German Practice Management FHIR Profiles (R4)
Version 0.99.1 - release

: Billing Rule Effect - TTL Representation

Active as of 2026-08-22

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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/CodeSystem/billing-rule-effect> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "billing-rule-effect"] ;
  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: CodeSystem billing-rule-effect</b></p><a name=\"billing-rule-effect\"> </a><a name=\"hcbilling-rule-effect\"> </a><p>This case-sensitive code system <code>https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-effect</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">reject<a name=\"billing-rule-effect-reject\"> </a></td><td>Reject</td><td>The billed item is non-conformant and must be rejected or corrected.</td></tr><tr><td style=\"white-space:nowrap\">requires-justification<a name=\"billing-rule-effect-requires-justification\"> </a></td><td>Requires justification</td><td>The billed item requires a documented justification.</td></tr><tr><td style=\"white-space:nowrap\">requires-approval<a name=\"billing-rule-effect-requires-approval\"> </a></td><td>Requires approval</td><td>The billed item requires an applicable approval or authorization.</td></tr><tr><td style=\"white-space:nowrap\">requires-agreement<a name=\"billing-rule-effect-requires-agreement\"> </a></td><td>Requires agreement</td><td>The billed item requires an applicable patient or contractual agreement.</td></tr><tr><td style=\"white-space:nowrap\">replace-code<a name=\"billing-rule-effect-replace-code\"> </a></td><td>Replace code</td><td>The billed item must be replaced by a declared alternative code.</td></tr><tr><td style=\"white-space:nowrap\">price-adjust<a name=\"billing-rule-effect-price-adjust\"> </a></td><td>Price adjustment</td><td>The rule changes the applicable price, points, factor, or valuation.</td></tr><tr><td style=\"white-space:nowrap\">advisory<a name=\"billing-rule-effect-advisory\"> </a></td><td>Advisory</td><td>The rule produces a non-blocking advisory finding.</td></tr><tr><td style=\"white-space:nowrap\">reporting-only<a name=\"billing-rule-effect-reporting-only\"> </a></td><td>Reporting only</td><td>The rule produces a reporting obligation without changing billability.</td></tr></table></div>"
  ] ;
  fhir:CodeSystem.url [ fhir:value "https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-effect"] ;
  fhir:CodeSystem.identifier [
     fhir:index 0 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.3.7985.16.21" ]
  ] ;
  fhir:CodeSystem.version [ fhir:value "1"] ;
  fhir:CodeSystem.name [ fhir:value "BillingRuleEffectCS"] ;
  fhir:CodeSystem.title [ fhir:value "Billing Rule Effect"] ;
  fhir:CodeSystem.status [ fhir:value "active"] ;
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-08-22T18:18:46+02:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "cognovis GmbH"] ;
  fhir:CodeSystem.contact [
     fhir:index 0 ;
     fhir:ContactDetail.name [ fhir:value "cognovis GmbH" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://www.cognovis.de" ]
     ], [
       fhir:index 1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "info@cognovis.de" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "Observable effects produced when a declarative billing rule matches or is violated."] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index 0 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "DE" ]
     ]
  ] ;
  fhir:CodeSystem.copyright [ fhir: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."] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "8"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index 0 ;
     fhir:CodeSystem.concept.code [ fhir:value "reject" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Reject" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The billed item is non-conformant and must be rejected or corrected." ]
  ], [
     fhir:index 1 ;
     fhir:CodeSystem.concept.code [ fhir:value "requires-justification" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Requires justification" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The billed item requires a documented justification." ]
  ], [
     fhir:index 2 ;
     fhir:CodeSystem.concept.code [ fhir:value "requires-approval" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Requires approval" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The billed item requires an applicable approval or authorization." ]
  ], [
     fhir:index 3 ;
     fhir:CodeSystem.concept.code [ fhir:value "requires-agreement" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Requires agreement" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The billed item requires an applicable patient or contractual agreement." ]
  ], [
     fhir:index 4 ;
     fhir:CodeSystem.concept.code [ fhir:value "replace-code" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Replace code" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The billed item must be replaced by a declared alternative code." ]
  ], [
     fhir:index 5 ;
     fhir:CodeSystem.concept.code [ fhir:value "price-adjust" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Price adjustment" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The rule changes the applicable price, points, factor, or valuation." ]
  ], [
     fhir:index 6 ;
     fhir:CodeSystem.concept.code [ fhir:value "advisory" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Advisory" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The rule produces a non-blocking advisory finding." ]
  ], [
     fhir:index 7 ;
     fhir:CodeSystem.concept.code [ fhir:value "reporting-only" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Reporting only" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The rule produces a reporting obligation without changing billability." ]
  ] .

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

<http://hl7.org/fhir/CodeSystem/billing-rule-effect.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/billing-rule-effect.ttl> .