Data Management with FHIR - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: RUM du PMSI MCO

Profil pour les Résumés d'Unité Médicale (RUM) du PMSI MCO.

Usages:

• This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Nom	Drapeaux	Card.	Type	Description et contraintes    Filter: Bindings Constraints Obligations
Claim		0..*	DMClaimPMSIMCO	Claim, Pre-determination or Pre-authorization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices pour extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:DRG		0..1	(Complex)	Groupe Homogène de Malade URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DRG
extension:ItemRank		1..1	positiveInt	Ordre des Item dans un claim URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/ItemRank
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Champ du PMSI concerné. Binding: ValueSet des type fr des claims (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PMSIMCO
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subType		1..1	CodeableConcept	More granular claim type Binding: ValueSet des type fr des claims (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RUM
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
use	Σ	1..1	code	claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: claim
patient	Σ	1..1	Reference(Patient)	The recipient of the products and services
billablePeriod	SΣ	0..1	Period	Relevant time frame for the claim
start	ΣC	0..1	dateTime	date d'entrée dans la première unité médicale visitée
end	ΣC	0..1	dateTime	date de sortie de la dernière unité médicale visitée
created	Σ	1..1	dateTime	Resource creation date
provider	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization)	Entité juridique émettrice
priority	Σ	1..1	CodeableConcept	Desired processing ugency Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: normal
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices pour diagnosis	S	1..*	BackboneElement	Pertinent diagnosis information Slice: Unordered, Open by value:type
diagnosis:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1		Nature of illness or problem Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
diagnosis:dp	S	1..1	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Principal)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DP
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
diagnosis:dr	S	0..1	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagonstic Relié)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DR
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
diagnosis:da	S	0..*	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Associé Significatif)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DA
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
diagnosis:dad	S	0..*	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 pour le PMSI (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Associé Documentaire)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DAD
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
procedure	S	0..*	BackboneElement	Clinical procedures performed
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Procedure instance identifier
procedure[x]		1..1	CodeableConcept	Specific clinical procedure Binding: Actes CCAM pour le PMSI (required)
insurance	Σ	1..*	BackboneElement	Patient insurance information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	1..1	positiveInt	Insurance instance identifier Required Pattern: 1
focal	Σ	1..1	boolean	Coverage to be used for adjudication Required Pattern: true
coverage	Σ	1..1	Reference(Coverage)	Insurance information
display	Σ	1..1	string	Text alternative for the resource Required Pattern: Assurance Maladie
Slices pour item		0..*	BackboneElement	Product or service provided Slice: Unordered, Open by value:category
item:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
category		0..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required)
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
item:RUMGrouped	S	0..1	BackboneElement	Product or service provided
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
category		1..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Liste des GHM pour le PMSI MCO (extensible)
Slices pour modifier		2..*	CodeableConcept	Product or service billing modifiers Slice: Unordered, Open by value:coding.system Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
modifier:MDE	S	1..1	CodeableConcept	Mode d'entrée du patient Binding: Mode d'entré du PMSI MCO (required)
modifier:MDS	S	1..1	CodeableConcept	Mode de sortie du patient Binding: Mode de sortie du PMSI MCO (required)
item:CCAMProcedure	S	0..*	BackboneElement	Product or service provided
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
category		1..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Actes CCAM pour le PMSI (extensible)
Documentation for this format

Terminology Bindings

Path	Statut	Usage	ValueSet	Version	Source
Claim.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Claim.type	Base	required	ValueSet des type fr des claims	📦0.1.0	This IG
Claim.subType	Base	required	ValueSet des type fr des claims	📦0.1.0	This IG
Claim.use	Base	required	Use	📍4.0.1	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dp.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dp.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dr.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dr.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:da.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:da.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dad.​diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 pour le PMSI	📦0.1.0	This IG
Claim.diagnosis:dad.​type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.procedure.procedure[x]	Base	required	Actes CCAM pour le PMSI	📦0.1.0	This IG
Claim.item.category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​productOrService	Base	extensible	Liste des GHM pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​modifier:MDE	Base	required	Mode d'entré du PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier:MDS	Base	required	Mode de sortie du PMSI MCO	📦0.1.0	This IG
Claim.item:CCAMProcedure.​category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:CCAMProcedure.​productOrService	Base	extensible	Actes CCAM pour le PMSI	📦0.1.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from DMClaimPMSIMCO

