1.2.276.0.76.3.1.135.8.10.11

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Template PolicyActivityV3

Beschreibung

Aktuelle Version

Id1.2.276.0.76.3.1.135.8.10.11Gültigkeit gültig ab 2016‑02‑25 19:07:54
StatusKyellow.png EntwurfVersions-Label2.1
NamePolicyActivityV3AnzeigenameVersicherungs-Policy
Beschreibung
KontextElternknoten des Template-Element mit Id 1.2.276.0.76.3.1.135.8.10.11
KlassifikationCDA Entry Level Template
Offen/GeschlossenOffen (auch andere als die definierten Elemente sind erlaubt)
Benutzt von / Benutzt
Benutzt von 3 Templates, Benutzt 1 Template
Benutzt von Template-Id als NameVersion
1.2.276.0.76.3.1.135.8.10.10ContainmentVersicherung (Coverage)2016‑02‑25 19:00:30
1.2.276.0.76.3.1.135.8.10.9Link.pngVersicherung2016‑02‑25 18:55:55
1.2.276.0.76.3.1.135.8.10.5Link.pngÜberweisungsschein2016‑01‑28 14:40:29
Benutzt Template-Id als NameVersion
2.16.840.1.113883.10.20.22.5.2InklusionUSRealmAddressADUSFIELDED2015‑08‑13
BeziehungSpezialisierung: Template 2.16.840.1.113883.10.12.301 (2005‑09‑07)
Version: Template 2.16.840.1.113883.10.20.22.4.61 (2013‑01‑31)
Spezialisierung: Template 2.16.840.1.113883.10.20.22.4.61 (2015‑08‑01)
ItemDTKardKonfBeschreibungLabel
cda:act
(PolicyActivityV3)
Treetree.png@classCode
cs1 … 1FACT
 EN-US.png SHALL contain exactly one [1..1] @classCode="ACT" Act (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-8898).
Treetree.png@moodCode
cs1 … 1FEVN
 EN-US.png SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-8899).
Treetree.pngcda:templateId
1 … 1MEN-US.png SHALL contain exactly one [1..1] templateId (CONF:1198-8900) such that itCONF:1198‑8900
Treeblank.pngTreetree.png@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.61
 EN-US.png SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.61" (CONF:1198-10516).
Treeblank.pngTreetree.png@extension
st1 … 1F2015-08-01
 EN-US.png SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32595).
Treetree.pngcda:id
1 … *EN-US.png SHALL contain at least one [1..*] id (CONF:1198-8901).

This id is a unique identifier for the policy or program providing the coverage		CONF:1198‑8901
Treetree.pngcda:code
1 … 1EN-US.png SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Health Insurance Type urn:oid:2.16.840.1.113883.3.88.12.3221.5.2 DYNAMIC (CONF:1198-8903).CONF:1198‑8903
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.3221.5.2 Health Insurance Type (DYNAMIC)
Treeblank.pngTreetree.pngcda:translation
1 … *MEN-US.png This code SHALL contain at least one [1..*] translation, which SHOULD be selected from ValueSet Payer urn:oid:2.16.840.1.114222.4.11.3591 (CONF:1198-32852).CONF:1198‑32852
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.114222.4.11.3591 Payer (DYNAMIC)
Treetree.pngcda:statusCode
1 … 1MEN-US.png SHALL contain exactly one [1..1] statusCode (CONF:1198-8902).CONF:1198‑8902
Treeblank.pngTreetree.png@code
1 … 1Fcompleted
Treetree.pngcda:performer
1 … 1MEN-US.png SHALL contain exactly one [1..1] performer (CONF:1198-8906) such that it

