PS Claim Information - tabular view

No Current Link To VocabularyCoded With ExtensionsCoded No Extensions
PORX_RM142002UK31
PSClaim

This message is used by the [Pharmacy] system to send the additional information required to make a Reimbursement Claim for a Protocol Supply event from the PPA or other reimbursement authority (e.g. PCT).

Reference: W5-14.4.3.1

Used by:
[1..1] classCode (CS {CNE:INFO} ){ Fixed="INFO" }

A code indicating that the PS Claim is for information purposes only

  • Fixed value: "INFO"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

A code to indicate this is an event.

  • Fixed value: "EVN"
[1..1] id (II)

The globally unique identifier for this instance of a PS Claim. 

The Identifier Global datatype flavour is used to carry this information as follows:

  • the root attribute will contain a UUID .
[1..1] code (CD {CNE:EventTypeSnCT} )

A fixed code from the EventTypeSnCT UK subset that describes this as a Protocol Supply Medication event.

The Coded Plain datatype flavour is used to carry this information as follows:

  • the code attribute will contain the fixed value "163531000000103", from the list of codes in the EventTypeSnCT vocabulary;
  • the codeSystem attribute will contain the OID value referenced in the EventTypeSnCT vocabulary,
  • the displayName attribute will contain the textual (human readable) description associated with the code.  
[1..1] effectiveTime (TS)

The date and timestamp of this message.

The date-timestamp must be given with the following precision:

  • YYYYMMDDHHMMSS
[1..1] typeId (II)

An identifier used to indicate the message type and version.

The Identifier External datatype flavour is used to carry this information as follows:

  • the root attribute shall contain the OID value for Type Identifiers = 2.16.840.1.113883.2.1.3.2.4.18.7
  • the extension attribute shall contain the fixed value of the message artifact id, "PORX_MT142002UK31".
[1..1] primaryInformationRecipient

This participation provides a link to the (payor) organisation to whom the reimbursement claim for the dispense will be presented.

[1..1] typeCode (CS {CNE:PRCP} ){ Fixed="PRCP" }

A code indicating that the receiving organisation is the primary recipient

  • Fixed value: "PRCP"
[1..1] participant      [CMET: UKCT_MT120401UK02]

NPfIT CMET fulfilling the specific role of an organisation, in this instance the payor organisation (which may be the PPA) to whom the claim is presented. Full details of the organisation and role profile are available from SDS.

This information is mandatory.

The following CMET data elements are required and must be provided:

AgentOrg
Organization
id Organisation SDS identifier
name Name of organisation

[0..1] receiver
A link to information about the individual collecting the prescription, if he/she is not the actual patient.
[1..1] typeCode (CS {CNE:RCV} ){ Fixed="RCV" }

A code to indicate the person who receives the prescription

  • Fixed value: "RCV"
[1..1] agent (Agent)

Details of the individual.

[0..1] pertinentInformation1
An act relationship to identify the PS Reimbursement Claim Rejection message that triggered a resubmission.
[1..1] typeCode (CS {CNE:PERT} ){ Fixed="PERT" }

Indicates that this is pertinent information.

  • Fixed value : "PERT"
[1..1] inversionInd (BL)

An indicator specifying that the ActRelationship.typeCode should be interpreted as if the roles of the source and target Acts were reversed. The inversion indicator is used when the meaning of ActRelationship.typeCode must be reversed.

In this instance, the inversionInd defaults to "false".

[1..1] negationInd (BL)

When "true" allows the sender to specifically state that the relationship does not apply.

In this context the negationInd defaults to "false".

[1..1] seperatableInd (BL)

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

If the source act is intended to be interpreted independently the value shall be "true" otherwise the value shall be "false".

The value of seperatableInd shall be evaluated for each usage of the pertinentInformation relationship.

In this context the seperatableInd defaults to "true".

In this instance, this indicates that this PS Claim, although it refers to the PS Reimbursement Claim Rejection that triggered this message, can still be considered independently

[1..1] pertinentReimbursementClaimRejectRef (ReimbursementClaimRejectRef)

Reference to a pertinent Reimbursement Claim Rejection message.

[1..1] pertinentInformation2
An act relationship that associates the PSClaim focal act with SupplyHeader - the primary act of the PSIS clinical message.
[1..1] typeCode (CS {CNE:PERT} ){ Fixed="PERT" }

Indicates that this is pertinent information.

