VN Core FHIR Implementation Guide — Bộ Hướng dẫn Triển khai FHIR Cốt lõi cho Việt Nam
0.1.0 - STU1 Draft Viet Nam flag

VN Core FHIR Implementation Guide — Bộ Hướng dẫn Triển khai FHIR Cốt lõi cho Việt Nam - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Yêu cầu thanh toán KCB VN Core — VN Core Claim Profile

Official URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim Version: 0.1.0
Draft as of 2026-03-20 Computable Name: VNCoreClaim

Profile Claim cho Việt Nam. Dùng cho yêu cầu thanh toán chi phí khám chữa bệnh BHYT. Mapping từ chuẩn dữ liệu đầu ra phục vụ BHXH (XML 4210 → QĐ 130 → QĐ 3176). Bảng kê chi phí theo QĐ 697/QĐ-BYT (19/3/2026) — 12 danh mục, 14 mã. Căn cứ:

  • QĐ 130/QĐ-BYT (2023) — Chuẩn dữ liệu đầu ra phục vụ BHXH
  • QĐ 4750/QĐ-BYT (2023) — Sửa đổi QĐ 130
  • QĐ 3176/QĐ-BYT (29/10/2024) — Sửa đổi QĐ 4750
  • QĐ 697/QĐ-BYT (19/3/2026) — Mẫu bảng kê chi phí KCB (thay QĐ 6556)
  • NĐ 188/2025/NĐ-CP — Hướng dẫn thi hành Luật BHYT
  • Luật BHYT 2008 sửa đổi 2014

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... type SΣ 1..1 CodeableConcept Loại yêu cầu: institutional (nội trú), professional (ngoại trú)
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
... subType S 0..1 CodeableConcept Mã đối tượng đến KCB (MA_DOITUONG_KCB per QĐ 3276/QĐ-BYT)
Binding: Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet (extensible)
... use SΣ 1..1 code Mục đích: claim (thanh toán) | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient SΣ 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Bệnh nhân (XML 3176: MA_BN)
... created SΣ 1..1 dateTime Ngày tạo yêu cầu
... insurer SΣ 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan BHXH thanh toán
... provider SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
... priority SΣ 1..1 CodeableConcept Mức ưu tiên xử lý
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... diagnosis S 1..* BackboneElement Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT)
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loại chẩn đoán (chính/phụ)
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
... procedure 0..* BackboneElement Thủ thuật/phẫu thuật — ICD-9-CM (XML 3176: MA_PTTT)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
... insurance SΣ 1..* BackboneElement Thông tin BHYT (XML 3176: MA_THE)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal SΣ 1..1 boolean Coverage to be used for adjudication
.... coverage SΣ 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) Thẻ BHYT (Coverage)
... accident 0..1 BackboneElement Thông tin tai nạn thương tích
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... date 1..1 date When the incident occurred
.... type 0..1 CodeableConcept Loại tai nạn (MA_TAI_NAN per QĐ 3176, Bảng 8)
Binding: Mã tai nạn thương tích — Vietnam Accident Type ValueSet (extensible)
... item S 0..* BackboneElement Chi tiết chi phí — 12 nhóm per QĐ 697/QĐ-BYT
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:department 0..1 CodeableConcept Khoa thực hiện (MA_KHOA)
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department
Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
..... extension:insuranceCostInfo 0..1 (Complex) BHYT: phạm vi, tỷ lệ TT, mức hưởng
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Item instance identifier
.... category S 0..1 CodeableConcept Nhóm chi phí: khám, giường, XN, CĐHA, thuốc, TBYT... (QĐ 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Mã dịch vụ/thuốc/TBYT
Binding: USCLSCodes (example): Allowable service and product codes.