Nom	Drapeaux	Card.	Type	Description et contraintes    Filter: Bindings Constraints Obligations
Claim		0..*	DMClaimPMSIMCO	Claim, Pre-determination or Pre-authorization
Slices pour extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:DRG		0..1	(Complex)	Groupe Homogène de Malade URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DRG
extension:ItemRank		1..1	positiveInt	Ordre des Item dans un claim URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/ItemRank
subType		1..1	CodeableConcept	More granular claim type Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RUM
billablePeriod	S	0..1	Period	Relevant time frame for the claim
start		0..1	dateTime	date d'entrée dans la première unité médicale visitée
end		0..1	dateTime	date de sortie de la dernière unité médicale visitée
Slices pour diagnosis	S	1..*	BackboneElement	Pertinent diagnosis information Slice: Unordered, Open by value:type
diagnosis:dp	S	1..1	BackboneElement	Pertinent diagnosis information
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Fixed Value: As shown (Diagnostic Principal)
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DP
diagnosis:dr	S	0..1	BackboneElement	Pertinent diagnosis information
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Fixed Value: As shown (Diagonstic Relié)
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DR
diagnosis:da	S	0..*	BackboneElement	Pertinent diagnosis information
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Fixed Value: As shown (Diagnostic Associé Significatif)
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DA
diagnosis:dad	S	0..*	BackboneElement	Pertinent diagnosis information
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 pour le PMSI (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Fixed Value: As shown (Diagnostic Associé Documentaire)
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DAD
procedure	S	0..*	BackboneElement	Clinical procedures performed
procedure[x]		1..1	CodeableConcept	Specific clinical procedure Binding: Actes CCAM pour le PMSI (required)
Slices pour item		0..*	BackboneElement	Product or service provided Slice: Unordered, Open by value:category
item:All Slices				Content/Rules for all slices
category		0..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required)
item:RUMGrouped	S	0..1	BackboneElement	Product or service provided
category		1..1	CodeableConcept	Benefit classification Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Liste des GHM pour le PMSI MCO (extensible)
Slices pour modifier		2..*	CodeableConcept	Product or service billing modifiers Slice: Unordered, Open by value:coding.system
modifier:MDE	S	1..1	CodeableConcept	Mode d'entrée du patient Binding: Mode d'entré du PMSI MCO (required)
coding
system		1..1	uri	Identity of the terminology system Required Pattern: https://aphp.fr/ig/fhir/core/CodeSystem/PMSIMCOMDE
modifier:MDS	S	1..1	CodeableConcept	Mode de sortie du patient Binding: Mode de sortie du PMSI MCO (required)
coding
system		1..1	uri	Identity of the terminology system Required Pattern: https://aphp.fr/ig/fhir/core/CodeSystem/PMSIMCOMDS
item:CCAMProcedure	S	0..*	BackboneElement	Product or service provided
category		1..1	CodeableConcept	Benefit classification Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Actes CCAM pour le PMSI (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Statut	Usage	ValueSet	Version	Source
Claim.diagnosis:dp.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dr.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:da.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dad.​diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 pour le PMSI	📦0.1.0	This IG
Claim.procedure.procedure[x]	Base	required	Actes CCAM pour le PMSI	📦0.1.0	This IG
Claim.item.category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​productOrService	Base	extensible	Liste des GHM pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier:MDE	Base	required	Mode d'entré du PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier:MDS	Base	required	Mode de sortie du PMSI MCO	📦0.1.0	This IG
Claim.item:CCAMProcedure.​productOrService	Base	extensible	Actes CCAM pour le PMSI	📦0.1.0	This IG

