ChargeItem

• Overview
• Terminology Bindings
• Extensions
  • Custom Extensions
• Search
  • Authorization Types
  • Parameters
  • Headers
  • Example
  • Errors
• Retrieve by id
  • Authorization Types
  • Headers
  • Example
  • Errors
• Operation: charge-item-credit
  • Authorization Types
  • Headers
  • Body Fields
  • Example
  • Errors

Overview

The ChargeItem resource describes the provision of healthcare provider products for a certain patient, therefore referring not only to the product, but containing in addition details of the provision, like date, time, amounts and participating organizations and persons. The main usage of the ChargeItem is to enable the billing process and internal cost allocation.

The following fields are returned if valued:

• ChargeItem id
• Status
• Code
• Subject
• Context
• Occurrence
• Performer
• Requesting Organization
• Quantity
• Enterer
• Entered Date
• Reason
• Account
• Extensions including bill code schedule, custom attribute, description, modifier code, national drug product, net price, offset by, performing location, procedure code, quantity conversion factor, replacing, revenue code, and unit price

Terminology Bindings

Chargeitem.code

Description A code that identifies the charge, like a billing code. Bill code type can be either CDM_SCHED, CPT, HCPCS, or PROCCODE. Details: Bill Codes Types System: https://fhir.cerner.com/<EHR source id>/CodeSystem/BillCodes-<Bill code type>

Chargeitem.reason

Description Describes why the event occurred in coded or textual form. Details: Bill Codes Types System: https://fhir.cerner.com/<EHR source id>/CodeSystem/BillCodes-ICD

Chargeitem.extension[x].extension[x].valueCodeableConcept

Description A code providing additional detail about a product or service. This binding is used in modifier-code extensions. Details: Bill Codes Types System: https://fhir.cerner.com/<EHR source id>/CodeSystem/BillCodes-MODIFIER

Chargeitem.extension[x].extension[x].valueCodeableConcept

Description A code providing information about the procedure performed on the patient associated to the resource. This binding is used in procedure-code extensions. Bill code type can be either CPT, HCPCS, or PROCCODE. Details: Bill Codes Types System: https://fhir.cerner.com/<EHR source id>/CodeSystem/BillCodes-<Bill code type>

Chargeitem.extension[x].valueCodeableConcept

Description The type of revenue or cost center providing the product and/or service. This binding is used in revenue-code extensions. Details: Bill Codes Types System: https://fhir.cerner.com/<EHR source id>/CodeSystem/BillCodes-REVENUE

Chargeitem.code.coding.extension[x].valueCoding

Description A defined group of bill codes that drives billing behavior. This binding is used in bill-code-schedule extensions. Details: Bill Code Schedule System: https://fhir.cerner.com/<EHR source id>/codeSet/14002

Chargeitem.reason.coding.extension[x].valueCoding

Description A defined group of bill codes that drives billing behavior. This binding is used in bill-code-schedule extensions. Details: Bill Code Schedule System: https://fhir.cerner.com/<EHR source id>/codeSet/14002

Chargeitem.extension[x].extension[x].valueCodeableConcept.coding.extension[x].valueCoding

Description A defined group of bill codes that drives billing behavior. This binding is used in bill-code-schedule extensions. Details: Bill Code Schedule System: https://fhir.cerner.com/<EHR source id>/codeSet/14002

Chargeitem.extension[x].valueMoney.currency

Description Currency codes from ISO 4217 (see https://www.iso.org/iso-4217-currency-codes.html). This binding is used in net-price and unit-price extensions. Details: Currencies System: urn:iso:std:iso:4217

Chargeitem.extension[x].extension[x].valueCodeableConcept

Description The national drug code for pharmacy charges. This binding is used in national-drug-product extensions. Details: National Drug Product System: https://hl7.org/fhir/sid/ndc

Chargeitem.extension[x].extension[x].valueQuantity

Description The quantity for national drug code for pharmacy charges. This binding is used in national-drug-product-quantity extensions. Details: National Drug Product Quantity System: http://unitsofmeasure.org

Chargeitem.performer.function

Description A code that identifies the function of the performer. Details: Performer function codes System: http://terminology.hl7.org/CodeSystem/v3-ParticipationType Details: Participation codes System: http://terminology.hl7.org/CodeSystem/v2-0912

Extensions

• Bill Code Schedule
• Custom Attribute
• Description
• Modifier Code
• National Drug Product
• Net Price
• Offset By
• Performing Location
• Priority
• Procedure Code
• Quantity Conversion Factor
• Replacing
• Revenue Code
• Unit Price

