listed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) 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() )`)
234. Claim.diagnosis.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Claim.diagnosis.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
236. Claim.diagnosis.extension:recordedDate
Slice Name | recordedDate
Definition | The date that a diagnosis was recorded. (HIxx-4)
Short | 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】
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(DiagnosisRecordedDate) (Extension Type: date)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
238. Claim.diagnosis.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
240. Claim.diagnosis.sequence
Definition | A number to uniquely identify diagnosis entries.
Short | sequence=1時為主要疾病；sequence>=2代表共病。Diagnosis instance identifier
Comments | Diagnosis are presented in list order to their expected importance: primary, secondary, etc.
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
242. Claim.diagnosis.diagnosis[x]
Definition | The nature of illness or problem in a coded form or as a reference to an external defined Condition.
Short | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。Nature of illness or problem
Control | 1..1
Binding | The codes SHOULD be taken from For example codes, see 臺灣健保署2023年中文版ICD-10-CM值集 http://hl7.org/fhir/ValueSet/icd-10|4.0.1 (preferred to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2023-tw` )
Type | CodeableConcept, Reference(Condition)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | Provides health context for the evaluation of the products and/or services.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
244. Claim.diagnosis.diagnosis[x].coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Claim.diagnosis.diagnosis[x].coding`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ system
246. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023
Slice Name | icd10-cm-2023
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1*
Binding | Unless not suitable, these codes SHALL be taken from For codes, see 臺灣健保署2023年中文版ICD-10-CM值集 (extensible to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2023-tw` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
248. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
250. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
252. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014
Slice Name | icd10-cm-2014
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1*
Binding | Unless not suitable, these codes SHALL be taken from For codes, see 臺灣健保署2014年中文版ICD-10-CM值集 (extensible to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2014-tw` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
254. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
256. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
258. Claim.diagnosis.type
Definition | When the condition was observed or the relative ranking.
Short | Timing or nature of the diagnosis
Comments | For example: admitting, primary, secondary, discharge.
Control | 0..1*
Binding | For example codes, see ExampleDiagnosisTypeCodes http://hl7.org/fhir/ValueSet/ex-diagnosistype|4.0.1 (example to `http://hl7.org/fhir/ValueSet/ex-diagnosistype|4.0.1` ) The type of the diagnosis: admitting, principal, discharge.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Often required to capture a particular diagnosis, for example: primary or discharge.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
260. Claim.diagnosis.type.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | 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。Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) pas-2: 長度不得超過4000 bytes。 (`toString().length() <= 4000`)
262. Claim.procedure
Definition | Procedures performed on the patient relevant to the billing items with the claim.
Short | Clinical procedures performed
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
264. Claim.procedure.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
266. Claim.procedure.sequence
Definition | A number to uniquely identify procedure entries.
Short | Procedure instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
268. Claim.procedure.date
Definition | Date and optionally time the procedure was performed.
Short | 手術(或其他處置)日期When the procedure was performed
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Required for auditing purposes.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
270. Claim.procedure.procedure[x]
Definition | The code or reference to a Procedure resource which identifies the clinical intervention performed.
Short | 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。Specific clinical procedure
Control | 1..1
Binding | The codes SHOULD be taken from For example codes, see 臺灣健保署2023年中文版ICD-10-PCS值集 http://hl7.org/fhir/ValueSet/icd-10-procedures|4.0.1 (preferred to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2023-tw` )
Type | CodeableConcept, Reference(Procedure)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | This identifies the actual clinical procedure.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
272. Claim.procedure.procedure[x].coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..1*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Claim.procedure.procedure[x].coding`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ system
274. Claim.procedure.procedure[x].coding:icd10-pcs-2023
Slice Name | icd10-pcs-2023
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1*
Binding | The codes SHALL be taken from For codes, see 臺灣健保署2023年中文版ICD-10-PCS值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2023-tw` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
276. Claim.procedure.procedure[x].coding:icd10-pcs-2023.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
278. Claim.procedure.procedure[x].coding:icd10-pcs-2023.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
280. Claim.procedure.procedure[x].coding:icd10-pcs-2014
Slice Name | icd10-pcs-2014
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1*
Binding | The codes SHALL be taken from For codes, see 臺灣健保署2014年中文版ICD-10-PCS值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2014-tw` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
282. Claim.procedure.procedure[x].coding:icd10-pcs-2014.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
284. Claim.procedure.procedure[x].coding:icd10-pcs-2014.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
286. Claim.procedure.procedure[x].coding:medical-service-payment
Slice Name | medical-service-payment
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1*
Binding | The codes SHALL be taken from For codes, see NHI-健保事前審查-醫療服務給付項目值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-medical-service-payment` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
288. Claim.procedure.procedure[x].coding:medical-service-payment.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
290. Claim.procedure.procedure[x].coding:medical-service-payment.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
292. Claim.insurance
Definition | Financial instruments for reimbursement for the health care products and services specified on the claim.
Short | Patient insurance information
Comments | All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.
Control | 1..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | At least one insurer is required for a claim to be a claim.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
294. Claim.insurance.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
296. Claim.insurance.sequence
Definition | A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order.
Short | Insurance instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | To maintain order of the coverages.
Pattern Value | `1`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
298. Claim.insurance.focal
Definition | A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.
Short | Coverage to be used for adjudication
Comments | A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.
Control | 1..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | To identify which coverage in the list is being used to adjudicate this claim.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
300. Claim.insurance.coverage
Definition | Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.
Short | Insurance information
Control | 1..1
Type | Reference(健保事前審查計畫-Coverage TWPAS, Coverage)
Is Modifier | false
Summary | true
Requirements | Required to allow the adjudicator to locate the correct policy and history within their information system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
302. Claim.item
Definition | A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.
Short | Product or service provided
Control | 10..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | The items to be processed for adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
304. Claim.item.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Claim.item.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
306. Claim.item.extension:requestedService
Slice Name | requestedService
Definition | 事前審查品項
Short | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(RequestedService) (Extension Type: Reference(事前審查品項-MedicationRequest Apply TWPAS))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
308. Claim.item.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
310. Claim.item.sequence
Definition | A number to uniquely identify item entries.
Short | Item instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
312. Claim.item.productOrService
Definition | When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
Short | 醫令類別Billing, service, product, or drug code
Comments | If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
Control | 1..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-醫令類別值集 http://hl7.org/fhir/ValueSet/service-uscls|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-order-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | Necessary to state what was provided or done.
Alternate Names | Drug Code, Bill Code, Service Code
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
314. Claim.item.modifier
Definition | Item typification or modifiers codes to convey additional context for the product or service.
Short | Product or service billing modifiers
Comments | For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
Control | 10..2*
Binding | For example codes, see ModifierTypeCodes http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1 (example to `http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1` ) Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | To support inclusion of the item for adjudication or to charge an elevated fee.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Claim.item.modifier`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ coding.system
316. Claim.item.modifier:continuation
Slice Name | continuation
Definition | Item typification or modifiers codes to convey additional context for the product or service.
Short | 續用註記，1:初次使用 | 2:申請再次使用Product or service billing modifiers
Comments | For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
Control | 10..1*
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-續用註記值集 http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-continuation-status` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | To support inclusion of the item for adjudication or to charge an elevated fee.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
318. Claim.item.modifier:continuation.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..1*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
320. Claim.item.modifier:continuation.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
322. Claim.item.modifier:continuation.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 1:初次使用 | 2:申請再次使用Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
324. Claim.item.modifier:lot
Slice Name | lot
Definition | Item typification or modifiers codes to convey additional context for the product or service.
Short | 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Product or service billing modifiers
Comments | For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
Control | 0..1*
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-用藥線別值集 http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-line-of-therapy` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | To support inclusion of the item for adjudication or to charge an elevated fee.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
326. Claim.item.modifier:lot.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..1*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
328. Claim.item.modifier:lot.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
330. Claim.item.modifier:lot.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 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Symbol in syntax defined by the system
Control | 10..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
332. Claim.item.programCode
Definition | Identifies the program under which this may be recovered.
Short | 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。Program the product or service is provided under
Comments | For example: Neonatal program, child dental program or drug users recovery program.
Control | 10..1* This element is affected by the following invariants: applyReason-1, applyReason-2, applyReason-3
Binding | For example codes, see ExampleProgramReasonCodes http://hl7.org/fhir/ValueSet/ex-program-code|4.0.1 (example to `http://hl7.org/fhir/ValueSet/ex-program-code|4.0.1` ) Program specific reason codes.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) pas-1: text、coding至少需存在一個。 (`text.exists() or coding.exists()`)
334. Claim.item.programCode.coding
Definition | A reference to a code defined by a terminology system.
Short | 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時，才可填寫。Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1*
Binding | The codes SHALL be taken from For codes, see NHI-健保事前審查-給付適應症值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-reason` )
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
336. Claim.item.programCode.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | 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時，請自行輸入文字。Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
338. Claim.item.quantity
Definition | The number of repetitions of a service or product.
Short | Count of products or services
Control | 10..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Required when the product or service code does not convey the quantity provided.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
340. Claim.item.quantity.value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | 事前審查申請數量Numerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 10..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
342. Claim.item.quantity.comparator
Definition | Not allowed to be used in this context How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..01
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
344. Claim.item.quantity.system
Definition | The identification of the system that provides the coded form of the unit.
Short | 事前審查申請數量單位之代碼系統，固定為「http://unitsofmeasure.org」。System that defines coded unit form
Control | 10..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
346. Claim.item.quantity.code
Definition | A computer processable form of the unit in some unit representation system.
Short | 事前審查申請數量單位Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 10..1
Binding | The codes SHALL be taken from For codes, see UCUMCodes (required to `http://hl7.org/fhir/ValueSet/ucum-units` ) 事前審查申請數量單位的代碼範圍請參考Common UCUM units。
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
348. Claim.item.bodySite
Definition | Physical service site on the patient (limb, tooth, etc.).
Short | 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)Anatomical location
Comments | For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.
