description: 此免疫製劑事前審查-Claim Immunologic Aagent TWPAS Profile說明本IG如何進一步定義FHIR的Claim Resource以呈現免疫製劑事前審查之內容 package_name: tw.gov.mohw.nhi.pas derivation: constraint name: ClaimImmTWPAS type: Claim elements: patient: type: Reference short: 病人資訊 mustSupport: true refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Patient-twpas'] index: 20 insurance: elements: sequence: pattern: {type: PositiveInt, value: 1} index: 190 coverage: type: Reference refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Coverage-twpas'] index: 191 diagnosis: short: sequence=1時為主要疾病；sequence>=2代表共病。 constraint: diagnosis: {human: diagnosis.sequence=1時才需填寫診斷日期、簡要病摘(申請原因), source: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas', severity: error, expression: 'sequence=1 implies (extension.where(url = ''http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate'').value.ofType(date).exists() and type.text.exists() )'} mustSupport: true index: 160 extensions: recordedDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate', min: 0, type: Extension, short: 診斷日期，sequence=1時為必填，表示為用藥事前審查之主要疾病；其他共病不須填寫診斷日期。YYYY-MM-DD，西元年月日。【此為參考Da Vinci PAS IG的extension設計】, mustSupport: true, index: 162} elements: extension: index: 161 slicing: rules: open ordered: false discriminator: - {path: url, type: value} min: null slices: recordedDate: match: {url: null} schema: {type: Extension, short: 診斷日期，sequence=1時為必填，表示為用藥事前審查之主要疾病；其他共病不須填寫診斷日期。YYYY-MM-DD，西元年月日。【此為參考Da Vinci PAS IG的extension設計】, mustSupport: true, url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate', index: 162} min: 0 sequence: {short: sequence=1時為主要疾病；sequence>=2代表共病。, index: 163} diagnosis: short: 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。 mustSupport: true choices: [diagnosisCodeableConcept] index: 165 diagnosisCodeableConcept: {type: CodeableConcept, short: 國際疾病分類代碼(含共病)，當前疾病狀態。ICD-10-CM。, mustSupport: true, choiceOf: diagnosis, index: 166} diagnosis[x]: elements: coding: index: 167 slicing: rules: closed discriminator: - {path: system, type: value} min: null slices: icd10-cm-2023: match: {system: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw'} schema: binding: {strength: extensible, valueSet: 'https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2023-tw'} mustSupport: true index: 168 elements: system: pattern: {type: Uri, value: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw'} mustSupport: true index: 169 code: {mustSupport: true, index: 170} required: [system, code] icd10-cm-2014: match: {system: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw'} schema: binding: {strength: extensible, valueSet: 'https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-cm-2014-tw'} mustSupport: true index: 171 elements: system: pattern: {type: Uri, value: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw'} mustSupport: true index: 172 code: {mustSupport: true, index: 173} required: [system, code] type: index: 174 elements: text: short: 簡要病摘(申請理由)。連結院內HIS系統之簡要病摘，或填寫原事前審查之申請理由。請勿將醫事機構名稱、病人及醫師姓名等資訊列入結果中上傳，且不得包含HTML或XML等語法。 constraint: pas-2: {human: 長度不得超過4000 bytes。, source: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas', severity: error, expression: toString().length() <= 4000} mustSupport: true index: 175 meta: index: 1 elements: lastUpdated: {short: 上傳日期時間。供案件追蹤與識別使用，醫院上傳時無須填寫。, index: 2} profile: pattern: {type: Canonical, value: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas'} index: 3 required: [profile] enterer: type: Reference short: 申請醫師，必須存在於醫事人員基本資料檔內，並於合約生效起迄日內。 mustSupport: true refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Practitioner-twpas'] index: 22 supportingInfo: array: true min: 2 index: 25 elements: sequence: {short: 因FHIR設計而必填、自動流水號（建議每次加1）、不得重複，作為每筆supportingInfo的唯一識別碼。最後一筆sequence號碼即表示總筆數。, index: 26} category: binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-supporting-info-type'} index: 27 slicing: rules: closed discriminator: - {path: category, type: value} min: 2 slices: medicalRecord: match: category: coding: - {code: medicalRecord, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 病歷資料（非屬影像報告檢查驗報告部分），可檢附其他佐證癌藥治療必要性之非結構化病歷。 