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FHIR IG Statistics: StructureDefinition/KBV_PR_AW_Abrechnung_vertragsaerztlich

Packagekbv.ita.aws
Resource TypeStructureDefinition
IdKBV_PR_AW_Abrechnung_vertragsaerztlich
FHIR VersionR4
Sourcehttps://simplifier.net/resolve?scope=kbv.ita.aws@1.2.0&canonical=https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Abrechnung_vertragsaerztlich
URLhttps://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Abrechnung_vertragsaerztlich
Version1.2.0
Statusactive
NameKBV_PR_AW_Abrechnung_vertragsaerztlich
CopyrightCopyright © [2020], Kassenärztliche Bundesvereinigung (KBV). All rights reserved.
TypeClaim
Kindresource

Resources that use this resource

StructureDefinition
KBV_PR_AW_AnlageKBV_PR_AW_Anlage

Resources that this resource uses

StructureDefinition
KBV_EX_AW_Abrechnung_vertragsaerztlich_ZusatzinformationKBV_EX_AW_Abrechnung_vertragsaerztlich_Zusatzinformation
KBV_PR_AW_Abrechnung_VorlaeufigKBV_PR_AW_Abrechnung_Vorlaeufig
KBV_PR_AW_BehandelnderFunktionKBV_PR_AW_BehandelnderFunktion
KBV_PR_AW_KrankenversicherungsverhaeltnisKBV_PR_AW_Krankenversicherungsverhaeltnis
KBV_PR_AW_Leistungsgenehmigung_HeilmittelKBV_PR_AW_Leistungsgenehmigung_Heilmittel
KBV_PR_AW_Leistungsgenehmigung_PsychotherapieKBV_PR_AW_Leistungsgenehmigung_Psychotherapie
KBV_PR_AW_PatientKBV_PR_AW_Patient
KBV_PR_AW_RingversuchszertifikatKBV_PR_AW_Ringversuchszertifikat
KBV_PR_AW_Weiterbehandlung_durchKBV_PR_AW_Weiterbehandlung_durch