This performer represents the Payer.		CONF:1198‑8906
wo [cda:templateId/@root='2.16.840.1.113883.10.20.22.4.87']
Treeblank.pngTreetree.png@typeCode
cs1 … 1FPRF
 EN-US.png SHALL contain exactly one [1..1] @typeCode="PRF" Performer (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8907).
Treeblank.pngTreetree.pngcda:templateId
1 … 1MEN-US.png SHALL contain exactly one [1..1] templateId (CONF:1198-16808).CONF:1198‑16808
Treeblank.pngTreeblank.pngTreetree.png@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.87
 EN-US.png This templateId SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.87" Payer Performer (CONF:1198-16809).
Treeblank.pngTreetree.pngcda:assignedEntity
1 … 1MCONF:1198‑8908
Treeblank.pngTreeblank.pngTreetree.pngcda:id
1 … *healthPlanInsuranceInformationSourceId
CONF:1198‑8909
Treeblank.pngTreeblank.pngTreetree.pngcda:code
0 … 1RCONF:1198‑8914
Treeblank.pngTreeblank.pngTreetree.pngcda:addr
AD0 … 1REN-US.png This assignedEntity MAY contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8910).CONF:1198‑8910
Eingefügt  von 2.16.840.1.113883.10.20.22.5.2 US Realm Address (AD.US.FIELDED) (2015‑08‑13)
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.png@use
0 … 1 EN-US.png SHOULD contain zero or one [0..1] @use, which SHALL be selected from ValueSet PostalAddressUse urn:oid:2.16.840.1.113883.1.11.10637 STATIC 2005-05-01 (CONF:81-7290).
 CONF
Der Wert von @use muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.10637 PostalAddressUse (2005‑05‑01)
 ConstraintEN-US.png *SHALL NOT* have mixed content except for white space
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:country
0 … 1REN-US.png SHOULD contain zero or one [0..1] country, which SHALL be selected from ValueSet Country urn:oid:2.16.840.1.113883.3.88.12.80.63 DYNAMIC (CONF:81-7295).CONF:81‑7295
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.63 Country (DYNAMIC)
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:state
0 … 1REN-US.png SHOULD contain zero or one [0..1] state (ValueSet: StateValueSet urn:oid:2.16.840.1.113883.3.88.12.80.1 DYNAMIC) (CONF:81-7293).CONF:81‑7293
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.1 StateValueSet (DYNAMIC)
 Schematron assertroleKred.png error 
 test(cda:country='US' and cda:state) or (cda:country!='US') or (not(cda:country) and cda:state) 
 MeldungState is required if the country is US. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies. 
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:city
1 … 1EN-US.png SHALL contain exactly one [1..1] city (CONF:81-7292).CONF:81‑7292
 Schematron assertroleKred.png error 
 test(cda:country='US' and cda:postalCode) or (cda:country!='US') or (not(cda:country) and cda:postalCode) 
 MeldungPostalCode is required if the country is US. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies 
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:postalCode
0 … 1RCONF:81‑7294
 ConstraintEN-US.png SHOULD contain zero or one [0..1] postalCode, which SHOULD be selected from ValueSet PostalCode urn:oid:2.16.840.1.113883.3.88.12.80.2 DYNAMIC (CONF:81-7294).
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.2 PostalCode (DYNAMIC)
 Schematron assertroleKred.png error 
 testcount(cda:streetAddressLine) > 0 and count(cda:streetAddressLine) < 5 
 MeldungSHALL contain exactly one [1..1] streetAddressLine (CONF:81-7291). 
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:streetAddressLine
1 … 1CONF:81‑7291
Treeblank.pngTreeblank.pngTreetree.pngcda:telecom
0 … *EN-US.png This assignedEntity MAY contain zero or more [0..*] telecom (CONF:1198-8911).CONF:1198‑8911
Treeblank.pngTreeblank.pngTreetree.pngcda:representedOrganization
0 … 1RCONF:1198‑8912
 Schematron assertroleKred.png error 
 testcda:performer[cda:templateId[@root='2.16.840.1.113883.10.20.22.4.87']]/cda:assignedEntity[count(cda:representedOrganization) < 2] 
 MeldungThis assignedEntity SHOULD contain zero or one [0..1] representedOrganization (CONF:1198-8912). 
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:name
0 … 1REN-US.png The representedOrganization, if present, SHOULD contain zero or one [0..1] name (CONF:1198-8913).CONF:1198‑8913
Treetree.pngcda:performer
0 … 1REN-US.png SHOULD contain zero or one [0..1] performer="PRF" Performer (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8961) such that it