array: true index: 125 elements: category: pattern: type: CodeableConcept value: coding: - {code: medicalRecord, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 126 timing: choices: [] index: 128 value: mustSupport: true choices: [valueReference] index: 130 valueReference: type: Reference mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/DocumentReference-twpas'] index: 131 required: [valueReference, value] tests: match: category: coding: - {code: tests, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 檢驗(查) array: true index: 83 elements: category: pattern: type: CodeableConcept value: coding: - {code: tests, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 84 timing: choices: [] index: 86 value: short: 檢驗(查) mustSupport: true choices: [valueReference] index: 88 valueReference: type: Reference short: 檢驗(查) mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-laboratory-result-twpas'] index: 89 required: [valueReference, value] phototherapy: match: category: coding: - {code: phototherapy, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 照光治療 array: true index: 111 elements: category: pattern: type: CodeableConcept value: coding: - {code: phototherapy, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 112 timing: choices: [] index: 114 value: short: 照光治療 mustSupport: true choices: [valueReference] index: 116 valueReference: type: Reference short: 照光治療 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Procedure-phototherapy-twpas'] index: 117 required: [valueReference, value] cancerStage: match: category: coding: - {code: cancerStage, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 癌症分期量表 array: true index: 62 elements: category: pattern: type: CodeableConcept value: coding: - {code: cancerStage, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 63 timing: choices: [] index: 65 value: short: 癌症分期量表 mustSupport: true choices: [valueReference] index: 67 valueReference: type: Reference short: 癌症分期量表 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-cancer-stage-twpas'] index: 68 required: [valueReference, value] medicationRequest: match: category: coding: - {code: medicationRequest, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 用藥品項 array: true index: 97 elements: category: pattern: type: CodeableConcept value: coding: - {code: medicationRequest, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 98 timing: choices: [] index: 100 value: short: 用藥品項 mustSupport: true choices: [valueReference] index: 102 valueReference: type: Reference short: 用藥品項 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/MedicationRequest-treat-twpas'] index: 103 required: [valueReference, value] radiotherapy: match: category: coding: - {code: radiotherapy, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 放射治療 array: true index: 104 elements: category: pattern: type: CodeableConcept value: coding: - {code: radiotherapy, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 105 timing: choices: [] index: 107 value: short: 放射治療 mustSupport: true choices: [valueReference] index: 109 valueReference: type: Reference short: 放射治療 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Procedure-twpas'] index: 110 required: [valueReference, value] examinationReport: match: category: coding: - {code: examinationReport, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 檢查報告 array: true index: 69 elements: category: pattern: type: CodeableConcept value: coding: - {code: examinationReport, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 70 timing: choices: [] index: 72 value: short: 檢查報告 mustSupport: true choices: [valueReference] index: 74 valueReference: type: Reference short: 檢查報告 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/DiagnosticReport-twpas'] index: 75 required: [valueReference, value] pregnancy: match: category: coding: - {code: pregnancyBreastfeedingStatus, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 是否懷孕或哺乳 index: 48 elements: category: pattern: type: CodeableConcept value: coding: - {code: pregnancyBreastfeedingStatus, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 49 timing: choices: [] index: 51 value: short: 是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳 mustSupport: true choices: [valueBoolean] index: 53 valueBoolean: {type: boolean, short: '是否懷孕或哺乳，false:未懷孕或哺乳 | true:有懷孕或哺乳', mustSupport: true, choiceOf: value, index: 54} required: [value, valueBoolean] geneInfo: match: category: coding: - {code: geneInfo, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 基因資訊 array: true index: 76 elements: category: pattern: type: CodeableConcept value: coding: - {code: geneInfo, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 77 timing: choices: [] index: 79 value: short: 基因資訊 mustSupport: true choices: [valueReference] index: 81 valueReference: type: Reference short: 基因資訊 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-diagnostic-twpas'] index: 82 required: [valueReference, value] weight: match: category: coding: - {code: weight, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 病人體重 constraint: HTWT: {human: 整數至多3位數及小數至多2位數, source: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas', severity: error, expression: value.ofType(Quantity).value < 1000 and ((value.ofType(Quantity).value * 100).round() / 100) = value.ofType(Quantity).value} _required: true index: 28 elements: category: pattern: type: CodeableConcept value: coding: - {code: weight, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 29 timing: choices: [] index: 31 value: mustSupport: true choices: [valueQuantity] index: 33 valueQuantity: {type: Quantity, mustSupport: true, choiceOf: value, index: 34} value[x]: elements: value: {short: 體重，整數至多3位數及小數至多2位數。