Nom	Drapeaux	Card.	Type	Description et contraintes    Filter: Bindings Constraints Obligations
Claim		0..*	DMClaimPMSIMCO	Claim, Pre-determination or Pre-authorization
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Bindings Additionnels But AllLanguages Binding Max
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices pour extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:DRG		0..1	(Complex)	Groupe Homogène de Malade URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DRG
extension:ItemRank		1..1	positiveInt	Ordre des Item dans un claim URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/ItemRank
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business Identifier for claim
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Champ du PMSI concerné. Binding: ValueSet des type fr des claims (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PMSIMCO
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subType		1..1	CodeableConcept	More granular claim type Binding: ValueSet des type fr des claims (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RUM
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
use	Σ	1..1	code	claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: claim
patient	Σ	1..1	Reference(Patient)	The recipient of the products and services
billablePeriod	SΣ	0..1	Period	Relevant time frame for the claim
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	0..1	dateTime	date d'entrée dans la première unité médicale visitée
end	ΣC	0..1	dateTime	date de sortie de la dernière unité médicale visitée
created	Σ	1..1	dateTime	Resource creation date
enterer		0..1	Reference(Practitioner | PractitionerRole)	Author of the claim
insurer	Σ	0..1	Reference(Organization)	Target
provider	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization)	Entité juridique émettrice
priority	Σ	1..1	CodeableConcept	Desired processing ugency Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: normal
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
fundsReserve		0..1	CodeableConcept	For whom to reserve funds Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
related		0..*	BackboneElement	Prior or corollary claims
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
claim		0..1	Reference(Claim)	Reference to the related claim
relationship		0..1	CodeableConcept	How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
reference		0..1	Identifier	File or case reference
prescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Prescription authorizing services and products
originalPrescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Original prescription if superseded by fulfiller
payee		0..1	BackboneElement	Recipient of benefits payable
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	Category of recipient Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
party		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)	Recipient reference
referral		0..1	Reference(ServiceRequest)	Treatment referral
facility		0..1	Reference(Location)	Servicing facility
careTeam		0..*	BackboneElement	Members of the care team
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Order of care team
provider		1..1	Reference(Practitioner | PractitionerRole | Organization)	Practitioner or organization
responsible		0..1	boolean	Indicator of the lead practitioner
role		0..1	CodeableConcept	Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
qualification		0..1	CodeableConcept	Practitioner credential or specialization Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.
supportingInfo		0..*	BackboneElement	Supporting information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Information instance identifier
category		1..1	CodeableConcept	Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
code		0..1	CodeableConcept	Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes.
timing[x]		0..1		When it occurred
timingDate			date
timingPeriod			Period
value[x]		0..1		Data to be provided
valueBoolean			boolean
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
reason		0..1	CodeableConcept	Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
Slices pour diagnosis	S	1..*	BackboneElement	Pertinent diagnosis information Slice: Unordered, Open by value:type
diagnosis:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1		Nature of illness or problem Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
type		0..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
diagnosis:dp	S	1..1	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Principal)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DP
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
diagnosis:dr	S	0..1	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagonstic Relié)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DR
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
diagnosis:da	S	0..*	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Associé Significatif)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DA
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
diagnosis:dad	S	0..*	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 pour le PMSI (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Associé Documentaire)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DAD
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
procedure	S	0..*	BackboneElement	Clinical procedures performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
date		0..1	dateTime	When the procedure was performed
procedure[x]		1..1	CodeableConcept	Specific clinical procedure Binding: Actes CCAM pour le PMSI (required)
udi		0..*	Reference(Device)	Unique device identifier
insurance	Σ	1..*	BackboneElement	Patient insurance information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	1..1	positiveInt	Insurance instance identifier Required Pattern: 1
focal	Σ	1..1	boolean	Coverage to be used for adjudication Required Pattern: true
identifier		0..1	Identifier	Pre-assigned Claim number
coverage	Σ	1..1	Reference(Coverage)	Insurance information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	1..1	string	Text alternative for the resource Required Pattern: Assurance Maladie
businessArrangement		0..1	string	Additional provider contract number
preAuthRef		0..*	string	Prior authorization reference number
claimResponse		0..1	Reference(ClaimResponse)	Adjudication results
accident		0..1	BackboneElement	Details of the event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date		1..1	date	When the incident occurred
type		0..1	CodeableConcept	The nature of the accident Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.
location[x]		0..1		Where the event occurred
locationAddress			Address
locationReference			Reference(Location)
Slices pour item		0..*	BackboneElement	Product or service provided Slice: Unordered, Open by value:category
item:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required)
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]		0..1		Date or dates of service or product delivery
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
bodySite		0..1	CodeableConcept	Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
subSite		0..*	CodeableConcept	Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
detail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
item:RUMGrouped	S	0..1	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		1..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Liste des GHM pour le PMSI MCO (extensible)
Slices pour modifier		2..*	CodeableConcept	Product or service billing modifiers Slice: Unordered, Open by value:coding.system Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
modifier:MDE	S	1..1	CodeableConcept	Mode d'entrée du patient Binding: Mode d'entré du PMSI MCO (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: https://aphp.fr/ig/fhir/core/CodeSystem/PMSIMCOMDE
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
modifier:MDS	S	1..1	CodeableConcept	Mode de sortie du patient Binding: Mode de sortie du PMSI MCO (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: https://aphp.fr/ig/fhir/core/CodeSystem/PMSIMCOMDS
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]		0..1		Date or dates of service or product delivery
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
bodySite		0..1	CodeableConcept	Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
subSite		0..*	CodeableConcept	Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
detail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
item:CCAMProcedure	S	0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		1..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Actes CCAM pour le PMSI (extensible)
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]		0..1		Date or dates of service or product delivery
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
bodySite		0..1	CodeableConcept	Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
subSite		0..*	CodeableConcept	Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
detail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
total		0..1	Money	Total claim cost
Documentation for this format