This performer represents the Guarantor.		CONF:1198‑8961
wo [cda:templateId/@root='2.16.840.1.113883.10.20.22.4.88']
Treeblank.pngTreetree.png@typeCode
cs0 … 1FPRF
Treeblank.pngTreetree.pngcda:templateId
1 … 1MEN-US.png SHALL contain exactly one [1..1] templateId (CONF:1198-16810).CONF:1198‑16810
Treeblank.pngTreeblank.pngTreetree.png@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.88
 EN-US.png This templateId SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.88" Guarantor Performer (CONF:1198-16811).
Treeblank.pngTreetree.pngcda:time
0 … 1REN-US.png SHOULD contain zero or one [0..1] time (CONF:1198-8963).CONF:1198‑8963
Treeblank.pngTreetree.pngcda:assignedEntity
1 … 1MCONF:1198‑8962
Treeblank.pngTreeblank.pngTreetree.pngcda:code
1 … 1MEN-US.png This assignedEntity SHALL contain exactly one [1..1] code (CONF:1198-8968).CONF:1198‑8968
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.png@code
1 … 1FGUAR
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.png@codeSystem
1 … 1F2.16.840.1.113883.5.110 (Role Class)
Treeblank.pngTreeblank.pngTreetree.pngcda:addr
AD0 … 1REN-US.png This assignedEntity SHOULD contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8964).CONF:1198‑8964
Eingefügt  von 2.16.840.1.113883.10.20.22.5.2 US Realm Address (AD.US.FIELDED) (2015‑08‑13)
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.png@use
0 … 1 EN-US.png SHOULD contain zero or one [0..1] @use, which SHALL be selected from ValueSet PostalAddressUse urn:oid:2.16.840.1.113883.1.11.10637 STATIC 2005-05-01 (CONF:81-7290).
 CONF
Der Wert von @use muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.10637 PostalAddressUse (2005‑05‑01)
 ConstraintEN-US.png *SHALL NOT* have mixed content except for white space
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:country
0 … 1REN-US.png SHOULD contain zero or one [0..1] country, which SHALL be selected from ValueSet Country urn:oid:2.16.840.1.113883.3.88.12.80.63 DYNAMIC (CONF:81-7295).CONF:81‑7295
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.63 Country (DYNAMIC)
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:state
0 … 1REN-US.png SHOULD contain zero or one [0..1] state (ValueSet: StateValueSet urn:oid:2.16.840.1.113883.3.88.12.80.1 DYNAMIC) (CONF:81-7293).CONF:81‑7293
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.1 StateValueSet (DYNAMIC)
 Schematron assertroleKred.png error 
 test(cda:country='US' and cda:state) or (cda:country!='US') or (not(cda:country) and cda:state) 
 MeldungState is required if the country is US. If country is not specified, it's assumed to be US. If country is something other than US, the state MAY be present but MAY be bound to different vocabularies. 
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:city
1 … 1EN-US.png SHALL contain exactly one [1..1] city (CONF:81-7292).CONF:81‑7292
 Schematron assertroleKred.png error 
 test(cda:country='US' and cda:postalCode) or (cda:country!='US') or (not(cda:country) and cda:postalCode) 
 MeldungPostalCode is required if the country is US. If country is not specified, it's assumed to be US. If country is something other than US, the postalCode MAY be present but MAY be bound to different vocabularies 
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:postalCode
0 … 1RCONF:81‑7294