, mustSupport: true, index: 35} system: pattern: {type: Uri, value: 'http://unitsofmeasure.org'} index: 36 code: pattern: {type: Code, value: kg} index: 37 required: [value, system, code] required: [value, valueQuantity] carePlanDocument: match: category: coding: - {code: carePlanDocument, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 治療計畫文件，P-IO(免疫檢查點抑制劑治療計畫)、P-CART(CAR-T多團隊會議紀錄)、P-STEMCELL(造血幹細胞移植計畫書)，附件形式PDF array: true index: 118 elements: category: pattern: type: CodeableConcept value: coding: - {code: carePlanDocument, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 119 timing: choices: [] index: 121 value: short: 治療計畫文件 mustSupport: true choices: [valueReference] index: 123 valueReference: type: Reference short: 治療計畫文件 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/DocumentReference-twpas'] index: 124 required: [valueReference, value] bloodgroup: match: category: coding: - {code: bloodgroup, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 血型 index: 139 elements: category: pattern: type: CodeableConcept value: coding: - {code: bloodgroup, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 140 timing: choices: [] index: 142 value: short: 血型 mustSupport: true choices: [valueReference] index: 144 valueReference: type: Reference short: 血型 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-blood-group-twpas'] index: 145 required: [valueReference, value] treatmentAssessment: match: category: coding: - {code: treatmentAssessment, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 結果資訊 array: true index: 132 elements: category: pattern: type: CodeableConcept value: coding: - {code: treatmentAssessment, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 133 timing: choices: [] index: 135 value: short: 結果資訊 mustSupport: true choices: [valueReference] index: 137 valueReference: type: Reference short: 結果資訊 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-tx-assessment-twpas'] index: 138 required: [valueReference, value] allergy: match: category: coding: - {code: allergy, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 過敏史 array: true index: 153 elements: category: pattern: type: CodeableConcept value: coding: - {code: allergy, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 154 timing: choices: [] index: 156 value: short: 過敏史 mustSupport: true choices: [valueReference] index: 158 valueReference: type: Reference short: 過敏史 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/AllergyIntolerance-twpas'] index: 159 required: [valueReference, value] opd: match: category: coding: - {code: opd, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 門診病歷 array: true index: 146 elements: category: pattern: type: CodeableConcept value: coding: - {code: opd, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 147 timing: choices: [] index: 149 value: short: 門診病歷 mustSupport: true choices: [valueReference] index: 151 valueReference: type: Reference short: 門診病歷 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Composition-opd-twpas'] index: 152 required: [valueReference, value] height: match: category: coding: - {code: height, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 病人身高 constraint: HTWT: {human: 整數至多3位數及小數至多2位數, source: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas', severity: error, expression: value.ofType(Quantity).value < 1000 and ((value.ofType(Quantity).value * 100).round() / 100) = value.ofType(Quantity).value} _required: true index: 38 elements: category: pattern: type: CodeableConcept value: coding: - {code: height, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 39 timing: choices: [] index: 41 value: mustSupport: true choices: [valueQuantity] index: 43 valueQuantity: {type: Quantity, mustSupport: true, choiceOf: value, index: 44} value[x]: elements: value: {short: 身高(cm)，整數至多3位數及小數至多2位數。