billing-required-fact
type: CodeSystem
node role: treeRoot
resource.id:
  value: billing-required-fact
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: CodeSystem billing-required-fact This case-sensitive code system https://fhir.cognovis.de/praxis/CodeSystem/billing-required-fact defines the following codes: Code Display Definition service-occurrence Service occurrence An occurrence of a billed or previously rendered service. service-value Service value A monetary, point, duration, quantity, or factor value attached to a service. diagnosis Diagnosis A diagnosis and its relevant status, certainty, site, and time context. procedure Procedure A documented procedure and its time and site context. finding Finding A documented clinical or administrative finding or measurement. patient-attribute Patient attribute A demographic or status attribute of the patient. provider-eligibility Provider eligibility A specialty, authorization, role, or relationship fact that establishes whether a provider may render or bill the service. care-setting Care setting A place, case type, care setting, time, or treatment-kind fact. contract-participation Contract participation A patient, provider, or practice enrollment in a contract or module. accompanying-information Accompanying information A structured field, justification, report, or itemized cost record. prior-authorization Prior authorization An applicable approved plan or authorization. patient-agreement Patient agreement An applicable agreement signed or accepted by the patient. billing-factor Billing factor The factor or multiplier applied to a billed item. analogue-reference Analogue reference The declared listed service used as an analogue for an unlisted service. cost-evidence Cost evidence Evidence supporting material, laboratory, or other reimbursable costs. approved-plan Approved plan An approved treatment or cost plan and its entitlement-relevant findings. volume Volume An accumulated count, value, or quota for the declared counting subject and window. treatment-episode Treatment episode The start, end, and continuity of the treatment episode a service …
code system.url:
  value: https://fhir.cognovis.de/praxis/CodeSystem/billing-required-fact
code system.identifier:
  index: 0
  identifier.system:
    value: urn:ietf:rfc:3986
  identifier.value:
    value: urn:oid:2.16.840.1.113883.3.7985.16.19
code system.version:
  value: 1
code system.name:
  value: BillingRequiredFactCS
code system.title:
  value: Billing Required Fact
code system.status:
  value: active
code system.experimental:
  value: false
code system.date:
  value: 2026-08-22T18:18:46+02:00
code system.publisher:
  value: cognovis GmbH
code system.contact:
  index: 0
  contact detail.name:
    value: cognovis GmbH
  contact detail.telecom:
    index: 0
    contact point.system:
      value: url
    contact point.value:
      value: https://www.cognovis.de
  contact detail.telecom:
    index: 1
    contact point.system:
      value: email
code system.description:
  value: Fact categories that a billing-rule evaluator may require from its caller.
code system.jurisdiction:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: urn:iso:std:iso:3166
    coding.code:
      value: DE
code system.copyright:
  value: Copyright 2026+ cognovis GmbH. Cognovis-authored material is licensed under Apache-2.0; third-party material retains its own terms as documented in THIRD_PARTY_NOTICES.md.
code system.case sensitive:
  value: true
code system.content:
  value: complete
code system.count:
  value: 19
code system.concept:
  index: 0
  code system.concept.code:
    value: service-occurrence
  code system.concept.display:
    value: Service occurrence
  code system.concept.definition:
    value: An occurrence of a billed or previously rendered service.
code system.concept:
  index: 1
  code system.concept.code:
    value: service-value
  code system.concept.display:
    value: Service value
  code system.concept.definition:
    value: A monetary, point, duration, quantity, or factor value attached to a service.
code system.concept:
  index: 2
  code system.concept.code:
    value: diagnosis
  code system.concept.display:
    value: Diagnosis
  code system.concept.definition:
    value: A diagnosis and its relevant status, certainty, site, and time context.
code system.concept:
  index: 3
  code system.concept.code:
    value: procedure
  code system.concept.display:
    value: Procedure
  code system.concept.definition:
    value: A documented procedure and its time and site context.
code system.concept:
  index: 4
  code system.concept.code:
    value: finding
  code system.concept.display:
    value: Finding
  code system.concept.definition:
    value: A documented clinical or administrative finding or measurement.
code system.concept:
  index: 5
  code system.concept.code:
    value: patient-attribute
  code system.concept.display:
    value: Patient attribute
  code system.concept.definition:
    value: A demographic or status attribute of the patient.
code system.concept:
  index: 6
  code system.concept.code:
    value: provider-eligibility
  code system.concept.display:
    value: Provider eligibility
  code system.concept.definition:
    value: A specialty, authorization, role, or relationship fact that establishes whether a provider may render or bill the service.
code system.concept:
  index: 7
  code system.concept.code:
    value: care-setting
  code system.concept.display:
    value: Care setting
  code system.concept.definition:
    value: A place, case type, care setting, time, or treatment-kind fact.
code system.concept:
  index: 8
  code system.concept.code:
    value: contract-participation
  code system.concept.display:
    value: Contract participation
  code system.concept.definition:
    value: A patient, provider, or practice enrollment in a contract or module.
code system.concept:
  index: 9
  code system.concept.code:
    value: accompanying-information
  code system.concept.display:
    value: Accompanying information
  code system.concept.definition:
    value: A structured field, justification, report, or itemized cost record.
code system.concept:
  index: 10
  code system.concept.code:
    value: prior-authorization
  code system.concept.display:
    value: Prior authorization
  code system.concept.definition:
    value: An applicable approved plan or authorization.
code system.concept:
  index: 11
  code system.concept.code:
    value: patient-agreement
  code system.concept.display:
    value: Patient agreement
  code system.concept.definition:
    value: An applicable agreement signed or accepted by the patient.
code system.concept:
  index: 12
  code system.concept.code:
    value: billing-factor
  code system.concept.display:
    value: Billing factor
  code system.concept.definition:
    value: The factor or multiplier applied to a billed item.
code system.concept:
  index: 13
  code system.concept.code:
    value: analogue-reference
  code system.concept.display:
    value: Analogue reference
  code system.concept.definition:
    value: The declared listed service used as an analogue for an unlisted service.
code system.concept:
  index: 14
  code system.concept.code:
    value: cost-evidence
  code system.concept.display:
    value: Cost evidence
  code system.concept.definition:
    value: Evidence supporting material, laboratory, or other reimbursable costs.
code system.concept:
  index: 15
  code system.concept.code:
    value: approved-plan
  code system.concept.display:
    value: Approved plan
  code system.concept.definition:
    value: An approved treatment or cost plan and its entitlement-relevant findings.
code system.concept:
  index: 16
  code system.concept.code:
    value: volume
  code system.concept.display:
    value: Volume
  code system.concept.definition:
    value: An accumulated count, value, or quota for the declared counting subject and window.
code system.concept:
  index: 17
  code system.concept.code:
    value: treatment-episode

value: Treatment episode

value: The start, end, and continuity of the treatment episode a service belongs to, used to place the service inside an episode-relative counting window.

index: 18
code system.concept.code:
  value: provider-specialty-group
code system.concept.display:
  value: Provider specialty group
code system.concept.definition:
  value: The grouping identity of the rendering provider: the specialty group or the care sector the provider belongs to. It is used to group providers for counting and to condition rules on that grouping, including rules that apply differently in an organisation spanning more than one care sector. The applicable values arrive as parameters and are never enumerated by this concept. It is grouping identity and does not assert that the provider is eligible to render or bill the service.