Narrative

No narrative content found in resource


Source

{
  "resourceType": "StructureDefinition",
  "url": "https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Abrechnung_vertragsaerztlich",
  "version": "1.2.0",
  "name": "KBV_PR_AW_Abrechnung_vertragsaerztlich",
  "status": "active",
  "publisher": "Kassenärztliche Bundesvereinigung (KBV)",
  "copyright": "Copyright © [2020], Kassenärztliche Bundesvereinigung (KBV). All rights reserved.",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Pattern"
    },
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/fivews",
      "name": "FiveWs Pattern Mapping"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Claim",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Claim",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Claim",
        "path": "Claim",
        "short": "Vertragsärztlich",
        "definition": "Eine Abrechnung in der vertragsärztlichen Versorgung"
      },
      {
        "id": "Claim.id",
        "path": "Claim.id",
        "min": 1
      },
      {
        "id": "Claim.meta",
        "path": "Claim.meta",
        "min": 1
      },
      {
        "id": "Claim.meta.versionId",
        "path": "Claim.meta.versionId",
        "min": 1
      },
      {
        "id": "Claim.meta.lastUpdated",
        "path": "Claim.meta.lastUpdated",
        "min": 1
      },
      {
        "id": "Claim.meta.profile",
        "path": "Claim.meta.profile",
        "min": 1,
        "max": "1",
        "fixedCanonical": "https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Abrechnung_vertragsaerztlich|1.2.0"
      },
      {
        "id": "Claim.text",
        "path": "Claim.text",
        "min": 1
      },
      {
        "id": "Claim.extension",
        "path": "Claim.extension",
        "slicing": {
          "discriminator": [
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              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Claim.extension:zusatzinformationen",
        "path": "Claim.extension",
        "sliceName": "zusatzinformationen",
        "short": "Vertragsärztliche Abrechnung Zusatzinformationen",
        "definition": "Diese Extension dient zur Angabe von Zusatzinformationen für eine vertragsärztliche Abrechnung.",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_Abrechnung_vertragsaerztlich_Zusatzinformation"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.extension:zusatzinformationen.extension",
        "path": "Claim.extension.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Claim.extension:zusatzinformationen.extension:schein-ID",
        "path": "Claim.extension.extension",
        "sliceName": "schein-ID",
        "mustSupport": true
      },
      {
        "id": "Claim.extension:zusatzinformationen.extension:kostentraeger-Abrechnungsbereich",
        "path": "Claim.extension.extension",
        "sliceName": "kostentraeger-Abrechnungsbereich",
        "mustSupport": true
      },
      {
        "id": "Claim.extension:zusatzinformationen.extension:abrechnungsgebiet",
        "path": "Claim.extension.extension",
        "sliceName": "abrechnungsgebiet",
        "mustSupport": true
      },
      {
        "id": "Claim.extension:zusatzinformationen.extension:scheinuntergruppe",
        "path": "Claim.extension.extension",
        "sliceName": "scheinuntergruppe",
        "mustSupport": true
      },
      {
        "id": "Claim.extension:zusatzinformationen.extension:kennziffer-SA",
        "path": "Claim.extension.extension",
        "sliceName": "kennziffer-SA",
        "mustSupport": true
      },
      {
        "id": "Claim.extension:zusatzinformationen.extension:abklaerung_somatischer_Ursachen_vor_Aufnahme_einer_Psychotherapie",
        "path": "Claim.extension.extension",
        "sliceName": "abklaerung_somatischer_Ursachen_vor_Aufnahme_einer_Psychotherapie",
        "mustSupport": true
      },
      {
        "id": "Claim.extension:zusatzinformationen.extension:unfall_Unfallfolgen",
        "path": "Claim.extension.extension",
        "sliceName": "unfall_Unfallfolgen",
        "mustSupport": true
      },
      {
        "id": "Claim.identifier",
        "path": "Claim.identifier",
        "max": "0"
      },
      {
        "id": "Claim.status",
        "path": "Claim.status",
        "definition": "nicht abgerechnet = draft\r\nabgerechnet = active",
        "mustSupport": true
      },
      {
        "id": "Claim.type.coding",
        "path": "Claim.type.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Claim.type.coding.system",
        "path": "Claim.type.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/claim-type"
      },
      {
        "id": "Claim.type.coding.code",
        "path": "Claim.type.coding.code",
        "short": "professional",
        "min": 1,
        "fixedCode": "professional"
      },
      {
        "id": "Claim.type.coding.userSelected",
        "path": "Claim.type.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Claim.type.text",
        "path": "Claim.type.text",
        "max": "0"
      },
      {
        "id": "Claim.subType",
        "path": "Claim.subType",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.subType.coding",
        "path": "Claim.subType.coding",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Claim.subType.coding.system",
        "path": "Claim.subType.coding.system",
        "min": 1,
        "fixedUri": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Art",
        "mustSupport": true
      },
      {
        "id": "Claim.subType.coding.version",
        "path": "Claim.subType.coding.version",
        "max": "0"
      },
      {
        "id": "Claim.subType.coding.code",
        "path": "Claim.subType.coding.code",
        "min": 1,
        "fixedCode": "Vertragsaerztlich",
        "mustSupport": true
      },
      {
        "id": "Claim.subType.coding.display",
        "path": "Claim.subType.coding.display",
        "max": "0"
      },
      {
        "id": "Claim.subType.coding.userSelected",
        "path": "Claim.subType.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Claim.subType.text",
        "path": "Claim.subType.text",
        "max": "0"
      },
      {
        "id": "Claim.use",
        "path": "Claim.use",
        "short": "claim",
        "fixedCode": "claim"
      },
      {
        "id": "Claim.patient",
        "path": "Claim.patient",
        "label": "TR01",
        "short": "Patientenbezug",
        "definition": "Patient Resource.",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
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            ]