 ConstraintEN-US.png SHOULD contain zero or one [0..1] postalCode, which SHOULD be selected from ValueSet PostalCode urn:oid:2.16.840.1.113883.3.88.12.80.2 DYNAMIC (CONF:81-7294).
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.3.88.12.80.2 PostalCode (DYNAMIC)
 Schematron assertroleKred.png error 
 testcount(cda:streetAddressLine) > 0 and count(cda:streetAddressLine) < 5 
 MeldungSHALL contain exactly one [1..1] streetAddressLine (CONF:81-7291). 
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:streetAddressLine
1 … 1CONF:81‑7291
Treeblank.pngTreeblank.pngTreetree.pngcda:telecom
0 … *REN-US.png This assignedEntity SHOULD contain zero or more [0..*] telecom (CONF:1198-8965).CONF:1198‑8965
 Schematron assertroleKred.png error 
 testcda:assignedPerson/cda:name | cda:representedOrganization/cda:name 
 Meldung*SHOULD* include assignedEntity/assignedPerson/name AND/OR assignedEntity/representedOrganization/name 
Treetree.pngcda:participant
1 … 1MEN-US.png SHALL contain exactly one [1..1] participant (CONF:1198-8916) such that itCONF:1198‑8916
wo [@typeCode='COV']
Treeblank.pngTreetree.png@typeCode
cs1 … 1FCOV
 EN-US.png SHALL contain exactly one [1..1] @typeCode="COV" Coverage target (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8917).
Treeblank.pngTreetree.pngcda:templateId
1 … 1MEN-US.png SHALL contain exactly one [1..1] templateId (CONF:1198-16812).CONF:1198‑16812
Treeblank.pngTreeblank.pngTreetree.png@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.89
 EN-US.png This templateId SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.89" Covered Party Participant (CONF:1198-16814).
Treeblank.pngTreetree.pngcda:time
0 … 1REN-US.png SHOULD contain zero or one [0..1] time (CONF:1198-8918).CONF:1198‑8918
Treeblank.pngTreeblank.pngTreetree.pngcda:low
0 … 1REN-US.png The time, if present, SHOULD contain zero or one [0..1] low (CONF:1198-8919).CONF:1198‑8919
Treeblank.pngTreeblank.pngTreetree.pngcda:high
0 … 1REN-US.png The time, if present, SHOULD contain zero or one [0..1] high (CONF:1198-8920).CONF:1198‑8920
Treeblank.pngTreetree.pngcda:participantRole
1 … 1MEN-US.png SHALL contain exactly one [1..1] participantRole (CONF:1198-8921).CONF:1198‑8921
Treeblank.pngTreeblank.pngTreetree.pngcda:id
1 … *EN-US.png This participantRole SHALL contain at least one [1..*] id (CONF:1198-8922).CONF:1198‑8922
 ConstraintEN-US.png This id is a unique identifier for the covered party member. Implementers *SHOULD* use the same GUID for each instance of a member identifier from the same health plan
Treeblank.pngTreeblank.pngTreetree.pngcda:code
CD1 … 1Vesichertenstatus
CONF:1198‑8923
 CONF
Der Wert von @code muss gewählt werden aus dem Value Set 1.2.276.0.76.11.162 S_KBV_VERSICHERTENSTATUS (DYNAMIC)
Treeblank.pngTreeblank.pngTreetree.pngcda:addr
0 … 1REN-US.png This participantRole SHOULD contain zero or one [0..1] addr (CONF:1198-8956).CONF:1198‑8956
 Schematron assertroleKred.png error 
 testcda:addr[cda:streetAddressLine and cda:city and (cda:country!='US' or ((not(cda:country) or cda:country!='US') and cda:state and cda:postalCode))] 
 MeldungThe content of addr *SHALL* be a conformant US Realm Address (AD.US.FIELDED) (2.16.840.1.113883.10.20.22.5.2) 
Treeblank.pngTreeblank.pngTreetree.pngcda:playingEntity
0 … 1RCONF:1198‑8932
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngcda:name
1 … *MEN-US.png The playingEntity, if present, SHALL contain at least one [1..*] name (CONF:1198-8930).

