Composition Billing Extension¶
| Canonical | ../StructureDefinition/composition-billing |
|---|---|
| Status | draft · 1.26.0 |
| Base | Extension (constraint) |
| Context | Composition (element) |
| Source | FSH · JSON |
The billing raised for the visit this note documents: the service code, the diagnostic codes supporting it, and the units where the fee code is charged per unit.
Elements / Details
Every element this profile touches, with its full definition. Element names in the tables link here.
Extension¶
| Short | Composition Billing Extension |
|---|---|
| Definition | The billing raised for the visit this note documents: the service code, the diagnostic codes
supporting it, and the units where the fee code is charged per unit.
A complex extension rather than a Claim. R4 gives Composition no element for billing, and a
separate Claim has its own lifecycle: it is submitted, adjudicated, reassessed and can be written
off, all without the note changing. Carrying the billing on the note keeps what the clinician
entered at closeout attached to what they wrote, which is the question this element answers. A
Claim raised from it answers a different one and is expected to exist alongside.
Code systems are provincial and are not constrained here. The service and diagnostic codes are
Coding, and the system names the provincial schedule they were drawn from. A guide-level binding
would have to pick a province.
FIRST PASS. This extension is declared from its production shape rather than from a modelling
pass. See the file comment for the canonical it publishes under and why that is not the URL the
software writes today.
MIGRATION. Nexus EMR writes this extension today at
http://services.well.com/fhir/StructureDefinition/composition-billing. That address is live in
stored notes and in code, and is under migration to the canonical declared here (FHIR-370). Write
the canonical; when reading, match on the URL suffix composition-billing so that notes filed
under either address are seen. |
| Cardinality | 0..* |
| Invariants | ele-1, ext-1 |
Extension.id¶
| Short | Unique id for inter-element referencing |
|---|---|
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..1 |
| Type | http://hl7.org/fhirpath/System.String |
Extension.extension¶
| Short | Additional content defined by implementations |
|---|---|
| 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. |
| 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. |
| Cardinality | 1..* |
| Type | Extension |
| Invariants | ele-1, ext-1 |
| Also called | extensions, user content |
Extension.extension:code¶
| Short | The service (fee) code billed for the visit |
|---|---|
| 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. |
| 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. |
| Cardinality | 1..1 |
| Type | Extension |
| Must Support | yes |
| Invariants | ele-1, ext-1 |
| Also called | extensions, user content |
Extension.extension:code.id¶
| Short | Unique id for inter-element referencing |
|---|---|
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..1 |
| Type | http://hl7.org/fhirpath/System.String |
Extension.extension:code.extension¶
| Short | Additional content defined by implementations |
|---|---|
| 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. |
| 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. |
| Cardinality | 0..0 |
| Type | Extension |
| Invariants | ele-1, ext-1 |
| Also called | extensions, user content |
Extension.extension:code.url¶
| Short | identifies the meaning of the extension |
|---|---|
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Cardinality | 1..1 |
| Type | http://hl7.org/fhirpath/System.String |
| Fixed value | code |
Extension.extension:code.value[x]¶
| Short | Value of extension |
|---|---|
| Definition | The service code, with system naming the provincial fee schedule it was drawn from. |
| Cardinality | 1..1 |
| Type | Coding |
| Must Support | yes |
| Invariants | ele-1 |
Extension.extension:dx¶
| Short | A diagnostic code supporting the claim; repeats |
|---|---|
| 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. |
| 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. |
| Cardinality | 0..* |
| Type | Extension |
| Must Support | yes |
| Invariants | ele-1, ext-1 |
| Also called | extensions, user content |
Extension.extension:dx.id¶
| Short | Unique id for inter-element referencing |
|---|---|
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..1 |
| Type | http://hl7.org/fhirpath/System.String |
Extension.extension:dx.extension¶
| Short | Additional content defined by implementations |
|---|---|
| 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. |
| 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. |
| Cardinality | 0..0 |
| Type | Extension |
| Invariants | ele-1, ext-1 |
| Also called | extensions, user content |
Extension.extension:dx.url¶
| Short | identifies the meaning of the extension |
|---|---|
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Cardinality | 1..1 |
| Type | http://hl7.org/fhirpath/System.String |
| Fixed value | dx |
Extension.extension:dx.value[x]¶
| Short | Value of extension |
|---|---|
| Definition | A diagnostic code supporting the claim. REPEATS: a claim routinely carries more than one, and a reader taking only the first has a different claim than the clinician entered. |
| Cardinality | 1..1 |
| Type | Coding |
| Must Support | yes |
| Invariants | ele-1 |
Extension.extension:units¶
| Short | Units billed; present only for a per-unit fee code |
|---|---|
| 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. |
| 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. |
| Cardinality | 0..1 |
| Type | Extension |
| Must Support | yes |
| Invariants | ele-1, ext-1 |
| Also called | extensions, user content |
Extension.extension:units.id¶
| Short | Unique id for inter-element referencing |
|---|---|
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Cardinality | 0..1 |
| Type | http://hl7.org/fhirpath/System.String |
Extension.extension:units.extension¶
| Short | Additional content defined by implementations |
|---|---|
| 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. |
| 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. |
| Cardinality | 0..0 |
| Type | Extension |
| Invariants | ele-1, ext-1 |
| Also called | extensions, user content |
Extension.extension:units.url¶
| Short | identifies the meaning of the extension |
|---|---|
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Cardinality | 1..1 |
| Type | http://hl7.org/fhirpath/System.String |
| Fixed value | units |
Extension.extension:units.value[x]¶
| Short | Value of extension |
|---|---|
| Definition | Units billed. Absent means the fee code is not charged per unit, NOT that one unit was billed. |
| Cardinality | 1..1 |
| Type | unsignedInt |
| Must Support | yes |
| Invariants | ele-1 |
Extension.url¶
| Short | identifies the meaning of the extension |
|---|---|
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Cardinality | 1..1 |
| Type | http://hl7.org/fhirpath/System.String |
| Fixed value | ../StructureDefinition/composition-billing |
Extension.value[x]¶
| Short | Value of extension |
|---|---|
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Cardinality | 0..0 |
| Type | base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta |
| Invariants | ele-1 |