Control | 0..1
Binding | The codes SHALL be taken from For example codes, see NHI-健保事前審查-申請部位值集 http://hl7.org/fhir/ValueSet/tooth|4.0.1 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-side` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows insurer to validate specific procedures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Claim
Invariants | sequence-1: diagnosis.sequence一定會有一個「1」，且只能出現一次。 (`diagnosis.where(sequence = 1).count() = 1`) supportingInfo: 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查報備)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。 (`(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'))`) applType: 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。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.exists())`)
2. Claim.meta
Control | 1..?
4. Claim.meta.profile
Control | 1..1
Pattern Value | `https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas`
6. Claim.extension
Control | 1..?
Slicing | This element introduces a set of slices on `Claim.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
8. Claim.extension:encounter
Slice Name | encounter
Short | 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】
Control | 1..1
Type | Extension(ClaimEncounter) (Extension Type: Reference(就醫科別-Encounter TWPAS))
Must Support | true
10. Claim.identifier
Short | 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填寫原送核案件之受理編號。
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Must Support | true
12. Claim.status
Pattern Value | `active`
14. Claim.type
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/claim-type", "code" : "institutional" }] }`
16. Claim.subType
Short | 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。
Control | 1..?
Binding | The codes SHALL be taken from NHI-健保事前審查-申報類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-type` )
Must Support | true
18. Claim.subType.coding
Control | 1..1
20. Claim.subType.coding.system
Control | 1..?
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type`
22. Claim.subType.coding.code
Short | 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填寫原送核案件之受理編號。
Control | 1..?
24. Claim.use
Pattern Value | `preauthorization`
26. Claim.patient
Short | 病人資訊
Type | Reference(病人資訊-Patient TWPAS)
Must Support | true
28. Claim.created
Short | 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。
Must Support | true
30. Claim.enterer
Short | 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。
Control | 1..?
Type | Reference(醫事人員-Practitioner TWPAS)
Must Support | true
32. Claim.provider
Short | 醫事機構代碼，必須存在於醫事機構基本資料檔內。
Type | Reference(醫事機構-Organization TWPAS)
Must Support | true
34. Claim.priority
Short | 申請案件類別，1:一般事前審查申請 | 3:自主審查報備 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。
Binding | The codes SHALL be taken from NHI-健保事前審查-申請案件類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-tmhb-type` )
Must Support | true
36. Claim.supportingInfo
Control | 2..?
Slicing | This element introduces a set of slices on `Claim.supportingInfo`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ category
38. Claim.supportingInfo.sequence
Short | 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。
40. Claim.supportingInfo.category
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
42. Claim.supportingInfo:weight
Slice Name | weight
Short | 病人體重
Control | 1..1
44. Claim.supportingInfo:weight.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "weight" }] }`
46. Claim.supportingInfo:weight.timing[x]
Control | 0..0
48. Claim.supportingInfo:weight.value[x]
Control | 1..?
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
50. Claim.supportingInfo:weight.value[x].value
Short | 體重，整數至多3位數及小數至多2位數。
Control | 1..?
Must Support | true
Invariants | HTWT: 整數至多3位數及小數至多2位數 (`value.toString().matches('^[0-9]{1,3}(.[0-9]{1,2})?$')`)
52. Claim.supportingInfo:weight.value[x].system
Control | 1..?
Pattern Value | `http://unitsofmeasure.org`
54. Claim.supportingInfo:weight.value[x].code
Control | 1..?
Pattern Value | `kg`
56. Claim.supportingInfo:height
Slice Name | height
Short | 病人身高
Control | 1..1
58. Claim.supportingInfo:height.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "height" }] }`
60. Claim.supportingInfo:height.timing[x]
Control | 0..0
62. Claim.supportingInfo:height.value[x]
Control | 1..?
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
64. Claim.supportingInfo:height.value[x].value
Short | 身高(cm)，整數至多3位數及小數至多2位數。
Control | 1..?
Must Support | true
Invariants | HTWT: 整數至多3位數及小數至多2位數 (`value.toString().matches('^[0-9]{1,3}(.[0-9]{1,2})?$')`)
66. Claim.supportingInfo:height.value[x].system
Control | 1..?
Pattern Value | `http://unitsofmeasure.org`
68. Claim.supportingInfo:height.value[x].code
Control | 1..?
Pattern Value | `cm`
70. Claim.supportingInfo:pregnancy
Slice Name | pregnancy
Short | 是否懷孕或哺乳
Control | 0..1
72. Claim.supportingInfo:pregnancy.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "pregnancyBreastfeedingStatus" }] }`
74. Claim.supportingInfo:pregnancy.timing[x]
Control | 0..0
76. Claim.supportingInfo:pregnancy.value[x]
Short | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳
Control | 1..?
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
78. Claim.supportingInfo:imagingReport
Slice Name | imagingReport
Short | 影像報告
Control | 0..*
80. Claim.supportingInfo:imagingReport.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "imagingReport" }] }`
82. Claim.supportingInfo:imagingReport.timing[x]
Control | 0..0
84. Claim.supportingInfo:imagingReport.value[x]
Short | 影像報告
Control | 1..?
Type | Reference(影像報告-DiagnosticReport Image TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
86. Claim.supportingInfo:cancerStage
Slice Name | cancerStage
Short | 癌症分期量表
Control | 0..*
88. Claim.supportingInfo:cancerStage.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "cancerStage" }] }`
90. Claim.supportingInfo:cancerStage.timing[x]
Control | 0..0
92. Claim.supportingInfo:cancerStage.value[x]
Short | 癌症分期量表
Control | 1..?
Type | Reference(癌症分期量表-Observation Cancer Stage TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
94. Claim.supportingInfo:examinationReport
Slice Name | examinationReport
Short | 檢查報告
Control | 0..*
96. Claim.supportingInfo:examinationReport.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "examinationReport" }] }`
98. Claim.supportingInfo:examinationReport.timing[x]
Control | 0..0
100. Claim.supportingInfo:examinationReport.value[x]
Short | 檢查報告
Control | 1..?
Type | Reference(檢查報告-DiagnosticReport TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
102. Claim.supportingInfo:geneInfo
Slice Name | geneInfo
Short | 基因資訊
Control | 0..*
104. Claim.supportingInfo:geneInfo.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "geneInfo" }] }`
106. Claim.supportingInfo:geneInfo.timing[x]
Control | 0..0
108. Claim.supportingInfo:geneInfo.value[x]
Short | 基因資訊
Control | 1..?
Type | Reference(基因資訊-Observation Diagnostic TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
110. Claim.supportingInfo:tests
Slice Name | tests
Short | 檢驗(查)
Control | 0..*
112. Claim.supportingInfo:tests.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "tests" }] }`
114. Claim.supportingInfo:tests.timing[x]
Control | 0..0
116. Claim.supportingInfo:tests.value[x]
Short | 檢驗(查)
Control | 1..?
Type | Reference(檢驗檢查-Observation Laboratory Result TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
118. Claim.supportingInfo:patientAssessment
Slice Name | patientAssessment
Short | 病人狀態評估
Control | 0..*
120. Claim.supportingInfo:patientAssessment.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "patientAssessment" }] }`
122. Claim.supportingInfo:patientAssessment.timing[x]
Control | 0..0
124. Claim.supportingInfo:patientAssessment.value[x]
Short | 病人狀態評估
Control | 1..?
Type | Reference(病人狀態評估-Observation Patient Assessment TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
126. Claim.supportingInfo:medicationRequest
Slice Name | medicationRequest
Short | 用藥品項
Control | 0..*
128. Claim.supportingInfo:medicationRequest.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "medicationRequest" }] }`
130. Claim.supportingInfo:medicationRequest.timing[x]
Control | 0..0
132. Claim.supportingInfo:medicationRequest.value[x]
Short | 用藥品項
Control | 1..?
Type | Reference(用藥品項-MedicationRequest Treat TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
134. Claim.supportingInfo:radiotherapy
Slice Name | radiotherapy
Short | 放射治療
Control | 0..*
136. Claim.supportingInfo:radiotherapy.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "radiotherapy" }] }`
138. Claim.supportingInfo:radiotherapy.timing[x]
Control | 0..0
140. Claim.supportingInfo:radiotherapy.value[x]
Short | 放射治療
Control | 1..?
Type | Reference(放射治療-Procedure TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
142. Claim.supportingInfo:carePlanDocument
Slice Name | carePlanDocument
Short | 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
Control | 0..*
144. Claim.supportingInfo:carePlanDocument.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "carePlanDocument" }] }`
146. Claim.supportingInfo:carePlanDocument.timing[x]
Control | 0..0
148. Claim.supportingInfo:carePlanDocument.value[x]
Short | 治療計畫文件
Control | 1..?
Type | Reference(文件參照-DocumentReference TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
150. Claim.supportingInfo:medicalRecord
Slice Name | medicalRecord
Short | 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。
Control | 0..*
152. Claim.supportingInfo:medicalRecord.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "medicalRecord" }] }`
154. Claim.supportingInfo:medicalRecord.timing[x]
Control | 0..0
156. Claim.supportingInfo:medicalRecord.value[x]
Control | 1..?
Type | Reference(文件參照-DocumentReference TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
158. Claim.supportingInfo:treatmentAssessment
Slice Name | treatmentAssessment
Short | 結果資訊
Control | 0..*
160. Claim.supportingInfo:treatmentAssessment.category
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "treatmentAssessment" }] }`
162. Claim.supportingInfo:treatmentAssessment.timing[x]
Control | 0..0
164. Claim.supportingInfo:treatmentAssessment.value[x]
Short | 結果資訊
Control | 1..?
Type | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
166. Claim.diagnosis
Short | sequence=1時為主要疾病；sequence>=2代表共病。
Control | 1..?
Must Support | true
Invariants | 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() )`)
168. Claim.diagnosis.extension
Slicing | This element introduces a set of slices on `Claim.diagnosis.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
170. Claim.diagnosis.extension:recordedDate
Slice Name | recordedDate
Short | 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】
Control | 0..*
Type | Extension(DiagnosisRecordedDate) (Extension Type: date)
Must Support | true
172. Claim.diagnosis.sequence
Short | sequence=1時為主要疾病；sequence>=2代表共病。
174. Claim.diagnosis.diagnosis[x]
Short | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。
Binding | The codes SHOULD be taken from 臺灣健保署2023年中文版ICD-10-CM值集 (preferred to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2023-tw` )
Type | CodeableConcept, Reference(Condition)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
176. Claim.diagnosis.diagnosis[x].coding
Slicing | This element introduces a set of slices on `Claim.diagnosis.diagnosis[x].coding`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ system
178. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023
Slice Name | icd10-cm-2023
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from 臺灣健保署2023年中文版ICD-10-CM值集 (extensible to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2023-tw` )
Must Support | true
180. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.system
Control | 1..?