Custom Extensions

All URLs for custom extensions are defined as https://fhir-ehr.cerner.com/r4/StructureDefinition/{id}

ID	Value[x] Type	Description
bill-code-schedule	coding	A defined group of bill codes that drives billing behavior.
custom-attribute	None (contains nested extensions)	A client defined custom attribute for the resource. Attribute values can be of type integer, string, decimal, or date.
description	string	A description providing additional details of the resource.
modifier-code	None (contains nested extensions)	A code providing additional detail about a product or service.
national-drug-product	None (contains nested extensions)	The national drug product used in care.
net-price	Money	The quantity times the unit price for a resource (total price).
offset-by	Reference	Indicates a resource that this resource is offset by. This resource is no longer active when offset.
performing-location	Reference	A location where the resource was performed.
priority	unsignedInt	The priority of the element within a list.
procedure-code	None (contains nested extensions)	A code providing information about the procedure performed on the patient associated to the resource.
quantity-conversion-factor	decimal	The conversion factor used to calculate the quantity for billing.
replacing	Reference	A reference to a resource that this resource is replacing.
revenue-code	None (contains nested extensions)	The type of revenue or cost center providing the product and/or service.
unit-price	Money	The price of a single unit for the resource.

Search

Search for ChargeItems that meet supplied query parameters:

GET /ChargeItem?:parameters

Authorization Types

Parameters

Name	Required?	Type	Description
_id	This or context or account	token	The logical resource id associated with the ChargeItem.
context	This or _id or account	reference	Encounter associated with the ChargeItem.
account	This or _id or context	reference	Account associated with the ChargeItem.
-status	See notes	token	The status of the ChargeItem. Example: billable
_count	No	number	The maximum number of results to return.

Notes:

• When searching by _id, only a single ChargeItem id can be provided.
• -status must be provided with context or account.
• -status must be set to billable.
• context must reference an Encounter.
• Only charge-group account types are supported.

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/ChargeItem?context=97953601&-status=billable

Response

Status: 200 OK

{
  "resourceType": "Bundle",
  "id": "0f2ae629-4e99-4843-a200-406dffce7091",
  "type": "searchset",
  "total": 1,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/ChargeItem?context=97953601&-status=billable"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/ChargeItem/292870306",
      "resource": {
        "resourceType": "ChargeItem",
        "id": "292870306",
        "meta": {
          "versionId": "1",
          "lastUpdated": "2020-03-09T17:23:00Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Charge Item</b></p><p><b>Status</b>: Billable</p><p><b>Patient</b>: 12742419</p><p><b>Encounter</b>: 97953601</p><p><b>Code</b>: 64897</p><p><b>Occurrence</b>: Mar  6, 2020  6:22 P.M. UTC</p></div>"
        },
        "extension": [
          {
            "valueMoney": {
              "value": 100,
              "currency": "USD"
            },
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/unit-price"
          },
          {
            "valueMoney": {
              "value": 800,
              "currency": "USD"
            },
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/net-price"
          },
          {
            "extension": [
              {
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "system": "http://hl7.org/fhir/sid/ndc",
                      "code": "1111-1111-111"
                    }
                  ]
                },
                "url": "national-drug-product-code"
              },
              {
                "valueQuantity": {
                  "value": 2.0,
                  "unit": "milligram (mass)",
                  "system": "http://unitsofmeasure.org",
                  "code": "mg"
                },
                "url": "national-drug-product-quantity"
              },
              {
                "valueDecimal": 2,
                "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/quantity-conversion-factor"
              }
            ],
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/national-drug-product"
          },
          {
            "valueString": "Acetaminophen Level",
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/description"
          },
          {
            "extension": [
              {
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "extension": [
                        {
                          "valueCoding": {
                            "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                            "code": "615214"
                          },
                          "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
                        }
                      ],
                      "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-CPT",
                      "code": "10081"
                    }
                  ]
                },
                "url": "code"
              },
              {
                "valueUnsignedInt": 1,
                "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/priority"
              }
            ],
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/procedure-code"
          },
          {
            "extension": [
              {
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "extension": [
                        {
                          "valueCoding": {
                            "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                            "code": "615215"
                          },
                          "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
                        }
                      ],
                      "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-HCPCS",
                      "code": "A0130"
                    }
                  ]
                },
                "url": "code"
              },
              {
                "valueUnsignedInt": 1,
                "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/priority"
              }
            ],
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/procedure-code"
          },
          {
            "extension": [
              {
                "valueCodeableConcept": {
                  "coding": [
                    {
                      "extension": [
                        {
                          "valueCoding": {
                            "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                            "code": "3692"
                          },
                          "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
                        }
                      ],
                      "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-MODIFIER",
                      "code": "66"
                    }
                  ]
                },
                "url": "code"
              },
              {
                "valueUnsignedInt": 1,
                "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/priority"
              }
            ],
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/modifier-code"
          },
          {
            "valueCodeableConcept": {
              "coding": [
                {
                  "extension": [
                    {
                      "valueCoding": {
                        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                        "code": "615217"
                      },
                      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
                    }
                  ],
                  "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-REVENUE",
                  "code": "0024"
                }
              ]
            },
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/revenue-code"
          }
        ],
        "status": "billable",
        "code": {
          "coding": [
            {
              "extension": [
                {
                  "valueCoding": {
                    "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                    "code": "667687"
                  },
                  "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
                }
              ],
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-CDM_SCHED",
              "code": "64897"
            }
          ]
        },
        "subject": {
          "reference": "Patient/12742419"
        },
        "context": {
          "reference": "Encounter/97953601"
        },
        "occurrenceDateTime": "2020-03-06T18:22:16Z",
        "performer": [
          {
            "function": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/v2-0912",
                  "code": "OP",
                  "display": "Ordering Provider"
                }
              ],
              "text": "Ordering Provider"
            },
            "actor": {
              "reference": "Practitioner/11817978"
            }
          }
        ],
        "requestingOrganization": {
          "reference": "Organization/1054423"
        },
        "quantity": {
          "value": 8
        },
        "enterer": {
          "reference": "Practitioner/12742359"
        },
        "enteredDate": "2020-03-09T17:22:57Z",
        "account": [
          {
            "reference": "Account/F61853062"
          },
          {
            "reference": "Account/C98900463"
          }
        ]
      }
    }
  ]
}

