German Practice Management FHIR Profiles (R4)
0.90.0 - STU1 Germany

German Practice Management FHIR Profiles (R4) - Local Development build (v0.90.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Preliminary Billing Claim Example - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/Claim/PraxisPreliminaryBillingClaimExample> a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "PraxisPreliminaryBillingClaimExample"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "https://fhir.cognovis.de/praxis/StructureDefinition/praxis-preliminary-billing-claim-de" ;
       fhir:index 0 ;
       fhir:link <https://fhir.cognovis.de/praxis/StructureDefinition/praxis-preliminary-billing-claim-de>
     ]
  ] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim PraxisPreliminaryBillingClaimExample</b></p><a name=\"PraxisPreliminaryBillingClaimExample\"> </a><a name=\"hcPraxisPreliminaryBillingClaimExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-praxis-preliminary-billing-claim-de.html\">Praxis Preliminary Billing Claim DE</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>subType</b>: <span title=\"Codes:{https://fhir.cognovis.de/praxis/CodeSystem/billing-claim-subtype vorlaeufig}\">Preliminary Billing Claim</span></p><p><b>use</b>: Predetermination</p><p><b>patient</b>: <a href=\"Patient-BillingClaimPatientExample.html\">Erika Musterfrau  Female, DoB: 1965-07-20 ( http://fhir.de/NamingSystem/gkv/kvid-10#A987654321)</a></p><p><b>created</b>: 2024-04-01 08:00:00+0200</p><p><b>insurer</b>: <a href=\"Organization-BillingClaimGKVInsurerExample.html\">Organization Techniker Krankenkasse</a></p><p><b>provider</b>: <a href=\"Practitioner-BillingClaimPractitionerExample.html\">Practitioner Hans Mueller </a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 1</p><p><b>diagnosis</b>: <a href=\"Condition-BillingClaimQuarterDiabetesConfirmedCondition.html\">Condition Diabetes mellitus, Typ 2, ohne Komplikationen</a></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 2</p><p><b>diagnosis</b>: <a href=\"Condition-BillingClaimQuarterDiabetesSuspectedCondition.html\">Condition Diabetes mellitus, Typ 2, ohne Komplikationen</a></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 3</p><p><b>diagnosis</b>: <a href=\"Condition-BillingClaimQuarterBackPainRightCondition.html\">Condition Lumboischialgie</a></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 4</p><p><b>diagnosis</b>: <a href=\"Condition-BillingClaimQuarterBackPainLeftCondition.html\">Condition Lumboischialgie</a></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 5</p><p><b>diagnosis</b>: <a href=\"Condition-BillingClaimQuarterBackPainDuplicateACondition.html\">Condition Lumboischialgie</a></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td>TK GKV-Versicherung</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_EBM 03000}\">Hausarztpauschale</span></p><p><b>quantity</b>: 1 1<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code1 = '1*')</span></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: <span title=\"Codes:{https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_EBM 03220}\">Chronikerzuschlag</span></p><p><b>quantity</b>: 1 1<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code1 = '1*')</span></p></blockquote></div>"
  ] ;
  fhir:Claim.status [ fhir:value "active"] ;
  fhir:Claim.type [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ;
       fhir:Coding.code [ fhir:value "professional" ]
     ]
  ] ;
  fhir:Claim.subType [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "https://fhir.cognovis.de/praxis/CodeSystem/billing-claim-subtype" ] ;
       fhir:Coding.code [ fhir:value "vorlaeufig" ]
     ]
  ] ;
  fhir:Claim.use [ fhir:value "predetermination"] ;
  fhir:Claim.patient [
     fhir:link <http://hl7.org/fhir/Patient/BillingClaimPatientExample> ;
     fhir:Reference.reference [ fhir:value "Patient/BillingClaimPatientExample" ]
  ] ;
  fhir:Claim.created [ fhir:value "2024-04-01T08:00:00+02:00"^^xsd:dateTime] ;
  fhir:Claim.insurer [
     fhir:link <http://hl7.org/fhir/Organization/BillingClaimGKVInsurerExample> ;
     fhir:Reference.reference [ fhir:value "Organization/BillingClaimGKVInsurerExample" ]
  ] ;
  fhir:Claim.provider [