  • Fixed value: "PERT"
[1..1] contextConductionInd (BL)

If "true", associations in the parent act are conducted across the ActRelationship to the child act.

In this context the contextConductionInd defaults to "true".

[1..1] templateId (II)

An identifier of the Act Relationship that relates clinical statements directly to the focal act.

The Identifier External datatype flavour is used to carry this information as follows:

  • the root attribute shall contain the value of the Template Identifiers OID = 2.16.840.1.113883.2.1.3.2.4.18.2
  • the extension attribute shall contain the fixed template ID "CSAB_RM-NPfITUK10.pertinentInformation"
[1..1] pertinentSupplyHeader (SupplyHeader)

The supply information pertinent to this PS Claim.

This information is mandatory.

[0..1] replacementOf

An act relationship between the focal act and a previous protocol supply event that this message replaces.

[1..1] typeCode (CS {CNE:RPLC} ){ Fixed="RPLC" }

Indicates that this is a replacement.

  • Fixed value: "RPLC"
[1..1] priorMessageRef (MessageRef)

A reference to a previous PS Claim event which this one is intended to replace.

[0..1] coverage
An act relationship that provides information about the patient's prescription charge exemption status.
[1..1] typeCode (CS {CNE:COVBY} ){ Fixed="COVBY" }

Indicates that the PSClaim (source act) is covered by or under the authority of ChargeExempt (target act).

  • Fixed value : "COVBY" (covered by)
[1..1] coveringChargeExempt (ChargeExempt)

The ChargeExempt applies to the PSClaim. In this instance, this indicates that the patient for this PSClaim may be exempt from paying prescription charges.

This information is optional and may be ommitted.

Agent

Role representing a person, other than the patient, who collects the prescription.

Used by: PSClaim
[1..1] classCode (CS {CNE:AGNT} ){ Fixed="AGNT" }

Indicates that the role is that of an agent.

  • Fixed value: "AGNT" 
[0..1] id (II)

A nationally agreed identifier for the role being played.  This may be either a code from a national coding (identified by an OID) or a DCE UUID.

[1..1] code (CV {CNE:PersonRelationshipType} )

Code indicating the relationship of the Agent to the patient.

The Coded Plain  datatype shall be used to carry this information as follows:

  • The code attribute will contain a value from the list of codes in the  PersonRelationshipType vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the  PersonRelationshipType vocabulary.
  • the displayName  attribute will contain the textual (human readable) description associated with the code
[1..1] agentPerson (Person)

Details of the person playing the Agent role.

ReimbursementClaimRejectRef

A reference to a previously rejected claim.

Used by: PSClaim
[1..1] classCode (CS {CNE:ADJUD} ){ Fixed="ADJUD" }

A code indicating that the PS Reimbursement Claim Rejection is an adjudication.

  • Fixed value: "ADJUD" (financial adjudication)
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

A code to indicate this is an event.

  • Fixed value: "EVN"
[1..1] id (II)

The unique identifier of the target act being referred to.  This shall be a DCE UUID carried in the root attribute of the id element.

In this instance, this is the globally unique number that identifies the previously rejected message.

SupplyHeader

A container for the collection of clinical statements that constitute the PS Claim Information.

Used by: PSClaim
[1..1] classCode (CS {CNE:SBADM} ){ Fixed="SBADM" }

A code to indicate introducing or applying a substance to a subject.

  • Fixed value: "SBADM"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

A code to indicate this is an event.

  • Fixed value: "EVN"
[1..1] id (II)

The globally unique identifier for this PS Claim Information clinical event. 

The Identifier Global datatype flavour is used to carry this information as follows:

  • the root attribute shall contain a DCE UUID that identifies this clinical event.
[1..1] code (CD {CNE:SubstanceAdministrationSnCT} )

A code from the SubstanceAdministrationSnCT UK subset that describes a Protocol Supply Claim.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain the fixed value "225426007", from the list of codes in the SusbtanceAdministrationSnCT vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the SusbtanceAdministrationSnCT vocabulary.
[1..1] effectiveTime (GTS)

Mandatory attribute required to maintain compliance with the CSMP.

