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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="KBV-PR-PTV-Claim-To-Review" />
  <url value="https://fhir.kbv.de/StructureDefinition/KBV_PR_PTV_Claim_To_Review" />
  <version value="1.0.0" />
  <name value="KBV_PR_PTV_Claim_To_Review" />
  <status value="draft" />
  <date value="2026-05-01" />
  <publisher value="Kassenärztliche Bundesvereinigung (KBV)" />
  <contact>
    <telecom>
      <system value="url" />
      <value value="http://www.kbv.de" />
    </telecom>
  </contact>
  <description value="Das Profil bildet die Antragsdaten auf Psychotherapie für die Begutachtung ab." />
  <copyright value="Copyright © [2025], Kassenärztliche Bundesvereinigung (KBV). All rights reserved. Im folgenden Profil können Codes aus den Codesystemen Snomed, Loinc oder Ucum enthalten sein, die dem folgenden Urheberrecht unterliegen: This material includes SNOMED Clinical Terms® SNOMED CT® which is used by permission of SNOMED International. All rights reserved. SNOMED CT®, was originally created by The College of American Pathologists. SNOMED and SNOMED CT are registered trademarks of SNOMED International. Implementers of these artefacts must have the appropriate SNOMED CT Affiliate license. This material contains content from Loinc http://loinc.org. Loinc is copyright ©; 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes Loinc Committee and is available at no cost under the license at http://loinc.org/license. Loinc® is a registered United States trademark of Regenstrief Institute, Inc. This product includes all or a portion of the UCUM table, UCUM codes, and UCUM definitions or is derived from it, subject to a license from Regenstrief Institute, Inc. and The UCUM Organization. Your use of the UCUM table, UCUM codes, UCUM definitions also is subject to this license, a copy of which is available at http://unitsofmeasure.org. The current complete UCUM table, UCUM Specification are available for download at http://unitsofmeasure.org. The UCUM table and UCUM codes are copyright ©; 1995-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures UCUM Organization. All rights reserved. THE UCUM TABLE IN ALL FORMATS, UCUM DEFINITIONS, AND SPECIFICATION ARE PROVIDED &amp;quot;AS IS.&amp;quot; ANY EXPRESS OR IMPLIED WARRANTIES ARE DISCLAIMED, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE." />
  <fhirVersion value="4.0.1" />
  <kind value="resource" />
  <abstract value="false" />
  <type value="Claim" />
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Claim" />
  <derivation value="constraint" />
  <differential>
    <element id="Claim">
      <path value="Claim" />
      <short value="Eine Zusammenfassung des Antrages auf Psychotherapie" />
      <definition value="Die Zusammenfassung des Antrages auf Psychotherapie" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.id">
      <path value="Claim.id" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.meta">
      <path value="Claim.meta" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.meta.id">
      <path value="Claim.meta.id" />
      <max value="0" />
    </element>
    <element id="Claim.meta.extension">
      <path value="Claim.meta.extension" />
      <max value="0" />
    </element>
    <element id="Claim.meta.versionId">
      <path value="Claim.meta.versionId" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.meta.lastUpdated">
      <path value="Claim.meta.lastUpdated" />
      <max value="0" />
    </element>
    <element id="Claim.meta.source">
      <path value="Claim.meta.source" />
      <max value="0" />
    </element>
    <element id="Claim.meta.profile">
      <path value="Claim.meta.profile" />
      <slicing>
        <discriminator>
          <type value="value" />
          <path value="$this" />
        </discriminator>
        <rules value="open" />
      </slicing>
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.meta.profile:PTVProfile">
      <path value="Claim.meta.profile" />
      <sliceName value="PTVProfile" />
      <min value="1" />
      <max value="1" />
      <fixedCanonical value="https://fhir.kbv.de/StructureDefinition/KBV_PR_PTV_Claim|1.0" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.meta.security">
      <path value="Claim.meta.security" />
      <max value="0" />
    </element>
    <element id="Claim.meta.tag">
      <path value="Claim.meta.tag" />
      <max value="0" />
    </element>
    <element id="Claim.implicitRules">
      <path value="Claim.implicitRules" />
      <max value="0" />
    </element>
    <element id="Claim.language">
      <path value="Claim.language" />
      <max value="0" />
    </element>
    <element id="Claim.contained">
      <path value="Claim.contained" />
      <max value="0" />
    </element>
    <element id="Claim.extension">
      <path value="Claim.extension" />
      <min value="2" />
    </element>
    <element id="Claim.extension:Unfallinformationen">
      <path value="Claim.extension" />
      <sliceName value="Unfallinformationen" />
      <min value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_Accident" />