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        ],
        "mustSupport": true
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      {
        "id": "Claim.patient.reference",
        "path": "Claim.patient.reference",
        "min": 1
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      {
        "id": "Claim.patient.type",
        "path": "Claim.patient.type",
        "max": "0"
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      {
        "id": "Claim.patient.identifier",
        "path": "Claim.patient.identifier",
        "max": "0"
      },
      {
        "id": "Claim.patient.display",
        "path": "Claim.patient.display",
        "max": "0"
      },
      {
        "id": "Claim.billablePeriod",
        "path": "Claim.billablePeriod",
        "short": "Abrechnungsquartal",
        "definition": "Anzugeben ist das Abrechnungsquartal. Dieses wird über ein Startdatum und eine Enddatum definiert. BSP Start 2020-01 Ende 2020-03",
        "mustSupport": true
      },
      {
        "id": "Claim.billablePeriod.start",
        "path": "Claim.billablePeriod.start",
        "mustSupport": true
      },
      {
        "id": "Claim.billablePeriod.end",
        "path": "Claim.billablePeriod.end",
        "mustSupport": true
      },
      {
        "id": "Claim.enterer",
        "path": "Claim.enterer",
        "max": "0"
      },
      {
        "id": "Claim.insurer",
        "path": "Claim.insurer",
        "max": "0"
      },
      {
        "id": "Claim.provider",
        "path": "Claim.provider",
        "short": "Behandelnderbezug",
        "definition": "BehandelnderFunktion Ressource.",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_BehandelnderFunktion|1.2.0"
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          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.provider.reference",
        "path": "Claim.provider.reference",
        "min": 1
      },
      {
        "id": "Claim.provider.type",
        "path": "Claim.provider.type",
        "max": "0"
      },
      {
        "id": "Claim.provider.identifier",
        "path": "Claim.provider.identifier",
        "max": "0"
      },
      {
        "id": "Claim.provider.display",
        "path": "Claim.provider.display",
        "max": "0"
      },
      {
        "id": "Claim.priority.coding",
        "path": "Claim.priority.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Claim.priority.coding.system",
        "path": "Claim.priority.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/processpriority"
      },
      {
        "id": "Claim.priority.coding.code",
        "path": "Claim.priority.coding.code",
        "short": "normal",
        "min": 1,
        "fixedCode": "normal"
      },
      {
        "id": "Claim.priority.coding.userSelected",
        "path": "Claim.priority.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Claim.priority.text",
        "path": "Claim.priority.text",
        "max": "0"
      },
      {
        "id": "Claim.fundsReserve",
        "path": "Claim.fundsReserve",
        "max": "0"
      },
      {
        "id": "Claim.related",
        "path": "Claim.related",
        "short": "Bezug zur vorlaeufigen Abrechnung",
        "definition": "Die Referenz zu der vorlaeufigen Abrechnung in der alle GOPs dokumentiert sind.",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Claim.related.claim",
        "path": "Claim.related.claim",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
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        ],
        "mustSupport": true
      },
      {
        "id": "Claim.related.claim.reference",
        "path": "Claim.related.claim.reference",
        "min": 1
      },
      {
        "id": "Claim.related.claim.type",
        "path": "Claim.related.claim.type",
        "max": "0"
      },
      {
        "id": "Claim.related.claim.identifier",
        "path": "Claim.related.claim.identifier",
        "max": "0"
      },
      {
        "id": "Claim.related.claim.display",
        "path": "Claim.related.claim.display",
        "max": "0"
      },
      {
        "id": "Claim.related.relationship",
        "path": "Claim.related.relationship",
        "max": "0"
      },
      {
        "id": "Claim.related.reference",
        "path": "Claim.related.reference",
        "max": "0"
      },
      {
        "id": "Claim.prescription",
        "path": "Claim.prescription",
        "max": "0"
      },
      {
        "id": "Claim.originalPrescription",
        "path": "Claim.originalPrescription",
        "max": "0"
      },
      {
        "id": "Claim.payee",
        "path": "Claim.payee",
        "max": "0"
      },
      {
        "id": "Claim.referral",
        "path": "Claim.referral",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
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          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.referral.reference",
        "path": "Claim.referral.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.referral.type",
        "path": "Claim.referral.type",
        "max": "0"
      },
      {
        "id": "Claim.referral.identifier",
        "path": "Claim.referral.identifier",
        "max": "0"
      },
      {
        "id": "Claim.referral.display",
        "path": "Claim.referral.display",
        "max": "0"
      },
      {
        "id": "Claim.facility",
        "path": "Claim.facility",
        "max": "0"
      },
      {
        "id": "Claim.careTeam",
        "path": "Claim.careTeam",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo",
        "path": "Claim.supportingInfo",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "category.coding.code"
            }
          ],
          "description": "Ringversuchszertifikate\r\nLeistungsgenehmigung",
          "rules": "closed"
        },
        "short": "Zusatzinformationen",
        "definition": "Anlage und Ringversuchszertifikate",
        "mustSupport": true
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      {
        "id": "Claim.supportingInfo:ringversuchszertifikat",
        "path": "Claim.supportingInfo",
        "sliceName": "ringversuchszertifikat",
        "short": "Ringversuchszertifikat",
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        "mustSupport": true
      },
      {
        "id": "Claim.supportingInfo:ringversuchszertifikat.category.coding",
        "path": "Claim.supportingInfo.category.coding",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Claim.supportingInfo:ringversuchszertifikat.category.coding.system",
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        "max": "0"
