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.
Overview
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.