.... quantity 0..1 SimpleQuantity(4.0.1) Số lượng
.... unitPrice 0..1 Money Đơn giá
.... net S 0..1 Money Thành tiền
... total S 0..1 Money Tổng chi phí (XML 3176: T_TONGCHI)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Claim.type Base extensible Claim Type Codes 📍4.0.1 FHIR Std.
Claim.subType Base extensible Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet 📦0.1.0 This IG
Claim.use Base required Use 📍4.0.1 FHIR Std.
Claim.priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
Claim.diagnosis.type Base example Example Diagnosis Type Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x] Base example ICD-10 Procedure Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
Claim.accident.type Base extensible Mã tai nạn thương tích — Vietnam Accident Type ValueSet 📦0.1.0 This IG
Claim.item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
Claim.item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Claim If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

This structure is derived from Claim

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... status S 1..1 code Trạng thái yêu cầu thanh toán
... type S 1..1 CodeableConcept Loại yêu cầu: institutional (nội trú), professional (ngoại trú)
... use S 1..1 code Mục đích: claim (thanh toán) | preauthorization | predetermination
... patient S 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Bệnh nhân (XML 3176: MA_BN)
... created S 1..1 dateTime Ngày tạo yêu cầu
... insurer S 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan BHXH thanh toán
... provider S 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
... priority S 1..1 CodeableConcept Mức ưu tiên xử lý
... diagnosis S 1..* BackboneElement Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 CodeableConcept, Reference(Condition) Nature of illness or problem
Slice: Unordered, Open by type:$this
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT)
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loại chẩn đoán (chính/phụ)
... procedure 0..* BackboneElement Thủ thuật/phẫu thuật — ICD-9-CM (XML 3176: MA_PTTT)
.... Slices for procedure[x] 1..1 CodeableConcept, Reference(Procedure) Specific clinical procedure
Slice: Unordered, Open by type:$this
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
... insurance S 1..* BackboneElement Thông tin BHYT (XML 3176: MA_THE)
.... focal S 1..1 boolean Coverage to be used for adjudication
.... coverage S 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) Thẻ BHYT (Coverage)
... accident 0..1 BackboneElement Thông tin tai nạn thương tích
.... type 0..1 CodeableConcept Loại tai nạn (MA_TAI_NAN per QĐ 3176, Bảng 8)
Binding: Mã tai nạn thương tích — Vietnam Accident Type ValueSet (extensible)
... item S 0..* BackboneElement Chi tiết chi phí — 12 nhóm per QĐ 697/QĐ-BYT
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:department 0..1 CodeableConcept Khoa thực hiện (MA_KHOA)
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department
Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
..... extension:insuranceCostInfo 0..1 (Complex) BHYT: phạm vi, tỷ lệ TT, mức hưởng
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
.... sequence S 1..1 positiveInt Item instance identifier
.... category S 0..1 CodeableConcept Nhóm chi phí: khám, giường, XN, CĐHA, thuốc, TBYT... (QĐ 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Mã dịch vụ/thuốc/TBYT
.... quantity 0..1 SimpleQuantity(4.0.1) Số lượng
.... unitPrice 0..1 Money Đơn giá
.... net S 0..1 Money Thành tiền
... total S 0..1 Money Tổng chi phí (XML 3176: T_TONGCHI)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Claim.subType Base extensible Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet 📦0.1.0 This IG
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
Claim.procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
Claim.accident.type Base extensible Mã tai nạn thương tích — Vietnam Accident Type ValueSet 📦0.1.0 This IG
Claim.item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier for claim
... status ?!SΣ 1..1 code Trạng thái yêu cầu thanh toán
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type SΣ 1..1 CodeableConcept Loại yêu cầu: institutional (nội trú), professional (ngoại trú)
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
... subType S 0..1 CodeableConcept Mã đối tượng đến KCB (MA_DOITUONG_KCB per QĐ 3276/QĐ-BYT)
Binding: Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet (extensible)
... use SΣ 1..1 code Mục đích: claim (thanh toán) | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient SΣ 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Bệnh nhân (XML 3176: MA_BN)
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created SΣ 1..1 dateTime Ngày tạo yêu cầu
... enterer 0..1 Reference(Practitioner | PractitionerRole) Author of the claim
... insurer SΣ 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan BHXH thanh toán
... provider SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
... priority SΣ 1..1 CodeableConcept Mức ưu tiên xử lý
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserve 0..1 CodeableConcept For whom to reserve funds
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..* BackboneElement Prior or corollary claims
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... claim 0..1 Reference(Claim) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
.... reference 0..1 Identifier File or case reference
... prescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Prescription authorizing services and products
... originalPrescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Original prescription if superseded by fulfiller
... payee 0..1 BackboneElement Recipient of benefits payable
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Category of recipient
Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) Recipient reference
... referral 0..1 Reference(ServiceRequest) Treatment referral
... facility 0..1 Reference(Location) Servicing facility
... careTeam 0..* BackboneElement Members of the care team
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Order of care team
.... provider 1..1 Reference(Practitioner | PractitionerRole | Organization) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
.... qualification 0..1 CodeableConcept Practitioner credential or specialization
Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.
