SIMPLIFIER.NET - FHIRPath Playground

FHIRPath

If you Log in or sign up, you can edit this script yourself.

{
  "resourceType": "StructureDefinition",
  "id": "KBV-PR-FOR-Coverage",
  "url": "https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Coverage",
  "version": "1.2.0",
  "name": "KBV_PR_FOR_Coverage",
  "status": "draft",
  "date": "2024-11-22",
  "publisher": "Kassenärztliche Bundesvereinigung (KBV)",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Coverage",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Coverage",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Coverage",
        "path": "Coverage",
        "definition": "Das Versicherungsverhältnis, welches genutzt werden kann, um die Kosten für die Behandlungskosten zu tragen.",
        "constraint": [
          {
            "key": "-for-angabeIKzustaendigeKrankenkasseEGKPflicht",
            "severity": "error",
            "human": "Das IK der zustaendigen Krankenkasse ist nicht vorhanden, sie ist aber bei den Kostentraegern vom Typ 'GKV', 'BG', 'SKT', 'PKV' oder 'UK' ein Pflichtelement.",
            "expression": "(type.coding.code='GKV' or type.coding.code='BG' or type.coding.code='SKT' or type.coding.code='UK' or type.coding.code='PKV') implies payor.identifier.exists()"
          },
          {
            "key": "-for-angabeVersichertenartPflicht",
            "severity": "error",
            "human": "Die Versichertenart ist nicht vorhanden, sie ist aber bei den Kostentraegern vom Typ 'GKV', 'BG', 'SKT', 'PKV' oder 'UK' ein Pflichtelement.",
            "expression": "(type.coding.code='GKV' or type.coding.code='BG' or type.coding.code='SKT' or type.coding.code='UK' or type.coding.code='PKV') implies extension('http://fhir.de/StructureDefinition/gkv/versichertenart').exists()"
          },
          {
            "key": "-for-angabeBesonderePersonengruppePflicht",
            "severity": "error",
            "human": "Die Besondere Personengruppe ist nicht vorhanden, sie ist aber bei den Kostentraegern vom Typ 'GKV', 'BG', 'SKT', 'PKV' oder 'UK' ein Pflichtelement.",
            "expression": "(type.coding.code='GKV' or type.coding.code='BG' or type.coding.code='SKT' or type.coding.code='UK' or type.coding.code='PKV') implies extension('http://fhir.de/StructureDefinition/gkv/besondere-personengruppe').exists()"
          },
          {
            "key": "-for-angabeIKKostentraegerVerbot",
            "severity": "error",
            "human": "Nur wenn der Kostentraeger vom Typ BG oder UK ist, dann kann das IK des Kostentraegers uebertragen werden",
            "expression": "(type.coding.code='GKV' or type.coding.code='SKT' or type.coding.code='SEL' or type.coding.code='PKV') implies payor.identifier.extension('https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_Alternative_IK').exists().not()"
          },
          {
            "key": "-for-angabeDMPPflicht",
            "severity": "error",
            "human": "Das DMP-Kennzeichen ist nicht vorhanden, dieses ist aber bei den Kostentraegern vom Typ 'GKV', 'BG', 'SKT', 'PKV' oder 'UK' ein Pflichtelement.",
            "expression": "(type.coding.code='GKV' or type.coding.code='BG' or type.coding.code='SKT' or type.coding.code='UK' or type.coding.code='PKV') implies extension('http://fhir.de/StructureDefinition/gkv/dmp-kennzeichen').exists()"
          }
        ]
      },
      {
        "id": "Coverage.id",
        "path": "Coverage.id",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.meta",
        "path": "Coverage.meta",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.meta.versionId",
        "path": "Coverage.meta.versionId",
        "max": "0"
      },
      {
        "id": "Coverage.meta.lastUpdated",
        "path": "Coverage.meta.lastUpdated",
        "max": "0"
      },
      {
        "id": "Coverage.meta.source",
        "path": "Coverage.meta.source",
        "max": "0"
      },
      {
        "id": "Coverage.meta.profile",
        "path": "Coverage.meta.profile",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "$this"
            }
          ],
          "rules": "open"
        },
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.meta.profile:forProfile",
        "path": "Coverage.meta.profile",
        "sliceName": "forProfile",
        "min": 1,
        "max": "1",
        "fixedCanonical": "https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Coverage|1.2",
        "mustSupport": true
      },
      {
        "id": "Coverage.meta.security",
        "path": "Coverage.meta.security",
        "max": "0"
      },
      {
        "id": "Coverage.meta.tag",
        "path": "Coverage.meta.tag",
        "max": "0"
      },
      {
