Stream: CARIN IG for Blue Button®
Topic: Pharmacy EoB missing discriminator
Lee Surprenant (Sep 16 2020 at 17:43):
Something I've been meaning to write up since last week's connectathon: I noticed a discrepency between the Pharmacy EoB and the other EoB profiles that I believe to be an error of omission.
Specifically, profiles like https://build.fhir.org/ig/HL7/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html have a fixed catagory for their adjudication:denialreason slice.
image.png
However, in the case of the pharmacy EoB at https://build.fhir.org/ig/HL7/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html, this category constraint is missing:
image.png
Lee Surprenant (Sep 16 2020 at 17:45):
Unless someone can explain that this is right, I will go ahead and open a JIRA for it
Lee Surprenant (Sep 16 2020 at 17:50):
Opened as FHIR#28554
Saul Kravitz (Sep 16 2020 at 23:07):
@Lee Surprenant It is correct. The payload -- the actual reason -- is in the reason code. The category is fixed as denialreason.
Lee Surprenant (Sep 16 2020 at 23:11):
What I’m saying is, in just pharmacy eob, it is not fixed.
Lee Surprenant (Sep 16 2020 at 23:11):
But it should be
Saul Kravitz (Sep 17 2020 at 13:46):
Reading is fundamental. You are correct. Fixed, rebuilding draft ... see https://saulakravitz.github.io/carin-bb-publish/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html in 5 min.
Last updated: Apr 12 2022 at 19:14 UTC