Must Support | true
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw`
182. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.code
Control | 1..?
Must Support | true
184. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014
Slice Name | icd10-cm-2014
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from 臺灣健保署2014年中文版ICD-10-CM值集 (extensible to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2014-tw` )
Must Support | true
186. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.system
Control | 1..?
Must Support | true
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw`
188. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.code
Control | 1..?
Must Support | true
190. Claim.diagnosis.type
Control | 0..1
192. Claim.diagnosis.type.text
Short | 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。
Must Support | true
Invariants | pas-2: 長度不得超過4000 bytes。 (`toString().length() <= 4000`)
194. Claim.procedure
196. Claim.procedure.date
Short | 手術(或其他處置)日期
Control | 1..?
Must Support | true
198. Claim.procedure.procedure[x]
Short | 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 | The codes SHOULD be taken from 臺灣健保署2023年中文版ICD-10-PCS值集 (preferred to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2023-tw` )
Type | CodeableConcept, Reference(Procedure)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
200. Claim.procedure.procedure[x].coding
Control | 1..1
Slicing | This element introduces a set of slices on `Claim.procedure.procedure[x].coding`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ system
202. Claim.procedure.procedure[x].coding:icd10-pcs-2023
Slice Name | icd10-pcs-2023
Control | 0..1
Binding | The codes SHALL be taken from 臺灣健保署2023年中文版ICD-10-PCS值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2023-tw` )
Must Support | true
204. Claim.procedure.procedure[x].coding:icd10-pcs-2023.system
Control | 1..?
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw`
206. Claim.procedure.procedure[x].coding:icd10-pcs-2023.code
Control | 1..?
Must Support | true
208. Claim.procedure.procedure[x].coding:icd10-pcs-2014
Slice Name | icd10-pcs-2014
Control | 0..1
Binding | The codes SHALL be taken from 臺灣健保署2014年中文版ICD-10-PCS值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2014-tw` )
Must Support | true
210. Claim.procedure.procedure[x].coding:icd10-pcs-2014.system
Control | 1..?
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw`
212. Claim.procedure.procedure[x].coding:icd10-pcs-2014.code
Control | 1..?
Must Support | true
214. Claim.procedure.procedure[x].coding:medical-service-payment
Slice Name | medical-service-payment
Control | 0..1
Binding | The codes SHALL be taken from NHI-健保事前審查-醫療服務給付項目值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-medical-service-payment` )
Must Support | true
216. Claim.procedure.procedure[x].coding:medical-service-payment.system
Control | 1..?
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw`
218. Claim.procedure.procedure[x].coding:medical-service-payment.code
Control | 1..?
Must Support | true
220. Claim.insurance
222. Claim.insurance.sequence
Pattern Value | `1`
224. Claim.insurance.coverage
Type | Reference(健保事前審查計畫-Coverage TWPAS)
226. Claim.item
Control | 1..?
228. Claim.item.extension
Control | 1..?
Slicing | This element introduces a set of slices on `Claim.item.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
230. Claim.item.extension:requestedService
Slice Name | requestedService
Short | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】
Control | 1..1
Type | Extension(RequestedService) (Extension Type: Reference(事前審查品項-MedicationRequest Apply TWPAS))
Must Support | true
232. Claim.item.productOrService
Short | 醫令類別
Binding | The codes SHALL be taken from NHI-健保事前審查-醫令類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-order-type` )
Must Support | true
234. Claim.item.modifier
Control | 1..2
Slicing | This element introduces a set of slices on `Claim.item.modifier`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ coding.system
236. Claim.item.modifier:continuation
Slice Name | continuation
Short | 續用註記，1:初次使用 | 2:申請再次使用
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-續用註記值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-continuation-status` )
Must Support | true
238. Claim.item.modifier:continuation.coding
Control | 1..1
240. Claim.item.modifier:continuation.coding.system
Control | 1..?
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status`
242. Claim.item.modifier:continuation.coding.code
Short | 1:初次使用 | 2:申請再次使用
Control | 1..?
244. Claim.item.modifier:lot
Slice Name | lot
Short | 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
Control | 0..1
Binding | The codes SHALL be taken from NHI-健保事前審查-用藥線別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-line-of-therapy` )
Must Support | true
246. Claim.item.modifier:lot.coding
Control | 1..1
248. Claim.item.modifier:lot.coding.system
Control | 1..?
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy`
250. Claim.item.modifier:lot.coding.code
Short | 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
Control | 1..?
Must Support | true
252. Claim.item.programCode
Short | 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。
Control | 1..1 This element is affected by the following invariants: applyReason-1, applyReason-2, applyReason-3
Must Support | true
Invariants | pas-1: text、coding至少需存在一個。 (`text.exists() or coding.exists()`)
254. Claim.item.programCode.coding
Short | 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時，才可填寫。
Control | 0..1
Binding | The codes SHALL be taken from NHI-健保事前審查-給付適應症值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-reason` )
256. Claim.item.programCode.text
Short | 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時，請自行輸入文字。
258. Claim.item.quantity
Control | 1..?
Must Support | true
260. Claim.item.quantity.value
Short | 事前審查申請數量
Control | 1..?
Must Support | true
262. Claim.item.quantity.system
Short | 事前審查申請數量單位之代碼系統，固定為「http://unitsofmeasure.org」。
Control | 1..?
Pattern Value | `http://unitsofmeasure.org`
264. Claim.item.quantity.code
Short | 事前審查申請數量單位
Control | 1..?
Binding | The codes SHALL be taken from UCUMCodes (required to `http://hl7.org/fhir/ValueSet/ucum-units` ) 事前審查申請數量單位的代碼範圍請參考Common UCUM units。
Must Support | true
266. Claim.item.bodySite
Short | 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 | The codes SHALL be taken from NHI-健保事前審查-申請部位值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-side` )

Guidance on how to interpret the contents of this table can be foundhere

0. Claim
Definition | A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.
Short | Claim, Pre-determination or Pre-authorization
Comments | The Claim resource fulfills three information request requirements: Claim - a request for adjudication for reimbursement for products and/or services provided; Preauthorization - a request to authorize the future provision of products and/or services including an anticipated adjudication; and, Predetermination - a request for a non-bind adjudication of possible future products and/or services.
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Adjudication Request, Preauthorization Request, Predetermination Request
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) sequence-1: diagnosis.sequence一定會有一個「1」，且只能出現一次。 (`diagnosis.where(sequence = 1).count() = 1`) supportingInfo: 當Claim.priority(案件類別)為1(一般事前審查申請)、3(自主審查報備)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。 (`(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'))`) applType: 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。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.exists())`)
2. Claim.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Claim.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 1..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Claim.meta.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
8. Claim.meta.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.meta.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. Claim.meta.versionId
Definition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.
Short | Version specific identifier
Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.
Control | 0..1
Type | id
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Claim.meta.lastUpdated
Definition | When the resource last changed - e.g. when the version changed.
Short | When the resource version last changed
Comments | This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
14. Claim.meta.source
Definition | A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.
Short | Identifies where the resource comes from
Comments | In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. Claim.meta.profile
Definition | A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.
Short | Profiles this resource claims to conform to
Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.
Control | 1..1
Type | canonical(StructureDefinition)
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Pattern Value | `https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. Claim.meta.security
Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.
Short | Security Labels applied to this resource
Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to `http://hl7.org/fhir/ValueSet/security-labels|4.0.1` ) Security Labels from the Healthcare Privacy and Security Classification System.
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. Claim.meta.tag
Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.
Short | Tags applied to this resource
Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.
Control | 0..*
Binding | For example codes, see CommonTags (example to `http://hl7.org/fhir/ValueSet/common-tags|4.0.1` ) Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
Type | Coding
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. Claim.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. Claim.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. Claim.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. Claim.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
30. Claim.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
32. Claim.extension:encounter
Slice Name | encounter
Definition | 就醫科別
Short | 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】
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(ClaimEncounter) (Extension Type: Reference(就醫科別-Encounter TWPAS))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
34. Claim.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
36. Claim.identifier
Definition | A unique identifier assigned to this claim.
Short | 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填寫原送核案件之受理編號。
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Must Support | true
Summary | false
Requirements | Allows claims to be distinguished and referenced.
Alternate Names | Claim Number
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. Claim.status
Definition | The status of the resource instance.
Short | active | cancelled | draft | entered-in-error
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from FinancialResourceStatusCodes (required to `http://hl7.org/fhir/ValueSet/fm-status|4.0.1` ) A code specifying the state of the resource instance.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.
Pattern Value | `active`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. Claim.type
Definition | The category of claim, e.g. oral, pharmacy, vision, institutional, professional.
Short | Category or discipline
Comments | The majority of jurisdictions use: oral, pharmacy, vision, professional and institutional, or variants on those terms, as the general styles of claims. The valueset is extensible to accommodate other jurisdictional requirements.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from ClaimTypeCodes (extensible to `http://hl7.org/fhir/ValueSet/claim-type|4.0.1` ) The type or discipline-style of the claim.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Claim type determine the general sets of business rules applied for information requirements and adjudication.
Pattern Value | `{ "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/claim-type", "code" : "institutional" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. Claim.subType
Definition | A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
Short | 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。
Comments | This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-申報類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | Some jurisdictions need a finer grained claim type for routing and adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Claim.subType.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
46. Claim.subType.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.subType.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
48. Claim.subType.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..1
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Claim.subType.coding.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
52. Claim.subType.coding.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.subType.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
54. Claim.subType.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Claim.subType.coding.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Claim.subType.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 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填寫原送核案件之受理編號。
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Claim.subType.coding.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Claim.subType.coding.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Claim.subType.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Claim.use
Definition | A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
Short | claim | preauthorization | predetermination
Control | 1..1
Binding | The codes SHALL be taken from Use (required to `http://hl7.org/fhir/ValueSet/claim-use|4.0.1` ) The purpose of the Claim: predetermination, preauthorization, claim.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This element is required to understand the nature of the request for adjudication.