If the covered party’s name is recorded differently in the health plan and in the registration/pharmacy benefit summary (due to marriage or for other reasons), use the name as it is recorded in the health plan.		CONF:1198‑8930
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.pngsdtc:birthTime
1 … 1MEN-US.png The playingEntity, if present, SHALL contain exactly one [1..1] sdtc:birthTime (CONF:1198-31344).

If the covered party’s date of birth is recorded differently in the health plan and in the registration/pharmacy benefit summary, use the date of birth as it is recorded in the health plan.		CONF:1198‑31344
 ConstraintEN-US.png The prefix sdtc: *SHALL* be bound to the namespace “urn:hl7-org:sdtc”. The use of the namespace provides a necessary extension to CDA R2 for the use of the birthTime element.
Treetree.pngcda:participant
0 … 1REN-US.png SHOULD contain zero or one [0..1] participant (CONF:1198-8934) such that it

When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information.		CONF:1198‑8934
wo [@typeCode='HLD']
Treeblank.pngTreetree.png@typeCode
cs1 … 1FHLD
 EN-US.png SHALL contain exactly one [1..1] @typeCode="HLD" Holder (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8935).
 ConstraintEN-US.png When the Subscriber is the patient, the participant element describing the subscriber *SHALL NOT* be present. This information will be recorded instead in the data elements used to record member information
Treeblank.pngTreetree.pngcda:templateId
1 … 1MEN-US.png SHALL contain exactly one [1..1] templateId (CONF:1198-16813).CONF:1198‑16813
Treeblank.pngTreeblank.pngTreetree.png@root
uid1 … 1F2.16.840.1.113883.10.20.22.4.90
 EN-US.png This templateId SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.90" Policy Holder Participant (CONF:1198-16815).
Treeblank.pngTreetree.pngcda:time
0 … 1EN-US.png MAY contain zero or one [0..1] time (CONF:1198-8938).CONF:1198‑8938
Treeblank.pngTreetree.pngcda:participantRole
1 … 1MEN-US.png SHALL contain exactly one [1..1] participantRole (CONF:1198-8936).CONF:1198‑8936
Treeblank.pngTreeblank.pngTreetree.pngcda:id
1 … *EN-US.png This participantRole SHALL contain at least one [1..*] id (CONF:1198-8937).CONF:1198‑8937
 ConstraintEN-US.png This id is a unique identifier for the subscriber of the coverage
Treeblank.pngTreeblank.pngTreetree.pngcda:addr
0 … 1REN-US.png This participantRole SHOULD contain zero or one [0..1] addr (CONF:1198-8925).CONF:1198‑8925
 Schematron assertroleKred.png error 
 testcda:addr[cda:streetAddressLine and cda:city and ((not(cda:country) or cda:country!='US') or (cda:country='US' and cda:state and cda:postalCode))] 
 MeldungThe content of addr *SHALL* be a conformant US Realm Address (AD.US.FIELDED) (2.16.840.1.113883.10.20.22.5.2) 
Treetree.pngcda:entryRelationship
1 … *MEN-US.png SHALL contain at least one [1..*] entryRelationship (CONF:1198-8939) such that itCONF:1198‑8939
Treeblank.pngTreetree.png@typeCode
cs1 … 1FREFR
 EN-US.png SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-8940).
 ConstraintEN-US.png The target of a policy activity with act/entryRelationship/@typeCode="REFR" *SHALL* be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) *OR* an act, with act[@classCode="ACT"] and act[[]@moodCode="DEF"[]], representing a description of the coverage plan.
A description of the coverage plan *SHALL* contain one or more act/id, to represent the plan identifier, and an act/text with the name of the plan.

Zusammenstellung aller Versionen dieses Templates

Abgerufen von „https://wiki.hl7.de/index.php?title=1.2.276.0.76.3.1.135.8.10.11&oldid=30372“