The attribute shall contain the nullFlavor "NA" as follows:

<effectiveTime nullFlavor="NA"/>

[1..1] legalAuthenticator

Details about the person from the dispensing organisation making the PS Claim.

[1..1] typeCode (CS {CNE:LA} ){ Fixed="LA" }

A code to indicate legal authenticator

  • Fixed value: "LA"
[1..1] contextControlCode (CS {CNE:OP} ){ Fixed="OP" }

A code that specifies how this Participation contributes to the context of the current Act, and whether it may be propagated to descendent Acts whose association allows such propagation.

The value of contextControlCode should be set appropriately according to the context of the participation being modelled.

  • Default value: "OP" - Overriding and propagating

The default value of "OP" indicates that the association overrides the existing context associated with the Act, and will propagate to any descendant Acts reached by conducting ActRelationships.

In this instance, a code that this professional propagates through to the clinical statements as the claimant unless specifically overriden for individual acts.

[1..1] time (TS)

The date and local time that the reimbursement claim is made.

The date-timestamp must be given with the following precision:

  • YYYYMMDDHHMMSS
[1..1] signatureText (ED)

The electronic signature of the contents to be signed as "legal and true" by the claimant.

The following information is to be included in the digital signature:

  • Claimant Information
  • Dispensing Organisation Information
  • Prescription Charge Exemption Information
  • Protocol Supply Medication Item Claim Information

Where there is no digital signature - i.e. in cases where the relevant documentation is issued and signed in ink by the prescriber or dispenser - this attribute shall contain nullFlavor "NA":

<signatureText nullFlavor="NA"/>

[1..1] participant      [CMET: UKCT_MT120201UK03]

NPfIT CMET to identify a person fulfilling the specific role for a person (legal authenticator) that signs this claim.

This information is optional and may be omitted.

The following CMET data elements are required and must be provided:

AgentPerson
id SDS role profile code
code SDS job role code (returned in the SAML assertion following successful end-user authentication)
Person
id SDS identifier
name Name
Organization
id Organisation SDS identifier
code Type of organisation
name Name of organisation
telecom Telephone number of organisation
addr Address of organisation
[1..*] pertinentInformation2

An act relationship to capture the actual PS line item information for the PS Notification event. This information may be determined manually or from local systems.

[1..1] typeCode (CS {CNE:PERT} ){ Fixed="PERT" }

Indicates that this is pertinent information.

  • Fixed value : "PERT"
[1..1] inversionInd (BL)

An indicator specifying that the ActRelationship.typeCode should be interpreted as if the roles of the source and target Acts were reversed. The inversion indicator is used when the meaning of ActRelationship.typeCode must be reversed.

In this instance, the inversionInd defaults to "false".

[1..1] contextConductionInd (BL)

If "true", associations in the parent act are conducted across the ActRelationship to the child act.

In this context the contextConductionInd defaults to "true".

[1..1] negationInd (BL)

When "true" allows the sender to specifically state that the relationship does not apply.

In this context the negationInd defaults to "false".

[1..1] seperatableInd (BL)

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

If the source act is intended to be interpreted independently the value shall be "true" otherwise the value shall be "false".

The value of seperatableInd shall be evaluated for each usage of the pertinentInformation relationship.

In this context the seperatableInd defaults to "true".

[1..1] templateId (II)

An identifier of the Act Relationship that supports the linkage of clinical statements using the "Asserted Relationship" mechanism.

The Identifier External datatype flavour is used to carry this information as follows:

  • the root attribute shall contain the value of the Template Identifiers OID = 2.16.840.1.113883.2.1.3.2.4.18.2
  • the extension attribute shall contain the fixed template ID "CSAB_RM-NPfITUK10.sourceOf"
[1..1] pertinentSuppliedLineItem (SuppliedLineItem)

Indicates that SuppliedLineItem is pertinent to SupplyHeader.

This information is mandatory. Data on one or more Line Items mas be provided.

[1..1] pertinentInformation1

An act relationship to capture the actual dispense information for the PS Notification event. This information may be determined manually or from local systems.

[1..1] typeCode (CS {CNE:PERT} ){ Fixed="PERT" }

Indicates that this is pertinent information.