      </type>
      <mustSupport value="true" />
      <isModifier value="false" />
    </element>
    <element id="Claim.extension:Unfallinformationen.url">
      <path value="Claim.extension.url" />
      <fixedUri value="https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_Accident" />
    </element>
    <element id="Claim.extension:Therapieangaben">
      <path value="Claim.extension" />
      <sliceName value="Therapieangaben" />
      <min value="1" />
      <type>
        <code value="Extension" />
        <profile value="https://fhir.kbv.de/StructureDefinition/KBV_EX_PTV_Therapy_Info" />
      </type>
      <mustSupport value="true" />
      <isModifier value="false" />
    </element>
    <element id="Claim.modifierExtension">
      <path value="Claim.modifierExtension" />
      <max value="0" />
    </element>
    <element id="Claim.identifier">
      <path value="Claim.identifier" />
      <min value="1" />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.status">
      <path value="Claim.status" />
      <fixedCode value="active" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.type">
      <path value="Claim.type" />
      <fixedCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/5.1.0/CodeSystem-claim-type.html" />
          <version value="5.0.0" />
          <code value="professional" />
          <display value="Professional" />
        </coding>
        <text value="Professional" />
      </fixedCodeableConcept>
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
      </binding>
    </element>
    <element id="Claim.type.id">
      <path value="Claim.type.id" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.type.extension">
      <path value="Claim.type.extension" />
      <max value="0" />
    </element>
    <element id="Claim.type.coding">
      <path value="Claim.type.coding" />
      <fixedCoding>
        <userSelected value="false" />
      </fixedCoding>
      <mustSupport value="true" />
    </element>
    <element id="Claim.subType">
      <path value="Claim.subType" />
      <max value="0" />
    </element>
    <element id="Claim.use">
      <path value="Claim.use" />
      <definition value="Eine Information darüber, ob es sich bei dem Antrag um Folgendes handelt: die Abrechnung bereits erbrachter Produkte und Dienstleistungen; die Beantragung einer Genehmigung und Abrechnung für künftige Leistungen; oder die Beantragung einer unverbindlichen Abrechnung der aufgeführten Produkte und Dienstleistungen, die künftig erbracht werden könnten." />
      <fixedCode value="preauthorization" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.patient">
      <path value="Claim.patient" />
      <short value="Der Patient" />
      <definition value="Der Patient, der die psychotherapeuthische Behnaldung in Ansprich nehmen soll" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_PTV_Patient_Pseudonym" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Claim.billablePeriod">
      <path value="Claim.billablePeriod" />
      <max value="0" />
    </element>
    <element id="Claim.created">
      <path value="Claim.created" />
      <short value="Ausstellungsdatum" />
      <definition value="Feld enthält das Datum, an dem das Dokument erstellt worden ist." />
      <mustSupport value="true" />
    </element>
    <element id="Claim.enterer">
      <path value="Claim.enterer" />
      <short value="Verantwortlicher Psychotherapeut" />
      <definition value="Der ausgebildete Psychotherapeut, der für die Antragsstellung verantwortlich ist und die Behandlung federführend begleitet." />
      <min value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Practitioner|1.3" />
        <aggregation value="bundled" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Claim.insurer">
      <path value="Claim.insurer" />
      <short value="Versicherung" />
      <definition value="Dieser Block enthält allgemeine Informationen zum Kostenträger." />
      <min value="1" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_PTV_Payor" />
        <aggregation value="bundled" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Claim.provider">
      <path value="Claim.provider" />
      <short value="Praxisinhaber" />
      <definition value="Der Inhaber der psyhotherapeutischen Praxis, in der die Therapie durchgeführt werden soll." />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_PTV_Therapist" />
        <aggregation value="bundled" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Claim.priority">
      <path value="Claim.priority" />
      <fixedCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/5.1.0/CodeSystem-processpriority.html" />
          <version value="0.1.0" />
          <code value="normal" />
          <display value="Normal" />
        </coding>
        <text value="Normal" />
      </fixedCodeableConcept>
      <mustSupport value="true" />
    </element>
    <element id="Claim.fundsReserve">
      <path value="Claim.fundsReserve" />
      <max value="0" />
    </element>
    <element id="Claim.related">
      <path value="Claim.related" />
