醫療保險理賠實作指引
1.0.0 - CI Build

醫療保險理賠實作指引 - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: PatientiClaim - Mappings

Active as of 2024-07-23

Mappings for the patient-iclaim resource profile.

Mappings for RIM Mapping (http://hl7.org/v3)

PatientiClaim
PatientEntity. Role, or Act, Patient[classCode=PAT]
   textAct.text?
   containedN/A
   identifierid
   identifier (idCardNumber)id
      idn/a
      extensionn/a
      useRole.code or implied by context
      typen/a, CD
         idn/a
         codingn/a, CV
            idn/a
            system./codeSystem
            version./codeSystemVersion
            code./code
            displayCV.displayName
            userSelectedCD.codingRationale
         text./originalText[mediaType/code="text/plain"]/data
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   identifier (medicalRecord)id
      idn/a
      extensionn/a
      useRole.code or implied by context
      typen/a, CD
         idn/a
         codingn/a, CV
            idn/a
            system./codeSystem
            version./codeSystemVersion
            code./code
            displayCV.displayName
            userSelectedCD.codingRationale
         text./originalText[mediaType/code="text/plain"]/data
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   activestatusCode
   namename
   name (official)name
      idn/a
      extensionn/a
      useunique(./use)
      text./formatted
      family./part[partType = FAM]
      given./part[partType = GIV]
      prefix./part[partType = PFX]
      suffix./part[partType = SFX]
      period./usablePeriod[type="IVL<TS>"]
   name (usual)name
      idn/a
      extensionn/a
      useunique(./use)
      text./formatted
      family./part[partType = FAM]
      given./part[partType = GIV]
      prefix./part[partType = PFX]
      suffix./part[partType = SFX]
      period./usablePeriod[type="IVL<TS>"]
   name (temp)name
      idn/a
      extensionn/a
      useunique(./use)
      text./formatted
      period./usablePeriod[type="IVL<TS>"]
   name (anonymous)name
      idn/a
      extensionn/a
      useunique(./use)
      text./formatted
      period./usablePeriod[type="IVL<TS>"]
   telecomtelecom
      idn/a
      extensionn/a
      system./scheme
      value./url
      useunique(./use)
      rankn/a
      period./usablePeriod[type="IVL<TS>"]
   genderplayer[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
   birthDateplayer[classCode=PSN|ANM and determinerCode=INSTANCE]/birthTime
   deceased[x]player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/deceasedTime
   addressn/a, AD
   maritalStatusn/a, CD
   multipleBirth[x]player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthInd, player[classCode=PSN|ANM and determinerCode=INSTANCE]/multipleBirthOrderNumber
   photoplayer[classCode=PSN|ANM and determinerCode=INSTANCE]/desc
   contactplayer[classCode=PSN|ANM and determinerCode=INSTANCE]/scopedRole[classCode=CON]
      idn/a
      extensionn/a
      modifierExtensionN/A
      relationshipn/a, CD
      namename
         idn/a
         extensionn/a
         useunique(./use)
         text./formatted
         family./part[partType = FAM]
         given./part[partType = GIV]
         prefix./part[partType = PFX]
         suffix./part[partType = SFX]
         period./usablePeriod[type="IVL<TS>"]
      telecomtelecom
         idn/a
         extensionn/a
         system./scheme
         value./url
         useunique(./use)
         rankn/a
         period./usablePeriod[type="IVL<TS>"]
      addressn/a, AD
      genderplayer[classCode=PSN|ANM and determinerCode=INSTANCE]/administrativeGender
      organizationscoper
      periodeffectiveTime
   communicationLanguageCommunication
      idn/a
      extensionn/a
      modifierExtensionN/A
      languagen/a, CD
      preferredpreferenceInd
   generalPractitionersubjectOf.CareEvent.performer.AssignedEntity
   managingOrganizationscoper
   linkoutboundLink
      idn/a
      extensionn/a
      modifierExtensionN/A
      otherid
      typetypeCode

Mappings for CDA (R2) (http://hl7.org/v3/cda)