     fhir:link <http://hl7.org/fhir/Practitioner/BillingClaimPractitionerExample> ;
     fhir:Reference.reference [ fhir:value "Practitioner/BillingClaimPractitionerExample" ]
  ] ;
  fhir:Claim.priority [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ] ;
       fhir:Coding.code [ fhir:value "normal" ]
     ]
  ] ;
  fhir:Claim.diagnosis [
     fhir:index 0 ;
     fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.diagnosis.diagnosisReference [
       fhir:link <http://hl7.org/fhir/Condition/BillingClaimQuarterDiabetesConfirmedCondition> ;
       fhir:Reference.reference [ fhir:value "Condition/BillingClaimQuarterDiabetesConfirmedCondition" ]
     ]
  ], [
     fhir:index 1 ;
     fhir:Claim.diagnosis.sequence [ fhir:value "2"^^xsd:positiveInteger ] ;
     fhir:Claim.diagnosis.diagnosisReference [
       fhir:link <http://hl7.org/fhir/Condition/BillingClaimQuarterDiabetesSuspectedCondition> ;
       fhir:Reference.reference [ fhir:value "Condition/BillingClaimQuarterDiabetesSuspectedCondition" ]
     ]
  ], [
     fhir:index 2 ;
     fhir:Claim.diagnosis.sequence [ fhir:value "3"^^xsd:positiveInteger ] ;
     fhir:Claim.diagnosis.diagnosisReference [
       fhir:link <http://hl7.org/fhir/Condition/BillingClaimQuarterBackPainRightCondition> ;
       fhir:Reference.reference [ fhir:value "Condition/BillingClaimQuarterBackPainRightCondition" ]
     ]
  ], [
     fhir:index 3 ;
     fhir:Claim.diagnosis.sequence [ fhir:value "4"^^xsd:positiveInteger ] ;
     fhir:Claim.diagnosis.diagnosisReference [
       fhir:link <http://hl7.org/fhir/Condition/BillingClaimQuarterBackPainLeftCondition> ;
       fhir:Reference.reference [ fhir:value "Condition/BillingClaimQuarterBackPainLeftCondition" ]
     ]
  ], [
     fhir:index 4 ;
     fhir:Claim.diagnosis.sequence [ fhir:value "5"^^xsd:positiveInteger ] ;
     fhir:Claim.diagnosis.diagnosisReference [
       fhir:link <http://hl7.org/fhir/Condition/BillingClaimQuarterBackPainDuplicateACondition> ;
       fhir:Reference.reference [ fhir:value "Condition/BillingClaimQuarterBackPainDuplicateACondition" ]
     ]
  ] ;
  fhir:Claim.insurance [
     fhir:index 0 ;
     fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ] ;
     fhir:Claim.insurance.coverage [
       fhir:Reference.display [ fhir:value "TK GKV-Versicherung" ]
     ]
  ] ;
  fhir:Claim.item [
     fhir:index 0 ;
     fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_EBM" ] ;
         fhir:Coding.code [ fhir:value "03000" ] ;
         fhir:Coding.display [ fhir:value "Hausarztpauschale" ]
       ]
     ] ;
     fhir:Claim.item.quantity [
       fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ] ;
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ] ;
       fhir:Quantity.code [ fhir:value "1" ]
     ]
  ], [
     fhir:index 1 ;
     fhir:Claim.item.sequence [ fhir:value "2"^^xsd:positiveInteger ] ;
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_EBM" ] ;
         fhir:Coding.code [ fhir:value "03220" ] ;
         fhir:Coding.display [ fhir:value "Chronikerzuschlag" ]
       ]
     ] ;
     fhir:Claim.item.quantity [
       fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ] ;
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ] ;
       fhir:Quantity.code [ fhir:value "1" ]
     ]
  ] .

<http://hl7.org/fhir/Patient/BillingClaimPatientExample> a fhir:Patient .

<http://hl7.org/fhir/Organization/BillingClaimGKVInsurerExample> a fhir:Organization .

<http://hl7.org/fhir/Practitioner/BillingClaimPractitionerExample> a fhir:Practitioner .

<http://hl7.org/fhir/Condition/BillingClaimQuarterDiabetesConfirmedCondition> a fhir:Condition .

<http://hl7.org/fhir/Condition/BillingClaimQuarterDiabetesSuspectedCondition> a fhir:Condition .

<http://hl7.org/fhir/Condition/BillingClaimQuarterBackPainRightCondition> a fhir:Condition .

<http://hl7.org/fhir/Condition/BillingClaimQuarterBackPainLeftCondition> a fhir:Condition .

<http://hl7.org/fhir/Condition/BillingClaimQuarterBackPainDuplicateACondition> a fhir:Condition .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Claim/PraxisPreliminaryBillingClaimExample.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/Claim/PraxisPreliminaryBillingClaimExample.ttl> .