  • Fixed value : "PERT"
[1..1] inversionInd (BL)

An indicator specifying that the ActRelationship.typeCode should be interpreted as if the roles of the source and target Acts were reversed. The inversion indicator is used when the meaning of ActRelationship.typeCode must be reversed.

In this instance, the inversionInd defaults to "false".

[1..1] negationInd (BL)

When "true" allows the sender to specifically state that the relationship does not apply.

In this context the negationInd defaults to "false".

[1..1] seperatableInd (BL)

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

If the source act is intended to be interpreted independently the value shall be "true" otherwise the value shall be "false".

The value of seperatableInd shall be evaluated for each usage of the pertinentInformation relationship.

In this context the seperatableInd defaults to "false"

In this instance, this indicates that this PS Claim can still be considered independently of the original PS Notification message.

[1..1] templateId (II)

An identifier of the Act Relationship that supports the linkage of clinical statements using the "Reference" mechanism.

The Identifier External datatype flavour is used to carry this information as follows:

  • the root attribute shall contain the value of the Template Identifiers OID = 2.16.840.1.113883.2.1.3.2.4.18.2
  • the extension attribute shall contain the fixed template ID "CSAB_RM-NPfITUK10.sourceOf1"
[1..1] pertinentSupplyHeaderRef (SupplyHeaderRef)

Indicates that the PS Notification SupplyHeaderRef is pertinent to SupplyHeader.

This information is mandatory.

MessageRef
An act identifying the protocol supply event which this PS Claim is to replace.
Used by: PSClaim
[1..1] classCode (CS {CNE:INFO} ){ Fixed="INFO" }

Indicates that this act is for information only.

  • Fixed value: "INFO"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

Indicates that this is an event

  • Fixed value: "EVN"
[1..1] id (II)

The unique identifier of the target act being referred to.  This shall be a DCE UUID carried in the root attribute of the id element.

In this instance, this is the id of the previous PS event that this PS Claim is to replace.

ChargeExempt
An act used to provide information about Prescription Charge Exemption (or otherwise) for the patient of the prescription. Reference: NPFIT-ETP-PZ-0159-v1.2 Table 2.
Used by: PSClaim
[1..1] classCode (CS {CNE:OBS} ){ Fixed="OBS" }

Indicates that this act is an observation

  • Fixed value: "OBS"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

Indicates that this is an event

  • Fixed value: "EVN"
[1..1] code (CV {CNE:PrescriptionAnnotation} )

Code representation for prescription charge exemption status.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain the fixed value "EX" from the list of codes in the PrescriptionAnnotation vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the PrescriptionAnnotation vocabulary.
[1..1] negationInd (BL)

A boolean indicator to denote if the patient is exempt from prescription charges.

  • Value: "true" => patient must pay charges
[1..1] value (CV {CNE:PrescriptionChargeExemption} )

Coded information specifying the prescription charge exemption status.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain a value from the list of codes in the PrescriptionChargeExemption vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the PrescriptionChargeExemption vocabulary.

Supporting textual (human readable) information as to the reason why this patient is exempt from paying prescription charges

[0..1] authorization

An act relationship to qualify Prescription Charge Exemption for the patient through the visual inspection of documentary evidence provided by the patient to the Dispenser.

[1..1] typeCode (CS {CNE:AUTH} ){ Fixed="AUTH" }

Indicates that the target act (EvidenceSeen) authorises the source act (ChargeExempt).

  • Fixed value : "AUTH"
[1..1] authorizingEvidenceSeen (EvidenceSeen)

Indicates that EvidenceSeen authorises ChargeExempt.

This information is optional and may be omitted.

Person

Details of a person.

Used by: Agent
[1..1] classCode (CS {CNE:PSN} ){ Fixed="PSN" }

Indicates this is a person.

  • Fixed value: "PSN"
[1..1] determinerCode (CS {CNE:INSTANCE} ){ Fixed="INSTANCE" }

Indicates that this is an individual instance of a person.

  • Fixed value "INSTANCE"
[1..1] name (PN)

The name of the person.

[0..1] telecom (TEL)

The telecommunication contact details of the person.

[0..1] addr (AD)

The address(es) of the person.

