| COCT_HD290000UV06 A_BillableClinicalService universal |
(Link to Excel View) Derived from RMIM: COCT_RM290000UV06 |
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| BillableClinicalService |
Design Comments: Assistant to the performer who participated in the delivery of the service. Can specify multiple if it helps these providers submit their own invoices. |
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| classCode [1..1] (M) Act (CS) {CNE:V:ActClassRoot, root= "ACT"} |
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| moodCode [1..1] (M) Act (CS) {CNE:V:ActMoodCompletionTrack} |
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| id [0..*] Act (DSET<II>) |
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| code [1..1] (M) Act (CD) {CWE:D:ActBillableServiceCode} |
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| effectiveTime [1..1] (M) Act (IVL<TS>) |
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| priorityCode [0..*] Act (DSET<CD>) {CWE:D:ActPriority} |
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| confidentialityCode [0..*] Act (DSET<CD>) {CWE:D:Confidentiality} |
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| repeatNumber [0..1] Act (IVL<INT.NONNEG>) |
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| reasonCode [0..*] Act (DSET<CD>) {CWE:D:ActBillableClinicalServiceReason} |
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| subject [0..*] (Subject5) | |||||||||
| reusableDevice [0..1] (ReusableDevice) | |||||||||
| product [0..*] (Product1) |
Design Comments: Repaired wheelchair, service provided but prescription (product) not filled (e.g. may due to harm to patient), etc. |
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| responsibleParty [0..1] (ResponsibleParty) | |||||||||
| secondaryPerformer [0..*] (SecondaryPerformer) | |||||||||
| performer [0..1] (Performer) | |||||||||
| author [0..1] (Author) | |||||||||
| consultant [0..*] (Consultant) | |||||||||
| location [0..1] (Location) |
Design Comments: The location identifier is used for the Diagnostic Approval Number (facility id) and the Claim Centre Number if required |
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| inFulfillmentOf [0..*] (InFulfillmentOf) | |||||||||
| reason1 [0..*] (Reason1) | |||||||||
| reason2 [0..*] (Reason4) |
Design Comments: An optional number indicating the primacy of referrals or diagnoses where more than one diagnosis or request is the reason for the BillableClinicalService. This will support indicating primary and secondary diagnoses. |
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| reason3 [0..*] (Reason3) | |||||||||
| component [0..1] (Component2) | |||||||||
| subjectOf1 [0..*] (Subject2) | |||||||||
| subjectOf2 [0..1] (Subject) | |||||||||
| componentOf [0..*] (Component1) | |||||||||
| Subject5 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationTargetSubject, root= "SBJ"} |
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| contextControlCode [0..1] Participation (CS) {CNE:V:ContextControl} |
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| patient [1..1] (R_PatientUniversal) | |||||||||
| ReusableDevice | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationReusableDevice, root= "RDV"} |
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| device [1..1] (Device) | |||||||||
| Device | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassAssignedEntity, root= "ASSIGNED"} |
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| id [1..1] (M) Role (II) |
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| Product1 |
Design Comments: Repaired wheelchair, service provided but prescription (product) not filled (e.g. may due to harm to patient), etc. |
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| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationProduct, root= "PRD"} |
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| manufacturedProduct [1..1] (ManufacturedProduct) |
Design Comments: Warranty information is not required for a service on a product, as the warranty information is not usually known by the provider (i.e. date of purchase, what is covered, etc.). |
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| ManufacturedProduct [Constraint: " Must have Role.cd or ManufacturedMaterial.cd "] |
Design Comments: Warranty information is not required for a service on a product, as the warranty information is not usually known by the provider (i.e. date of purchase, what is covered, etc.). |
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| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassManufacturedProduct, root= "MANU"} |
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| id [0..1] Role (II) |
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| code [0..1] Role (CD) {CWE:D:ManufacturerItemCode} |
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| manufacturedMaterial [0..1] (ManufacturedMaterial) | |||||||||
| manufacturerManufacturedProductOrganization [0..1] (ManufacturedProductOrganization) | |||||||||
| ManufacturedMaterial | |||||||||
| classCode [1..1] (M) ManufacturedMaterial (CS) {CNE:V:EntityClassManufacturedMaterial, root= "MMAT"} |
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| determinerCode [1..1] (M) ManufacturedMaterial (CS) {CNE:V:x_DeterminerInstanceKind} |
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| code [0..1] ManufacturedMaterial (CD) {CWE:D:MaterialEntityClassType} |
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| ManufacturedProductOrganization | |||||||||
| classCode [1..1] (M) Organization (CS) {CNE:V:EntityClassOrganization, root= "ORG"} |
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| determinerCode [1..1] (M) Organization (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"} |
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| name [0..1] Organization (ON) |
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| telecom [0..1] Organization (TEL) |
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| ResponsibleParty | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationResponsibleParty, root= "RESP"} |
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| assignedEntity [1..1] (AssignedEntity) | |||||||||
| SecondaryPerformer | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationSecondaryPerformer, root= "SPRF"} |
