description: 此事前審查-Claim TWNHIBASE Profile說明本IG如何進一步定義FHIR的Claim Resource以呈現健保署基礎事前審查之內容
package_name: tw.gov.mohw.nhi.base
derivation: constraint
name: ClaimTWNHIBASE
type: Claim
elements:
  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 。
    binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/base/ValueSet/nhi-apply-type'}
    mustSupport: true
    index: 0
    elements:
      coding:
        index: 1
        elements:
          system:
            pattern: {type: Uri, value: 'https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-apply-type'}
            index: 2
          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 。', index: 3}
        required: [system, code]
    required: [coding]
  patient:
    type: Reference
    short: 病人資訊
    mustSupport: true
    refers: ['https://nhicore.nhi.gov.tw/base/StructureDefinition/Patient-twnhibase']
    index: 4
  created: {short: 申請日期，YYYY-MM-DD，機構自填。, mustSupport: true, index: 5}
  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/base/StructureDefinition/Organization-twnhibase']
    index: 6
  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/base/ValueSet/nhi-tmhb-type'}
    index: 7
  supportingInfo:
    index: 8
    elements:
      category:
        binding: {strength: required, valueSet: 'https://nhicore.nhi.gov.tw/base/ValueSet/nhi-supporting-info-type'}
        index: 9
    slicing:
      rules: open
      discriminator:
      - {path: category, type: value}
      min: null
      slices:
        geneInfo:
          match:
            category:
              coding:
              - {code: geneInfo, system: 'https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type'}
          schema:
            short: 基因資訊
            array: true
            index: 10
            elements:
              category:
                pattern:
                  type: CodeableConcept
                  value:
                    coding:
                    - {code: geneInfo, system: 'https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type'}
                index: 11
              timing:
                choices: []
                index: 13
              value:
                mustSupport: true
                choices: [valueReference]
                index: 15
              valueReference:
                type: Reference
                mustSupport: true
                choiceOf: value
                refers: ['https://nhicore.nhi.gov.tw/base/StructureDefinition/Observation-diagnostic-twnhibase']
                index: 16
            required: [valueReference, value]
  diagnosis:
    short: sequence=1時為主要疾病；sequence>=2代表共病。
    mustSupport: true
    index: 17
    extensions:
      recordedDate: {url: 'http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate', min: 0, type: Extension, short: 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: 19}
    elements:
      extension:
        index: 18
        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，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: 19}
              min: 0
      sequence: {short: sequence=1時為主要疾病；sequence>=2代表共病。, index: 20}
      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: 22
      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: 23}
      diagnosis[x]:
        elements:
          coding:
            index: 24
            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: 25
                    elements:
                      system:
                        pattern: {type: Uri, value: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw'}
                        mustSupport: true
                        index: 26
                      code: {mustSupport: true, index: 27}
                    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: 28
                    elements:
                      system:
                        pattern: {type: Uri, value: 'https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2014-tw'}
                        mustSupport: true
                        index: 29
                      code: {mustSupport: true, index: 30}
                    required: [system, code]
      type:
        index: 31
        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。, mustSupport: true, index: 32}
        required: [text]
package_version: 1.0.0
class: profile
kind: resource
url: https://nhicore.nhi.gov.tw/base/StructureDefinition/Claim-twnhibase
base: http://hl7.org/fhir/StructureDefinition/Claim
version: 1.0.0
required: [diagnosis, subType]