Data Model Libraries
    Preparing search index...

    ClaimItemDetailComponent Class

    FHIR Specification

    • Short: Product or service provided
    • Definition: A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.
    • Requirements: The items to be processed for adjudication.

    Hierarchy (View Summary)

    Implements

    Index

    Constructors

    Properties

    sequence: null | PositiveIntType

    Claim.item.detail.sequence Element

    FHIR Specification

    • Short: Item instance identifier
    • Definition: A number to uniquely identify item entries.
    • Requirements: Necessary to provide a mechanism to link to items from within the claim and within the adjudication details of the ClaimResponse.
    • FHIR Type: positiveInt
    • Cardinality: 1..1
    • isModifier: false
    • isSummary: false
    revenue?: CodeableConcept

    Claim.item.detail.revenue Element

    FHIR Specification

    • Short: Revenue or cost center code
    • Definition: The type of revenue or cost center providing the product and/or service.
    • Requirements: Needed in the processing of institutional claims.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    category?: CodeableConcept

    Claim.item.detail.category Element

    FHIR Specification

    • Short: Benefit classification
    • Definition: Code to identify the general type of benefits under which products and services are provided.
    • Comment: Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
    • 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.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    productOrService: null | CodeableConcept

    Claim.item.detail.productOrService Element

    FHIR Specification

    • Short: Billing, service, product, or drug code
    • 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.
    • Comment: 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'.
    • Requirements: Necessary to state what was provided or done.
    • FHIR Type: CodeableConcept
    • Cardinality: 1..1
    • isModifier: false
    • isSummary: false
    modifier?: CodeableConcept[]

    Claim.item.detail.modifier Element

    FHIR Specification

    • Short: Service/Product billing modifiers
    • Definition: Item typification or modifiers codes to convey additional context for the product or service.
    • Comment: 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.
    • Requirements: To support inclusion of the item for adjudication or to charge an elevated fee.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false
    programCode?: CodeableConcept[]

    Claim.item.detail.programCode Element

    FHIR Specification

    • Short: Program the product or service is provided under
    • Definition: Identifies the program under which this may be recovered.
    • Comment: For example: Neonatal program, child dental program or drug users recovery program.
    • Requirements: Commonly used in in the identification of publicly provided program focused on population segments or disease classifications.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false
    quantity?: Quantity

    Claim.item.detail.quantity Element

    FHIR Specification

    • Short: Count of products or services
    • Definition: The number of repetitions of a service or product.
    • Requirements: Required when the product or service code does not convey the quantity provided.
    • FHIR Type: Quantity
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    unitPrice?: Money

    Claim.item.detail.unitPrice Element

    FHIR Specification

    • Short: Fee, charge or cost per item
    • 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.
    • Requirements: The amount charged to the patient by the provider for a single unit.
    • FHIR Type: Money
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    factor?: DecimalType

    Claim.item.detail.factor Element

    FHIR Specification

    • Short: Price scaling 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.
    • Comment: To show a 10% senior's discount, the value entered is: 0.90 (1.00 - 0.10).
    • Requirements: When discounts are provided to a patient (example: Senior's discount) then this must be documented for adjudication.
    • FHIR Type: decimal
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    net?: Money

    FHIR Specification

    • Short: Total item cost
    • Definition: The quantity times the unit price for an additional service or product or charge.
    • Comment: For example, the formula: quantity * unitPrice * factor = net. Quantity and factor are assumed to be 1 if not supplied.
    • Requirements: Provides the total amount claimed for the group (if a grouper) or the line item.
    • FHIR Type: Money
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    udi?: Reference[]

    Claim.item.detail.udi Element

    FHIR Specification

    • Short: Unique device identifier
    • Definition: Unique Device Identifiers associated with this line item.
    • Requirements: The UDI code allows the insurer to obtain device level information on the product supplied.
    • FHIR Type: Reference
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false

    Claim.item.detail.subDetail Element

    FHIR Specification

    • Short: Product or service provided
    • Definition: A claim detail line. Either a simple (a product or service) or a 'group' of sub-details which are simple items.
    • Requirements: The items to be processed for adjudication.
    • FHIR Type: BackboneElement
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false

    Methods

    • Parse the provided ClaimItemDetailComponent JSON to instantiate the ClaimItemDetailComponent data model.

      Parameters

      • sourceJson: Value

        JSON representing FHIR ClaimItemDetailComponent

      • OptionaloptSourceField: string

        Optional data source field (e.g. <complexTypeName>.<complexTypeFieldName>); defaults to ClaimItemDetailComponent

      Returns undefined | ClaimItemDetailComponent

      ClaimItemDetailComponent data model or undefined for ClaimItemDetailComponent

      JsonError if the provided JSON is not a valid JSON object

    • Determines if the modifierExtension property exists.

      Parameters

      • Optionalurl: string

        the url that identifies a specific Extension

      Returns boolean

      true if an Extension has the provided url; false otherwise

      If the url is provided, determines if an Extension having the provided url exists. If the url is not provided, determines if the modifierExtension property exists and has any values.

      AssertionError for invalid url

    • Returns undefined | string

      the id property value

    • Assigns the provided value to the id property.

      Parameters

      • value: undefined | string

        the id value

      Returns this

      this

      PrimitiveTypeError for invalid value

    • Returns boolean

      true if id exists and has a value; false otherwise

    • Determines if the extension property exists.

      Parameters

      • Optionalurl: string

        the url that identifies a specific Extension

      Returns boolean

      true if an Extension has the provided url; false otherwise

      If the url is provided, determines if an Extension having the provided url exists. If the url is not provided, determines if the extension property exists and has any values.

      AssertionError for invalid url

    • Determines if the extension property exists.

      Parameters

      • url: string

        the url that identifies a specific Extension

      Returns undefined | IExtension

      an Extension having the provided url

      If the url is provided, determines if an Extension having the provided url exists. If the url is not provided, determines if the extension property exists and has any values.

      AssertionError for invalid url

    • Adds the provided Extension to the extension property array.

      Parameters

      • extension: undefined | IExtension

        the Extension value to add to the extension property array

      Returns this

      this

    • Removes the Extension having the provided url from the extension property array.

      Parameters

      • url: string

        the url that identifies a specific Extension to remove

      Returns void

      AssertionError for invalid url

    • Returns boolean

      true if the instance is a FHIR complex or primitive datatype; false otherwise