Terminology Bindings

Path	Statut	Usage	ValueSet	Version	Source
Claim.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Claim.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Claim.type	Base	required	ValueSet des type fr des claims	📦0.1.0	This IG
Claim.subType	Base	required	ValueSet des type fr des claims	📦0.1.0	This IG
Claim.use	Base	required	Use	📍4.0.1	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍4.0.1	FHIR Std.
Claim.fundsReserve	Base	example	FundsReserve	📍4.0.1	FHIR Std.
Claim.related.relationship	Base	example	Example Related Claim Relationship Codes	📍4.0.1	FHIR Std.
Claim.payee.type	Base	example	PayeeType	📍4.0.1	FHIR Std.
Claim.careTeam.role	Base	example	Claim Care Team Role Codes	📍4.0.1	FHIR Std.
Claim.careTeam.qualification	Base	example	Example Provider Qualification Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​category	Base	example	Claim Information Category Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​code	Base	example	Exception Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​reason	Base	example	Missing Tooth Reason Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dp.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dp.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dp.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dp.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dr.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dr.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dr.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dr.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:da.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:da.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:da.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:da.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dad.​diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 pour le PMSI	📦0.1.0	This IG
Claim.diagnosis:dad.​type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dad.​onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dad.​packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.procedure.type	Base	example	Example Procedure Type Codes	📍4.0.1	FHIR Std.
Claim.procedure.procedure[x]	Base	required	Actes CCAM pour le PMSI	📦0.1.0	This IG
Claim.insurance.coverage.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Claim.accident.type	Base	extensible	ActIncidentCode	📦3.0.0	THO v6.5
Claim.item.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item.location[x]	Base	example	Example Service Place Codes	📍4.0.1	FHIR Std.
Claim.item.bodySite	Base	example	Oral Site Codes	📍4.0.1	FHIR Std.
Claim.item.subSite	Base	example	Surface Codes	📍4.0.1	FHIR Std.
Claim.item.detail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.detail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item.detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.detail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​productOrService	Base	extensible	Liste des GHM pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​modifier:MDE	Base	required	Mode d'entré du PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier:MDS	Base	required	Mode de sortie du PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​location[x]	Base	example	Example Service Place Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​bodySite	Base	example	Oral Site Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​subSite	Base	example	Surface Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:CCAMProcedure.​productOrService	Base	extensible	Actes CCAM pour le PMSI	📦0.1.0	This IG
Claim.item:CCAMProcedure.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​location[x]	Base	example	Example Service Place Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​bodySite	Base	example	Oral Site Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​subSite	Base	example	Surface Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from DMClaimPMSIMCO

Résumé

Mandatory: 6 elements(9 nested mandatory elements)
Must-Support: 11 elements
Fixed: 4 elements

Extensions

This structure refers to these extensions:

• https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DRG
• https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/ItemRank

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Claim.diagnosis
• The element 1 is sliced based on the value of Claim.item
• The element 1 is sliced based on the value of Claim.item.modifier

