ChargeItem

This Resource is still under development.

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:

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

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.

This Resource Action is still under development.

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:

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

This Resource Action is still under development.

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

This Resource Action is still under development.

Creates an offsetting ChargeItem for an existing debit ChargeItem.

POST /ChargeItem/:id/$credit

Implementation Notes

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
parameter Yes List of BackboneElement
  • Description
    • Parameters defined by the operation.
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
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
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
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

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.