<status value="active" /> <experimental value="false" /> <description value="Indicates a code that can be sent as a 'modifier' on the Claim item in a subsequent adjudication call that would override the adjudication reason being extended." /> <fhirVersion value="5.0.0" /> <mapping> <identity value="BPCS" /> <name value="Internal BPCS API" /> </mapping> <kind value="complex-type" /> <abstract value="false" /> <context> <type value="element" /> <expression value="ClaimResponse.item.reviewOutcome.reason" /> </context> <type value="Extension" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Extension" /> <derivation value="constraint" /> <snapshot> <element id="Extension"> <path value="Extension" /> <short value="Allowed modifier" /> <definition value="Indicates a code that can be sent as a 'modifier' on the Claim item in a subsequent adjudication call that would override the adjudication reason being extended." /> <comment value="In some cases 'allowed modifiers' may be listed that, on claim submission turn out to be disallowed. In this situation, the modifier will be dropped from the list of allowed modifiers after the initial adjudication." /> <min value="0" /> <max value="*" /> <base> <path value="Extension" /> <min value="0" /> <max value="*" /> </base> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Extension.id"> <path value="Extension.id" /> <representation value="xmlAttr" /> <short value="Unique id for inter-element referencing" /> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." /> <min value="0" /> <max value="1" /> <base> <path value="Element.id" /> <min value="0" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="string" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <condition value="ele-1" /> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> </element> <element id="Extension.extension"> <path value="Extension.extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <description value="Extensions are always sliced by (at least) url" /> <rules value="open" /> </slicing> <short value="Additional content defined by implementations" /> <definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." /> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." /> <alias value="extensions" /> <alias value="user content" /> <min value="0" /> <max value="*" /> <base> <path value="Element.extension" /> <min value="0" /> <max value="*" /> </base> <type> <code value="Extension" /> </type> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="ext-1" /> <severity value="error" /> <human value="Must have either extensions or value[x], not both" /> <expression value="extension.exists() != value.exists()" /> <source value="http://hl7.org/fhir/StructureDefinition/Extension" /> </constraint> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Extension.url"> <path value="Extension.url" /> <representation value="xmlAttr" /> <short value="identifies the meaning of the extension" /> <definition value="Source of the definition for the extension code - a logical name or a URL." /> <comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." /> <min value="1" /> <max value="1" /> <base> <path value="Extension.url" /> <min value="1" /> <max value="1" /> </base> <type> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type"> <valueUrl value="uri" /> </extension> <code value="http://hl7.org/fhirpath/System.String" /> </type> <fixedUri value="https://bpcs.exchange/fhir/StructureDefinition/ext-ClaimResponse-AllowedModifier" /> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> </element> <element id="Extension.value[x]"> <path value="Extension.value[x]" /> <short value="A reference to a code defined by a terminology system" /> <definition value="A reference to a code defined by a terminology system." /> <comment value="Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information." /> <min value="0" /> <max value="1" /> <base> <path value="Extension.value[x]" /> <min value="0" /> <max value="1" /> </base> <type> <code value="Coding" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Coding-simple" /> </type> <condition value="ext-1" /> <constraint> <key value="ele-1" /> <severity value="error" /> <human value="All FHIR elements must have a @value or children" /> <expression value="hasValue() or (children().count() > id.count())" /> <source value="http://hl7.org/fhir/StructureDefinition/Element" /> </constraint> <constraint> <key value="cod-1" /> <severity value="warning" /> <human value="A Coding SHOULD NOT have a display unless a code is also present. Computation on Coding.display alone is generally unsafe. Consider using CodeableConcept.text" /> <expression value="code.exists().not() implies display.exists().not()" /> <source value="http://hl7.org/fhir/StructureDefinition/Coding" /> </constraint> <mustSupport value="true" /> <binding> <strength value="extensible" /> <valueSet value="https://bpcs.exchange/fhir/ValueSet/vs-ClaimResponse-AllowedModifier" /> </binding> <mapping> <identity value="rim" /> <map value="n/a" /> </mapping> <mapping> <identity value="rim" /> <map value="N/A" /> </mapping> <mapping> <identity value="v2" /> <map value="CE/CNE/CWE subset one of the sets of component 1-3 or 4-6" /> </mapping> <mapping> <identity value="rim" /> <map value="CV" /> </mapping> <mapping> <identity value="orim" /> <map value="fhir:Coding rdfs:subClassOf dt:CDCoding" /> </mapping> <mapping> <identity value="BPCS" /> <map value="AssessmentFlag.reasnUseCd, other override codes populated by intermediary based on what overrides are permitted for a given response code or EFlag" /> </mapping> </element> </snapshot> <differential> <element id="Extension"> <path value="Extension" /> <short value="Allowed modifier" /> <definition value="Indicates a code that can be sent as a 'modifier' on the Claim item in a subsequent adjudication call that would override the adjudication reason being extended." /> <comment value="In some cases 'allowed modifiers' may be listed that, on claim submission turn out to be disallowed. In this situation, the modifier will be dropped from the list of allowed modifiers after the initial adjudication." /> </element> <element id="Extension.url"> <path value="Extension.url" /> <fixedUri value="https://bpcs.exchange/fhir/StructureDefinition/ext-ClaimResponse-AllowedModifier" /> </element> <element id="Extension.value[x]"> <path value="Extension.value[x]" /> <type> <code value="Coding" /> <profile value="https://bpcs.exchange/fhir/StructureDefinition/profile-Coding-simple" /> </type> <mustSupport value="true" /> <binding> <strength value="extensible" /> <valueSet value="https://bpcs.exchange/fhir/ValueSet/vs-ClaimResponse-AllowedModifier" /> </binding> <mapping> <identity value="BPCS" /> <map value="AssessmentFlag.reasnUseCd, other override codes populated by intermediary based on what overrides are permitted for a given response code or EFlag" /> </mapping> </element> </differential> </StructureDefinition>