Pattern Value | `preauthorization`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. Claim.patient
Definition | The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.
Short | 病人資訊
Control | 1..1
Type | Reference(病人資訊-Patient TWPAS)
Is Modifier | false
Must Support | true
Summary | true
Requirements | The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. Claim.billablePeriod
Definition | The period for which charges are being submitted.
Short | Relevant time frame for the claim
Comments | Typically this would be today or in the past for a claim, and today or in the future for preauthorizations and predeterminations. Typically line item dates of service should fall within the billing period if one is specified.
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Requirements | A number jurisdictions required the submission of the billing period when submitting claims for example for hospital stays or long-term care.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. Claim.created
Definition | The date this resource was created.
Short | 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。
Comments | This field is independent of the date of creation of the resource as it may reflect the creation date of a source document prior to digitization. Typically for claims all services must be completed as of this date.
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to record a timestamp for use by both the recipient and the issuer.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Claim.enterer
Definition | Individual who created the claim, predetermination or preauthorization.
Short | 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。
Control | 1..1
Type | Reference(醫事人員-Practitioner TWPAS)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Some jurisdictions require the contact information for personnel completing claims.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. Claim.insurer
Definition | The Insurer who is target of the request.
Short | Target
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Claim.provider
Definition | The provider which is responsible for the claim, predetermination or preauthorization.
Short | 醫事機構代碼，必須存在於醫事機構基本資料檔內。
Comments | Typically this field would be 1..1 where this party is responsible for the claim but not necessarily professionally responsible for the provision of the individual products and services listed below.
Control | 1..1
Type | Reference(醫事機構-Organization TWPAS)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. Claim.priority
Definition | The provider-required urgency of processing the request. Typical values include: stat, routine deferred.
Short | 申請案件類別，1:一般事前審查申請 | 3:自主審查報備 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。
Comments | If a claim processor is unable to complete the processing as per the priority then they should generate and error and not process the request.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-申請案件類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-tmhb-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | The provider may need to indicate their processing requirements so that the processor can indicate if they are unable to comply.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Claim.fundsReserve
Definition | A code to indicate whether and for whom funds are to be reserved for future claims.
Short | For whom to reserve funds
Comments | This field is only used for preauthorizations.
Control | 0..1
Binding | For example codes, see Funds Reservation Codes (example to `http://hl7.org/fhir/ValueSet/fundsreserve|4.0.1` ) For whom funds are to be reserved: (Patient, Provider, None).
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.
Alternate Names | Fund pre-allocation
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Claim.related
Definition | Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
Short | Prior or corollary claims
Comments | For example, for the original treatment and follow-up exams.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | For workplace or other accidents it is common to relate separate claims arising from the same event.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. Claim.related.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
88. Claim.related.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
90. Claim.related.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
92. Claim.related.claim
Definition | Reference to a related claim.
Short | Reference to the related claim
Control | 0..1
Type | Reference(Claim)
Is Modifier | false
Summary | false
Requirements | For workplace or other accidents it is common to relate separate claims arising from the same event.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Claim.related.relationship
Definition | A code to convey how the claims are related.
Short | How the reference claim is related
Comments | For example, prior claim or umbrella.
Control | 0..1
Binding | For example codes, see ExampleRelatedClaimRelationshipCodes (example to `http://hl7.org/fhir/ValueSet/related-claim-relationship|4.0.1` ) Relationship of this claim to a related Claim.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Some insurers need a declaration of the type of relationship.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Claim.related.reference
Definition | An alternate organizational reference to the case or file to which this particular claim pertains.
Short | File or case reference
Comments | For example, Property/Casualty insurer claim # or Workers Compensation case # .
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | false
Requirements | In cases where an event-triggered claim is being submitted to an insurer which requires a reference number to be specified on all exchanges.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Claim.prescription
Definition | Prescription to support the dispensing of pharmacy, device or vision products.
Short | Prescription authorizing services and products
Control | 0..1
Type | Reference(DeviceRequest, MedicationRequest, VisionPrescription)
Is Modifier | false
Summary | false
Requirements | Required to authorize the dispensing of controlled substances and devices.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Claim.originalPrescription
Definition | Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.
Short | Original prescription if superseded by fulfiller
Comments | For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefore issues a new prescription for an alternate medication which has the same therapeutic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.
Control | 0..1
Type | Reference(DeviceRequest, MedicationRequest, VisionPrescription)
Is Modifier | false
Summary | false
Requirements | Often required when a fulfiller varies what is fulfilled from that authorized on the original prescription.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Claim.payee
Definition | The party to be reimbursed for cost of the products and services according to the terms of the policy.
Short | Recipient of benefits payable
Comments | Often providers agree to receive the benefits payable to reduce the near-term costs to the patient. The insurer may decline to pay the provider and choose to pay the subscriber instead.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | The provider needs to specify who they wish to be reimbursed and the claims processor needs express who they will reimburse.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Claim.payee.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
106. Claim.payee.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
108. Claim.payee.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
110. Claim.payee.type
Definition | Type of Party to be reimbursed: subscriber, provider, other.
Short | Category of recipient
Control | 1..1
Binding | For example codes, see Claim Payee Type Codes (example to `http://hl7.org/fhir/ValueSet/payeetype|4.0.1` ) A code for the party to be reimbursed.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Need to know who should receive payment with the most common situations being the Provider (assignment of benefits) or the Subscriber.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
112. Claim.payee.party
Definition | Reference to the individual or organization to whom any payment will be made.
Short | Recipient reference
Comments | Not required if the payee is 'subscriber' or 'provider'.
Control | 0..1
Type | Reference(Practitioner, PractitionerRole, Organization, Patient, RelatedPerson)
Is Modifier | false
Summary | false
Requirements | Need to provide demographics if the payee is not 'subscriber' nor 'provider'.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
114. Claim.referral
Definition | A reference to a referral resource.
Short | Treatment referral
Comments | The referral resource which lists the date, practitioner, reason and other supporting information.
Control | 0..1
Type | Reference(ServiceRequest)
Is Modifier | false
Summary | false
Requirements | Some insurers require proof of referral to pay for services or to pay specialist rates for services.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
116. Claim.facility
Definition | Facility where the services were provided.
Short | Servicing facility
Control | 0..1
Type | Reference(Location)
Is Modifier | false
Summary | false
Requirements | Insurance adjudication can be dependant on where services were delivered.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. Claim.careTeam
Definition | The members of the team who provided the products and services.
Short | Members of the care team
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Common to identify the responsible and supporting practitioners.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. Claim.careTeam.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
122. Claim.careTeam.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
124. Claim.careTeam.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
126. Claim.careTeam.sequence
Definition | A number to uniquely identify care team entries.
Short | Order of care team
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the care team and provide a mechanism to link individuals to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. Claim.careTeam.provider
Definition | Member of the team who provided the product or service.
Short | Practitioner or organization
Control | 1..1
Type | Reference(Practitioner, PractitionerRole, Organization)
Is Modifier | false
Summary | false
Requirements | Often a regulatory requirement to specify the responsible provider.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
130. Claim.careTeam.responsible
Definition | The party who is billing and/or responsible for the claimed products or services.
Short | Indicator of the lead practitioner
Comments | Responsible might not be required when there is only a single provider listed.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | When multiple parties are present it is required to distinguish the lead or responsible individual.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
132. Claim.careTeam.role
Definition | The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.
Short | Function within the team
Comments | Role might not be required when there is only a single provider listed.
Control | 0..1
Binding | For example codes, see ClaimCareTeamRoleCodes (example to `http://hl7.org/fhir/ValueSet/claim-careteamrole|4.0.1` ) The role codes for the care team members.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | When multiple parties are present it is required to distinguish the roles performed by each member.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
134. Claim.careTeam.qualification
Definition | The qualification of the practitioner which is applicable for this service.
Short | Practitioner credential or specialization
Control | 0..1
Binding | For example codes, see ExampleProviderQualificationCodes (example to `http://hl7.org/fhir/ValueSet/provider-qualification|4.0.1` ) Provider professional qualifications.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Need to specify which qualification a provider is delivering the product or service under.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. Claim.supportingInfo
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | Supporting information
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 2..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Claim.supportingInfo`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ category
138. Claim.supportingInfo.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
140. Claim.supportingInfo.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
142. Claim.supportingInfo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
144. Claim.supportingInfo.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
146. Claim.supportingInfo.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
148. Claim.supportingInfo.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
150. Claim.supportingInfo.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..1
Type | Choice of: date, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
152. Claim.supportingInfo.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 0..1
Type | Choice of: boolean, string, Quantity, Attachment, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. Claim.supportingInfo.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Claim.supportingInfo:weight
Slice Name | weight
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 病人體重
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 1..1
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Claim.supportingInfo:weight.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
160. Claim.supportingInfo:weight.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
162. Claim.supportingInfo:weight.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
164. Claim.supportingInfo:weight.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
166. Claim.supportingInfo:weight.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "weight" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
168. Claim.supportingInfo:weight.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
170. Claim.supportingInfo:weight.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
172. Claim.supportingInfo:weight.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. Claim.supportingInfo:weight.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
176. Claim.supportingInfo:weight.value[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.supportingInfo.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
178. Claim.supportingInfo:weight.value[x].value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | 體重，整數至多3位數及小數至多2位數。
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 1..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) HTWT: 整數至多3位數及小數至多2位數 (`value.toString().matches('^[0-9]{1,3}(.[0-9]{1,2})?$')`)
180. Claim.supportingInfo:weight.value[x].comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
182. Claim.supportingInfo:weight.value[x].unit
Definition | A human-readable form of the unit.
