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  1. FHIR Specification Feedback
  2. FHIR-30369

Change the cardinality of amounttype.amount in item-level adjudication

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    • Type: Change Request
    • Status: Resolved - change required (View Workflow)
    • Priority: Medium
    • Resolution: Persuasive

      Description

      Change amounttype.amount from 'May' to 'Must' in item-level adjudication.  

      The current IG states —

      In the institutional EOBs:

         - must have either header or item-level adjudication

             - header-level adjudication, if present, must include an amounttype slice, and this must include a $ amount. (1..1 MS)

             - item-level adjudication, if present, must include an amounttype slice, and this may include a $ amount  (0..1 MS)

         - total is required, and must include an amounttype slice, and this must include a $ amount. (1..1 MS).  (like header-level adjudication)

       

      In the pharmacy and Professional  EOB:
             - item-level adjudication is required, and  must include an amounttype slice, and this 
      may * include a*$ amount  (0..1 MS)

             - total is required, and must include an amounttype slice, and this must include a $ amount. (1..1 MS).  (like header-level adjudication)

       

      In all four profiles change the cardinality of item.amounttype from (0..1) to (1..1)

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            Assignee:
            Unassigned Unassigned
            Reporter:
            taylorpatriciab Patricia Taylor
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