... supportingInfo 0..* BackboneElement Supporting information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Information instance identifier
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
.... code 0..1 CodeableConcept Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.
.... timing[x] 0..1 When it occurred
..... timingDate date
..... timingPeriod Period
.... value[x] 0..1 Data to be provided
..... valueBoolean boolean
..... valueString string
..... valueQuantity Quantity
..... valueAttachment Attachment
..... valueReference Reference(Resource)
.... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis S 1..* BackboneElement Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT)
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loại chẩn đoán (chính/phụ)
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1 CodeableConcept Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
.... packageCode 0..1 CodeableConcept Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
... procedure 0..* BackboneElement Thủ thuật/phẫu thuật — ICD-9-CM (XML 3176: MA_PTTT)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... type 0..* CodeableConcept Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
.... udi 0..* Reference(Device) Unique device identifier
... insurance SΣ 1..* BackboneElement Thông tin BHYT (XML 3176: MA_THE)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal SΣ 1..1 boolean Coverage to be used for adjudication
.... identifier 0..1 Identifier Pre-assigned Claim number
.... coverage SΣ 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) Thẻ BHYT (Coverage)
.... businessArrangement 0..1 string Additional provider contract number
.... preAuthRef 0..* string Prior authorization reference number
.... claimResponse 0..1 Reference(ClaimResponse) Adjudication results
... accident 0..1 BackboneElement Thông tin tai nạn thương tích
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... date 1..1 date When the incident occurred
.... type 0..1 CodeableConcept Loại tai nạn (MA_TAI_NAN per QĐ 3176, Bảng 8)
Binding: Mã tai nạn thương tích — Vietnam Accident Type ValueSet (extensible)
.... location[x] 0..1 Where the event occurred
..... locationAddress Address
..... locationReference Reference(Location)
... item S 0..* BackboneElement Chi tiết chi phí — 12 nhóm per QĐ 697/QĐ-BYT
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:department 0..1 CodeableConcept Khoa thực hiện (MA_KHOA)
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department
Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
..... extension:insuranceCostInfo 0..1 (Complex) BHYT: phạm vi, tỷ lệ TT, mức hưởng
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Item instance identifier
.... careTeamSequence 0..* positiveInt Applicable careTeam members
.... diagnosisSequence 0..* positiveInt Applicable diagnoses
.... procedureSequence 0..* positiveInt Applicable procedures
.... informationSequence 0..* positiveInt Applicable exception and supporting information
.... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category S 0..1 CodeableConcept Nhóm chi phí: khám, giường, XN, CĐHA, thuốc, TBYT... (QĐ 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Mã dịch vụ/thuốc/TBYT
Binding: USCLSCodes (example): Allowable service and product codes.
