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

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Resource Profile: CDMExplanationOfBenefit - Mappings

Active as of 2022-11-10

Mappings for the cdm-explanation-of-benefit resource profile.

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

CDMExplanationOfBenefit
ExplanationOfBenefit	Event
identifier	Event.identifier
status	Event.status
type	Event.code
patient	Event.subject
created	Event.occurrence[x]
enterer	Event.performer.agent
insurer	Event.performer.agent
facility	Event.performer.location

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

CDMExplanationOfBenefit
ExplanationOfBenefit
identifier	FiveWs.identifier
status	FiveWs.status
type	FiveWs.class
subType	FiveWs.class
use	FiveWs.class
patient	FiveWs.subject[x], FiveWs.subject
billablePeriod	FiveWs.done[x]
created	FiveWs.recorded
enterer	FiveWs.author
insurer	FiveWs.author
provider	FiveWs.source
referral	FiveWs.cause
facility	FiveWs.where[x]
claim	FiveWs.why[x]
careTeam
provider	FiveWs.actor
item
serviced[x]	FiveWs.done[x]
location[x]	FiveWs.where[x]
addItem
provider	FiveWs.source
serviced[x]	FiveWs.done[x]
location[x]	FiveWs.where[x]

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

CDMExplanationOfBenefit
ExplanationOfBenefit
identifier
use	N/A
type	CX.5
system	CX.4 / EI-2-4
value	CX.1 / EI.1
period	CX.7 + CX.8
assigner	CX.4 / (CX.4,CX.9,CX.10)
priority	Request.priority
insurance	Coverage
item
quantity
value	SN.2 / CQ - N/A
unit	(see OBX.6 etc.) / CQ.2
system	(see OBX.6 etc.) / CQ.2
code	(see OBX.6 etc.) / CQ.2

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

CDMExplanationOfBenefit
ExplanationOfBenefit	Entity. Role, or Act
meta	n/a, N/A
text	Act.text?
modifierExtension	N/A
identifier
id	n/a
extension	n/a
use	Role.code or implied by context
type	Role.code or implied by context
system	II.root or Role.id.root
value	II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
period	Role.effectiveTime or implied by context
assigner	II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
related
id	n/a
extension	n/a
modifierExtension	N/A
payee
id	n/a
extension	n/a
modifierExtension	N/A
careTeam
id	n/a
extension	n/a
modifierExtension	N/A
supportingInfo
id	n/a
extension	n/a
modifierExtension	N/A
diagnosis
id	n/a
extension	n/a
modifierExtension	N/A
procedure
id	n/a
extension	n/a
modifierExtension	N/A
insurance
id	n/a
extension	n/a
modifierExtension	N/A
accident
id	n/a
extension	n/a
modifierExtension	N/A
item
id	n/a
modifierExtension	N/A
quantity
id	n/a
extension	n/a
value	PQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
unit	PQ.unit
system	CO.codeSystem, PQ.translation.codeSystem
code	PQ.code, MO.currency, PQ.translation.code
adjudication
id	n/a
extension	n/a
modifierExtension	N/A
detail
id	n/a
extension	n/a
modifierExtension	N/A
subDetail
id	n/a
extension	n/a
modifierExtension	N/A
addItem
id	n/a
extension	n/a
modifierExtension	N/A
detail
id	n/a
extension	n/a
modifierExtension	N/A
subDetail
id	n/a
extension	n/a
modifierExtension	N/A
adjudication
id	n/a
modifierExtension	N/A
total
id	n/a
extension	n/a
modifierExtension	N/A
payment
id	n/a
extension	n/a
modifierExtension	N/A
processNote
id	n/a
extension	n/a
modifierExtension	N/A
benefitBalance
id	n/a
extension	n/a
modifierExtension	N/A
financial
id	n/a
extension	n/a
modifierExtension	N/A