      <max value="0" />
    </element>
    <element id="Claim.prescription">
      <path value="Claim.prescription" />
      <max value="0" />
    </element>
    <element id="Claim.originalPrescription">
      <path value="Claim.originalPrescription" />
      <max value="0" />
    </element>
    <element id="Claim.payee">
      <path value="Claim.payee" />
      <max value="0" />
    </element>
    <element id="Claim.referral">
      <path value="Claim.referral" />
      <max value="0" />
    </element>
    <element id="Claim.facility">
      <path value="Claim.facility" />
      <short value="Behandlungsort" />
      <definition value="Ort bzw. Praxis, in der die Behandlung durchgeführt wird." />
      <max value="0" />
      <mustSupport value="false" />
    </element>
    <element id="Claim.careTeam">
      <path value="Claim.careTeam" />
      <short value="Durchführender Therapeut" />
      <definition value="Der Therapeut, der die Psychotherapie tatsächlich durchführt. Kann der Praxisinhaber sien, aber auch eine in der Praxis angestellte Person oder eine Person in Ausbildung sein." />
      <max value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.careTeam.provider">
      <path value="Claim.careTeam.provider" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_PTV_Therapist" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Claim.careTeam.role">
      <path value="Claim.careTeam.role" />
      <max value="0" />
    </element>
    <element id="Claim.careTeam.qualification">
      <path value="Claim.careTeam.qualification" />
      <max value="0" />
    </element>
    <element id="Claim.supportingInfo">
      <path value="Claim.supportingInfo" />
      <max value="0" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.supportingInfo.extension">
      <path value="Claim.supportingInfo.extension" />
      <max value="0" />
    </element>
    <element id="Claim.supportingInfo.modifierExtension">
      <path value="Claim.supportingInfo.modifierExtension" />
      <max value="0" />
    </element>
    <element id="Claim.supportingInfo.category">
      <path value="Claim.supportingInfo.category" />
      <fixedCodeableConcept>
        <text value="info" />
      </fixedCodeableConcept>
      <mustSupport value="false" />
    </element>
    <element id="Claim.supportingInfo.code">
      <path value="Claim.supportingInfo.code" />
      <max value="0" />
    </element>
    <element id="Claim.supportingInfo.timing[x]">
      <path value="Claim.supportingInfo.timing[x]" />
      <max value="0" />
    </element>
    <element id="Claim.supportingInfo.value[x]">
      <path value="Claim.supportingInfo.value[x]" />
      <max value="0" />
      <type>
        <code value="Reference" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Claim.supportingInfo.reason">
      <path value="Claim.supportingInfo.reason" />
      <max value="0" />
    </element>
    <element id="Claim.diagnosis">
      <path value="Claim.diagnosis" />
      <max value="1" />
    </element>
    <element id="Claim.diagnosis.diagnosis[x]">
      <path value="Claim.diagnosis.diagnosis[x]" />
      <short value="ICD-10-Diagnosen" />
      <definition value="Antragsgebründende Diagnosen, die eine psychotherapeutische Behandlung rechtfertigen würden" />
      <type>
        <code value="CodeableConcept" />
      </type>
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_PTV_Condition_ICD" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Claim.diagnosis.type">
      <path value="Claim.diagnosis.type" />
      <max value="0" />
    </element>
    <element id="Claim.diagnosis.onAdmission">
      <path value="Claim.diagnosis.onAdmission" />
      <max value="0" />
    </element>
    <element id="Claim.diagnosis.packageCode">
      <path value="Claim.diagnosis.packageCode" />
      <max value="0" />
    </element>
    <element id="Claim.procedure">
      <path value="Claim.procedure" />
      <max value="0" />
    </element>
    <element id="Claim.insurance">
      <path value="Claim.insurance" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.insurance.extension">
      <path value="Claim.insurance.extension" />
      <max value="0" />
    </element>
    <element id="Claim.insurance.modifierExtension">
      <path value="Claim.insurance.modifierExtension" />
      <max value="0" />
    </element>
    <element id="Claim.insurance.identifier.extension">
      <path value="Claim.insurance.identifier.extension" />
      <max value="0" />
    </element>
    <element id="Claim.insurance.identifier.type">
      <path value="Claim.insurance.identifier.type" />
      <max value="0" />
    </element>
    <element id="Claim.insurance.coverage">
      <path value="Claim.insurance.coverage" />
      <type>
        <code value="Reference" />
        <targetProfile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Coverage|1.3" />
      </type>
      <mustSupport value="true" />
    </element>
    <element id="Claim.insurance.coverage.extension">
      <path value="Claim.insurance.coverage.extension" />
      <max value="0" />
    </element>
