FHIR IG Statistics: StructureDefinition/KBV_PR_AW_Abrechnung_vertragsaerztlich
Resources that use this resource
Resources that this resource uses
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": [
{
"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": [
"https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Patient|1.2.0"
]
}
],
"mustSupport": true
},
{
"id": "Claim.patient.reference",
"path": "Claim.patient.reference",
"min": 1
},
{
"id": "Claim.patient.type",
"path": "Claim.patient.type",
"max": "0"
},
{
"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"
]
}
],
"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": [
"https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Abrechnung_Vorlaeufig|1.2.0"
]
}
],
"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": [
"https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Weiterbehandlung_durch|1.2.0"
]
}
],
"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
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat",
"path": "Claim.supportingInfo",
"sliceName": "ringversuchszertifikat",
"short": "Ringversuchszertifikat",
"definition": "Dieses Element kann zur Referenzierung von Ringversuchszertifikaten genutzt werden.",
"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",
"path": "Claim.supportingInfo.category.coding.system",
"min": 1,
"fixedUri": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Information_Kategorie",
"mustSupport": true
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.category.coding.version",
"path": "Claim.supportingInfo.category.coding.version",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.category.coding.code",
"path": "Claim.supportingInfo.category.coding.code",
"min": 1,
"fixedCode": "Ringversuchszertifikat",
"mustSupport": true
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.category.coding.display",
"path": "Claim.supportingInfo.category.coding.display",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.category.coding.userSelected",
"path": "Claim.supportingInfo.category.coding.userSelected",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.category.text",
"path": "Claim.supportingInfo.category.text",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.code",
"path": "Claim.supportingInfo.code",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.timing[x]",
"path": "Claim.supportingInfo.timing[x]",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.value[x]",
"path": "Claim.supportingInfo.value[x]",
"slicing": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"rules": "closed"
},
"min": 1,
"type": [
{
"code": "Reference"
}
]
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.value[x]:valueReference",
"path": "Claim.supportingInfo.value[x]",
"sliceName": "valueReference",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Ringversuchszertifikat|1.2.0"
]
}
],
"mustSupport": true
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.value[x]:valueReference.reference",
"path": "Claim.supportingInfo.value[x].reference",
"min": 1,
"mustSupport": true
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.value[x]:valueReference.type",
"path": "Claim.supportingInfo.value[x].type",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.value[x]:valueReference.identifier",
"path": "Claim.supportingInfo.value[x].identifier",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.value[x]:valueReference.display",
"path": "Claim.supportingInfo.value[x].display",
"max": "0"
},
{
"id": "Claim.supportingInfo:ringversuchszertifikat.reason",
"path": "Claim.supportingInfo.reason",
"max": "0"
},
{
"id": "Claim.supportingInfo:leistungsgenehmigung",
"path": "Claim.supportingInfo",
"sliceName": "leistungsgenehmigung",
"short": "Leistungsgenehmingungen",
"definition": "Dieses Attribut wird zur Referenzierung von Leistungsgenehmingungen genutzt.",
"mustSupport": true
},
{
"id": "Claim.supportingInfo:leistungsgenehmigung.category.coding",
"path": "Claim.supportingInfo.category.coding",
"min": 1,
"max": "1",
"mustSupport": true
},
{
"id": "Claim.supportingInfo:leistungsgenehmigung.category.coding.system",
"path": "Claim.supportingInfo.category.coding.system",
"min": 1,
"fixedUri": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Information_Kategorie",
"mustSupport": true
},
{
"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": {
"discriminator": [
{
"type": "type",
"path": "$this"
}
],
"rules": "closed"
},
"min": 1,
"type": [
{
"code": "Reference"
}
]
},
{
"id": "Claim.supportingInfo:leistungsgenehmigung.value[x]:valueReference",
"path": "Claim.supportingInfo.value[x]",
"sliceName": "valueReference",
"min": 1,
"type": [
{
"code": "Reference",
"targetProfile": [
"https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Leistungsgenehmigung_Heilmittel|1.2.0",
"https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Leistungsgenehmigung_Psychotherapie|1.2.0"
]
}
],
"mustSupport": true
},
{
"id": "Claim.supportingInfo:leistungsgenehmigung.value[x]:valueReference.reference",
"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",
"max": "0"
},
{
"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",
"max": "0"
},
{
"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
},
{
"id": "Claim.insurance.coverage.reference",
"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",
"max": "0"
},
{
"id": "Claim.insurance.businessArrangement",
"path": "Claim.insurance.businessArrangement",
"max": "0"
},
{
"id": "Claim.insurance.preAuthRef",
"path": "Claim.insurance.preAuthRef",
"max": "0"
},
{
"id": "Claim.insurance.claimResponse",
"path": "Claim.insurance.claimResponse",
"max": "0"
},
{
"id": "Claim.accident",
"path": "Claim.accident",
"max": "0"
},
{
"id": "Claim.item",
"path": "Claim.item",
"max": "0"
},
{
"id": "Claim.total",
"path": "Claim.total",
"max": "0"
}
]
}
}