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| functionCode [0..1] Participation (CD) {CWE:D:ParticipationFunction} |
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| assignedEntity [1..1] (AssignedEntity) | |||||||||
| Performer | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationPhysicalPerformer, root= "PRF"} |
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| functionCode [0..1] Participation (CD) {CWE:D:ParticipationFunction} |
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| assignedEntity [1..1] (AssignedEntity) | |||||||||
| Author | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationAuthorOriginator, root= "AUT"} |
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| assignedEntity [1..1] (AssignedEntity) | |||||||||
| AssignedEntity | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassAssignedEntity, root= "ASSIGNED"} |
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| id [0..*] Role (DSET<II>) |
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| code [0..1] Role (CD) {CWE:D:AssignedRoleType} |
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| assignedProviderEntity [0..1] (ProviderEntity) | |||||||||
| indirectAuthority [0..*] (IndirectAuthorithyOver) | |||||||||
| ProviderEntity | |||||||||
| choice of ProviderPerson |
Design Comments: Telecom, gender, birth time, addr are only required if provider is not known to the Payor |
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| or NonPersonLivingSubject | |||||||||
| or Device2 | |||||||||
| ProviderPerson |
Design Comments: Telecom, gender, birth time, addr are only required if provider is not known to the Payor |
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| classCode [1..1] (M) Person (CS) {CNE:V:EntityClassPerson, root= "PSN"} |
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| determinerCode [1..1] (M) Person (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"} |
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| name [1..1] (M) Person (PN) |
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| telecom [0..1] Person (TEL) |
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| administrativeGenderCode [0..1] Person (CD) {CNE:D:AdministrativeGender} |
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| birthTime [0..1] Person (TS) |
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| addr [0..1] Person (AD) |
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| NonPersonLivingSubject | |||||||||
| classCode [1..1] (M) NonPersonLivingSubject (CS) {CNE:V:EntityClassNonPersonLivingSubject, root= "NLIV"} |
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| determinerCode [1..1] (M) NonPersonLivingSubject (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"} |
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| id [0..*] NonPersonLivingSubject (DSET<II>) |
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| code [0..1] NonPersonLivingSubject (CD) {CWE:D:NonPersonLivingSubjectEntityType} |
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| name [0..1] NonPersonLivingSubject (TN) |
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| Device2 | |||||||||
| classCode [1..1] (M) Device (CS) {CNE:V:EntityClassDevice, root= "DEV"} |
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| determinerCode [1..1] (M) Device (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"} |
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| id [0..*] Device (DSET<II>) |
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| code [0..1] Device (CD) {CWE:D:DeviceGenericType} |
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| name [0..1] Device (ST) |
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| manufacturerModelName [0..1] Device (SC) {CWE:D:ManufacturerModelName} |
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| softwareName [0..1] Device (SC) {CWE:D:SoftwareName} |
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| IndirectAuthorithyOver | |||||||||
| typeCode [1..1] (M) RoleLink (CS) {CNE:V:RoleLinkHasIndirectAuthorityOver, root= "INDAUTH"} |
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| healthCareProvider [1..1] (HealthCareProvider) | |||||||||
| HealthCareProvider | |||||||||
| classCode [1..1] (M) LicensedEntity (CS) {CNE:V:RoleClassHealthcareProvider, root= "PROV"} |
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| id [0..*] LicensedEntity (DSET<II>) |
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| code [0..1] LicensedEntity (CD) {CWE:D:HealthcareProviderRoleType} |
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| effectiveTime [0..1] LicensedEntity (IVL<TS>) |
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| healthCareProviderPerson [0..1] (ProviderPerson) | |||||||||
| Consultant | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationConsultant, root= "CON"} |
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| assignedEntity [1..1] (AssignedEntity) | |||||||||
| Location |
Design Comments: The location identifier is used for the Diagnostic Approval Number (facility id) and the Claim Centre Number if required |
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| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationTargetLocation, root= "LOC"} |
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| serviceDeliveryLocation [1..1] (R_ServiceDeliveryLocationContact) | |||||||||
| InFulfillmentOf | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipFulfills, root= "FLFS"} |
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| serviceRequest [1..1] (ServiceRequest) | |||||||||
| ServiceRequest | |||||||||
| classCode [1..1] (M) Act (CS) {CNE:V:ActClassRoot, root= "ACT"} |
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| moodCode [1..1] (M) Act (CS) {CNE:V:ActMoodRequest, root= "RQO"} |
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| id [0..*] Act (DSET<II>) |
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| code [0..1] Act (CD) {CWE:D:ActCode} |
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| author [0..1] (Author1) | |||||||||
| Author1 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationAuthorOriginator, root= "AUT"} |
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| time [0..1] Participation (TS) |
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| assignedEntity [1..1] (AssignedEntity) | |||||||||
| Reason1 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipReason, root= "RSON"} |