        "id": "Coverage.implicitRules",
        "path": "Coverage.implicitRules",
        "max": "0"
      },
      {
        "id": "Coverage.language",
        "path": "Coverage.language",
        "max": "0"
      },
      {
        "id": "Coverage.text",
        "path": "Coverage.text",
        "max": "0"
      },
      {
        "id": "Coverage.contained",
        "path": "Coverage.contained",
        "max": "0"
      },
      {
        "id": "Coverage.extension",
        "path": "Coverage.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "closed"
        },
        "max": "4",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:BesonderePersonengruppe",
        "path": "Coverage.extension",
        "sliceName": "BesonderePersonengruppe",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.de/StructureDefinition/gkv/besondere-personengruppe"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:BesonderePersonengruppe.value[x]",
        "path": "Coverage.extension.value[x]",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:BesonderePersonengruppe.value[x].system",
        "path": "Coverage.extension.value[x].system",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:BesonderePersonengruppe.value[x].version",
        "path": "Coverage.extension.value[x].version",
        "max": "0"
      },
      {
        "id": "Coverage.extension:BesonderePersonengruppe.value[x].code",
        "path": "Coverage.extension.value[x].code",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:BesonderePersonengruppe.value[x].display",
        "path": "Coverage.extension.value[x].display",
        "max": "0"
      },
      {
        "id": "Coverage.extension:BesonderePersonengruppe.value[x].userSelected",
        "path": "Coverage.extension.value[x].userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.extension:DMPKennzeichen",
        "path": "Coverage.extension",
        "sliceName": "DMPKennzeichen",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.de/StructureDefinition/gkv/dmp-kennzeichen"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:DMPKennzeichen.value[x]",
        "path": "Coverage.extension.value[x]",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:DMPKennzeichen.value[x].system",
        "path": "Coverage.extension.value[x].system",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:DMPKennzeichen.value[x].version",
        "path": "Coverage.extension.value[x].version",
        "max": "0"
      },
      {
        "id": "Coverage.extension:DMPKennzeichen.value[x].code",
        "path": "Coverage.extension.value[x].code",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:DMPKennzeichen.value[x].display",
        "path": "Coverage.extension.value[x].display",
        "max": "0"
      },
      {
        "id": "Coverage.extension:DMPKennzeichen.value[x].userSelected",
        "path": "Coverage.extension.value[x].userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.extension:Versichertenart",
        "path": "Coverage.extension",
        "sliceName": "Versichertenart",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.de/StructureDefinition/gkv/versichertenart"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:Versichertenart.value[x]",
        "path": "Coverage.extension.value[x]",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:Versichertenart.value[x].system",
        "path": "Coverage.extension.value[x].system",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:Versichertenart.value[x].version",
        "path": "Coverage.extension.value[x].version",
        "max": "0"
      },
      {
        "id": "Coverage.extension:Versichertenart.value[x].code",
        "path": "Coverage.extension.value[x].code",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:Versichertenart.value[x].display",
        "path": "Coverage.extension.value[x].display",
        "max": "0"
      },
      {
        "id": "Coverage.extension:Versichertenart.value[x].userSelected",
        "path": "Coverage.extension.value[x].userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.extension:WOP",
        "path": "Coverage.extension",
        "sliceName": "WOP",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://fhir.de/StructureDefinition/gkv/wop"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:WOP.value[x]",
        "path": "Coverage.extension.value[x]",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:WOP.value[x].system",
        "path": "Coverage.extension.value[x].system",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:WOP.value[x].version",
        "path": "Coverage.extension.value[x].version",
        "max": "0"
      },
      {
        "id": "Coverage.extension:WOP.value[x].code",