Short | Unit representation
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
184. Claim.supportingInfo:weight.value[x].system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 1..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
186. Claim.supportingInfo:weight.value[x].code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Pattern Value | `kg`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
188. Claim.supportingInfo:weight.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. Claim.supportingInfo:height
Slice Name | height
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 病人身高
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 1..1
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
192. Claim.supportingInfo:height.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
194. Claim.supportingInfo:height.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
196. Claim.supportingInfo:height.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
198. Claim.supportingInfo:height.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. Claim.supportingInfo:height.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "height" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
202. Claim.supportingInfo:height.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
204. Claim.supportingInfo:height.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
206. Claim.supportingInfo:height.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
208. Claim.supportingInfo:height.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
210. Claim.supportingInfo:height.value[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.supportingInfo.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
212. Claim.supportingInfo:height.value[x].value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | 身高(cm)，整數至多3位數及小數至多2位數。
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 1..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) HTWT: 整數至多3位數及小數至多2位數 (`value.toString().matches('^[0-9]{1,3}(.[0-9]{1,2})?$')`)
214. Claim.supportingInfo:height.value[x].comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
216. Claim.supportingInfo:height.value[x].unit
Definition | A human-readable form of the unit.
Short | Unit representation
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Claim.supportingInfo:height.value[x].system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 1..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
220. Claim.supportingInfo:height.value[x].code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Pattern Value | `cm`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
222. Claim.supportingInfo:height.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
224. Claim.supportingInfo:pregnancy
Slice Name | pregnancy
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 是否懷孕或哺乳
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
226. Claim.supportingInfo:pregnancy.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
228. Claim.supportingInfo:pregnancy.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
230. Claim.supportingInfo:pregnancy.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
232. Claim.supportingInfo:pregnancy.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Claim.supportingInfo:pregnancy.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "pregnancyBreastfeedingStatus" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. Claim.supportingInfo:pregnancy.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
238. Claim.supportingInfo:pregnancy.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
240. Claim.supportingInfo:pregnancy.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | boolean
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
242. Claim.supportingInfo:pregnancy.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
244. Claim.supportingInfo:imagingReport
Slice Name | imagingReport
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 影像報告
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
246. Claim.supportingInfo:imagingReport.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
248. Claim.supportingInfo:imagingReport.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
250. Claim.supportingInfo:imagingReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
252. Claim.supportingInfo:imagingReport.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
254. Claim.supportingInfo:imagingReport.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "imagingReport" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
256. Claim.supportingInfo:imagingReport.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
258. Claim.supportingInfo:imagingReport.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
260. Claim.supportingInfo:imagingReport.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 影像報告
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(影像報告-DiagnosticReport Image TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
262. Claim.supportingInfo:imagingReport.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
264. Claim.supportingInfo:cancerStage
Slice Name | cancerStage
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 癌症分期量表
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
266. Claim.supportingInfo:cancerStage.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
268. Claim.supportingInfo:cancerStage.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
270. Claim.supportingInfo:cancerStage.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
272. Claim.supportingInfo:cancerStage.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
274. Claim.supportingInfo:cancerStage.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "cancerStage" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
276. Claim.supportingInfo:cancerStage.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
278. Claim.supportingInfo:cancerStage.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
280. Claim.supportingInfo:cancerStage.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 癌症分期量表
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(癌症分期量表-Observation Cancer Stage TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. Claim.supportingInfo:cancerStage.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
284. Claim.supportingInfo:examinationReport
Slice Name | examinationReport
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 檢查報告
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
286. Claim.supportingInfo:examinationReport.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
288. Claim.supportingInfo:examinationReport.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
290. Claim.supportingInfo:examinationReport.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
292. Claim.supportingInfo:examinationReport.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
294. Claim.supportingInfo:examinationReport.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "examinationReport" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
296. Claim.supportingInfo:examinationReport.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
298. Claim.supportingInfo:examinationReport.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
300. Claim.supportingInfo:examinationReport.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 檢查報告
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(檢查報告-DiagnosticReport TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
302. Claim.supportingInfo:examinationReport.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
304. Claim.supportingInfo:geneInfo
Slice Name | geneInfo
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 基因資訊
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
306. Claim.supportingInfo:geneInfo.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
308. Claim.supportingInfo:geneInfo.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
310. Claim.supportingInfo:geneInfo.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
312. Claim.supportingInfo:geneInfo.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
314. Claim.supportingInfo:geneInfo.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "geneInfo" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
316. Claim.supportingInfo:geneInfo.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
318. Claim.supportingInfo:geneInfo.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
320. Claim.supportingInfo:geneInfo.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 基因資訊
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(基因資訊-Observation Diagnostic TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
322. Claim.supportingInfo:geneInfo.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
324. Claim.supportingInfo:tests
Slice Name | tests
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 檢驗(查)
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
326. Claim.supportingInfo:tests.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
328. Claim.supportingInfo:tests.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
330. Claim.supportingInfo:tests.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
332. Claim.supportingInfo:tests.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
334. Claim.supportingInfo:tests.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "tests" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
336. Claim.supportingInfo:tests.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
338. Claim.supportingInfo:tests.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
340. Claim.supportingInfo:tests.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 檢驗(查)
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(檢驗檢查-Observation Laboratory Result TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
342. Claim.supportingInfo:tests.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
344. Claim.supportingInfo:patientAssessment
Slice Name | patientAssessment
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 病人狀態評估
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
346. Claim.supportingInfo:patientAssessment.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
348. Claim.supportingInfo:patientAssessment.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
350. Claim.supportingInfo:patientAssessment.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
352. Claim.supportingInfo:patientAssessment.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
354. Claim.supportingInfo:patientAssessment.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "patientAssessment" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
356. Claim.supportingInfo:patientAssessment.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
358. Claim.supportingInfo:patientAssessment.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
360. Claim.supportingInfo:patientAssessment.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 病人狀態評估
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(病人狀態評估-Observation Patient Assessment TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
362. Claim.supportingInfo:patientAssessment.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
364. Claim.supportingInfo:medicationRequest
Slice Name | medicationRequest
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 用藥品項
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
366. Claim.supportingInfo:medicationRequest.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
368. Claim.supportingInfo:medicationRequest.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
370. Claim.supportingInfo:medicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
372. Claim.supportingInfo:medicationRequest.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
374. Claim.supportingInfo:medicationRequest.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "medicationRequest" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
376. Claim.supportingInfo:medicationRequest.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
378. Claim.supportingInfo:medicationRequest.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
380. Claim.supportingInfo:medicationRequest.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 用藥品項
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(用藥品項-MedicationRequest Treat TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
382. Claim.supportingInfo:medicationRequest.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
384. Claim.supportingInfo:radiotherapy
Slice Name | radiotherapy
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 放射治療
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
386. Claim.supportingInfo:radiotherapy.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
388. Claim.supportingInfo:radiotherapy.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
390. Claim.supportingInfo:radiotherapy.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
392. Claim.supportingInfo:radiotherapy.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
394. Claim.supportingInfo:radiotherapy.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "radiotherapy" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
396. Claim.supportingInfo:radiotherapy.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
398. Claim.supportingInfo:radiotherapy.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
400. Claim.supportingInfo:radiotherapy.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 放射治療
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(放射治療-Procedure TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
402. Claim.supportingInfo:radiotherapy.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
404. Claim.supportingInfo:carePlanDocument
Slice Name | carePlanDocument
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 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
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
406. Claim.supportingInfo:carePlanDocument.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
408. Claim.supportingInfo:carePlanDocument.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
410. Claim.supportingInfo:carePlanDocument.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
412. Claim.supportingInfo:carePlanDocument.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
414. Claim.supportingInfo:carePlanDocument.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "carePlanDocument" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
416. Claim.supportingInfo:carePlanDocument.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
418. Claim.supportingInfo:carePlanDocument.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
420. Claim.supportingInfo:carePlanDocument.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 治療計畫文件
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(文件參照-DocumentReference TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
422. Claim.supportingInfo:carePlanDocument.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
424. Claim.supportingInfo:medicalRecord
Slice Name | medicalRecord
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 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。
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
426. Claim.supportingInfo:medicalRecord.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
428. Claim.supportingInfo:medicalRecord.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
430. Claim.supportingInfo:medicalRecord.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
432. Claim.supportingInfo:medicalRecord.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
434. Claim.supportingInfo:medicalRecord.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "medicalRecord" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
436. Claim.supportingInfo:medicalRecord.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
438. Claim.supportingInfo:medicalRecord.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
440. Claim.supportingInfo:medicalRecord.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | Data to be provided
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(文件參照-DocumentReference TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
442. Claim.supportingInfo:medicalRecord.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
444. Claim.supportingInfo:treatmentAssessment
Slice Name | treatmentAssessment
Definition | Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Short | 結果資訊
Comments | Often there are multiple jurisdiction specific valuesets which are required.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Typically these information codes are required to support the services rendered or the adjudication of the services rendered.
Alternate Names | Attachments Exception Codes Occurrence Codes Value codes
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
446. Claim.supportingInfo:treatmentAssessment.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
448. Claim.supportingInfo:treatmentAssessment.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
450. Claim.supportingInfo:treatmentAssessment.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
452. Claim.supportingInfo:treatmentAssessment.sequence
Definition | A number to uniquely identify supporting information entries.
Short | 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。
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the supporting information items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
454. Claim.supportingInfo:treatmentAssessment.category
Definition | The general class of the information supplied: information; exception; accident, employment; onset, etc.
Short | Classification of the supplied information
Comments | This may contain a category for the local bill type codes.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-補充資訊類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to group or associate information items with common characteristics. For example: admission information or prior treatments.
Pattern Value | `{ "coding" : [{ "system" : "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type", "code" : "treatmentAssessment" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
456. Claim.supportingInfo:treatmentAssessment.code
Definition | System and code pertaining to the specific information regarding special conditions relating to the setting, treatment or patient for which care is sought.
Short | Type of information
Control | 0..1
Binding | For example codes, see ExceptionCodes (example to `http://hl7.org/fhir/ValueSet/claim-exception|4.0.1` ) The valuset used for additional information codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to identify the kind of additional information.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
458. Claim.supportingInfo:treatmentAssessment.timing[x]
Definition | The date when or period to which this information refers.
Short | When it occurred
Control | 0..0
Type | Choice of: date, Period
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
460. Claim.supportingInfo:treatmentAssessment.value[x]
Definition | Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.