SuppliedLineItem
A grouping to record the details about the medication line item dispensed to satisfy the requirements for the treatment specified in the PS line item.
Used by: SupplyHeader
[1..1] classCode (CS {CNE:SBADM} ){ Fixed="SBADM" }

A code to indicate introducing or applying a substance to a subject.

  • Fixed value: "SBADM"
[1..1] moodCode (CS {CNE:PRMS} ){ Fixed="PRMS" }

Indicates that this is a promise for a service.

  • Fixed value: "PRMS" (intent to perform a service based on a committment)
[1..1] id (II)

UUID identifying this instance of a service request. This identifier is universally unique across all records. It is in the form of a UUID.  

In this instance, this is the globally unique identifier for each Medication Line Item in the PS Notification event.

[1..1] code (CD {CNE:SubstanceAdministrationSnCT} )

A code from the SubstanceAdministrationSnCT UK subset that describes the medication to be supplied.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain a value from the list of codes in the SubstanceAdministrationSnCT vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the SubstanceAdministrationSnCT vocabulary.
[1..1] effectiveTime (GTS)

Mandatory attribute required to maintain compliance with the CSMP.

The attribute shall contain the nullFlavor "NA" as follows:

<effectiveTime nullFlavor="NA"/>

[1..*] component

Details of the actual medication treatment dispensed as identified in the PS Notification for the line item.

[1..1] typeCode (CS {CNE:COMP} ){ Fixed="COMP" }

Indicates that this is a component.

  • Fixed value : "COMP"
[1..1] seperatableInd (BL)

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

If the source act is intended to be interpreted independently the value shall be "true" otherwise the value shall be "false".

The value of seperatableInd shall be evaluated for each usage of the component relationship.

In this context the seperatableInd defaults to "false".

[1..1] suppliedLineItemQuantity (SuppliedLineItemQuantity)

Indicates that SuppliedLineItemQuantity is a component to SuplpiedLinetItem.

This information is madatory. One or more SuppliedLineItemQuantity objects may be provided.

[1..1] pertinentInformation

An act relationship to record information about the supplied Line Items from the PS Notification.

[1..1] typeCode (CS {CNE:PERT} ){ Fixed="PERT" }

Indicates pertinent information.

  • Fixed value: "PERT"
[1..1] inversionInd (BL)

An indicator specifying that the ActRelationship.typeCode should be interpreted as if the roles of the source and target Acts were reversed. The inversion indicator is used when the meaning of ActRelationship.typeCode must be reversed.

In this context the inversionInd defaults to "false".

[1..1] negationInd (BL)

When "true" allows the sender to specifically state that the relationship does not apply.

In this context the negationInd defaults to "false".

[1..1] seperatableInd (BL)

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

If the source act is intended to be interpreted independently the value shall be "true" otherwise the value shall be "false".

The value of seperatableInd shall be evaluated for each usage of the pertinentInformation relationship.

In this context the seperatableInd defaults to "false".

[1..1] templateId (II)

An identifier of the Act Relationship that supports the linkage of clinical statements using the "Reference" mechanism.

The Identifier External datatype flavour is used to carry this information as follows:

  • the root attribute shall contain the value of the Template Identifiers OID = 2.16.840.1.113883.2.1.3.2.4.18.2
  • the extension attribute shall contain the fixed template ID "CSAB_RM-NPfITUK10.sourceOf1"
[1..1] pertinentSuppliedLineItemRef (SuppliedLineItemRef)

Indicates that SuppliedLineItemRef is pertinent to the SuppliedLineItem.

This information is mandatory.

SupplyHeaderRef
Reference to one or more previous PS events in the case of partial dispenses.
Used by: SupplyHeader
[1..1] classCode (CS {CNE:SBADM} ){ Fixed="SBADM" }

A code to indicate introducing or applying a substance to a subject.

  • Fixed value: "SBADM"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

A code to indicate this is an event.

  • Fixed value: "EVN"
[1..1] id (II)

The unique identifier of the target act being referred to.  This shall be a DCE UUID carried in the root attribute of the id element.

In this instance, this is a link to the unique clinical header information in the associated PS Notification message.