, mustSupport: true, index: 45} system: pattern: {type: Uri, value: 'http://unitsofmeasure.org'} index: 46 code: pattern: {type: Code, value: cm} index: 47 required: [value, system, code] required: [value, valueQuantity] patientAssessment: match: category: coding: - {code: patientAssessment, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 病人狀態評估 array: true index: 90 elements: category: pattern: type: CodeableConcept value: coding: - {code: patientAssessment, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 91 timing: choices: [] index: 93 value: short: 病人狀態評估 mustSupport: true choices: [valueReference] index: 95 valueReference: type: Reference short: 病人狀態評估 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Observation-pat-assessment-twpas'] index: 96 required: [valueReference, value] imagingReport: match: category: coding: - {code: imagingReport, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} schema: short: 影像報告 array: true index: 55 elements: category: pattern: type: CodeableConcept value: coding: - {code: imagingReport, system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type'} index: 56 timing: choices: [] index: 58 value: short: 影像報告 mustSupport: true choices: [valueReference] index: 60 valueReference: type: Reference short: 影像報告 mustSupport: true choiceOf: value refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/DiagnosticReport-image-twpas'] index: 61 required: [valueReference, value] use: pattern: {type: Code, value: preauthorization} index: 19 item: index: 192 extensions: requestedService: {url: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService', min: 1, max: 1, type: Extension, short: 事前審查品項【此為參考Da Vinci PAS IG的extension設計】, mustSupport: true, index: 194} elements: extension: index: 193 slicing: rules: open ordered: false discriminator: - {path: url, type: value} min: 1 slices: requestedService: match: {url: null} schema: {type: Extension, short: 事前審查品項【此為參考Da Vinci PAS IG的extension設計】, mustSupport: true, url: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService', index: 194} min: 1 max: 1 productOrService: short: 醫令類別 binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-order-type'} mustSupport: true index: 195 modifier: array: true min: 1 max: 2 index: 196 slicing: rules: closed ordered: false discriminator: - {path: coding.system, type: value} min: 1 max: 2 slices: continuation: match: coding: {system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status'} schema: short: 續用註記，1:初次使用 | 2:申請再次使用 binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-continuation-status'} mustSupport: true _required: true index: 197 elements: coding: index: 198 elements: system: pattern: {type: Uri, value: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status'} index: 199 code: {short: '1:初次使用 | 2:申請再次使用', index: 200} required: [system, code] required: [coding] lot: match: coding: {system: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy'} schema: short: 用藥線別，0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療 binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-line-of-therapy'} mustSupport: true index: 201 elements: coding: index: 202 elements: system: pattern: {type: Uri, value: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy'} index: 203 code: {short: '0:不適用 | 1:第一線治療 | 2:第二線治療 | 3:第三線治療 | 4:第四線治療 | 5:第五線治療', mustSupport: true, index: 204} required: [system, code] required: [coding] programCode: short: 給付適應症條件，藥品給付規定內所規範之適應症或條件，若有特定事前審查品項代碼應以代碼填報。 constraint: pas-1: {human: text、coding至少需存在一個。, source: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas', severity: error, expression: text.exists() or coding.exists()} mustSupport: true index: 205 elements: coding: short: 給付適應症條件，當事前審查品項代碼為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229時，才可填寫。 binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-reason'} index: 206 text: {short: 給付適應症條件，事前審查品項代碼不為KC009612B5、KC010892B5、KC011112DE、KC011162B5、KC011362B5、KC01013229、KC01013230、KC01025219、KC01050238、KC01085229、KC00958229、JC00154261、KC01088229時，請自行輸入文字。, index: 207} quantity: mustSupport: true index: 208 elements: value: {short: 事前審查申請數量, mustSupport: true, index: 209} system: {short: 事前審查申請數量單位及包裝類型之代碼系統, index: 210} code: short: 事前審查申請數量單位及包裝類型 binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/apply-quantity-unit'} mustSupport: true index: 211 required: [value, system, code] bodySite: short: 申請部位，R:右側 | L:左側 | B:兩側。(此專案暫不檢核，未來待確認) binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-side'} index: 212 required: [extension, quantity, modifier, programCode] type: pattern: type: CodeableConcept value: coding: - {code: institutional, system: 'http://terminology.hl7.org/CodeSystem/claim-type'} index: 14 created: {short: 申請日期，YYYY-MM-DD，機構自填。