.... modifier 0..* CodeableConcept Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... quantity 0..1 SimpleQuantity(4.0.1) Số lượng
.... unitPrice 0..1 Money Đơn giá
.... factor 0..1 decimal Price scaling factor
.... net S 0..1 Money Thành tiền
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..1 CodeableConcept Anatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..* CodeableConcept Anatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
.... encounter 0..* Reference(Encounter) Encounters related to this billed item
.... detail 0..* BackboneElement Product or service provided
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Item instance identifier
..... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
..... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
..... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
..... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... net 0..1 Money Total item cost
..... udi 0..* Reference(Device) Unique device identifier
..... subDetail 0..* BackboneElement Product or service provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... sequence 1..1 positiveInt Item instance identifier
...... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
...... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
...... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
...... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
... total S 0..1 Money Tổng chi phí (XML 3176: T_TONGCHI)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Claim.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Claim.type Base extensible Claim Type Codes 📍4.0.1 FHIR Std.
Claim.subType Base extensible Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet 📦0.1.0 This IG
Claim.use Base required Use 📍4.0.1 FHIR Std.
Claim.priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
Claim.fundsReserve Base example FundsReserve 📍4.0.1 FHIR Std.
Claim.related.relationship Base example Example Related Claim Relationship Codes 📍4.0.1 FHIR Std.
Claim.payee.type Base example PayeeType 📍4.0.1 FHIR Std.
Claim.careTeam.role Base example Claim Care Team Role Codes 📍4.0.1 FHIR Std.
Claim.careTeam.qualification Base example Example Provider Qualification Codes 📍4.0.1 FHIR Std.
Claim.supportingInfo.​category Base example Claim Information Category Codes 📍4.0.1 FHIR Std.
Claim.supportingInfo.​code Base example Exception Codes 📍4.0.1 FHIR Std.
Claim.supportingInfo.​reason Base example Missing Tooth Reason Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
Claim.diagnosis.type Base example Example Diagnosis Type Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.packageCode Base example Example Diagnosis Related Group Codes 📍4.0.1 FHIR Std.
Claim.procedure.type Base example Example Procedure Type Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x] Base example ICD-10 Procedure Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
Claim.accident.type Base extensible Mã tai nạn thương tích — Vietnam Accident Type ValueSet 📦0.1.0 This IG
Claim.item.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
Claim.item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
Claim.item.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
Claim.item.location[x] Base example Example Service Place Codes 📍4.0.1 FHIR Std.
Claim.item.bodySite Base example Oral Site Codes 📍4.0.1 FHIR Std.
Claim.item.subSite Base example Surface Codes 📍4.0.1 FHIR Std.
Claim.item.detail.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.detail.category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
Claim.item.detail.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
Claim.item.detail.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.detail.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Claim If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... type SΣ 1..1 CodeableConcept Loại yêu cầu: institutional (nội trú), professional (ngoại trú)
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
... subType S 0..1 CodeableConcept Mã đối tượng đến KCB (MA_DOITUONG_KCB per QĐ 3276/QĐ-BYT)
Binding: Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet (extensible)
... use SΣ 1..1 code Mục đích: claim (thanh toán) | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient SΣ 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Bệnh nhân (XML 3176: MA_BN)
... created SΣ 1..1 dateTime Ngày tạo yêu cầu
... insurer SΣ 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan BHXH thanh toán
... provider SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
... priority SΣ 1..1 CodeableConcept Mức ưu tiên xử lý
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... diagnosis S 1..* BackboneElement Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT)
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loại chẩn đoán (chính/phụ)
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
... procedure 0..* BackboneElement Thủ thuật/phẫu thuật — ICD-9-CM (XML 3176: MA_PTTT)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
... insurance SΣ 1..* BackboneElement Thông tin BHYT (XML 3176: MA_THE)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal SΣ 1..1 boolean Coverage to be used for adjudication
.... coverage SΣ 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) Thẻ BHYT (Coverage)
... accident 0..1 BackboneElement Thông tin tai nạn thương tích
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... date 1..1 date When the incident occurred
.... type 0..1 CodeableConcept Loại tai nạn (MA_TAI_NAN per QĐ 3176, Bảng 8)
Binding: Mã tai nạn thương tích — Vietnam Accident Type ValueSet (extensible)
... item S 0..* BackboneElement Chi tiết chi phí — 12 nhóm per QĐ 697/QĐ-BYT
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:department 0..1 CodeableConcept Khoa thực hiện (MA_KHOA)
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department
Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
..... extension:insuranceCostInfo 0..1 (Complex) BHYT: phạm vi, tỷ lệ TT, mức hưởng
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Item instance identifier
.... category S 0..1 CodeableConcept Nhóm chi phí: khám, giường, XN, CĐHA, thuốc, TBYT... (QĐ 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Mã dịch vụ/thuốc/TBYT
Binding: USCLSCodes (example): Allowable service and product codes.