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      {
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      },
      {
        "id": "Claim.supportingInfo:ringversuchszertifikat.category.coding.display",
        "path": "Claim.supportingInfo.category.coding.display",
        "max": "0"
      },
      {
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        "path": "Claim.supportingInfo.category.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:ringversuchszertifikat.category.text",
        "path": "Claim.supportingInfo.category.text",
        "max": "0"
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      {
        "id": "Claim.supportingInfo:ringversuchszertifikat.code",
        "path": "Claim.supportingInfo.code",
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        "id": "Claim.supportingInfo:ringversuchszertifikat.timing[x]",
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          ],
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        "mustSupport": true
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      },
      {
        "id": "Claim.supportingInfo:ringversuchszertifikat.reason",
        "path": "Claim.supportingInfo.reason",
        "max": "0"
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        "id": "Claim.supportingInfo:leistungsgenehmigung",
        "path": "Claim.supportingInfo",
        "sliceName": "leistungsgenehmigung",
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      },
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        "mustSupport": true
      },
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        "id": "Claim.supportingInfo:leistungsgenehmigung.category.coding.system",
        "path": "Claim.supportingInfo.category.coding.system",
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      },
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        "id": "Claim.supportingInfo:leistungsgenehmigung.category.coding.version",
        "path": "Claim.supportingInfo.category.coding.version",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.category.coding.code",
        "path": "Claim.supportingInfo.category.coding.code",
        "min": 1,
        "fixedCode": "Leistungsgenehmingung",
        "mustSupport": true
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.category.coding.display",
        "path": "Claim.supportingInfo.category.coding.display",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.category.coding.userSelected",
        "path": "Claim.supportingInfo.category.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.category.text",
        "path": "Claim.supportingInfo.category.text",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.code",
        "path": "Claim.supportingInfo.code",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.timing[x]",
        "path": "Claim.supportingInfo.timing[x]",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.value[x]",
        "path": "Claim.supportingInfo.value[x]",
        "slicing": {
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          ],
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        },
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        "type": [
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            "code": "Reference"
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      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.value[x]:valueReference",
        "path": "Claim.supportingInfo.value[x]",
        "sliceName": "valueReference",
        "min": 1,
        "type": [
          {
            "code": "Reference",
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          }
        ],
        "mustSupport": true
      },
      {
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        "path": "Claim.supportingInfo.value[x].reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.value[x]:valueReference.type",
        "path": "Claim.supportingInfo.value[x].type",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.value[x]:valueReference.identifier",
        "path": "Claim.supportingInfo.value[x].identifier",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.value[x]:valueReference.display",
        "path": "Claim.supportingInfo.value[x].display",
        "max": "0"
      },
      {
        "id": "Claim.supportingInfo:leistungsgenehmigung.reason",
        "path": "Claim.supportingInfo.reason",
        "max": "0"
      },
      {
        "id": "Claim.diagnosis",
        "path": "Claim.diagnosis",
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      },
      {
        "id": "Claim.procedure",
        "path": "Claim.procedure",
        "max": "0"
      },
      {
        "id": "Claim.insurance",
        "path": "Claim.insurance",
        "short": "Krankenversicherung",
        "definition": "Referenz zur Krankenversicherung",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Claim.insurance.identifier",
        "path": "Claim.insurance.identifier",
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      },
      {
        "id": "Claim.insurance.coverage",
        "path": "Claim.insurance.coverage",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Krankenversicherungsverhaeltnis|1.2.0"
            ]
          }
        ],
        "mustSupport": true
      },
      {
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        "path": "Claim.insurance.coverage.reference",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.insurance.coverage.type",
        "path": "Claim.insurance.coverage.type",
        "max": "0"
      },
      {
        "id": "Claim.insurance.coverage.identifier",
        "path": "Claim.insurance.coverage.identifier",
        "max": "0"
      },
      {
        "id": "Claim.insurance.coverage.display",
        "path": "Claim.insurance.coverage.display",
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      },
      {
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        "path": "Claim.insurance.businessArrangement",
        "max": "0"
      },
      {
        "id": "Claim.insurance.preAuthRef",
        "path": "Claim.insurance.preAuthRef",
        "max": "0"
      },
      {
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        "path": "Claim.insurance.claimResponse",
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      },
      {
        "id": "Claim.accident",
        "path": "Claim.accident",
        "max": "0"
      },
      {
        "id": "Claim.item",
        "path": "Claim.item",
        "max": "0"
      },
      {
        "id": "Claim.total",
        "path": "Claim.total",
        "max": "0"
      }
    ]
  }
}