Claim.item(0).category.coding(0).code is the FHIR mapping (per x12 278 documentation) for Service Type Code.

In a 278 transaction, Service Type Code can be reported at either the Patient Event level (2000F) or the service level (2000E).  It is our understanding that, for a 278 transaction, Service Type Code must be reported in one location or the other.

In the PAS Implementation Guide, Claim.item.category has a “Binding: https://valueset.x12.org/x217/005010/request/2000F/UM/1/03/00/1365 (required)”.  However, the cardinality for that element is 0..1

In the PAS Claim profile, Service Type Code can only be represented at the item level.  Since it is a required field for a valid 278 submission, we are questioning whether the cardinality for Claim.item.category.coding.code should be changed to 1..1 (making it a required element).