Short | 結果資訊
Comments | Could be used to provide references to other resources, document. For example could contain a PDF in an Attachment of the Police Report for an Accident.
Control | 1..1
Type | Reference(治療後疾病狀態評估-Observation Treatment Assessment TWPAS)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | To convey the data content to be provided when the information is more than a simple code or period.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
462. Claim.supportingInfo:treatmentAssessment.reason
Definition | Provides the reason in the situation where a reason code is required in addition to the content.
Short | Explanation for the information
Comments | For example: the reason for the additional stay, or why a tooth is missing.
Control | 0..1
Binding | For example codes, see MissingToothReasonCodes (example to `http://hl7.org/fhir/ValueSet/missing-tooth-reason|4.0.1` ) Reason codes for the missing teeth.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed when the supporting information has both a date and amount/value and requires explanation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
464. Claim.diagnosis
Definition | Information about diagnoses relevant to the claim items.
Short | sequence=1時為主要疾病；sequence>=2代表共病。
Control | 1..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | Required for the adjudication by provided context for the services and product listed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) 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() )`)
466. Claim.diagnosis.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
468. Claim.diagnosis.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.diagnosis.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
470. Claim.diagnosis.extension:recordedDate
Slice Name | recordedDate
Definition | The date that a diagnosis was recorded. (HIxx-4)
Short | 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】
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(DiagnosisRecordedDate) (Extension Type: date)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
472. Claim.diagnosis.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
474. Claim.diagnosis.sequence
Definition | A number to uniquely identify diagnosis entries.
Short | sequence=1時為主要疾病；sequence>=2代表共病。
Comments | Diagnosis are presented in list order to their expected importance: primary, secondary, etc.
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to maintain the order of the diagnosis items and provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
476. Claim.diagnosis.diagnosis[x]
Definition | The nature of illness or problem in a coded form or as a reference to an external defined Condition.
Short | 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。
Control | 1..1
Binding | The codes SHOULD be taken from 臺灣健保署2023年中文版ICD-10-CM值集 (preferred to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2023-tw` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | Provides health context for the evaluation of the products and/or services.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
478. Claim.diagnosis.diagnosis[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
480. Claim.diagnosis.diagnosis[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.diagnosis.diagnosis[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
482. Claim.diagnosis.diagnosis[x].coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Claim.diagnosis.diagnosis[x].coding`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ system
484. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023
Slice Name | icd10-cm-2023
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from 臺灣健保署2023年中文版ICD-10-CM值集 (extensible to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2023-tw` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
486. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
488. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.diagnosis.diagnosis[x].coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
490. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
492. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
494. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
496. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
498. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2023.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
500. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014
Slice Name | icd10-cm-2014
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from 臺灣健保署2014年中文版ICD-10-CM值集 (extensible to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2014-tw` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
502. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
504. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.diagnosis.diagnosis[x].coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
506. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
508. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
510. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
512. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
514. Claim.diagnosis.diagnosis[x].coding:icd10-cm-2014.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
516. Claim.diagnosis.diagnosis[x].text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
518. Claim.diagnosis.type
Definition | When the condition was observed or the relative ranking.
Short | Timing or nature of the diagnosis
Comments | For example: admitting, primary, secondary, discharge.
Control | 0..1
Binding | For example codes, see ExampleDiagnosisTypeCodes (example to `http://hl7.org/fhir/ValueSet/ex-diagnosistype|4.0.1` ) The type of the diagnosis: admitting, principal, discharge.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Often required to capture a particular diagnosis, for example: primary or discharge.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
520. Claim.diagnosis.type.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
522. Claim.diagnosis.type.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.diagnosis.type.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
524. Claim.diagnosis.type.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
526. Claim.diagnosis.type.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | 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。
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) pas-2: 長度不得超過4000 bytes。 (`toString().length() <= 4000`)
528. Claim.diagnosis.onAdmission
Definition | Indication of whether the diagnosis was present on admission to a facility.
Short | Present on admission
Control | 0..1
Binding | For example codes, see ExampleDiagnosisOnAdmissionCodes (example to `http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission|4.0.1` ) Present on admission.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Many systems need to understand for adjudication if the diagnosis was present a time of admission.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
530. Claim.diagnosis.packageCode
Definition | A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.
Short | Package billing code
Comments | For example DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardial Infarction and a DRG for HeartAttack would be assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.
Control | 0..1
Binding | For example codes, see ExampleDiagnosisRelatedGroupCodes (example to `http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup|4.0.1` ) The DRG codes associated with the diagnosis.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Required to relate the current diagnosis to a package billing code that is then referenced on the individual claim items which are specific to the health condition covered by the package code.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
532. Claim.procedure
Definition | Procedures performed on the patient relevant to the billing items with the claim.
Short | Clinical procedures performed
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | The specific clinical invention are sometimes required to be provided to justify billing a greater than customary amount for a service.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
534. Claim.procedure.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
536. Claim.procedure.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
538. Claim.procedure.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
540. Claim.procedure.sequence
Definition | A number to uniquely identify procedure entries.
Short | Procedure instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to provide a mechanism to link to claim details.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
542. Claim.procedure.type
Definition | When the condition was observed or the relative ranking.
Short | Category of Procedure
Comments | For example: primary, secondary.
Control | 0..*
Binding | For example codes, see ExampleProcedureTypeCodes (example to `http://hl7.org/fhir/ValueSet/ex-procedure-type|4.0.1` ) Example procedure type codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Often required to capture a particular diagnosis, for example: primary or discharge.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
544. Claim.procedure.date
Definition | Date and optionally time the procedure was performed.
Short | 手術(或其他處置)日期
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Required for auditing purposes.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
546. Claim.procedure.procedure[x]
Definition | The code or reference to a Procedure resource which identifies the clinical intervention performed.
Short | 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。
Control | 1..1
Binding | The codes SHOULD be taken from 臺灣健保署2023年中文版ICD-10-PCS值集 (preferred to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2023-tw` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Must Support | true
Summary | false
Requirements | This identifies the actual clinical procedure.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
548. Claim.procedure.procedure[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
550. Claim.procedure.procedure[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.procedure.procedure[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
552. Claim.procedure.procedure[x].coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..1
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Claim.procedure.procedure[x].coding`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ system
554. Claim.procedure.procedure[x].coding:icd10-pcs-2023
Slice Name | icd10-pcs-2023
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1
Binding | The codes SHALL be taken from 臺灣健保署2023年中文版ICD-10-PCS值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2023-tw` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
556. Claim.procedure.procedure[x].coding:icd10-pcs-2023.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
558. Claim.procedure.procedure[x].coding:icd10-pcs-2023.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.procedure.procedure[x].coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
560. Claim.procedure.procedure[x].coding:icd10-pcs-2023.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
562. Claim.procedure.procedure[x].coding:icd10-pcs-2023.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
564. Claim.procedure.procedure[x].coding:icd10-pcs-2023.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
566. Claim.procedure.procedure[x].coding:icd10-pcs-2023.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
568. Claim.procedure.procedure[x].coding:icd10-pcs-2023.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
570. Claim.procedure.procedure[x].coding:icd10-pcs-2014
Slice Name | icd10-pcs-2014
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1
Binding | The codes SHALL be taken from 臺灣健保署2014年中文版ICD-10-PCS值集 (required to `https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2014-tw` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
572. Claim.procedure.procedure[x].coding:icd10-pcs-2014.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
574. Claim.procedure.procedure[x].coding:icd10-pcs-2014.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.procedure.procedure[x].coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
576. Claim.procedure.procedure[x].coding:icd10-pcs-2014.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
578. Claim.procedure.procedure[x].coding:icd10-pcs-2014.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
580. Claim.procedure.procedure[x].coding:icd10-pcs-2014.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
582. Claim.procedure.procedure[x].coding:icd10-pcs-2014.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
584. Claim.procedure.procedure[x].coding:icd10-pcs-2014.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
586. Claim.procedure.procedure[x].coding:medical-service-payment
Slice Name | medical-service-payment
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1
Binding | The codes SHALL be taken from NHI-健保事前審查-醫療服務給付項目值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-medical-service-payment` )
Type | Coding
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
588. Claim.procedure.procedure[x].coding:medical-service-payment.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
590. Claim.procedure.procedure[x].coding:medical-service-payment.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.procedure.procedure[x].coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
592. Claim.procedure.procedure[x].coding:medical-service-payment.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
594. Claim.procedure.procedure[x].coding:medical-service-payment.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
596. Claim.procedure.procedure[x].coding:medical-service-payment.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | Symbol in syntax defined by the system
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
598. Claim.procedure.procedure[x].coding:medical-service-payment.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
600. Claim.procedure.procedure[x].coding:medical-service-payment.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
602. Claim.procedure.procedure[x].text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
604. Claim.procedure.udi
Definition | Unique Device Identifiers associated with this line item.
Short | Unique device identifier
Control | 0..*
Type | Reference(Device)
Is Modifier | false
Summary | false
Requirements | The UDI code allows the insurer to obtain device level information on the product supplied.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
606. Claim.insurance
Definition | Financial instruments for reimbursement for the health care products and services specified on the claim.
Short | Patient insurance information
Comments | All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'Coverage.subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.
Control | 1..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | At least one insurer is required for a claim to be a claim.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
608. Claim.insurance.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
610. Claim.insurance.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
612. Claim.insurance.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
614. Claim.insurance.sequence
Definition | A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order.
Short | Insurance instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | To maintain order of the coverages.
Pattern Value | `1`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
616. Claim.insurance.focal
Definition | A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.
Short | Coverage to be used for adjudication
Comments | A patient may (will) have multiple insurance policies which provide reimbursement for healthcare services and products. For example a person may also be covered by their spouse's policy and both appear in the list (and may be from the same insurer). This flag will be set to true for only one of the listed policies and that policy will be used for adjudicating this claim. Other claims would be created to request adjudication against the other listed policies.
Control | 1..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | To identify which coverage in the list is being used to adjudicate this claim.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
618. Claim.insurance.identifier
Definition | The business identifier to be used when the claim is sent for adjudication against this insurance policy.