Key Elements View

Nom	Drapeaux	Card.	Type	Description et contraintes    Filter: Bindings Constraints Obligations
Claim		0..*	DMClaimPMSIMCO	Claim, Pre-determination or Pre-authorization
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices pour extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:DRG		0..1	(Complex)	Groupe Homogène de Malade URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DRG
extension:ItemRank		1..1	positiveInt	Ordre des Item dans un claim URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/ItemRank
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Champ du PMSI concerné. Binding: ValueSet des type fr des claims (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PMSIMCO
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subType		1..1	CodeableConcept	More granular claim type Binding: ValueSet des type fr des claims (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RUM
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
use	Σ	1..1	code	claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: claim
patient	Σ	1..1	Reference(Patient)	The recipient of the products and services
billablePeriod	SΣ	0..1	Period	Relevant time frame for the claim
start	ΣC	0..1	dateTime	date d'entrée dans la première unité médicale visitée
end	ΣC	0..1	dateTime	date de sortie de la dernière unité médicale visitée
created	Σ	1..1	dateTime	Resource creation date
provider	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization)	Entité juridique émettrice
priority	Σ	1..1	CodeableConcept	Desired processing ugency Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: normal
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices pour diagnosis	S	1..*	BackboneElement	Pertinent diagnosis information Slice: Unordered, Open by value:type
diagnosis:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1		Nature of illness or problem Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
diagnosis:dp	S	1..1	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Principal)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DP
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
diagnosis:dr	S	0..1	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagonstic Relié)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DR
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
diagnosis:da	S	0..*	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Associé Significatif)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DA
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
diagnosis:dad	S	0..*	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 pour le PMSI (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Associé Documentaire)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DAD
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
procedure	S	0..*	BackboneElement	Clinical procedures performed
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Procedure instance identifier
procedure[x]		1..1	CodeableConcept	Specific clinical procedure Binding: Actes CCAM pour le PMSI (required)
insurance	Σ	1..*	BackboneElement	Patient insurance information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	1..1	positiveInt	Insurance instance identifier Required Pattern: 1
focal	Σ	1..1	boolean	Coverage to be used for adjudication Required Pattern: true
coverage	Σ	1..1	Reference(Coverage)	Insurance information
display	Σ	1..1	string	Text alternative for the resource Required Pattern: Assurance Maladie
Slices pour item		0..*	BackboneElement	Product or service provided Slice: Unordered, Open by value:category
item:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
category		0..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required)
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
item:RUMGrouped	S	0..1	BackboneElement	Product or service provided
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
category		1..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Liste des GHM pour le PMSI MCO (extensible)
Slices pour modifier		2..*	CodeableConcept	Product or service billing modifiers Slice: Unordered, Open by value:coding.system Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
modifier:MDE	S	1..1	CodeableConcept	Mode d'entrée du patient Binding: Mode d'entré du PMSI MCO (required)
modifier:MDS	S	1..1	CodeableConcept	Mode de sortie du patient Binding: Mode de sortie du PMSI MCO (required)
item:CCAMProcedure	S	0..*	BackboneElement	Product or service provided
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
category		1..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Actes CCAM pour le PMSI (extensible)
Documentation for this format

Terminology Bindings

Path	Statut	Usage	ValueSet	Version	Source
Claim.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Claim.type	Base	required	ValueSet des type fr des claims	📦0.1.0	This IG
Claim.subType	Base	required	ValueSet des type fr des claims	📦0.1.0	This IG
Claim.use	Base	required	Use	📍4.0.1	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dp.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dp.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dr.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dr.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:da.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:da.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dad.​diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 pour le PMSI	📦0.1.0	This IG
Claim.diagnosis:dad.​type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.procedure.procedure[x]	Base	required	Actes CCAM pour le PMSI	📦0.1.0	This IG
Claim.item.category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​productOrService	Base	extensible	Liste des GHM pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​modifier:MDE	Base	required	Mode d'entré du PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier:MDS	Base	required	Mode de sortie du PMSI MCO	📦0.1.0	This IG
Claim.item:CCAMProcedure.​category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:CCAMProcedure.​productOrService	Base	extensible	Actes CCAM pour le PMSI	📦0.1.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