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.

Retrieve by id

List an individual ChargeItem by its id:

GET /ChargeItem/:id

Authorization Types

Headers

Accept: application/json+fhir
Authorization: <OAuth2 Bearer Token>

Example

Request

GET https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/ChargeItem/292870306

Response

Status: 200 OK

{
  "resourceType": "ChargeItem",
  "id": "292870306",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2020-03-09T17:23:00Z"
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Charge Item</b></p><p><b>Status</b>: Billable</p><p><b>Patient</b>: 12742419</p><p><b>Encounter</b>: 97953601</p><p><b>Code</b>: 64897</p><p><b>Occurrence</b>: Mar  6, 2020  6:22 P.M. UTC</p></div>"
  },
  "extension": [
    {
      "valueMoney": {
        "value": 100,
        "currency": "USD"
      },
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/unit-price"
    },
    {
      "valueMoney": {
        "value": 800,
        "currency": "USD"
      },
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/net-price"
    },
    {
      "extension": [
        {
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/sid/ndc",
                "code": "1111-1111-111"
              }
            ]
          },
          "url": "national-drug-product-code"
        },
        {
          "valueQuantity": {
            "value": 2.0,
            "unit": "milligram (mass)",
            "system": "http://unitsofmeasure.org",
            "code": "mg"
          },
          "url": "national-drug-product-quantity"
        },
        {
          "valueDecimal": 2,
          "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/quantity-conversion-factor"
        }
      ],
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/national-drug-product"
    },
    {
      "valueReference": {
        "reference": "ChargeItem/157320880"
      },
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/offset-by"
    },
    {
      "valueString": "Acetaminophen Level",
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/description"
    },
    {
      "extension": [
        {
          "valueCodeableConcept": {
            "coding": [
              {
                "extension": [
                  {
                    "valueCoding": {
                      "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                      "code": "615215"
                    },
                    "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
                  }
                ],
                "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-CPT",
                "code": "10081"
              }
            ]
          },
          "url": "code"
        },
        {
          "valueUnsignedInt": 1,
          "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/priority"
        }
      ],
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/procedure-code"
    },
    {
      "extension": [
        {
          "valueCodeableConcept": {
            "coding": [
              {
                "extension": [
                  {
                    "valueCoding": {
                      "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                      "code": "615215"
                    },
                    "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
                  }
                ],
                "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-HCPCS",
                "code": "A0130"
              }
            ]
          },
          "url": "code"
        },
        {
          "valueUnsignedInt": 1,
          "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/priority"
        }
      ],
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/procedure-code"
    },
    {
      "extension": [
        {
          "valueCodeableConcept": {
            "coding": [
              {
                "extension": [
                  {
                    "valueCoding": {
                      "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                      "code": "3692"
                    },
                    "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
                  }
                ],
                "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-MODIFIER",
                "code": "66"
              }
            ]
          },
          "url": "code"
        },
        {
          "valueUnsignedInt": 1,
          "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/priority"
        }
      ],
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/modifier-code"
    },
    {
      "valueCodeableConcept": {
        "coding": [
          {
            "extension": [
              {
                "valueCoding": {
                  "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
                  "code": "615217"
                },
                "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
              }
            ],
            "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-REVENUE",
            "code": "0024"
          }
        ]
      },
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/revenue-code"
    }
  ],
  "status": "billable",
  "code": {
    "coding": [
      {
        "extension": [
          {
            "valueCoding": {
              "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/codeSet/14002",
              "code": "667687"
            },
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/bill-code-schedule"
          }
        ],
        "system": "https://fhir.cerner.com/ec2458f2-1e24-41c8-b71b-0e701af7583d/CodeSystem/BillCodes-CDM_SCHED",
        "code": "64897"
      }
    ]
  },
  "subject": {
    "reference": "Patient/12742419"
  },
  "context": {
    "reference": "Encounter/97953601"
  },
  "occurrenceDateTime": "2020-03-06T18:22:16Z",
  "performer": [
    {
      "function": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0912",
            "code": "OP",
            "display": "Ordering Provider"
          }
        ],
        "text": "Ordering Provider"
      },
      "actor": {
        "reference": "Practitioner/11817978"
      }
    }
  ],
  "requestingOrganization": {
    "reference": "Organization/1054423"
  },
  "quantity": {
    "value": 8
  },
  "enterer": {
    "reference": "Practitioner/12742359"
  },
  "enteredDate": "2020-03-09T17:22:57Z",
  "account": [
    {
      "reference": "Account/F61853062"
    },
    {
      "reference": "Account/C98900463"
    }
  ]
}

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.

Operation: charge-item-credit

Creates an offsetting ChargeItem for an existing debit ChargeItem.

POST /ChargeItem/:id/$credit

Implementation Notes

• Only the body fields mentioned below are supported. Unsupported fields will be ignored.

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
Accept: application/fhir+json
Content-Type: application/fhir+json

Body Fields

Name	Required	Type
resourceType	Yes	string
Description The type of the FHIR resource. Example { "resourceType": "Parameters" } Notes resourceType must be Parameters top of section
parameter	Yes	List of BackboneElement
Description Parameters defined by the operation. top of section
versionId	Yes	id
Description The version id of the ChargeItem that is the target of the credit operation. Example { "parameter": [ { "name": "versionId", "valueId": "2" } ] } Notes The value must be in the form of valueId Only one value can be defined top of section
subject	Yes	Reference (Patient)
Description The Patient associated with the ChargeItem. Example { "parameter": [ { "name": "subject", "valueReference": { "reference": "Patient/13388355" } } ] } Notes The value must be in the form of valueReference Only one value can be defined top of section
context	Yes	Reference (Encounter)
Description The Encounter associated with the ChargeItem. Example { "parameter": [ { "name": "context", "valueReference": { "reference": "Encounter/98255557" } } ] } Notes The value must be in the form of valueReference Only one value can be defined top of section
transactionId	Yes	uuid
Description A UUID to uniquely identify the credit operation. Example { "parameter": [ { "name": "transactionId", "valueUuid": "urn:uuid:aa7623a0-0c7b-11ec-82a8-0242ac130003" } ] } Notes The value must be in the form of valueUuid Only one value can be defined top of section

Example

Request

POST https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/ChargeItem/292427912/$credit

Body

{
  "resourceType": "Parameters",
  "parameter": [
    {
      "name": "versionId",
      "valueId": "2"
    },
    {
      "name": "transactionId",
      "valueUuid": "urn:uuid:5bb8acae-0c7d-11ec-82a8-0242ac130003"
    },
    {
      "name": "subject",
      "valueReference": {
        "reference": "Patient/12782842"
      }
    },
    {
      "name": "context",
      "valueReference": {
        "reference": "Encounter/98019577"
      }
    }
  ]
}

Response

Status: 201 Created

Cache-Control: no-cache
Content-Length: 0
Content-Type: text/html
Date: Tue, 07 Sep 2021 17:23:14 GMT
Etag: W/"0"
Location: https://fhir-ehr.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/ChargeItem/2180632343
Last-Modified: Tue, 07 Sep 2021 17:25:14 GMT
Vary: Origin
X-Request-Id: 11111111111111111111111111111111

The ETag response header indicates the current If-Match version to use on subsequent updates.

Errors

The common errors and OperationOutcomes may be returned.