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

: Billing Rule Result Reason - 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-reason> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "billing-rule-reason"] ;
  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-reason</b></p><a name=\"billing-rule-reason\"> </a><a name=\"hcbilling-rule-reason\"> </a><p>This case-sensitive code system <code>https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-reason</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\">RULES_UNAVAILABLE<a name=\"billing-rule-reason-RULES_UNAVAILABLE\"> </a></td><td>Rules unavailable</td><td>No readable rule corpus is available for the applicable catalog scope.</td></tr><tr><td style=\"white-space:nowrap\">RULESET_STALE<a name=\"billing-rule-reason-RULESET_STALE\"> </a></td><td>Ruleset stale</td><td>The available ruleset is outside its accepted freshness or effective-period contract.</td></tr><tr><td style=\"white-space:nowrap\">RULESET_PARTIAL<a name=\"billing-rule-reason-RULESET_PARTIAL\"> </a></td><td>Ruleset partial</td><td>The available ruleset declares partial structured coverage.</td></tr><tr><td style=\"white-space:nowrap\">RULESET_UNSUPPORTED<a name=\"billing-rule-reason-RULESET_UNSUPPORTED\"> </a></td><td>Ruleset unsupported</td><td>The ruleset schema or semantic version is unsupported.</td></tr><tr><td style=\"white-space:nowrap\">RULE_CLASS_UNSUPPORTED<a name=\"billing-rule-reason-RULE_CLASS_UNSUPPORTED\"> </a></td><td>Rule class unsupported</td><td>The evaluator does not support the declared rule class semantic major.</td></tr><tr><td style=\"white-space:nowrap\">RULE_PARAMETER_UNSUPPORTED<a name=\"billing-rule-reason-RULE_PARAMETER_UNSUPPORTED\"> </a></td><td>Rule parameter unsupported</td><td>The evaluator does not support a declared must-understand parameter.</td></tr><tr><td style=\"white-space:nowrap\">SOURCE_COVERAGE_INCOMPLETE<a name=\"billing-rule-reason-SOURCE_COVERAGE_INCOMPLETE\"> </a></td><td>Source coverage incomplete</td><td>The source manifest declares a must-understand structured or prose coverage gap.</td></tr><tr><td style=\"white-space:nowrap\">SERVICE_DATE_UNRESOLVED<a name=\"billing-rule-reason-SERVICE_DATE_UNRESOLVED\"> </a></td><td>Service date unresolved</td><td>No unambiguous ruleset version can be resolved for the service date.</td></tr><tr><td style=\"white-space:nowrap\">REQUIRED_FACT_NOT_SUPPLIED<a name=\"billing-rule-reason-REQUIRED_FACT_NOT_SUPPLIED\"> </a></td><td>Required fact not supplied</td><td>The caller did not supply a fact required by the rule.</td></tr><tr><td style=\"white-space:nowrap\">REQUIRED_FACT_SOURCE_UNAVAILABLE<a name=\"billing-rule-reason-REQUIRED_FACT_SOURCE_UNAVAILABLE\"> </a></td><td>Required fact source unavailable</td><td>The source needed to determine a required fact is unavailable.</td></tr><tr><td style=\"white-space:nowrap\">RULE_VIOLATION<a name=\"billing-rule-reason-RULE_VIOLATION\"> </a></td><td>Rule violation</td><td>The evaluated facts violate the declared rule.</td></tr><tr><td style=\"white-space:nowrap\">RULE_REQUIREMENT_UNMET<a name=\"billing-rule-reason-RULE_REQUIREMENT_UNMET\"> </a></td><td>Rule requirement unmet</td><td>A declared approval, agreement, companion, documentation, or other requirement is unmet.</td></tr><tr><td style=\"white-space:nowrap\">RULE_ADVISORY<a name=\"billing-rule-reason-RULE_ADVISORY\"> </a></td><td>Rule advisory</td><td>The rule produced a non-blocking advisory result.</td></tr></table></div>"
  ] ;
  fhir:CodeSystem.url [ fhir:value "https://fhir.cognovis.de/praxis/CodeSystem/billing-rule-reason"] ;
  fhir:CodeSystem.identifier [
     fhir:index 0 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:2.16.840.1.113883.3.7985.16.22" ]
  ] ;
  fhir:CodeSystem.version [ fhir:value "1"] ;
  fhir:CodeSystem.name [ fhir:value "BillingRuleReasonCS"] ;
  fhir:CodeSystem.title [ fhir:value "Billing Rule Result Reason"] ;
  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 "Stable machine-readable reasons for source-neutral billing-rule outcomes."] ;
  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 "13"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index 0 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULES_UNAVAILABLE" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Rules unavailable" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "No readable rule corpus is available for the applicable catalog scope." ]
  ], [
     fhir:index 1 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULESET_STALE" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Ruleset stale" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The available ruleset is outside its accepted freshness or effective-period contract." ]
  ], [
     fhir:index 2 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULESET_PARTIAL" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Ruleset partial" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The available ruleset declares partial structured coverage." ]
  ], [
     fhir:index 3 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULESET_UNSUPPORTED" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Ruleset unsupported" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The ruleset schema or semantic version is unsupported." ]
  ], [
     fhir:index 4 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULE_CLASS_UNSUPPORTED" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Rule class unsupported" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The evaluator does not support the declared rule class semantic major." ]
  ], [
     fhir:index 5 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULE_PARAMETER_UNSUPPORTED" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Rule parameter unsupported" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The evaluator does not support a declared must-understand parameter." ]
  ], [
     fhir:index 6 ;
     fhir:CodeSystem.concept.code [ fhir:value "SOURCE_COVERAGE_INCOMPLETE" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Source coverage incomplete" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The source manifest declares a must-understand structured or prose coverage gap." ]
  ], [
     fhir:index 7 ;
     fhir:CodeSystem.concept.code [ fhir:value "SERVICE_DATE_UNRESOLVED" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Service date unresolved" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "No unambiguous ruleset version can be resolved for the service date." ]
  ], [
     fhir:index 8 ;
     fhir:CodeSystem.concept.code [ fhir:value "REQUIRED_FACT_NOT_SUPPLIED" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Required fact not supplied" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The caller did not supply a fact required by the rule." ]
  ], [
     fhir:index 9 ;
     fhir:CodeSystem.concept.code [ fhir:value "REQUIRED_FACT_SOURCE_UNAVAILABLE" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Required fact source unavailable" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The source needed to determine a required fact is unavailable." ]
  ], [
     fhir:index 10 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULE_VIOLATION" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Rule violation" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The evaluated facts violate the declared rule." ]
  ], [
     fhir:index 11 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULE_REQUIREMENT_UNMET" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Rule requirement unmet" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "A declared approval, agreement, companion, documentation, or other requirement is unmet." ]
  ], [
     fhir:index 12 ;
     fhir:CodeSystem.concept.code [ fhir:value "RULE_ADVISORY" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Rule advisory" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The rule produced a non-blocking advisory result." ]
  ] .

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

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