Differential View

This structure is derived from DMClaimPMSIMCO

Nom	Drapeaux	Card.	Type	Description et contraintes    Filter: Bindings Constraints Obligations
Claim		0..*	DMClaimPMSIMCO	Claim, Pre-determination or Pre-authorization
Slices pour extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:DRG		0..1	(Complex)	Groupe Homogène de Malade URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DRG
extension:ItemRank		1..1	positiveInt	Ordre des Item dans un claim URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/ItemRank
subType		1..1	CodeableConcept	More granular claim type Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RUM
billablePeriod	S	0..1	Period	Relevant time frame for the claim
start		0..1	dateTime	date d'entrée dans la première unité médicale visitée
end		0..1	dateTime	date de sortie de la dernière unité médicale visitée
Slices pour diagnosis	S	1..*	BackboneElement	Pertinent diagnosis information Slice: Unordered, Open by value:type
diagnosis:dp	S	1..1	BackboneElement	Pertinent diagnosis information
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Fixed Value: As shown (Diagnostic Principal)
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DP
diagnosis:dr	S	0..1	BackboneElement	Pertinent diagnosis information
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Fixed Value: As shown (Diagonstic Relié)
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DR
diagnosis:da	S	0..*	BackboneElement	Pertinent diagnosis information
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Fixed Value: As shown (Diagnostic Associé Significatif)
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DA
diagnosis:dad	S	0..*	BackboneElement	Pertinent diagnosis information
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 pour le PMSI (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Fixed Value: As shown (Diagnostic Associé Documentaire)
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DAD
procedure	S	0..*	BackboneElement	Clinical procedures performed
procedure[x]		1..1	CodeableConcept	Specific clinical procedure Binding: Actes CCAM pour le PMSI (required)
Slices pour item		0..*	BackboneElement	Product or service provided Slice: Unordered, Open by value:category
item:All Slices				Content/Rules for all slices
category		0..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required)
item:RUMGrouped	S	0..1	BackboneElement	Product or service provided
category		1..1	CodeableConcept	Benefit classification Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Liste des GHM pour le PMSI MCO (extensible)
Slices pour modifier		2..*	CodeableConcept	Product or service billing modifiers Slice: Unordered, Open by value:coding.system
modifier:MDE	S	1..1	CodeableConcept	Mode d'entrée du patient Binding: Mode d'entré du PMSI MCO (required)
coding
system		1..1	uri	Identity of the terminology system Required Pattern: https://aphp.fr/ig/fhir/core/CodeSystem/PMSIMCOMDE
modifier:MDS	S	1..1	CodeableConcept	Mode de sortie du patient Binding: Mode de sortie du PMSI MCO (required)
coding
system		1..1	uri	Identity of the terminology system Required Pattern: https://aphp.fr/ig/fhir/core/CodeSystem/PMSIMCOMDS
item:CCAMProcedure	S	0..*	BackboneElement	Product or service provided
category		1..1	CodeableConcept	Benefit classification Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Actes CCAM pour le PMSI (extensible)
Documentation for this format

Terminology Bindings (Differential)

Path	Statut	Usage	ValueSet	Version	Source
Claim.diagnosis:dp.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dr.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:da.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dad.​diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 pour le PMSI	📦0.1.0	This IG
Claim.procedure.procedure[x]	Base	required	Actes CCAM pour le PMSI	📦0.1.0	This IG
Claim.item.category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​productOrService	Base	extensible	Liste des GHM pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier:MDE	Base	required	Mode d'entré du PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier:MDS	Base	required	Mode de sortie du PMSI MCO	📦0.1.0	This IG
Claim.item:CCAMProcedure.​productOrService	Base	extensible	Actes CCAM pour le PMSI	📦0.1.0	This IG