        "path": "Coverage.extension.value[x].code",
        "mustSupport": true
      },
      {
        "id": "Coverage.extension:WOP.value[x].display",
        "path": "Coverage.extension.value[x].display",
        "max": "0"
      },
      {
        "id": "Coverage.extension:WOP.value[x].userSelected",
        "path": "Coverage.extension.value[x].userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.identifier",
        "path": "Coverage.identifier",
        "short": "Primaerer Identifier der Versicherung",
        "definition": "Ein gesetzliches Versicherungsverhältnis sollte stets durch die eindeutige 30-stellige Versichertennummer identifiziert werden. Ist diese nicht bekannt, so wird die 10-stellige VersichertenID statt dessen verwendet.",
        "max": "0",
        "mustSupport": true
      },
      {
        "id": "Coverage.status",
        "path": "Coverage.status",
        "fixedCode": "active",
        "mustSupport": true
      },
      {
        "id": "Coverage.type",
        "path": "Coverage.type",
        "short": "Kostenträgertyp",
        "definition": "Art des Kostenträgers",
        "min": 1,
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://fhir.kbv.de/ValueSet/KBV_VS_FOR_Payor_type"
        }
      },
      {
        "id": "Coverage.type.coding",
        "path": "Coverage.type.coding",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Coverage.type.coding.system",
        "path": "Coverage.type.coding.system",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.type.coding.version",
        "path": "Coverage.type.coding.version",
        "max": "0"
      },
      {
        "id": "Coverage.type.coding.code",
        "path": "Coverage.type.coding.code",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.type.coding.display",
        "path": "Coverage.type.coding.display",
        "max": "0"
      },
      {
        "id": "Coverage.type.coding.userSelected",
        "path": "Coverage.type.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.type.text",
        "path": "Coverage.type.text",
        "max": "0"
      },
      {
        "id": "Coverage.policyHolder",
        "path": "Coverage.policyHolder",
        "max": "0"
      },
      {
        "id": "Coverage.subscriber",
        "path": "Coverage.subscriber",
        "max": "0"
      },
      {
        "id": "Coverage.subscriberId",
        "path": "Coverage.subscriberId",
        "max": "0"
      },
      {
        "id": "Coverage.beneficiary",
        "path": "Coverage.beneficiary",
        "short": "Begünstigte Person",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.kbv.de/StructureDefinition/KBV_PR_FOR_Patient|1.2"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.beneficiary.reference",
        "path": "Coverage.beneficiary.reference",
        "definition": "An dieser Stelle wird die Referenz zum Patienten hinterlegt.",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.beneficiary.type",
        "path": "Coverage.beneficiary.type",
        "max": "0"
      },
      {
        "id": "Coverage.beneficiary.identifier",
        "path": "Coverage.beneficiary.identifier",
        "max": "0"
      },
      {
        "id": "Coverage.beneficiary.display",
        "path": "Coverage.beneficiary.display",
        "max": "0"
      },
      {
        "id": "Coverage.dependent",
        "path": "Coverage.dependent",
        "max": "0"
      },
      {
        "id": "Coverage.relationship",
        "path": "Coverage.relationship",
        "max": "0"
      },
      {
        "id": "Coverage.period",
        "path": "Coverage.period",
        "constraint": [
          {
            "key": "-for-begrenzungDate",
            "severity": "error",
            "human": "Beschränkung auf die Angaben JJJJ-MM-TT",
            "expression": "end.toString().length() = 10"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.period.start",
        "path": "Coverage.period.start",
        "max": "0"
      },
      {
        "id": "Coverage.period.end",
        "path": "Coverage.period.end",
        "short": "Versicherungsschutz Ende",
        "definition": "Angabe zum Versicherungsschutz Ende",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Coverage.payor",
        "path": "Coverage.payor",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.reference",
        "path": "Coverage.payor.reference",
        "max": "0"
      },
      {
        "id": "Coverage.payor.type",
        "path": "Coverage.payor.type",
        "max": "0"
      },
      {
        "id": "Coverage.payor.identifier",
        "path": "Coverage.payor.identifier",
        "short": "IKs",
        "type": [
          {
            "code": "Identifier",
            "profile": [
              "http://fhir.de/StructureDefinition/identifier-iknr"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.identifier.extension",
        "path": "Coverage.payor.identifier.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "closed"
        },
        "max": "1"
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID",
        "path": "Coverage.payor.identifier.extension",
        "sliceName": "alternativeID",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.kbv.de/StructureDefinition/KBV_EX_FOR_Alternative_IK"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]",
        "path": "Coverage.payor.identifier.extension.value[x]",
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]:valueIdentifier",
        "path": "Coverage.payor.identifier.extension.value[x]",
        "sliceName": "valueIdentifier",
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]:valueIdentifier.use",
        "path": "Coverage.payor.identifier.extension.value[x].use",
        "mustSupport": false
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]:valueIdentifier.type",
        "path": "Coverage.payor.identifier.extension.value[x].type",
        "mustSupport": false
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]:valueIdentifier.type.coding",
        "path": "Coverage.payor.identifier.extension.value[x].type.coding",
        "mustSupport": false
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]:valueIdentifier.type.coding.system",
        "path": "Coverage.payor.identifier.extension.value[x].type.coding.system",
        "mustSupport": false
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]:valueIdentifier.type.coding.code",
        "path": "Coverage.payor.identifier.extension.value[x].type.coding.code",
        "mustSupport": false
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]:valueIdentifier.system",
        "path": "Coverage.payor.identifier.extension.value[x].system",
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.identifier.extension:alternativeID.value[x]:valueIdentifier.value",
        "path": "Coverage.payor.identifier.extension.value[x].value",
        "constraint": [
          {
            "key": "-for-laengeIK",
            "severity": "error",
            "human": "Die IK-Nummer muss 9-stellig numerisch sein.",
            "expression": "matches('^[0-9]{9}$')"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.identifier.type.coding.version",
        "path": "Coverage.payor.identifier.type.coding.version",
        "max": "0"
      },
      {
        "id": "Coverage.payor.identifier.type.coding.display",
        "path": "Coverage.payor.identifier.type.coding.display",
        "max": "0"
      },
      {
        "id": "Coverage.payor.identifier.type.coding.userSelected",
        "path": "Coverage.payor.identifier.type.coding.userSelected",
        "max": "0"
      },
      {
        "id": "Coverage.payor.identifier.type.text",
        "path": "Coverage.payor.identifier.type.text",
        "max": "0"
      },
      {
        "id": "Coverage.payor.identifier.system",
        "path": "Coverage.payor.identifier.system",
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.identifier.value",
        "path": "Coverage.payor.identifier.value",
        "constraint": [
          {
            "key": "-for-laengeIK",
            "severity": "error",
            "human": "Die IK-Nummer muss 9-stellig numerisch sein.",
            "expression": "matches('^[0-9]{9}$')"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Coverage.payor.identifier.period",
        "path": "Coverage.payor.identifier.period",
        "max": "0"
      },
      {
        "id": "Coverage.payor.identifier.assigner",
        "path": "Coverage.payor.identifier.assigner",
        "max": "0"
      },
      {
        "id": "Coverage.payor.display",
        "path": "Coverage.payor.display",
        "short": "Kostenträgername",
        "min": 1,
        "maxLength": 45,
        "mustSupport": true
      },
      {
        "id": "Coverage.class",
        "path": "Coverage.class",
        "max": "0"
      },
      {
        "id": "Coverage.order",
        "path": "Coverage.order",
        "max": "0"
      },
      {
        "id": "Coverage.network",
        "path": "Coverage.network",
        "max": "0"
      },
      {
        "id": "Coverage.costToBeneficiary",
        "path": "Coverage.costToBeneficiary",
        "max": "0"
      },
      {
        "id": "Coverage.subrogation",
        "path": "Coverage.subrogation",
        "max": "0"
      },
      {
        "id": "Coverage.contract",
        "path": "Coverage.contract",
        "max": "0"
      }
    ]
  }
}

name : KBV_PR_FOR_Coverage

{

}