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| sequenceNumber [1..1] (M) ActRelationship (INT.NONNEG) |
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| injury [1..1] (Injury) | |||||||||
| Injury | |||||||||
| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassObservation, root= "OBS"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| code [1..1] (M) Observation (CD) {CWE:D:ActInjuryCode} |
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| text [0..1] Observation (ED) |
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| effectiveTime [0..1] Observation (IVL<TS>) |
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| value [1..1] Observation (CD) {CWE:D:InjuryObservationValue} |
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| targetSiteCode [1..1] Observation (CD) {CWE:D:InjuryActSite} |
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| origin [0..*] (Origin) | |||||||||
| Origin | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationOrigin, root= "ORG"} |
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| injuryLocation [1..1] (InjuryLocation) |
Design Comments: Need LocationRoleType domain |
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| InjuryLocation |
Design Comments: Need LocationRoleType domain |
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| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassLocatedEntity, root= "LOCE"} |
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| id [0..*] Role (DSET<II>) |
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| code [0..1] Role (CD) {CWE:D:LocationRoleType} |
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| name [0..*] Role (COLL<TN>) |
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| addr [0..1] Role (AD) |
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| telecom [0..*] Role (COLL<TEL>) |
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| locatedInjuryPlace [0..1] (InjuryPlace) |
Design Comments: This is the place where the injury was incurred |
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| subjectOf [0..*] (Subject3) | |||||||||
| InjuryPlace |
Design Comments: This is the place where the injury was incurred |
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| classCode [1..1] (M) Place (CS) {CNE:V:EntityClassPlace, root= "PLC"} |
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| determinerCode [1..1] (M) Place (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"} |
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| id [0..*] Place (DSET<II>) |
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| code [0..1] Place (CD) {CWE:D:PlaceEntityType} |
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| name [0..*] Place (COLL<EN>) |
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| desc [0..1] Place (ED) |
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| positionText [0..1] Place (ED) |
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| injuryLocation [0..*] (InjuryLocation) | |||||||||
| Subject3 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationTargetSubject, root= "SBJ"} |
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| position [1..1] (A_SpatialCoordinateUniversal) | |||||||||
| Reason4 |
Design Comments: An optional number indicating the primacy of referrals or diagnoses where more than one diagnosis or request is the reason for the BillableClinicalService. This will support indicating primary and secondary diagnoses. |
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| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipReason, root= "RSON"} |
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| sequenceNumber [0..1] ActRelationship (INT.NONNEG) |
Design Comments: An optional number indicating the primacy of referrals or diagnoses where more than one diagnosis or request is the reason for the BillableClinicalService. This will support indicating primary and secondary diagnoses. |
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| patientCareProvisionRequest [1..1] (PatientCareProvisionRequest) | |||||||||
| PatientCareProvisionRequest | |||||||||
| classCode [1..1] (M) Act (CS) {CNE:V:ActClassCareProvision, root= "PCPR"} |
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| moodCode [1..1] (M) Act (CS) {CNE:V:ActMoodRequest, root= "RQO"} |
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| id [0..*] Act (DSET<II>) |
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| code [0..1] Act (CD) {CWE:D:ActCode} |
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| effectiveTime [0..1] Act (IVL<TS>) |
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| author [0..1] (Author2) |
Design Comments: Referrer. |
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| reason [0..*] (Reason) | |||||||||
| Author2 |
Design Comments: Referrer. |
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| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationAuthorOriginator, root= "AUT"} |
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| time [0..1] Participation (IVL<TS>) |
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| assignedEntity [1..1] (AssignedEntity) | |||||||||
| Reason | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipReason, root= "RSON"} |
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| administrativeDiagnosisReference [1..1] (AdministrativeDiagnosisReference) | |||||||||
| AdministrativeDiagnosisReference | |||||||||
| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassObservation, root= "OBS"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| id [1..1] (M) Observation (II) |
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| Reason3 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipReason, root= "RSON"} |
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| priorityNumber [0..1] ActRelationship (INT) |
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| administrativeDiagnosis [1..1] (AdministrativeDiagnosis) | |||||||||
| AdministrativeDiagnosis | |||||||||
| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassObservation, root= "OBS"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| id [0..*] Observation (DSET<II>) |
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| code [1..1] (M) Observation (CD) {CWE:V:ObservationDiagnosisTypes} |