.... quantity 0..1 SimpleQuantity(4.0.1) Số lượng
.... unitPrice 0..1 Money Đơn giá
.... net S 0..1 Money Thành tiền
... total S 0..1 Money Tổng chi phí (XML 3176: T_TONGCHI)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Claim.type Base extensible Claim Type Codes 📍4.0.1 FHIR Std.
Claim.subType Base extensible Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet 📦0.1.0 This IG
Claim.use Base required Use 📍4.0.1 FHIR Std.
Claim.priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
Claim.diagnosis.type Base example Example Diagnosis Type Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x] Base example ICD-10 Procedure Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
Claim.accident.type Base extensible Mã tai nạn thương tích — Vietnam Accident Type ValueSet 📦0.1.0 This IG
Claim.item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
Claim.item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Claim If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

This structure is derived from Claim

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... status S 1..1 code Trạng thái yêu cầu thanh toán
... type S 1..1 CodeableConcept Loại yêu cầu: institutional (nội trú), professional (ngoại trú)
... use S 1..1 code Mục đích: claim (thanh toán) | preauthorization | predetermination
... patient S 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Bệnh nhân (XML 3176: MA_BN)
... created S 1..1 dateTime Ngày tạo yêu cầu
... insurer S 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan BHXH thanh toán
... provider S 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
... priority S 1..1 CodeableConcept Mức ưu tiên xử lý
... diagnosis S 1..* BackboneElement Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 CodeableConcept, Reference(Condition) Nature of illness or problem
Slice: Unordered, Open by type:$this
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT)
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loại chẩn đoán (chính/phụ)
... procedure 0..* BackboneElement Thủ thuật/phẫu thuật — ICD-9-CM (XML 3176: MA_PTTT)
.... Slices for procedure[x] 1..1 CodeableConcept, Reference(Procedure) Specific clinical procedure
Slice: Unordered, Open by type:$this
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
... insurance S 1..* BackboneElement Thông tin BHYT (XML 3176: MA_THE)
.... focal S 1..1 boolean Coverage to be used for adjudication
.... coverage S 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) Thẻ BHYT (Coverage)
... accident 0..1 BackboneElement Thông tin tai nạn thương tích
.... type 0..1 CodeableConcept Loại tai nạn (MA_TAI_NAN per QĐ 3176, Bảng 8)
Binding: Mã tai nạn thương tích — Vietnam Accident Type ValueSet (extensible)
... item S 0..* BackboneElement Chi tiết chi phí — 12 nhóm per QĐ 697/QĐ-BYT
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:department 0..1 CodeableConcept Khoa thực hiện (MA_KHOA)
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department
Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
..... extension:insuranceCostInfo 0..1 (Complex) BHYT: phạm vi, tỷ lệ TT, mức hưởng
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
.... sequence S 1..1 positiveInt Item instance identifier
.... category S 0..1 CodeableConcept Nhóm chi phí: khám, giường, XN, CĐHA, thuốc, TBYT... (QĐ 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Mã dịch vụ/thuốc/TBYT
.... quantity 0..1 SimpleQuantity(4.0.1) Số lượng
.... unitPrice 0..1 Money Đơn giá
.... net S 0..1 Money Thành tiền
... total S 0..1 Money Tổng chi phí (XML 3176: T_TONGCHI)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Claim.subType Base extensible Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet 📦0.1.0 This IG
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
Claim.procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
Claim.accident.type Base extensible Mã tai nạn thương tích — Vietnam Accident Type ValueSet 📦0.1.0 This IG
Claim.item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim Claim, Pre-determination or Pre-authorization
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier for claim
... status ?!SΣ 1..1 code Trạng thái yêu cầu thanh toán
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type SΣ 1..1 CodeableConcept Loại yêu cầu: institutional (nội trú), professional (ngoại trú)
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
... subType S 0..1 CodeableConcept Mã đối tượng đến KCB (MA_DOITUONG_KCB per QĐ 3276/QĐ-BYT)
Binding: Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet (extensible)
... use SΣ 1..1 code Mục đích: claim (thanh toán) | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient SΣ 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Bệnh nhân (XML 3176: MA_BN)
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created SΣ 1..1 dateTime Ngày tạo yêu cầu
... enterer 0..1 Reference(Practitioner | PractitionerRole) Author of the claim