Short | Pre-assigned Claim number
Comments | Only required in jurisdictions where insurers, rather than the provider, are required to send claims to insurers that appear after them in the list. This element is not required when 'subrogation=true'.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | false
Requirements | This will be the claim number should it be necessary to create this claim in the future. This is provided so that payors may forward claims to other payors in the Coordination of Benefit for adjudication rather than the provider being required to initiate each adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
620. Claim.insurance.coverage
Definition | Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.
Short | Insurance information
Control | 1..1
Type | Reference(健保事前審查計畫-Coverage TWPAS)
Is Modifier | false
Summary | true
Requirements | Required to allow the adjudicator to locate the correct policy and history within their information system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
622. Claim.insurance.businessArrangement
Definition | A business agreement number established between the provider and the insurer for special business processing purposes.
Short | Additional provider contract number
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Providers may have multiple business arrangements with a given insurer and must supply the specific contract number for adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
624. Claim.insurance.preAuthRef
Definition | Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
Short | Prior authorization reference number
Comments | This value is an alphanumeric string that may be provided over the phone, via text, via paper, or within a ClaimResponse resource and is not a FHIR Identifier.
Control | 0..*
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Providers must quote previously issued authorization reference numbers in order to obtain adjudication as previously advised on the Preauthorization.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
626. Claim.insurance.claimResponse
Definition | The result of the adjudication of the line items for the Coverage specified in this insurance.
Short | Adjudication results
Comments | Must not be specified when 'focal=true' for this insurance.
Control | 0..1
Type | Reference(ClaimResponse)
Is Modifier | false
Summary | false
Requirements | An insurer need the adjudication results from prior insurers to determine the outstanding balance remaining by item for the items in the curent claim.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
628. Claim.accident
Definition | Details of an accident which resulted in injuries which required the products and services listed in the claim.
Short | Details of the event
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | When healthcare products and services are accident related, benefits may be payable under accident provisions of policies, such as automotive, etc before they are payable under normal health insurance.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
630. Claim.accident.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
632. Claim.accident.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
634. Claim.accident.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
636. Claim.accident.date
Definition | Date of an accident event related to the products and services contained in the claim.
Short | When the incident occurred
Comments | The date of the accident has to precede the dates of the products and services but within a reasonable timeframe.
Control | 1..1
Type | date
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Required for audit purposes and adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
638. Claim.accident.type
Definition | The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.
Short | The nature of the accident
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from ActIncidentCode (extensible to `http://terminology.hl7.org/ValueSet/v3-ActIncidentCode` ) Type of accident: work place, auto, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Coverage may be dependant on the type of accident.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
640. Claim.accident.location[x]
Definition | The physical location of the accident event.
Short | Where the event occurred
Control | 0..1
Type | Choice of: Address, Reference(Location)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Requirements | Required for audit purposes and determination of applicable insurance liability.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
642. Claim.item
Definition | A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.
Short | Product or service provided
Control | 1..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | The items to be processed for adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
644. Claim.item.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
646. Claim.item.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.item.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
648. Claim.item.extension:requestedService
Slice Name | requestedService
Definition | 事前審查品項
Short | 事前審查品項【此為參考Da Vinci PAS IG的extension設計】
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(RequestedService) (Extension Type: Reference(事前審查品項-MedicationRequest Apply TWPAS))
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
650. Claim.item.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
652. Claim.item.sequence
Definition | A number to uniquely identify item entries.
Short | Item instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
654. Claim.item.careTeamSequence
Definition | CareTeam members related to this service or product.
Short | Applicable careTeam members
Control | 0..*
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Need to identify the individuals and their roles in the provision of the product or service.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
656. Claim.item.diagnosisSequence
Definition | Diagnosis applicable for this service or product.
Short | Applicable diagnoses
Control | 0..*
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Need to related the product or service to the associated diagnoses.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
658. Claim.item.procedureSequence
Definition | Procedures applicable for this service or product.
Short | Applicable procedures
Control | 0..*
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Need to provide any listed specific procedures to support the product or service being claimed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
660. Claim.item.informationSequence
Definition | Exceptions, special conditions and supporting information applicable for this service or product.
Short | Applicable exception and supporting information
Control | 0..*
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Need to reference the supporting information items that relate directly to this product or service.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
662. Claim.item.revenue
Definition | The type of revenue or cost center providing the product and/or service.
Short | Revenue or cost center code
Control | 0..1
Binding | For example codes, see ExampleRevenueCenterCodes (example to `http://hl7.org/fhir/ValueSet/ex-revenue-center|4.0.1` ) Codes for the revenue or cost centers supplying the service and/or products.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed in the processing of institutional claims.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
664. Claim.item.category
Definition | Code to identify the general type of benefits under which products and services are provided.
Short | Benefit classification
Comments | Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
Control | 0..1
Binding | For example codes, see BenefitCategoryCodes (example to `http://hl7.org/fhir/ValueSet/ex-benefitcategory|4.0.1` ) Benefit categories such as: oral-basic, major, glasses.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
666. Claim.item.productOrService
Definition | When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
Short | 醫令類別
Comments | If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-醫令類別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-order-type` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | Necessary to state what was provided or done.
Alternate Names | Drug Code, Bill Code, Service Code
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
668. Claim.item.modifier
Definition | Item typification or modifiers codes to convey additional context for the product or service.
Short | Product or service billing modifiers
Comments | For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
Control | 1..2
Binding | For example codes, see ModifierTypeCodes (example to `http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1` ) Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | To support inclusion of the item for adjudication or to charge an elevated fee.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Claim.item.modifier`. The slices areUnordered and Closed, and can be differentiated using the following discriminators: value @ coding.system
670. Claim.item.modifier:continuation
Slice Name | continuation
Definition | Item typification or modifiers codes to convey additional context for the product or service.
Short | 續用註記，1:初次使用 | 2:申請再次使用
Comments | For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
Control | 1..1
Binding | The codes SHALL be taken from NHI-健保事前審查-續用註記值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-continuation-status` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | To support inclusion of the item for adjudication or to charge an elevated fee.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
672. Claim.item.modifier:continuation.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
674. Claim.item.modifier:continuation.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.item.modifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
676. Claim.item.modifier:continuation.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..1
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
678. Claim.item.modifier:continuation.coding.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
680. Claim.item.modifier:continuation.coding.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.item.modifier.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
682. Claim.item.modifier:continuation.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
684. Claim.item.modifier:continuation.coding.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
686. Claim.item.modifier:continuation.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 1:初次使用 | 2:申請再次使用
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
688. Claim.item.modifier:continuation.coding.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
690. Claim.item.modifier:continuation.coding.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
692. Claim.item.modifier:continuation.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
694. Claim.item.modifier:lot
Slice Name | lot
Definition | Item typification or modifiers codes to convey additional context for the product or service.
Short | 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
Comments | For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or outside of office hours.
Control | 0..1
Binding | The codes SHALL be taken from NHI-健保事前審查-用藥線別值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-line-of-therapy` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | To support inclusion of the item for adjudication or to charge an elevated fee.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
696. Claim.item.modifier:lot.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
698. Claim.item.modifier:lot.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.item.modifier.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
700. Claim.item.modifier:lot.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..1
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
702. Claim.item.modifier:lot.coding.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
704. Claim.item.modifier:lot.coding.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.item.modifier.coding.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
706. Claim.item.modifier:lot.coding.system
Definition | The identification of the code system that defines the meaning of the symbol in the code.
Short | Identity of the terminology system
Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be unambiguous about the source of the definition of the symbol.
Pattern Value | `https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
708. Claim.item.modifier:lot.coding.version
Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Short | Version of the system - if relevant
Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
Note | This is a business version Id, not a resource version Id (see discussion)
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
710. Claim.item.modifier:lot.coding.code
Definition | A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Short | 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
Control | 1..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need to refer to a particular code in the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
712. Claim.item.modifier:lot.coding.display
Definition | A representation of the meaning of the code in the system, following the rules of the system.
Short | Representation defined by the system
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
714. Claim.item.modifier:lot.coding.userSelected
Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Short | If this coding was chosen directly by the user
Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
Control | 0..1
Type | boolean
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
716. Claim.item.modifier:lot.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
718. Claim.item.programCode
Definition | Identifies the program under which this may be recovered.
Short | 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。
Comments | For example: Neonatal program, child dental program or drug users recovery program.
Control | 1..1 This element is affected by the following invariants: applyReason-1, applyReason-2, applyReason-3
Binding | For example codes, see ExampleProgramReasonCodes (example to `http://hl7.org/fhir/ValueSet/ex-program-code|4.0.1` ) Program specific reason codes.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Requirements | Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) pas-1: text、coding至少需存在一個。 (`text.exists() or coding.exists()`)
720. Claim.item.programCode.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
722. Claim.item.programCode.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.item.programCode.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
724. Claim.item.programCode.coding
Definition | A reference to a code defined by a terminology system.
Short | 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時，才可填寫。
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..1
Binding | The codes SHALL be taken from NHI-健保事前審查-給付適應症值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-reason` )
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
726. Claim.item.programCode.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | 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時，請自行輸入文字。
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
728. Claim.item.serviced[x]
Definition | The date or dates when the service or product was supplied, performed or completed.
Short | Date or dates of service or product delivery
Control | 0..1
Type | Choice of: date, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Needed to determine whether the service or product was provided during the term of the insurance coverage.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
730. Claim.item.location[x]
Definition | Where the product or service was provided.
Short | Place of service or where product was supplied
Control | 0..1
Binding | For example codes, see ExampleServicePlaceCodes (example to `http://hl7.org/fhir/ValueSet/service-place|4.0.1` ) Place of service: pharmacy, school, prison, etc.
Type | Choice of: CodeableConcept, Address, Reference(Location)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Requirements | The location can alter whether the item was acceptable for insurance purposes or impact the determination of the benefit amount.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
732. Claim.item.quantity
Definition | The number of repetitions of a service or product.
Short | Count of products or services
Control | 1..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Required when the product or service code does not convey the quantity provided.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
734. Claim.item.quantity.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
736. Claim.item.quantity.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Claim.item.quantity.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
738. Claim.item.quantity.value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | 事前審查申請數量
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 1..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
740. Claim.item.quantity.comparator
Definition | Not allowed to be used in this context
Short | < | <= | >= | > - how to understand the value
Control | 0..0
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
742. Claim.item.quantity.unit
Definition | A human-readable form of the unit.