Snapshot View

Nom	Drapeaux	Card.	Type	Description et contraintes    Filter: Bindings Constraints Obligations
Claim		0..*	DMClaimPMSIMCO	Claim, Pre-determination or Pre-authorization
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Bindings Additionnels But AllLanguages Binding Max
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices pour extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:DRG		0..1	(Complex)	Groupe Homogène de Malade URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DRG
extension:ItemRank		1..1	positiveInt	Ordre des Item dans un claim URL: https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/ItemRank
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business Identifier for claim
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Champ du PMSI concerné. Binding: ValueSet des type fr des claims (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PMSIMCO
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subType		1..1	CodeableConcept	More granular claim type Binding: ValueSet des type fr des claims (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrClaimType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: RUM
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
use	Σ	1..1	code	claim | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: claim
patient	Σ	1..1	Reference(Patient)	The recipient of the products and services
billablePeriod	SΣ	0..1	Period	Relevant time frame for the claim
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	ΣC	0..1	dateTime	date d'entrée dans la première unité médicale visitée
end	ΣC	0..1	dateTime	date de sortie de la dernière unité médicale visitée
created	Σ	1..1	dateTime	Resource creation date
enterer		0..1	Reference(Practitioner | PractitionerRole)	Author of the claim
insurer	Σ	0..1	Reference(Organization)	Target
provider	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization)	Entité juridique émettrice
priority	Σ	1..1	CodeableConcept	Desired processing ugency Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: normal
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
fundsReserve		0..1	CodeableConcept	For whom to reserve funds Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
related		0..*	BackboneElement	Prior or corollary claims
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
claim		0..1	Reference(Claim)	Reference to the related claim
relationship		0..1	CodeableConcept	How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
reference		0..1	Identifier	File or case reference
prescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Prescription authorizing services and products
originalPrescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Original prescription if superseded by fulfiller
payee		0..1	BackboneElement	Recipient of benefits payable
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	Category of recipient Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
party		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)	Recipient reference
referral		0..1	Reference(ServiceRequest)	Treatment referral
facility		0..1	Reference(Location)	Servicing facility
careTeam		0..*	BackboneElement	Members of the care team
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Order of care team
provider		1..1	Reference(Practitioner | PractitionerRole | Organization)	Practitioner or organization
responsible		0..1	boolean	Indicator of the lead practitioner
role		0..1	CodeableConcept	Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
qualification		0..1	CodeableConcept	Practitioner credential or specialization Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.
supportingInfo		0..*	BackboneElement	Supporting information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Information instance identifier
category		1..1	CodeableConcept	Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
code		0..1	CodeableConcept	Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes.
timing[x]		0..1		When it occurred
timingDate			date
timingPeriod			Period
value[x]		0..1		Data to be provided
valueBoolean			boolean
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
reason		0..1	CodeableConcept	Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
Slices pour diagnosis	S	1..*	BackboneElement	Pertinent diagnosis information Slice: Unordered, Open by value:type
diagnosis:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1		Nature of illness or problem Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
type		0..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
diagnosis:dp	S	1..1	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Principal)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DP
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
diagnosis:dr	S	0..1	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagonstic Relié)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DR
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
diagnosis:da	S	0..*	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Associé Significatif)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DA
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
diagnosis:dad	S	0..*	BackboneElement	Pertinent diagnosis information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Diagnosis instance identifier
diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Binding: Liste des diagnostiques CIM-10 pour le PMSI (required)
type		1..*	CodeableConcept	Timing or nature of the diagnosis Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge. Fixed Value: As shown (Diagnostic Associé Documentaire)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
coding		1..1	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..0	string	Unique id for inter-element referencing
extension		0..0	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/PMSIMCODiagType
version		0..0	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: DAD
display		0..0	string	Representation defined by the system
userSelected		0..0	boolean	If this coding was chosen directly by the user
text		0..0	string	Plain text representation of the concept
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
procedure	S	0..*	BackboneElement	Clinical procedures performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
date		0..1	dateTime	When the procedure was performed
procedure[x]		1..1	CodeableConcept	Specific clinical procedure Binding: Actes CCAM pour le PMSI (required)
udi		0..*	Reference(Device)	Unique device identifier
insurance	Σ	1..*	BackboneElement	Patient insurance information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	1..1	positiveInt	Insurance instance identifier Required Pattern: 1
focal	Σ	1..1	boolean	Coverage to be used for adjudication Required Pattern: true
identifier		0..1	Identifier	Pre-assigned Claim number
coverage	Σ	1..1	Reference(Coverage)	Insurance information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	1..1	string	Text alternative for the resource Required Pattern: Assurance Maladie
businessArrangement		0..1	string	Additional provider contract number
preAuthRef		0..*	string	Prior authorization reference number
claimResponse		0..1	Reference(ClaimResponse)	Adjudication results
accident		0..1	BackboneElement	Details of the event
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date		1..1	date	When the incident occurred
type		0..1	CodeableConcept	The nature of the accident Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.
location[x]		0..1		Where the event occurred
locationAddress			Address
locationReference			Reference(Location)
Slices pour item		0..*	BackboneElement	Product or service provided Slice: Unordered, Open by value:category
item:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required)
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]		0..1		Date or dates of service or product delivery
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
bodySite		0..1	CodeableConcept	Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
subSite		0..*	CodeableConcept	Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
detail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
item:RUMGrouped	S	0..1	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		1..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Liste des GHM pour le PMSI MCO (extensible)
Slices pour modifier		2..*	CodeableConcept	Product or service billing modifiers Slice: Unordered, Open by value:coding.system Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
modifier:MDE	S	1..1	CodeableConcept	Mode d'entrée du patient Binding: Mode d'entré du PMSI MCO (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: https://aphp.fr/ig/fhir/core/CodeSystem/PMSIMCOMDE
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
modifier:MDS	S	1..1	CodeableConcept	Mode de sortie du patient Binding: Mode de sortie du PMSI MCO (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: https://aphp.fr/ig/fhir/core/CodeSystem/PMSIMCOMDS
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]		0..1		Date or dates of service or product delivery
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
bodySite		0..1	CodeableConcept	Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
subSite		0..*	CodeableConcept	Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
detail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
item:CCAMProcedure	S	0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		1..1	CodeableConcept	Benefit classification Binding: Categorisation des items de claim pour le PMSI MCO (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://interop.aphp.fr/ig/fhir/dm/CodeSystem/FrMCOClaimItemCategory
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: Actes CCAM pour le PMSI (extensible)
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]		0..1		Date or dates of service or product delivery
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
bodySite		0..1	CodeableConcept	Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
subSite		0..*	CodeableConcept	Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
detail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
total		0..1	Money	Total claim cost
Documentation for this format