    <element id="Claim.insurance.coverage.type">
      <path value="Claim.insurance.coverage.type" />
      <max value="0" />
    </element>
    <element id="Claim.insurance.businessArrangement">
      <path value="Claim.insurance.businessArrangement" />
      <max value="0" />
    </element>
    <element id="Claim.insurance.preAuthRef">
      <path value="Claim.insurance.preAuthRef" />
      <max value="0" />
    </element>
    <element id="Claim.insurance.claimResponse">
      <path value="Claim.insurance.claimResponse" />
      <max value="0" />
    </element>
    <element id="Claim.accident">
      <path value="Claim.accident" />
      <max value="0" />
    </element>
    <element id="Claim.item">
      <path value="Claim.item" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.item.sequence">
      <path value="Claim.item.sequence" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.item.careTeamSequence">
      <path value="Claim.item.careTeamSequence" />
      <max value="0" />
    </element>
    <element id="Claim.item.diagnosisSequence">
      <path value="Claim.item.diagnosisSequence" />
      <max value="0" />
    </element>
    <element id="Claim.item.procedureSequence">
      <path value="Claim.item.procedureSequence" />
      <max value="0" />
    </element>
    <element id="Claim.item.informationSequence">
      <path value="Claim.item.informationSequence" />
      <max value="0" />
    </element>
    <element id="Claim.item.revenue">
      <path value="Claim.item.revenue" />
      <max value="0" />
    </element>
    <element id="Claim.item.category">
      <path value="Claim.item.category" />
      <max value="0" />
    </element>
    <element id="Claim.item.productOrService">
      <path value="Claim.item.productOrService" />
      <short value="Therapieeinheiten für Patienten oder Bezugsperson" />
      <definition value="Gibt an für wen die Therapieeinheiten beantragt werden. Für den Patienten oder die Bezugsperson." />
      <comment value="." />
      <requirements value="." />
      <mustSupport value="true" />
      <binding>
        <strength value="required" />
        <description value="Therapieeinheiten für Patienten oder Bezugsperson" />
        <valueSet value="https://fhir.kbv.de/CodeSystem/KBV_CS_PTV_Therapy_Units" />
      </binding>
    </element>
    <element id="Claim.item.productOrService.coding.system">
      <path value="Claim.item.productOrService.coding.system" />
      <fixedUri value="https://fhir.kbv.de/CodeSystem/KBV_CS_PTV_Therapy_Units" />
    </element>
    <element id="Claim.item.productOrService.coding.version">
      <path value="Claim.item.productOrService.coding.version" />
      <max value="0" />
    </element>
    <element id="Claim.item.productOrService.coding.userSelected">
      <path value="Claim.item.productOrService.coding.userSelected" />
      <max value="0" />
    </element>
    <element id="Claim.item.modifier">
      <path value="Claim.item.modifier" />
      <max value="0" />
    </element>
    <element id="Claim.item.programCode">
      <path value="Claim.item.programCode" />
      <max value="0" />
    </element>
    <element id="Claim.item.serviced[x]">
      <path value="Claim.item.serviced[x]" />
      <max value="0" />
    </element>
    <element id="Claim.item.location[x]">
      <path value="Claim.item.location[x]" />
      <max value="0" />
    </element>
    <element id="Claim.item.quantity">
      <path value="Claim.item.quantity" />
      <min value="1" />
      <mustSupport value="true" />
    </element>
    <element id="Claim.item.quantity.extension">
      <path value="Claim.item.quantity.extension" />
      <max value="0" />
    </element>
    <element id="Claim.item.quantity.system">
      <path value="Claim.item.quantity.system" />
      <max value="0" />
    </element>
    <element id="Claim.item.quantity.code">
      <path value="Claim.item.quantity.code" />
      <max value="0" />
    </element>
    <element id="Claim.item.unitPrice">
      <path value="Claim.item.unitPrice" />
      <max value="0" />
    </element>
    <element id="Claim.item.factor">
      <path value="Claim.item.factor" />
      <max value="0" />
    </element>
    <element id="Claim.item.net">
      <path value="Claim.item.net" />
      <max value="0" />
    </element>
    <element id="Claim.item.udi">
      <path value="Claim.item.udi" />
      <max value="0" />
    </element>
    <element id="Claim.item.bodySite">
      <path value="Claim.item.bodySite" />
      <max value="0" />
    </element>
    <element id="Claim.item.subSite">
      <path value="Claim.item.subSite" />
      <max value="0" />
    </element>
    <element id="Claim.item.encounter">
      <path value="Claim.item.encounter" />
      <max value="0" />
    </element>
    <element id="Claim.item.detail">
      <path value="Claim.item.detail" />
      <max value="0" />
    </element>
    <element id="Claim.total">
      <path value="Claim.total" />
      <max value="0" />
    </element>
  </differential>
</StructureDefinition>

name : KBV_PR_PTV_Claim_To_Review

{

}

<name value="KBV_PR_PTV_Claim_To_Review" />