EvidenceSeen
Confirmation from the dispenser as to whether documentary evidence has been visually examined to qualify a patient's exemption from prescription charges.
Used by: ChargeExempt
[1..1] classCode (CS {CNE:OBS} ){ Fixed="OBS" }

Indicates that this act is an observation

  • Fixed value: "OBS"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

Indicates that this is an event

  • Fixed value: "EVN"
[1..1] code (CV {CNE:PrescriptionAnnotation} )

Indicates whether supporting documentary evidence has been visually inspected in respect of a patient's exemption from prescription charges.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain the fixed value "ES" from the list of codes in the PrescriptionAnnotation vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the PrescriptionAnnotation vocabulary.
[1..1] negationInd (BL)

Indicates whether or not the patient has shown the dispenser evidence of their exemption from prescription charges.

  • value: "true" => evidence has not been seen

Not required if patient does not claim exemption.

SuppliedLineItemQuantity
Details of the actual medication treatment dispensed in respect of this PS Claim.
Used by: SuppliedLineItem
[1..1] classCode (CS {CNE:SPLY} ){ Fixed="SPLY" }

A code to indicate supply.

  • Fixed value: "SPLY"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

Indicates that this is an event

  • Fixed value: "EVN"
[1..1] code (CD {CNE:SupplyActSnCT} )

A code from the SupplyActSnCT UK subset that describes the supply of pharmaceutical products and medical devices.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain a value from the list of codes in the SupplyActSnCT vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the SupplyActSnCT vocabulary.
[1..1] product

A participation that provides a link to the actual medication dispensed in response to a Protocol Supply Definition Line Item treatment request.

[1..1] typeCode (CS {CNE:PRD} ){ Fixed="PRD" }

A code to a product (medicine) taken from stock

  • Fixed value: "PRD"
[1..1] contextControlCode (CS {CNE:ContextControl} )

A code that specifies how this Participation contributes to the context of the current Act, and whether it may be propagated to descendent Acts whose association allows such propagation.

The value of contextControlCode should be set appropriately according to the context of the participation being modelled.

  • Default value: "OP" - Overriding and propagating

The default value of "OP" indicates that the association overrides the existing context associated with the Act, and will propagate to any descendant Acts reached by conducting ActRelationships.

In this instance, a code that this product propogates through to the clinical statements as the medication unless specifically overriden for individual acts.

[1..1] suppliedManufacturedProduct (SuppliedManufacturedProduct)

A link to the entity that describes the physical characteristics of the suppliedManufacturedProduct.

[1..1] pertinentInformation1

An act relationship that identifies whether a prescription charge was paid for the medication Line Item.

[1..1] typeCode (CS {CNE:PERT} ){ Fixed="PERT" }

Indicates that this is pertinent information.

  • Fixed value: "PERT" 
[1..1] contextConductionInd (BL)

If "true", associations in the parent act are conducted across the ActRelationship to the child act.

In this context the contextConductionInd defaults to "true".

[1..1] seperatableInd (BL)

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

If the source act is intended to be interpreted independently the value shall be "true" otherwise the value shall be "false".

The value of seperatableInd shall be evaluated for each usage of the pertinentInformation relationship.

In this context the seperatableInd defaults to "false".

[1..1] pertinentChargePayment (ChargePayment)

The charge payment pertinent to this line item.

This information is mandatory.

[1..*] pertinentInformation2

An act relationship for dispensing endorsements required in support of the reimbursement claim for a medication Line Item.

[1..1] typeCode (CS {CNE:PERT} ){ Fixed="PERT" }

Indicates that this is pertinent information.

  • Fixed value: "PERT"
[1..1] contextConductionInd (BL)

If "true", associations in the parent act are conducted across the ActRelationship to the child act.

In this context the contextConductionInd defaults to "true".

[1..1] seperatableInd (BL)

This attribute indicates whether or not the source Act is intended to be interpreted independently of the target Act.

If the source act is intended to be interpreted independently the value shall be "true" otherwise the value shall be "false".

The value of seperatableInd shall be evaluated for each usage of the pertinentInformation relationship.

In this context the seperatableInd defaults to "true".

[1..1] pertinentDispensingEndorsement (DispensingEndorsement)

Indicates that DispensingEndorsement is pertinent to SuppliedLineItemQuantity.

This information is mandatory.

SuppliedLineItemRef
When a prescription is being fulfilled through partial dispense acts, this act ref provides a link to a line item of the PS event that this claim is being made for.
Used by: SuppliedLineItem
[1..1] classCode (CS {CNE:SBADM} ){ Fixed="SBADM" }

A code to indicate introducing or applying a substance to a subject.