... insurer SΣ 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan BHXH thanh toán
... provider SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
... priority SΣ 1..1 CodeableConcept Mức ưu tiên xử lý
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserve 0..1 CodeableConcept For whom to reserve funds
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..* BackboneElement Prior or corollary claims
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... claim 0..1 Reference(Claim) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
.... reference 0..1 Identifier File or case reference
... prescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Prescription authorizing services and products
... originalPrescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Original prescription if superseded by fulfiller
... payee 0..1 BackboneElement Recipient of benefits payable
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 CodeableConcept Category of recipient
Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) Recipient reference
... referral 0..1 Reference(ServiceRequest) Treatment referral
... facility 0..1 Reference(Location) Servicing facility
... careTeam 0..* BackboneElement Members of the care team
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Order of care team
.... provider 1..1 Reference(Practitioner | PractitionerRole | Organization) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
.... qualification 0..1 CodeableConcept Practitioner credential or specialization
Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.
... supportingInfo 0..* BackboneElement Supporting information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Information instance identifier
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
.... code 0..1 CodeableConcept Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.
.... timing[x] 0..1 When it occurred
..... timingDate date
..... timingPeriod Period
.... value[x] 0..1 Data to be provided
..... valueBoolean boolean
..... valueString string
..... valueQuantity Quantity
..... valueAttachment Attachment
..... valueReference Reference(Resource)
.... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis S 1..* BackboneElement Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT)
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loại chẩn đoán (chính/phụ)
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1 CodeableConcept Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
.... packageCode 0..1 CodeableConcept Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
... procedure 0..* BackboneElement Thủ thuật/phẫu thuật — ICD-9-CM (XML 3176: MA_PTTT)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... type 0..* CodeableConcept Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
.... udi 0..* Reference(Device) Unique device identifier
... insurance SΣ 1..* BackboneElement Thông tin BHYT (XML 3176: MA_THE)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal SΣ 1..1 boolean Coverage to be used for adjudication
.... identifier 0..1 Identifier Pre-assigned Claim number
.... coverage SΣ 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) Thẻ BHYT (Coverage)
.... businessArrangement 0..1 string Additional provider contract number
.... preAuthRef 0..* string Prior authorization reference number
.... claimResponse 0..1 Reference(ClaimResponse) Adjudication results
... accident 0..1 BackboneElement Thông tin tai nạn thương tích
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... date 1..1 date When the incident occurred
.... type 0..1 CodeableConcept Loại tai nạn (MA_TAI_NAN per QĐ 3176, Bảng 8)
Binding: Mã tai nạn thương tích — Vietnam Accident Type ValueSet (extensible)
.... location[x] 0..1 Where the event occurred
..... locationAddress Address
..... locationReference Reference(Location)
... item S 0..* BackboneElement Chi tiết chi phí — 12 nhóm per QĐ 697/QĐ-BYT
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:department 0..1 CodeableConcept Khoa thực hiện (MA_KHOA)
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department
Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
..... extension:insuranceCostInfo 0..1 (Complex) BHYT: phạm vi, tỷ lệ TT, mức hưởng
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Item instance identifier
.... careTeamSequence 0..* positiveInt Applicable careTeam members
.... diagnosisSequence 0..* positiveInt Applicable diagnoses
.... procedureSequence 0..* positiveInt Applicable procedures
.... informationSequence 0..* positiveInt Applicable exception and supporting information
.... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category S 0..1 CodeableConcept Nhóm chi phí: khám, giường, XN, CĐHA, thuốc, TBYT... (QĐ 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Mã dịch vụ/thuốc/TBYT
Binding: USCLSCodes (example): Allowable service and product codes.