Short | Unit representation
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
744. Claim.item.quantity.system
Definition | The identification of the system that provides the coded form of the unit.
Short | 事前審查申請數量單位之代碼系統，固定為「http://unitsofmeasure.org」。
Control | 1..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
746. Claim.item.quantity.code
Definition | A computer processable form of the unit in some unit representation system.
Short | 事前審查申請數量單位
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 1..1
Binding | The codes SHALL be taken from UCUMCodes (required to `http://hl7.org/fhir/ValueSet/ucum-units` ) 事前審查申請數量單位的代碼範圍請參考Common UCUM units。
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
748. Claim.item.unitPrice
Definition | If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
Short | Fee, charge or cost per item
Control | 0..1
Type | Money
Is Modifier | false
Summary | false
Requirements | The amount charged to the patient by the provider for a single unit.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
750. Claim.item.factor
Definition | A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
Short | Price scaling factor
Comments | To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
752. Claim.item.net
Definition | The quantity times the unit price for an additional service or product or charge.
Short | Total item cost
Comments | For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
Control | 0..1
Type | Money
Is Modifier | false
Summary | false
Requirements | Provides the total amount claimed for the group (if a grouper) or the line item.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
754. Claim.item.udi
Definition | Unique Device Identifiers associated with this line item.
Short | Unique device identifier
Control | 0..*
Type | Reference(Device)
Is Modifier | false
Summary | false
Requirements | The UDI code allows the insurer to obtain device level information on the product supplied.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
756. Claim.item.bodySite
Definition | Physical service site on the patient (limb, tooth, etc.).
Short | 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)
Comments | For example: Providing a tooth code, allows an insurer to identify a provider performing a filling on a tooth that was previously removed.
Control | 0..1
Binding | The codes SHALL be taken from NHI-健保事前審查-申請部位值集 (required to `https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-side` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows insurer to validate specific procedures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
758. Claim.item.subSite
Definition | A region or surface of the bodySite, e.g. limb region or tooth surface(s).
Short | Anatomical sub-location
Control | 0..*
Binding | For example codes, see SurfaceCodes (example to `http://hl7.org/fhir/ValueSet/surface|4.0.1` ) The code for the tooth surface and surface combinations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Allows insurer to validate specific procedures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
760. Claim.item.encounter
Definition | The Encounters during which this Claim was created or to which the creation of this record is tightly associated.
Short | Encounters related to this billed item
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
Control | 0..*
Type | Reference(Encounter)
Is Modifier | false
Summary | false
Requirements | Used in some jurisdictions to link clinical events to claim items.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
762. Claim.item.detail
Definition | A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.
Short | Product or service provided
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | The items to be processed for adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
764. Claim.item.detail.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
766. Claim.item.detail.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
768. Claim.item.detail.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
770. Claim.item.detail.sequence
Definition | A number to uniquely identify item entries.
Short | Item instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
772. Claim.item.detail.revenue
Definition | The type of revenue or cost center providing the product and/or service.
Short | Revenue or cost center code
Control | 0..1
Binding | For example codes, see ExampleRevenueCenterCodes (example to `http://hl7.org/fhir/ValueSet/ex-revenue-center|4.0.1` ) Codes for the revenue or cost centers supplying the service and/or products.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed in the processing of institutional claims.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
774. Claim.item.detail.category
Definition | Code to identify the general type of benefits under which products and services are provided.
Short | Benefit classification
Comments | Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
Control | 0..1
Binding | For example codes, see BenefitCategoryCodes (example to `http://hl7.org/fhir/ValueSet/ex-benefitcategory|4.0.1` ) Benefit categories such as: oral-basic, major, glasses.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
776. Claim.item.detail.productOrService
Definition | When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
Short | Billing, service, product, or drug code
Comments | If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
Control | 1..1
Binding | For example codes, see USCLSCodes (example to `http://hl7.org/fhir/ValueSet/service-uscls|4.0.1` ) Allowable service and product codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Necessary to state what was provided or done.
Alternate Names | Drug Code, Bill Code, Service Code
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
778. Claim.item.detail.modifier
Definition | Item typification or modifiers codes to convey additional context for the product or service.
Short | Service/Product billing modifiers
Comments | For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
Control | 0..*
Binding | For example codes, see ModifierTypeCodes (example to `http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1` ) Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | To support inclusion of the item for adjudication or to charge an elevated fee.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
780. Claim.item.detail.programCode
Definition | Identifies the program under which this may be recovered.
Short | Program the product or service is provided under
Comments | For example: Neonatal program, child dental program or drug users recovery program.
Control | 0..*
Binding | For example codes, see ExampleProgramReasonCodes (example to `http://hl7.org/fhir/ValueSet/ex-program-code|4.0.1` ) Program specific reason codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
782. Claim.item.detail.quantity
Definition | The number of repetitions of a service or product.
Short | Count of products or services
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Requirements | Required when the product or service code does not convey the quantity provided.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
784. Claim.item.detail.unitPrice
Definition | If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
Short | Fee, charge or cost per item
Control | 0..1
Type | Money
Is Modifier | false
Summary | false
Requirements | The amount charged to the patient by the provider for a single unit.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
786. Claim.item.detail.factor
Definition | A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
Short | Price scaling factor
Comments | To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
788. Claim.item.detail.net
Definition | The quantity times the unit price for an additional service or product or charge.
Short | Total item cost
Comments | For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
Control | 0..1
Type | Money
Is Modifier | false
Summary | false
Requirements | Provides the total amount claimed for the group (if a grouper) or the line item.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
790. Claim.item.detail.udi
Definition | Unique Device Identifiers associated with this line item.
Short | Unique device identifier
Control | 0..*
Type | Reference(Device)
Is Modifier | false
Summary | false
Requirements | The UDI code allows the insurer to obtain device level information on the product supplied.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
792. Claim.item.detail.subDetail
Definition | A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.
Short | Product or service provided
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | The items to be processed for adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
794. Claim.item.detail.subDetail.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
796. Claim.item.detail.subDetail.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
798. Claim.item.detail.subDetail.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
800. Claim.item.detail.subDetail.sequence
Definition | A number to uniquely identify item entries.
Short | Item instance identifier
Control | 1..1
Type | positiveInt
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
802. Claim.item.detail.subDetail.revenue
Definition | The type of revenue or cost center providing the product and/or service.
Short | Revenue or cost center code
Control | 0..1
Binding | For example codes, see ExampleRevenueCenterCodes (example to `http://hl7.org/fhir/ValueSet/ex-revenue-center|4.0.1` ) Codes for the revenue or cost centers supplying the service and/or products.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed in the processing of institutional claims.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
804. Claim.item.detail.subDetail.category
Definition | Code to identify the general type of benefits under which products and services are provided.
Short | Benefit classification
Comments | Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
Control | 0..1
Binding | For example codes, see BenefitCategoryCodes (example to `http://hl7.org/fhir/ValueSet/ex-benefitcategory|4.0.1` ) Benefit categories such as: oral-basic, major, glasses.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Needed in the processing of institutional claims as this allows the insurer to determine whether a facial X-Ray is for dental, orthopedic, or facial surgery purposes.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
806. Claim.item.detail.subDetail.productOrService
Definition | When the value is a group code then this item collects a set of related claim details, otherwise this contains the product, service, drug or other billing code for the item.
Short | Billing, service, product, or drug code
Comments | If this is an actual service or product line, i.e. not a Group, then use code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI). If a grouping item then use a group code to indicate the type of thing being grouped e.g. 'glasses' or 'compound'.
Control | 1..1
Binding | For example codes, see USCLSCodes (example to `http://hl7.org/fhir/ValueSet/service-uscls|4.0.1` ) Allowable service and product codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Necessary to state what was provided or done.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
808. Claim.item.detail.subDetail.modifier
Definition | Item typification or modifiers codes to convey additional context for the product or service.
Short | Service/Product billing modifiers
Comments | For example in Oral whether the treatment is cosmetic or associated with TMJ, or for Medical whether the treatment was outside the clinic or out of office hours.
Control | 0..*
Binding | For example codes, see ModifierTypeCodes (example to `http://hl7.org/fhir/ValueSet/claim-modifiers|4.0.1` ) Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | To support inclusion of the item for adjudication or to charge an elevated fee.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
810. Claim.item.detail.subDetail.programCode
Definition | Identifies the program under which this may be recovered.
Short | Program the product or service is provided under
Comments | For example: Neonatal program, child dental program or drug users recovery program.
Control | 0..*
Binding | For example codes, see ExampleProgramReasonCodes (example to `http://hl7.org/fhir/ValueSet/ex-program-code|4.0.1` ) Program specific reason codes.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
812. Claim.item.detail.subDetail.quantity
Definition | The number of repetitions of a service or product.
Short | Count of products or services
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Requirements | Required when the product or service code does not convey the quantity provided.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
814. Claim.item.detail.subDetail.unitPrice
Definition | If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.
Short | Fee, charge or cost per item
Control | 0..1
Type | Money
Is Modifier | false
Summary | false
Requirements | The amount charged to the patient by the provider for a single unit.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
816. Claim.item.detail.subDetail.factor
Definition | A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.
Short | Price scaling factor
Comments | To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
818. Claim.item.detail.subDetail.net
Definition | The quantity times the unit price for an additional service or product or charge.
Short | Total item cost
Comments | For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
Control | 0..1
Type | Money
Is Modifier | false
Summary | false
Requirements | Provides the total amount claimed for the group (if a grouper) or the line item.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
820. Claim.item.detail.subDetail.udi
Definition | Unique Device Identifiers associated with this line item.
Short | Unique device identifier
Control | 0..*
Type | Reference(Device)
Is Modifier | false
Summary | false
Requirements | The UDI code allows the insurer to obtain device level information on the product supplied.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
822. Claim.total
Definition | The total value of the all the items in the claim.
Short | Total claim cost
Control | 0..1
Type | Money
Is Modifier | false
Summary | false
Requirements | Used for control total purposes.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)