Blue Button 2.0

D.4.1.4 StructureDefinition: BluebuttonOutpatientClaim - Mappings

Mappings for the StructureDefinition-bluebutton-outpatient-claim Profile.

Mappings for W5 Mapping (https://bluebutton.cms.gov/assets/ig/w5)

BluebuttonOutpatientClaim

ExplanationOfBenefit

financial.other

identifier

id

status

type

class

patient

who.focus

billablePeriod

when.done

provider

who.source

organization

who.source

facility

where

careTeam

provider

who.actor

item

servicedDate (servicedDate)

when.done

locationAddress (locationAddress)

where

Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

BluebuttonOutpatientClaim

ExplanationOfBenefit

patient

C06,C07,C08, C05, C04

provider

B02

organization

B02

information

code

F23

insurance

item

sequence

F07

service

F06

modifier

F16 (required field for Oral) and F05

servicedDate (servicedDate)

F09

payment

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

BluebuttonOutpatientClaim

ExplanationOfBenefit

identifier

CX / EI (occasionally, more often EI maps to a resource id or a URL)

system

CX.4 / EI-2-4

value

CX.1 / EI.1

type

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

display

C*E.2 - but note this is not well followed

text

C*E.9. But note many systems use C*E.2 for this

patient

billablePeriod

DR

start

DR.1

end

DR.2

provider

identifier

CX / EI (occasionally, more often EI maps to a resource id or a URL)

organization

identifier

CX / EI (occasionally, more often EI maps to a resource id or a URL)

facility

identifier

CX / EI (occasionally, more often EI maps to a resource id or a URL)

information

category

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

display

C*E.2 - but note this is not well followed

code

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

display

C*E.2 - but note this is not well followed

careTeam

provider

identifier

CX / EI (occasionally, more often EI maps to a resource id or a URL)

role

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

display

C*E.2 - but note this is not well followed

diagnosis

diagnosis[x]

CE/CNE/CWE

type

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

packageCode

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

procedure

procedure[x]

CE/CNE/CWE

insurance

Coverage

coverage

item

revenue

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

service

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

version

C*E.7

code

C*E.1

modifier

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

locationAddress (locationAddress)

CE/CNE/CWE

state

XAD.4

quantity

SN (see also Range) or CQ

value

SN.2 / CQ - N/A

adjudication

category

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

display

C*E.2 - but note this is not well followed

reason

CE/CNE/CWE

coding

CE/CNE/CWE subset one of the sets of component 1-3 or 4-6

system

C*E.3

code

C*E.1

amount

SN (see also Range) or CQ

value

SN.2 / CQ - N/A

system

(see OBX.6 etc.) / CQ.2

code

(see OBX.6 etc.) / CQ.2

totalCost

SN (see also Range) or CQ

value

SN.2 / CQ - N/A

system

(see OBX.6 etc.) / CQ.2

code

(see OBX.6 etc.) / CQ.2

payment

amount

SN (see also Range) or CQ

value

SN.2 / CQ - N/A

system

(see OBX.6 etc.) / CQ.2

Mappings for RIM Mapping (http://hl7.org/v3)

BluebuttonOutpatientClaim

ExplanationOfBenefit

Entity. Role, or Act

id

n/a

extension

n/a

extension (outpatient-nch-profnl-cmpnt-chrg-amt-extension)

n/a

extension (outpatient-nch-bene-ptb-ddctbl-amt-extension)

n/a

extension (outpatient-nch-bene-ptb-coinsrnc-amt-extension)

n/a

extension (outpatient-clm-op-prvrd-pmt-amt-extension)

n/a

extension (outpatient-clm-op-bene-pmt-amt-extension)

n/a

extension (outpatient-nch-bene-blood-ddctbl-lblty-am-extension)

n/a

extension (outpatient-clm-mdcr-non-pmt-rsn-cd-extension)

n/a

extension (outpatient-prpayamt-extension)

n/a

extension (outpatient-fi-num-extension)

n/a

modifierExtension

n/a

identifier

n/a

extension

n/a

system

n/a

value

n/a

status

n/a

type

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

display

n/a

text

n/a

patient

n/a

extension

n/a

reference

n/a

billablePeriod

n/a

extension

n/a

extension (outpatient-claim-query-cd-extension)

n/a

start

n/a

end

n/a

provider

n/a

extension

n/a

identifier

n/a

organization

n/a

extension

n/a

identifier

n/a

facility

n/a

extension

n/a

extension (outpatient-clm-fac-type-cd-extension)

n/a

identifier

n/a

information

n/a

extension

n/a

modifierExtension

n/a

sequence

n/a

category

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

display

n/a

code

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

display

n/a

value[x]

n/a

careTeam

n/a

extension

n/a

modifierExtension

n/a

sequence

n/a

provider

n/a

extension

n/a

identifier

n/a

role

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

display

n/a

diagnosis

n/a

extension

n/a

modifierExtension

n/a

sequence

n/a

diagnosis[x]

n/a

type

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

packageCode

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

procedure

n/a

extension

n/a

modifierExtension

n/a

sequence

n/a

date

n/a

procedure[x]

n/a

insurance

n/a

extension

n/a

modifierExtension

n/a

coverage

n/a

extension

n/a

reference

n/a

item

n/a

extension

n/a

extension (outpatient-rev-cntr-ndc-qty-extension)

n/a

modifierExtension

n/a

sequence

n/a

careTeamLinkId

n/a

revenue

n/a

extension

n/a

extension (outpatient-rev-cntr-stus-ind-cd-extension)

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

service

n/a

extension

n/a

extension (outpatient-rev-cntr-ide-ndc-upc-num-extension)

n/a

coding

n/a

extension

n/a

system

n/a

version

n/a

code

n/a

modifier

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

servicedDate (servicedDate)

n/a

extension

n/a

locationAddress (locationAddress)

n/a

extension

n/a

state

n/a

quantity

n/a

extension

n/a

value

n/a

adjudication

n/a

extension

n/a

modifierExtension

n/a

category

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

display

n/a

reason

n/a

extension

n/a

coding

n/a

extension

n/a

system

n/a

code

n/a

amount

n/a

extension

n/a

value

n/a

system

n/a

code

n/a

totalCost

n/a

extension

n/a

value

n/a

system

n/a

code

n/a

payment

n/a

extension

n/a

modifierExtension

n/a

amount

n/a

extension

n/a

value

n/a

system

n/a

Blue Button 2.0 Version: 1.1.1 ®© FHIR Version: 3.0.1 (IG Publisher v3.0.1-11916) generated on Tue, Nov 27, 2018 15:56+0000. |