.... modifier 0..* CodeableConcept Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... quantity 0..1 SimpleQuantity(4.0.1) Số lượng
.... unitPrice 0..1 Money Đơn giá
.... factor 0..1 decimal Price scaling factor
.... net S 0..1 Money Thành tiền
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..1 CodeableConcept Anatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..* CodeableConcept Anatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
.... encounter 0..* Reference(Encounter) Encounters related to this billed item
.... detail 0..* BackboneElement Product or service provided
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... sequence 1..1 positiveInt Item instance identifier
..... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
..... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
..... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
..... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... net 0..1 Money Total item cost
..... udi 0..* Reference(Device) Unique device identifier
..... subDetail 0..* BackboneElement Product or service provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... sequence 1..1 positiveInt Item instance identifier
...... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
...... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
...... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
...... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
... total S 0..1 Money Tổng chi phí (XML 3176: T_TONGCHI)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Claim.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Claim.type Base extensible Claim Type Codes 📍4.0.1 FHIR Std.
Claim.subType Base extensible Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet 📦0.1.0 This IG
Claim.use Base required Use 📍4.0.1 FHIR Std.
Claim.priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
Claim.fundsReserve Base example FundsReserve 📍4.0.1 FHIR Std.
Claim.related.relationship Base example Example Related Claim Relationship Codes 📍4.0.1 FHIR Std.
Claim.payee.type Base example PayeeType 📍4.0.1 FHIR Std.
Claim.careTeam.role Base example Claim Care Team Role Codes 📍4.0.1 FHIR Std.
Claim.careTeam.qualification Base example Example Provider Qualification Codes 📍4.0.1 FHIR Std.
Claim.supportingInfo.​category Base example Claim Information Category Codes 📍4.0.1 FHIR Std.
Claim.supportingInfo.​code Base example Exception Codes 📍4.0.1 FHIR Std.
Claim.supportingInfo.​reason Base example Missing Tooth Reason Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
Claim.diagnosis.type Base example Example Diagnosis Type Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.packageCode Base example Example Diagnosis Related Group Codes 📍4.0.1 FHIR Std.
Claim.procedure.type Base example Example Procedure Type Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x] Base example ICD-10 Procedure Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
Claim.accident.type Base extensible Mã tai nạn thương tích — Vietnam Accident Type ValueSet 📦0.1.0 This IG
Claim.item.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
Claim.item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
Claim.item.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
Claim.item.location[x] Base example Example Service Place Codes 📍4.0.1 FHIR Std.
Claim.item.bodySite Base example Oral Site Codes 📍4.0.1 FHIR Std.
Claim.item.subSite Base example Surface Codes 📍4.0.1 FHIR Std.
Claim.item.detail.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.detail.category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
Claim.item.detail.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
Claim.item.detail.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.detail.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Claim If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron