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PKV: Umstellung von Sozialtarif auf Tarifart unter Nutzung der KBV-VS/CS #63

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PKV: Umstellung von Sozialtarif auf Tarifart unter Nutzung der KBV-VS/CS #63

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6 changes: 3 additions & 3 deletions src/fhir/fsh-generated/fsh-index.json → src/fhir/fsh-generated/data/fsh-index.json
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Expand Up @@ -448,10 +448,10 @@
"endLine": 48
},
{
"outputFile": "StructureDefinition-VSDMSozialtarifPKV.json",
"fshName": "VSDMSozialtarifPKV",
"outputFile": "StructureDefinition-VSDMTarifartPKV.json",
"fshName": "VSDMTarifartPKV",
"fshType": "Extension",
"fshFile": "extensions/VSDMSozialtarifPKV.fsh",
"fshFile": "extensions/VSDMTarifartPKV.fsh",
"startLine": 1,
"endLine": 18
},
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2 changes: 1 addition & 1 deletion src/fhir/fsh-generated/fsh-index.txt
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Expand Up @@ -55,7 +55,7 @@ StructureDefinition-VSDMKrankenhausleistungenPKV.json VSDMKran
StructureDefinition-VSDMOperationOutcome.json VSDMOperationOutcome Profile profiles/VSDMOperationOutcome.fsh 1 - 79
StructureDefinition-VSDMPatient.json VSDMPatient Profile profiles/VSDMPatient.fsh 1 - 183
StructureDefinition-VSDMPayorOrganization.json VSDMPayorOrganization Profile profiles/VSDMPayorOrganization.fsh 1 - 48
StructureDefinition-VSDMSozialtarifPKV.json VSDMSozialtarifPKV Extension extensions/VSDMSozialtarifPKV.fsh 1 - 18
StructureDefinition-VSDMTarifartPKV.json VSDMTarifartPKV Extension extensions/VSDMTarifartPKV.fsh 1 - 18
StructureDefinition-VSDMVersichertenartPKV.json VSDMVersichertenartPKV Extension extensions/VSDMVersichertenartPKV.fsh 1 - 20
ValueSet-VSDMDMPVS.json VSDMDMPVS ValueSet valuesets/VSDMDMPVS.fsh 1 - 32
ValueSet-VSDMErrorcodeVS.json VSDMErrorcodeVS ValueSet valuesets/VSDMErrorcodeVS.fsh 1 - 8
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8 changes: 8 additions & 0 deletions src/fhir/fsh-generated/resources/Bundle-VSDMBundle-PKV-A123456780.json
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Expand Up @@ -109,6 +109,14 @@
]
},
"extension": [
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"valueCoding": {
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF",
"code": "01",
"display": "Individualtarif"
}
},
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMVersichertenartPKV",
"valueCoding": {
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8 changes: 8 additions & 0 deletions src/fhir/fsh-generated/resources/Bundle-VSDMBundle-PKV-B234567895.json
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Expand Up @@ -130,6 +130,14 @@
]
},
"extension": [
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"valueCoding": {
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF",
"code": "01",
"display": "Individualtarif"
}
},
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMVersichertenartPKV",
"valueCoding": {
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8 changes: 8 additions & 0 deletions src/fhir/fsh-generated/resources/Bundle-VSDMBundle-PKV-C345678908.json
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Expand Up @@ -124,6 +124,14 @@
]
},
"extension": [
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"valueCoding": {
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF",
"code": "01",
"display": "Individualtarif"
}
},
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMVersichertenartPKV",
"valueCoding": {
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8 changes: 8 additions & 0 deletions src/fhir/fsh-generated/resources/Bundle-VSDMBundle-PKV-D456789013.json
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Expand Up @@ -158,6 +158,14 @@
]
},
"extension": [
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"valueCoding": {
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF",
"code": "01",
"display": "Individualtarif"
}
},
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMVersichertenartPKV",
"valueCoding": {
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16 changes: 8 additions & 8 deletions src/fhir/fsh-generated/resources/Bundle-VSDMBundle-PKV-E567890127.json
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Expand Up @@ -147,6 +147,14 @@
]
},
"extension": [
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"valueCoding": {
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF",
"code": "02",
"display": "Standardtarif"
}
},
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMVersichertenartPKV",
"valueCoding": {
Expand Down Expand Up @@ -179,14 +187,6 @@
"valueBoolean": false
}
]
},
{
"valueCoding": {
"system": "https://gematik.de/fhir/vsdm2/CodeSystem/VSDMSozialtarifPKVCS",
"code": "S",
"display": "Standardtarif"
},
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMSozialtarifPKV"
}
],
"status": "active",
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16 changes: 8 additions & 8 deletions src/fhir/fsh-generated/resources/Bundle-VSDMBundle-PKV-F678901231.json
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Expand Up @@ -120,6 +120,14 @@
]
},
"extension": [
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"valueCoding": {
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF",
"code": "04",
"display": "Notlagentarif"
}
},
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMVersichertenartPKV",
"valueCoding": {
Expand Down Expand Up @@ -156,14 +164,6 @@
"valueBoolean": false
}
]
},
{
"valueCoding": {
"system": "https://gematik.de/fhir/vsdm2/CodeSystem/VSDMSozialtarifPKVCS",
"code": "N",
"display": "Notlagentarif"
},
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMSozialtarifPKV"
}
],
"status": "active",
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16 changes: 8 additions & 8 deletions src/fhir/fsh-generated/resources/Bundle-VSDMBundle-PKV-G789012344.json
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Expand Up @@ -117,6 +117,14 @@
]
},
"extension": [
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"valueCoding": {
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF",
"code": "03",
"display": "Basistarif"
}
},
{
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMVersichertenartPKV",
"valueCoding": {
Expand Down Expand Up @@ -153,14 +161,6 @@
"valueBoolean": false
}
]
},
{
"valueCoding": {
"system": "https://gematik.de/fhir/vsdm2/CodeSystem/VSDMSozialtarifPKVCS",
"code": "B",
"display": "Basistarif"
},
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMSozialtarifPKV"
}
],
"status": "active",
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6 changes: 4 additions & 2 deletions src/fhir/fsh-generated/resources/StructureDefinition-VSDDatensatzPKV.json
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Expand Up @@ -1544,7 +1544,8 @@
"mapping": [
{
"identity": "VSD-Datensatz-PKV-Coverage",
"map": "VSDMCoveragePKV.extension:sozialtarif"
"map": "VSDMCoveragePKV.extension:tarifart",
"comment": "Es wird eine vorhandene Erweiterung verwendet; ein nicht angegebener Sozialtarif wird auf den Wert 01 Individualtarif abgebildet."
}
]
},
Expand Down Expand Up @@ -2479,7 +2480,8 @@
"mapping": [
{
"identity": "VSD-Datensatz-PKV-Coverage",
"map": "VSDMCoveragePKV.extension:sozialtarif"
"map": "VSDMCoveragePKV.extension:tarifart",
"comment": "Es wird eine vorhandene Erweiterung verwendet; ein nicht angegebener Sozialtarif wird auf den Wert 01 Individualtarif abgebildet."
}
]
},
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32 changes: 16 additions & 16 deletions src/fhir/fsh-generated/resources/StructureDefinition-VSDMCoveragePKV.json
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Expand Up @@ -334,7 +334,7 @@
"extensions",
"user content"
],
"min": 1,
"min": 2,
"max": "*",
"base": {
"path": "DomainResource.extension",
Expand Down Expand Up @@ -482,18 +482,18 @@
]
},
{
"id": "Coverage.extension:sozialtarif",
"id": "Coverage.extension:tarifart",
"path": "Coverage.extension",
"sliceName": "sozialtarif",
"short": "PKV-Sozialtarif",
"definition": "Anwendung eines PKV-verbandseinheitlichen Tarifs mit Besonderheiten bezüglich der Leistungen und privatärztliche Abrechnungen.",
"sliceName": "tarifart",
"short": "PKV-Tarifart",
"definition": "Tarifart des PKV-Versicherten, inklusive Anwendung eines PKV-verbandseinheitlichen Tarifs mit Besonderheiten bezüglich der Leistungen und privatärztliche Abrechnungen.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"min": 1,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
Expand All @@ -503,7 +503,7 @@
{
"code": "Extension",
"profile": [
"https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMSozialtarifPKV"
"https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV"
]
}
],
Expand Down Expand Up @@ -2494,7 +2494,7 @@
"ordered": false,
"rules": "open"
},
"min": 1
"min": 2
},
{
"id": "Coverage.extension:beihilfe",
Expand Down Expand Up @@ -2533,18 +2533,18 @@
"mustSupport": true
},
{
"id": "Coverage.extension:sozialtarif",
"id": "Coverage.extension:tarifart",
"path": "Coverage.extension",
"sliceName": "sozialtarif",
"short": "PKV-Sozialtarif",
"definition": "Anwendung eines PKV-verbandseinheitlichen Tarifs mit Besonderheiten bezüglich der Leistungen und privatärztliche Abrechnungen.",
"min": 0,
"max": "*",
"sliceName": "tarifart",
"short": "PKV-Tarifart",
"definition": "Tarifart des PKV-Versicherten, inklusive Anwendung eines PKV-verbandseinheitlichen Tarifs mit Besonderheiten bezüglich der Leistungen und privatärztliche Abrechnungen.",
"min": 1,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMSozialtarifPKV"
"https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV"
]
}
],
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30 changes: 15 additions & 15 deletions ...ructureDefinition-VSDMSozialtarifPKV.json → .../StructureDefinition-VSDMTarifartPKV.json
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@@ -1,15 +1,15 @@
{
"resourceType": "StructureDefinition",
"id": "VSDMSozialtarifPKV",
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMSozialtarifPKV",
"id": "VSDMTarifartPKV",
"url": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"version": "1.0.0",
"name": "VSDMSozialtarifPKV",
"title": "PKV-Sozialtarif",
"name": "VSDMTarifartPKV",
"title": "PKV-Tarifart",
"status": "draft",
"experimental": false,
"date": "2023-12-31",
"publisher": "gematik GmbH",
"description": "Anwendung eines PKV-verbandseinheitlichen Tarifs im Versichertenstammdatenmanagement (VSDM) 2.0",
"description": "Tarifart des PKV-Versicherten im Versichertenstammdatenmanagement (VSDM) 2.0",
"fhirVersion": "4.0.1",
"mapping": [
{
Expand All @@ -34,8 +34,8 @@
{
"id": "Extension",
"path": "Extension",
"short": "PKV-Sozialtarif",
"definition": "Anwendung eines PKV-verbandseinheitlichen Tarifs mit Besonderheiten bezüglich der Leistungen und privatärztliche Abrechnungen.",
"short": "PKV-Tarifart",
"definition": "Tarifart des PKV-Versicherten, inklusive Anwendung eines PKV-verbandseinheitlichen Tarifs mit Besonderheiten bezüglich der Leistungen und privatärztliche Abrechnungen.",
"min": 0,
"max": "*",
"base": {
Expand Down Expand Up @@ -196,7 +196,7 @@
]
}
],
"fixedUri": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMSozialtarifPKV",
"fixedUri": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV",
"isModifier": false,
"isSummary": false,
"mapping": [
Expand Down Expand Up @@ -237,7 +237,7 @@
"isSummary": false,
"binding": {
"strength": "required",
"valueSet": "https://gematik.de/fhir/vsdm2/ValueSet/VSDMSozialtarifPKVVS"
"valueSet": "https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_PKV_TARIFF"
},
"mapping": [
{
Expand Down Expand Up @@ -359,7 +359,7 @@
"code": "uri"
}
],
"patternUri": "https://gematik.de/fhir/vsdm2/CodeSystem/VSDMSozialtarifPKVCS",
"patternUri": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF",
"constraint": [
{
"key": "ele-1",
Expand Down Expand Up @@ -581,8 +581,8 @@
{
"id": "Extension",
"path": "Extension",
"short": "PKV-Sozialtarif",
"definition": "Anwendung eines PKV-verbandseinheitlichen Tarifs mit Besonderheiten bezüglich der Leistungen und privatärztliche Abrechnungen."
"short": "PKV-Tarifart",
"definition": "Tarifart des PKV-Versicherten, inklusive Anwendung eines PKV-verbandseinheitlichen Tarifs mit Besonderheiten bezüglich der Leistungen und privatärztliche Abrechnungen."
},
{
"id": "Extension.extension",
Expand All @@ -592,7 +592,7 @@
{
"id": "Extension.url",
"path": "Extension.url",
"fixedUri": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMSozialtarifPKV"
"fixedUri": "https://gematik.de/fhir/vsdm2/StructureDefinition/VSDMTarifartPKV"
},
{
"id": "Extension.value[x]",
Expand All @@ -604,14 +604,14 @@
],
"binding": {
"strength": "required",
"valueSet": "https://gematik.de/fhir/vsdm2/ValueSet/VSDMSozialtarifPKVVS"
"valueSet": "https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_PKV_TARIFF"
}
},
{
"id": "Extension.value[x].system",
"path": "Extension.value[x].system",
"min": 1,
"patternUri": "https://gematik.de/fhir/vsdm2/CodeSystem/VSDMSozialtarifPKVCS"
"patternUri": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF"
},
{
"id": "Extension.value[x].code",
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10 changes: 10 additions & 0 deletions src/fhir/input/fsh/aliases.fsh
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Expand Up @@ -58,6 +58,11 @@ Alias: $csLOINC = http://loinc.org
// - VSDMOperationOutcome.issue[vsdm-error].details.coding
Alias: $csOperationOutcomeCodes = http://terminology.hl7.org/CodeSystem/operation-outcome

// PKV-Tarifart, verwendet für
// - VSDMTarifartPKV
// - VSDMCoveragePKV.extension[tarifart]
Alias: $csTarifartPKV = https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PKV_TARIFF

// besondere Personengruppe, verwendet für
// - VSDMBesonderePersonengruppeVS
// - VSDMCoverageGKV.extension[besonderePersonengruppe]
Expand Down Expand Up @@ -104,6 +109,11 @@ Alias: $vsIssueType = http://hl7.org/fhir/ValueSet/issue-type
// - VSDMCoverageGKV.extension[besonderePersonengruppe]
Alias: $vsPersonengruppe = https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_PERSONENGRUPPE

// PKV-Tarifart, verwendet für
// - VSDMTarifartPKV
// - VSDMCoveragePKV.extension[tarifart]
Alias: $vsTarifartPKV = https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_PKV_TARIFF

// Versichertenstatus / Versichertenart, verwendet für
// - Beispiel für VSDMCoverageGKV
Alias: $vsVersichertenartGKV = https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_KBV_VERSICHERTENSTATUS
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1 change: 1 addition & 0 deletions src/fhir/input/fsh/examples/VSDMCoveragePKV-A123456780.fsh
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Expand Up @@ -14,6 +14,7 @@ Usage: #inline
* extension[einbett].valueUnsignedInt = 100
* extension[wahlarzt].valueUnsignedInt = 100
* extension[belegarzt].valueUnsignedInt = 100
* extension[tarifart].valueCoding = #01 "Individualtarif"
* extension[versichertenart].valueCoding = VSDMVersichertenartPKVCS#VN "Versicherungsnehmer"
* status = #active
* type = $csVersicherungsart#PKV
Expand Down
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