Data Model Libraries
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    Class CoverageEligibilityRequestItemComponent

    CoverageEligibilityRequestItemComponent Class

    FHIR Specification

    • Short: Item to be evaluated for eligibiity
    • Definition: Service categories or billable services for which benefit details and/or an authorization prior to service delivery may be required by the payor.
    • Requirements: The items to be processed for the request.

    Hierarchy (View Summary)

    Implements

    Index

    Constructors

    Properties

    supportingInfoSequence?: PositiveIntType[]

    CoverageEligibilityRequest.item.supportingInfoSequence Element

    FHIR Specification

    • Short: Applicable exception or supporting information
    • Definition: Exceptions, special conditions and supporting information applicable for this service or product line.
    • Requirements: Needed to support or inform the consideration for eligibility.
    • FHIR Type: positiveInt
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false
    category?: CodeableConcept

    CoverageEligibilityRequest.item.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 to convey the category of service or product for which eligibility is sought.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    productOrService?: CodeableConcept

    CoverageEligibilityRequest.item.productOrService Element

    FHIR Specification

    • Short: Billing, service, product, or drug code
    • Definition: This contains the product, service, drug or other billing code for the item.
    • Comment: Code to indicate the Professional Service or Product supplied (e.g. CTP, HCPCS, USCLS, ICD10, NCPDP, DIN, RxNorm, ACHI, CCI).
    • Requirements: Needed to convey the actual service or product for which eligibility is sought.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    modifier?: CodeableConcept[]

    CoverageEligibilityRequest.item.modifier Element

    FHIR Specification

    • Short: Product or service 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 provision of the item or to charge an elevated fee.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false
    provider?: Reference

    CoverageEligibilityRequest.item.provider Element

    FHIR Specification

    quantity?: Quantity

    CoverageEligibilityRequest.item.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

    CoverageEligibilityRequest.item.unitPrice Element

    FHIR Specification

    • Short: Fee, charge or cost per item
    • Definition: The amount charged to the patient by the provider for a single unit.
    • Requirements: Needed to support the evaluation of the eligibility.
    • FHIR Type: Money
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    facility?: Reference

    CoverageEligibilityRequest.item.facility Element

    FHIR Specification

    CoverageEligibilityRequest.item.diagnosis Element

    FHIR Specification

    • Short: Applicable diagnosis
    • Definition: Patient diagnosis for which care is sought.
    • Requirements: Needed to support the evaluation of the eligibility.
    • FHIR Type: BackboneElement
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false
    detail?: Reference[]

    CoverageEligibilityRequest.item.detail Element

    FHIR Specification

    • Short: Product or service details
    • Definition: The plan/proposal/order describing the proposed service in detail.
    • Requirements: Needed to provide complex service proposal such as a Device or a plan.
    • FHIR Type: Reference
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false

    Methods

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

      Parameters

      • sourceJson: Value

        JSON representing FHIR CoverageEligibilityRequestItemComponent

      • OptionaloptSourceField: string

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

      Returns undefined | CoverageEligibilityRequestItemComponent

      CoverageEligibilityRequestItemComponent data model or undefined for CoverageEligibilityRequestItemComponent

      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 and only if the data model has required fields (min cardinality > 0) and at least one of those required fields in the instance is empty; false otherwise

    • Returns boolean

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