健保署收案後另建受理日期，將呈現在ClaimResponse的disposition和created欄位。, mustSupport: true, index: 21} procedure: elements: date: {short: 手術(或其他處置)日期, mustSupport: true, index: 176} procedure: short: 手術(或其他處置)項目，經動脈導管肝臟腫瘤化學栓塞術(TACE)及冷凍療法等非屬手術。ICD-10-PCS 或 健保代碼 或 其他。 mustSupport: true choices: [procedureCodeableConcept] index: 178 procedureCodeableConcept: {type: CodeableConcept, short: 手術(或其他處置)項目，經動脈導管肝臟腫瘤化學栓塞術(TACE)及冷凍療法等非屬手術。ICD-10-PCS 或 健保代碼 或 其他。, mustSupport: true, choiceOf: procedure, index: 179} procedure[x]: elements: coding: index: 180 slicing: rules: closed discriminator: - {path: system, type: value} min: 1 max: 1 slices: icd10-pcs-2023: match: {system: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw'} schema: binding: {strength: required, valueSet: 'https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2023-tw'} mustSupport: true index: 181 elements: system: pattern: {type: Uri, value: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw'} index: 182 code: {mustSupport: true, index: 183} required: [system, code] icd10-pcs-2014: match: {system: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw'} schema: binding: {strength: required, valueSet: 'https://twcore.mohw.gov.tw/ig/twcore/ValueSet/icd-10-pcs-2014-tw'} mustSupport: true index: 184 elements: system: pattern: {type: Uri, value: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2014-tw'} index: 185 code: {mustSupport: true, index: 186} required: [system, code] medical-service-payment: match: {system: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw'} schema: binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-medical-service-payment'} mustSupport: true index: 187 elements: system: pattern: {type: Uri, value: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/medical-service-payment-tw'} index: 188 code: {mustSupport: true, index: 189} required: [system, code] required: [coding] required: [date] extension: index: 4 slicing: rules: open ordered: false discriminator: - {path: url, type: value} min: 1 slices: encounter: match: {url: null} schema: {type: Extension, short: 就醫科別，為細分科之就醫科別，作為審查分科用。【此為參考Da Vinci PAS IG的extension設計】, mustSupport: true, url: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter', index: 5} min: 1 max: 1 priority: short: 申請案件類別，1:一般事前審查申請 | 3:自主審查 | 4:緊急報備；專審系統識別用，對應PXXT_CODE(TMHB,001)。 binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-tmhb-type'} mustSupport: true index: 24 status: pattern: {type: Code, value: active} index: 13 id: {short: 收件序號/案件編號，供案件追蹤與識別使用，醫院上傳時無須填寫。, index: 0} identifier: mustSupport: true index: 6 slicing: rules: open discriminator: - {path: use, type: value} min: null slices: acpt_no: match: {use: official} schema: short: 受理編號。供案件追蹤與識別使用，醫院上傳時無須填寫。 mustSupport: true array: true index: 7 elements: use: pattern: {type: Code, value: official} index: 8 required: [use] orig_file_name: match: {use: usual} schema: short: 原始檔名。供案件追蹤與識別使用，醫院上傳時無須填寫。 mustSupport: true index: 9 elements: use: pattern: {type: Code, value: usual} index: 10 required: [use] old_acpt_no: match: {use: secondary} schema: short: '原受理編號。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。' mustSupport: true index: 11 elements: use: pattern: {type: Code, value: secondary} index: 12 required: [use] subType: short: '申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。院所上傳送核(subType = #1)案件時，不需填寫「原受理編號」資訊，受理成功後會由系統自動產生受理編號。當Claim.subType(申報類別)為2(送核補件)、3(申復)、4(爭議審議)或5(申復補件)時，院所才需於Claim.identifier:old_acpt_no填寫原送核案件之受理編號。' binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/pas/ValueSet/nhi-apply-type'} mustSupport: true index: 15 elements: coding: index: 16 elements: system: pattern: {type: Uri, value: 'https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type'} index: 17 code: {short: '申報類別，1:送核 | 2:送核補件 | 3:申復 | 4:爭議審議 | 5:申復補件 。當申報類別為2(送核補件)、3(申復)、4(爭議審議)、5(申復補件)時，院所才需於Claim.identifier填寫原送核案件之受理編號。', index: 18} required: [system, code] required: [coding] provider: type: Reference short: 醫事機構代碼，必須存在於醫事機構基本資料檔內。 mustSupport: true refers: ['https://nhicore.nhi.gov.tw/pas/StructureDefinition/Organization-twpas'] index: 23 package_version: 1.2.3 extensions: encounter: {url: 'https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter', min: 1, max: 1, type: Extension, short: 就醫科別，為細分科之就醫科別，作為審查分科用。【此為參考Da Vinci PAS IG的extension設計】, mustSupport: true, index: 5} class: profile kind: resource url: https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas base: http://hl7.org/fhir/StructureDefinition/Claim version: 1.2.3 required: [diagnosis, extension, enterer, item, meta, subType]