Terminology Bindings

Path	Statut	Usage	ValueSet	Version	Source
Claim.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Claim.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Claim.type	Base	required	ValueSet des type fr des claims	📦0.1.0	This IG
Claim.subType	Base	required	ValueSet des type fr des claims	📦0.1.0	This IG
Claim.use	Base	required	Use	📍4.0.1	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍4.0.1	FHIR Std.
Claim.fundsReserve	Base	example	FundsReserve	📍4.0.1	FHIR Std.
Claim.related.relationship	Base	example	Example Related Claim Relationship Codes	📍4.0.1	FHIR Std.
Claim.payee.type	Base	example	PayeeType	📍4.0.1	FHIR Std.
Claim.careTeam.role	Base	example	Claim Care Team Role Codes	📍4.0.1	FHIR Std.
Claim.careTeam.qualification	Base	example	Example Provider Qualification Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​category	Base	example	Claim Information Category Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​code	Base	example	Exception Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​reason	Base	example	Missing Tooth Reason Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dp.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DP pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dp.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dp.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dp.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dr.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DR pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:dr.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dr.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dr.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:da.diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 acceptable en DA pour les PMSI MCO et HAD	📦0.1.0	This IG
Claim.diagnosis:da.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:da.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:da.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dad.​diagnosis[x]	Base	required	Liste des diagnostiques CIM-10 pour le PMSI	📦0.1.0	This IG
Claim.diagnosis:dad.​type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dad.​onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis:dad.​packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.procedure.type	Base	example	Example Procedure Type Codes	📍4.0.1	FHIR Std.
Claim.procedure.procedure[x]	Base	required	Actes CCAM pour le PMSI	📦0.1.0	This IG
Claim.insurance.coverage.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Claim.accident.type	Base	extensible	ActIncidentCode	📦3.0.0	THO v6.5
Claim.item.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item.location[x]	Base	example	Example Service Place Codes	📍4.0.1	FHIR Std.
Claim.item.bodySite	Base	example	Oral Site Codes	📍4.0.1	FHIR Std.
Claim.item.subSite	Base	example	Surface Codes	📍4.0.1	FHIR Std.
Claim.item.detail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.detail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item.detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.detail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​productOrService	Base	extensible	Liste des GHM pour le PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​modifier:MDE	Base	required	Mode d'entré du PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​modifier:MDS	Base	required	Mode de sortie du PMSI MCO	📦0.1.0	This IG
Claim.item:RUMGrouped.​programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​location[x]	Base	example	Example Service Place Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​bodySite	Base	example	Oral Site Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​subSite	Base	example	Surface Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:RUMGrouped.​detail.subDetail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​category	Base	required	Categorisation des items de claim pour le PMSI MCO	📦0.1.0	This IG
Claim.item:CCAMProcedure.​productOrService	Base	extensible	Actes CCAM pour le PMSI	📦0.1.0	This IG
Claim.item:CCAMProcedure.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​location[x]	Base	example	Example Service Place Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​bodySite	Base	example	Oral Site Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​subSite	Base	example	Surface Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item:CCAMProcedure.​detail.subDetail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()

This structure is derived from DMClaimPMSIMCO

Résumé

Mandatory: 6 elements(9 nested mandatory elements)
Must-Support: 11 elements
Fixed: 4 elements

Extensions

This structure refers to these extensions:

• https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DRG
• https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/ItemRank

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Claim.diagnosis
• The element 1 is sliced based on the value of Claim.item
• The element 1 is sliced based on the value of Claim.item.modifier