LinuxForHealth FHIR Implementation Guide - Local Development build (v8.0.0). See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: CDMCoverage - Mappings

Active as of 2022-11-10

Mappings for the cdm-coverage resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

CDMCoverage
Coverage	Event
status	Event.status
beneficiary	Event.subject
period	Event.occurrence[x]

Mappings for RIM Mapping (http://hl7.org/v3)

CDMCoverage
Coverage	Entity. Role, or Act, Coverage
meta	n/a, N/A
text	Act.text?
extension
extension (snapshotAgeInMonths)
extension (snapshotAgeInYears)
extension (employeeSnapshotAgeInYears)
extension (ageGroup)
extension (ageGenderGroup)
extension (attributedProviderReferenceWithPeriod)
extension (benefitStatus)
id	n/a
url	N/A
value[x]	N/A
value[x] (valueCodeableConcept)	N/A
extension (claimGroupIdentifier)
extension (cobraIndicator)
extension (coverageDays)
extension (coverageMonth)
extension (coverageInsurancePlan)
extension (dualEligibilityIndicator)
extension (enrollmentPcp)
extension (enrollmentPcpNameOnEnrollment)
extension (enrollmentPcpZipOnEnrollment)
extension (employeeAverageScheduledHours)
extension (employeeBirthDate)
extension (employeeCompany)
extension (employeeCostCenter)
extension (employeeCount)
extension (employeeBusinessUnit)
extension (employeeDepartment)
extension (employeeDivision)
extension (employeeExemptIndicator)
extension (employeeFamilySize)
extension (employeeFTECount)
extension (employeeId)
extension (employeeJobFamily)
extension (employeeJobGrade)
extension (employeeJobLocation)
extension (employeePayFrequency)
extension (employeePerformanceRating)
extension (employeeShift)
extension (employeeSubBusinessUnit)
extension (salaryIndicator)
extension (unionWorkerIndicator)
extension (employeeEducationLevel)
id	n/a
url	N/A
value[x]	N/A
value[x] (valueCodeableConcept)	N/A
extension (employeeGender)
id	n/a
url	N/A
value[x]	N/A
value[x] (valueCodeableConcept)	N/A
extension (employeeHireDate)
extension (employeeTerminationDate)
extension (employeeTerminationReason)
extension (employeeJobTitle)
id	n/a
url	N/A
value[x]	N/A
value[x] (valueCodeableConcept)	N/A
extension (employeeLaborUnion)
extension (employeeRetirementDate)
extension (employeeStatus)
extension (employeeUnionId)
extension (employeeWageAmount)
extension (employeeWageBasis)
extension (employeeYearOfService)
extension (employer)
extension (familyIncomeLevel)
extension (jobClassCode)
extension (jobLocationZipcode)
extension (longTermDisabilityBenefitRate)
extension (medicareCoverage)
id	n/a
url	N/A
value[x]	N/A
value[x] (valueCodeableConcept)	N/A
extension (medicareIndicator)
extension (memberEmployeeIndicator)
extension (planEmployeeCode)
extension (regionCode)
extension (restrictedBenefits)
extension (shortTermDisabilityBenefitRate)
extension (ssiIndicator)
extension (ssiStatus)
id	n/a
url	N/A
value[x]	N/A
value[x] (valueCodeableConcept)	N/A
extension (tanfBenefits)
id	n/a
url	N/A
value[x]	N/A
value[x] (valueCodeableConcept)	N/A
modifierExtension	N/A
identifier	n/a, II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
status	Act.status
period	Act.effectiveTime
class
id	n/a
extension	n/a
modifierExtension	N/A
costToBeneficiary
id	n/a
extension	n/a
modifierExtension	N/A
exception
id	n/a
extension	n/a
modifierExtension	N/A
contract	n/a

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

CDMCoverage
Coverage
status	FiveWs.status
type	FiveWs.class
policyHolder	FiveWs.subject[x], FiveWs.subject
subscriber	FiveWs.subject[x], FiveWs.subject
subscriberId	FiveWs.subject[x], FiveWs.subject
beneficiary	FiveWs.subject[x], FiveWs.subject
period	FiveWs.done[x]
payor	FiveWs.author

Mappings for Canadian Dental Association eclaims standard (http://www.cda-adc.ca/en/services/cdanet/)

CDMCoverage
Coverage
policyHolder	D01 through D09
subscriber	D01 through D09
subscriberId	D01 through D09
beneficiary	D01 through D09
dependent	C17
relationship	C03
payor	A05
class
value	C11 (Division,Section)
name	C11 (Division,Section)
network	D10
costToBeneficiary
value[x]	C11 (Division,Section)
contract	D01 through D09

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

CDMCoverage
Coverage
identifier	CX / EI (occasionally, more often EI maps to a resource id or a URL)
type	IN1-15
policyHolder	IN1-16, 18, 19-name of insured, address, date of birth
subscriber	IN1-16, 18, 19-name of insured, address, date of birth
subscriberId	IN1-16, 18, 19-name of insured, address, date of birth
beneficiary	IN1-16, 18, 19-name of insured, address, date of birth
dependent	- No exact HL7 v2 equivalent concept seems to exist;
period	IN1-12 / IN1-13
payor	IN1-3
class
value	IN1-8
name	IN1-8
order	- No exact HL7 v2 equivalent concept seems to exist;
costToBeneficiary
value[x]	IN1-8
contract	IN1-16, 18, 19

Mappings for Canadian Pharmacy Associaiton eclaims standard (http://www.pharmacists.ca/)

CDMCoverage
Coverage
policyHolder	C.35
subscriber	C.35
subscriberId	C.35
beneficiary	C.35
payor	C.30
class
value	C.31
name	C.31
costToBeneficiary
value[x]	C.31
contract	C.35