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| text [0..1] Observation (ED) |
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| effectiveTime [0..1] Observation (IVL<TS>) |
Design Comments: May be used to indicate the time or interval of time during which the administrative diagnosis was made. |
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| value [1..1] Observation (CD) {CWE:D:DiagnosisValue} |
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| Component2 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipHasComponent, root= "COMP"} |
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| specimenCollectionEvent [1..1] (SpecimenCollectionEvent) | |||||||||
| SpecimenCollectionEvent | |||||||||
| classCode [1..1] (M) Procedure (CS) {CNE:V:ActClassProcedure, root= "PROC"} |
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| moodCode [1..1] (M) Procedure (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| product [1..1] (Product2) | |||||||||
| location [1..1] (Location1) | |||||||||
| Product2 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationProduct, root= "PRD"} |
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| specimen [1..1] (Specimen) | |||||||||
| Specimen | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassSpecimen, root= "SPEC"} |
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| Location1 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationTargetLocation, root= "LOC"} |
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| serviceDeliveryLocation [1..1] (R_ServiceDeliveryLocationContact) | |||||||||
| Subject2 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipHasSubject, root= "SUBJ"} |
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| billableModifier [1..1] (BillableModifier) |
Design Comments: In the V2 chapter 6 post transactions, procedure and procedure modifiers are sent in two places. The first is an attribute of the financial detail (FT1 segment) and the second is an attribute of the procedure detail (PR1 segment). The attributes in the FT1 segment are used to link to the corresponding procedure detail PR1 segment. Procedure is in FT1;25 and PR1;3 Procedure modifiers are in FT1;26 and PR1;16 (they repeat) |
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| BillableModifier |
Design Comments: In the V2 chapter 6 post transactions, procedure and procedure modifiers are sent in two places. The first is an attribute of the financial detail (FT1 segment) and the second is an attribute of the procedure detail (PR1 segment). The attributes in the FT1 segment are used to link to the corresponding procedure detail PR1 segment. Procedure is in FT1;25 and PR1;3 Procedure modifiers are in FT1;26 and PR1;16 (they repeat) |
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| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassObservation, root= "OBS"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| code [0..1] Observation (CD) {CWE:V:ActBillableModifierCode} |
UsageNotes: ERROR - Business name from Visio is too long and was truncated. Full businessName follows. (Codes modifying ActBillableCodes, e.g., CPT Left, Right, which may be incorporated in any resulting Invoice as an InvoiceElement.modiferCode |
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| Subject | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipHasSubject, root= "SUBJ"} |
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| substitution [1..1] (Substitution) |
Design Comments: If present, indicates that this service was substituted for another, unspecified service |
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| Substitution |
Design Comments: If present, indicates that this service was substituted for another, unspecified service |
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| classCode [1..1] (M) Act (CS) {CNE:V:ActClassSubstitution, root= "SUBST"} |
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| moodCode [1..1] (M) Act (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| Component1 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipHasComponent, root= "COMP"} |
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| patientEncounter [1..1] (PatientEncounter) | |||||||||
| PatientEncounter | |||||||||
| classCode [1..1] (M) PatientEncounter (CS) {CNE:V:ActClassEncounter, root= "ENC"} |
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| moodCode [1..1] (M) PatientEncounter (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| id [0..*] PatientEncounter (DSET<II>) |
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| code [0..1] PatientEncounter (CD) {CWE:V:ActEncounterCode} |
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| effectiveTime [0..1] PatientEncounter (IVL<TS>) |
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| activityTime [0..1] PatientEncounter (IVL<TS>) |
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| priorityCode [0..1] PatientEncounter (CD) {CWE:V:x_EncounterAdmissionUrgency} |
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| admissionReferralSourceCode [0..1] PatientEncounter (CD) {CWE:D:EncounterReferralSource} |
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| dischargeDispositionCode [0..1] PatientEncounter (CD) {CWE:D:EncounterDischargeDisposition} |
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| reason [0..*] (Reason5) | |||||||||
| Reason5 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipReason, root= "RSON"} |
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| priorityNumber [0..1] ActRelationship (INT) |
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| presentingIndication [1..1] (PresentingIndication) | |||||||||
| PresentingIndication | |||||||||
| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassObservation, root= "OBS"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| code [0..1] Observation (CD) {CWE:D:ObservationIndicationType} |
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| text [0..1] Observation (ED) |
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| effectiveTime [0..1] Observation (IVL<TS>) |
Design Comments: May be used to indicate the time or interval of time during which the presenting indication observation was made. |
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| value [0..1] Observation (ANY) {CWE:D:ObservationValue} |
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