PatientiClaim
PatientClinicalDocument.recordTarget.patientRole
   identifier.id
   identifier (idCardNumber).id
   identifier (medicalRecord).id
   activen/a
   name.patient.name
   name (official).patient.name
   name (usual).patient.name
   name (temp).patient.name
   name (anonymous).patient.name
   telecom.telecom
   gender.patient.administrativeGenderCode
   birthDate.patient.birthTime
   deceased[x]n/a
   multipleBirth[x]n/a
   photon/a
   contactn/a
      namen/a
      telecomn/a
      gendern/a
      organizationn/a
      periodn/a
   communicationpatient.languageCommunication
      preferred.preferenceInd
   generalPractitionern/a
   managingOrganization.providerOrganization
   linkn/a
      othern/a
      typen/a

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

PatientiClaim
Patient
   identifierFiveWs.identifier
   identifier (idCardNumber)FiveWs.identifier
   identifier (medicalRecord)FiveWs.identifier
   activeFiveWs.status

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

PatientiClaim
Patient
   identifierPID-3
   identifier (idCardNumber)PID-3
      useN/A
      typeCE/CNE/CWE
         codingCE/CNE/CWE subset one of the sets of component 1-3 or 4-6
            systemC*E.3
            versionC*E.7
            codeC*E.1
            displayC*E.2 - but note this is not well followed
            userSelectedSometimes implied by being first
         textC*E.9. But note many systems use C*E.2 for this
      systemCX.4 / EI-2-4
      valueCX.1 / EI.1
      periodCX.7 + CX.8
      assignerCX.4 / (CX.4,CX.9,CX.10)
   identifier (medicalRecord)PID-3
      useN/A
      typeCE/CNE/CWE
         codingCE/CNE/CWE subset one of the sets of component 1-3 or 4-6
            systemC*E.3
            versionC*E.7
            codeC*E.1
            displayC*E.2 - but note this is not well followed
            userSelectedSometimes implied by being first
         textC*E.9. But note many systems use C*E.2 for this
      systemCX.4 / EI-2-4
      valueCX.1 / EI.1
      periodCX.7 + CX.8
      assignerCX.4 / (CX.4,CX.9,CX.10)
   namePID-5, PID-9
   name (official)PID-5, PID-9
      useXPN.7, but often indicated by which field contains the name
      textimplied by XPN.11
      familyXPN.1/FN.1
      givenXPN.2 + XPN.3
      prefixXPN.5
      suffixXPN/4
      periodXPN.13 + XPN.14
   name (usual)PID-5, PID-9
      useXPN.7, but often indicated by which field contains the name
      textimplied by XPN.11
      familyXPN.1/FN.1
      givenXPN.2 + XPN.3
      prefixXPN.5
      suffixXPN/4
      periodXPN.13 + XPN.14
   name (temp)PID-5, PID-9
      useXPN.7, but often indicated by which field contains the name
      textimplied by XPN.11
      periodXPN.13 + XPN.14
   name (anonymous)PID-5, PID-9
      useXPN.7, but often indicated by which field contains the name
      textimplied by XPN.11
      periodXPN.13 + XPN.14
   telecomPID-13, PID-14, PID-40
      systemXTN.3
      valueXTN.1 (or XTN.12)
      useXTN.2 - but often indicated by field
      rankn/a
      periodN/A
   genderPID-8
   birthDatePID-7
   deceased[x]PID-30 (bool) and PID-29 (datetime)
   addressXAD
   maritalStatusCE/CNE/CWE
   multipleBirth[x]PID-24 (bool), PID-25 (integer)
   photoOBX-5 - needs a profile
   contact
      relationshipCE/CNE/CWE
      nameNK1-2
         useXPN.7, but often indicated by which field contains the name
         textimplied by XPN.11
         familyXPN.1/FN.1
         givenXPN.2 + XPN.3
         prefixXPN.5
         suffixXPN/4
         periodXPN.13 + XPN.14
      telecomNK1-5, NK1-6, NK1-40
         systemXTN.3
         valueXTN.1 (or XTN.12)
         useXTN.2 - but often indicated by field
         rankn/a
         periodN/A
      addressXAD
      genderNK1-15
      organizationNK1-13, NK1-30, NK1-31, NK1-32, NK1-41
   communication
      languageCE/CNE/CWE
      preferredPID-15
   generalPractitionerPD1-4
   link
      otherPID-3, MRG-1

Mappings for LOINC code for the element (http://loinc.org)

PatientiClaim
Patient
   birthDate21112-8