  • Fixed value: "SBADM"
[1..1] moodCode (CS {CNE:PRMS} ){ Fixed="PRMS" }

Indicates that this is a promise of a service.

  • Fixed value: "PRMS"
[1..1] id (II)

The unique identifier of the target act being referred to.  This shall be a DCE UUID carried in the root attribute of the id element.

In this instance this is the globally unique number to identify a SuppliedLineItem of a previous PS Supply event.

SuppliedManufacturedProduct
Details of the physical characteristics of the dispensed medication.
Used by: SuppliedLineItemQuantity
[1..1] classCode (CS {CNE:MANU} ){ Fixed="MANU" }

Indicates that this is a manufactured material.

  • Fixed value "MANU"
[1..1] manufacturedSuppliedMaterial (SuppliedMaterial)

A link to the entity that describes the physical characteristics of the supplied medication.

ChargePayment
Details on whether a prescription charge was paid for the medication treatment. Reference: NPFIT-ETP-PZ-0159-v1.2 Table 14.
Used by: SuppliedLineItemQuantity
[1..1] classCode (CS {CNE:OBS} ){ Fixed="OBS" }

Indicates that this act is an observation

  • Fixed value: "OBS"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

Indicates that this is an event

  • Fixed value: "EVN"
[1..1] code (CV {CNE:PrescriptionAnnotation} )

Indicates that this is represents dispense charge payment.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain the fixed value "CP" from the list of codes in the PrescriptionAnnotation vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the PrescriptionAnnotation vocabulary.
[1..1] value (BL)

Boolean values to indicate the status of the Charge Payment:

  • value: "true" => there has been a charge payment
  • value: "false" => there has not been a charge payment
DispensingEndorsement

Details of the endorsement(s) to support the claim for this medication item. Reference: NPFIT-ETP-PZ-0159-v1.2 Table 4.

Used by: SuppliedLineItemQuantity
[1..1] classCode (CS {CNE:OBS} ){ Fixed="OBS" }

Indicates that this act is an observation

  • Fixed value: "OBS"
[1..1] moodCode (CS {CNE:EVN} ){ Fixed="EVN" }

Indicates that this is an event

  • Fixed value: "EVN"
[1..1] code (CV {CNE:PrescriptionAnnotation} )

Indicates that this is represents a dispensing endorsement.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain the fixed value "DE" from the list of codes in the PrescriptionAnnotation vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the PrescriptionAnnotation vocabulary.
[0..1] text (ST)

Textual (human readable) representation required in support of the reimbursement claim for the medication item.

[1..1] value (CV {CNE:DispensingEndorsement} )

Coded representation of the dispensing endorsement.

The Coded with Code System datatype flavour is used to carry this information as follows:

  • The code attribute will contain a value from the list of codes in the DispensingEndorsement vocabulary;
  • The codeSystem attribute will contain the OID value referenced in the DispensingEndorsement vocabulary.
SuppliedMaterial
Details of the physical characteristics of the dispensed medication.
Used by: SuppliedManufacturedProduct
[1..1] classCode (CS {CNE:MMAT} ){ Fixed="MMAT" }

Indicates that this is a manufactured material entity.

  • Fixed value "MMAT"

The classCode is carried as an attribute of the SuppliedManufacturedProduct element.

[1..1] determinerCode (CS {CNE:INSTANCE} ){ Fixed="INSTANCE" }

Indicates that this is an instance of material entity.

  • Fixed value "INSTANCE"

The determinerCode is carried as an attribute of the SuppliedMaterial element.

[1..1] code (CE {CNE:ManufacturedMaterialSnCT} )

A code from the SNOMED CT UK subset that describes a manufactured material (e.g. a pharmaceutical product or personal medical device).

The Coded Plain datatype shall be used to carry this information as follows:

  • The code attribute will contain the dm+d codification associated with the product or device
  • The codeSystem attribute will contain the OID for SNOMED CT
  • the displayName attribute will contain the textual (human readable) description associated with the code

NOTE: this attribute uses the CE data type due to limitations in the current HL7 toolset, which prevent it from being modelled using the CD dataype.