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  1. FHIR Specification Feedback
  2. FHIR-41465

Adjust QI-Core Coverage must supports

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US QI Core (FHIR)
    • current
    • Clinical Quality Information
    • QICore Coverage
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      Now that US Core 6.1.0 includes a Coverage profile, QI-Core Coverage profile should inherit the US Core profile with the following modifications:

      QI-Core Profile-based path  **  Action Include in QI-Core 6.0 Justification
      Coverage   KEEP YES Insurance or medical plan or a payment agreement
      us-core-15: Member Id in Coverage.identifier or Coverage.subscriberId SHALL be present
      Coverage.implicitRules   KEEP YES Present in US Core
      Coverage.modifierExtension   KEEP YES Present in US Core
      Coverage.slices for identifier   KEEP YES USCDI US Core
      Coverage.slicesforidentifer.extension:identifier.memberid   KEEP YES USCDI US Core
      Coverage.slicesforidentifier.extension:identifier.memberid.use   KEEP YES US Core required binding to IdentifierUse
      Coverage.slicesforidentifier.extension:identifier.memberid.type   KEEP YES US Core extensible binding to Identifier Type Codes
      Coverage.slicesforidentifier.extension:identifier.memberid.type.coding   KEEP YES Code defined by a terminology system
      Fixed Value: (complex)
      Coverage.slicesforidentifier.extension:identifier.memberid.type.system    KEEP YES Identity of the terminology system
      Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
      Coverage.slicesforidentifier.extension:identifier.memberid.type.code   KEEP YES Symbol in syntax defined by the system
      Fixed Value: MB
      Coverage.status   KEEP YES USCDI – required binding to FinancialResourceStatusCodes
      Coverage.type   KEEP YES (Consider change binding to extensible) USCDI – extensible binding to Payer Type (VSAC 2.16.840.1.114222.4.11.3591) – listed as required in QI-Core 5.0
      Coverage.policyHolder   KEEP YES Not in US Core
      Coverage.subscriberId   KEEP YES USCDI – US Core string
      Coverag.beneficiary   KEEP YES (Reference QI-Core Patient) USCDI US Core references US Core Patient – change to QI-Core Patient
      Coverage.period   KEEP YES USCDI US Core
      Coverage.payor   KEEP YES USCDI US Core (US Core only references US Core Organization) Keep QI-Core reference to QICoreOrganization and QICorePatient
      Coverage.slices for class   ADD YES INCLUDE ALL SUB-ELEMENTS TO US CORE slices for class – import to QI-Core – these are USCDI elements
      Coverage.order   REMOVE NO Not present in USCDI/US Core
      Coverage.contract   REMOVE NO Not present in USCDI/US Core

       

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      Now that US Core 6.1.0 includes a Coverage profile, QI-Core Coverage profile should inherit the US Core profile with the following modifications: QI-Core Profile-based path  **  Action Include in QI-Core 6.0 Justification Coverage   KEEP YES Insurance or medical plan or a payment agreement us-core-15:  Member Id in Coverage.identifier or Coverage.subscriberId SHALL be present Coverage. implicitRules   KEEP YES Present in US Core Coverage. modifierExtension   KEEP YES Present in US Core Coverage. slices for identifier   KEEP YES USCDI US Core Coverage.slicesforidentifer. extension:identifier.memberid   KEEP YES USCDI US Core Coverage.slicesforidentifier.extension:identifier.memberid. use   KEEP YES US Core required binding to IdentifierUse Coverage.slicesforidentifier.extension:identifier.memberid. type   KEEP YES US Core extensible binding to Identifier Type Codes Coverage.slicesforidentifier.extension:identifier.memberid. type .coding   KEEP YES Code defined by a terminology system Fixed Value:  (complex) Coverage.slicesforidentifier.extension:identifier.memberid. type .system    KEEP YES Identity of the terminology system Fixed Value:   http://terminology.hl7.org/CodeSystem/v2-0203 Coverage.slicesforidentifier.extension:identifier.memberid. type .code   KEEP YES Symbol in syntax defined by the system Fixed Value:  MB Coverage. status   KEEP YES USCDI – required binding to FinancialResourceStatusCodes Coverage. type   KEEP YES (Consider change binding to extensible) USCDI – extensible binding to Payer Type (VSAC 2.16.840.1.114222.4.11.3591) – listed as required in QI-Core 5.0 Coverage. policyHolder   KEEP YES Not in US Core Coverage. subscriberId   KEEP YES USCDI – US Core string Coverag. beneficiary   KEEP YES (Reference QI-Core Patient) USCDI US Core references US Core Patient – change to QI-Core Patient Coverage. period   KEEP YES USCDI US Core Coverage. payor   KEEP YES USCDI US Core (US Core only references US Core Organization) Keep QI-Core reference to QICoreOrganization and QICorePatient Coverage. slices for class   ADD YES INCLUDE ALL SUB-ELEMENTS TO US CORE slices for class – import to QI-Core – these are USCDI elements Coverage. order   REMOVE NO Not present in USCDI/US Core Coverage. contract   REMOVE NO Not present in USCDI/US Core  
    • Floyd Eisenberg/Abdullah Rafiqi: 23-0-1
    • Enhancement
    • Non-compatible

    Description

      Adjust the set of Must Support elements for this profile based on the rationale in tracker FHIR-41340

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            jen_seeman Jennifer Seeman
            karlnaden Karl Naden
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            Dates

              Created:
              Updated:
              Resolved: