Business Rules

HealthcareService programs and services

References the following elements: .program, .category, .type.service, .type.procedure

We need to computationally enforce relationships between disparate code systems and/or FHIR elements. For example (pulling from Colorado State BHA Billing Manual pg. 31): CPT code 90785 is allowed to have only the following HCPCS/CPT modifiers HE, HK, U4, TM. In addition, the code is only allowed at a subset of Place of Service (03 School, 04 Shelter, 11 Office, etc.), for a certain subset of Service Provider(??) and Provider Bill Types (01, 02, etc.).