source: ccr2ccd-xslt/trunk/make/PayersSectionMedicareTemplate.xml@ 993

Last change on this file since 993 was 991, checked in by George Lilly, 14 years ago

latest qrda work

File size: 4.0 KB
Line 
1<component>
2<section>
3<!--We are including only a coverage activity for Medicare here. There is also policy activity and and authorization activity that I don't think we need to report for QRDA, at least not for most reports-->
4<templateId root="2.16.840.1.113883.10.20.1.9"/>
5<!-- 48768-6 is payment sources and is fixed CQ-188,189,190-->
6<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
7<!--CQ-191,192-->
8<title>Payers</title>
9<!--medicare-->
10<entry typeCode="DRIV">
11<!--WVP moodCode is DEF is definition to describe the characteristics of who must be involved in an act CQ-194,195-->
12<act classCode="ACT" moodCode="DEF">
13<!--WVP coverage activity template is the 10.20.1.20 CQ-193-->
14<templateId root="2.16.840.1.113883.10.20.1.20"/>
15<!--Coverage Shall Include and Act ID CQ-196-->
16<!--looks like a UUID to me-->
17<id root="1751b180-8a54-11df-a4ee-0800200c9c66"/><!--FIX!!!???-->
18<!--CQ-197-198 It appears that statusCode="completed" need to follow the code code ... here and below-->
19
20<!--CQ199,200-->
21<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" displayName="Payment sources"/>
22<statusCode code="completed"/>
23
24<!--A coverage activity shall contain on or more act/entryRelationship. The value for act/entryRelationship/@typeCode shall be COMP which SHALL be the CMS QRDA Policy Activity CQ-201, 203-->
25<!--It MAY contain an entryRelationship/sequenceNumber CQ-202-->
26<entryRelationship typeCode="COMP">
27<!-- for the act is event with moodCode EVN CQ-205,206,207-->
28<act classCode="ACT" moodCode="EVN">
29<!--Policy activity is the 10.20.1.26 template CQ-205-->
30<templateId root="2.16.840.1.113883.10.20.1.26"/>
31
32<!-- act/id which is the group or contract number related to the insurance policy or program CQ-208-->
33<id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/><!--!!!FIX-->
34<!--Act statusCode must be completed CQ-210-->
35<!--This SHOULD be present and comes from the downloadable resource S display name is in quotes AUTOPOL - "automobile" policy;EHCPOL additional insurance in addition to Medicare in this case
36HSAPOL "Health Spending Account";PUBLICPOL "public healthcare" which is NOT Medicare - maybe a state program for example
37WBCPOL is "workers compensation" CQ-211,212-->
38<!--<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>-->
39<code code="PUBLICPOL" codeSystem="2.16.840.1.113883.5.4" displayName="Public Healthcare"/>
40<!--WVP performer type codes are numerous but PRF is performer representing the Payer CQ-213-->
41<statusCode code="completed"/>
42<performer typeCode="PRF">
43
44<!--performer/assignedEntity id is the payer identification and the extension comes from the downloadable resource section I insurance plan TYPE CQ-214-->
45<assignedEntity>
46<id root="2.16.840.1.113883.12.86" extension="MC"/>
47<!--<representedOrganization>
48<name>CMS</name>
49</representedOrganization>-->
50</assignedEntity>
51</performer>
52<!-- Act/participant @typeCode this represents the covered party CQ-215-->
53<participant typeCode="COV">
54<participantRole>
55<!--A covered party in a policy activity SHOULD contain one or more participant/participantRole/id to represent the patien's member of subscriber identifier with respect to the payer
56For participant/paricipantRole/id either the Social Security Number or HIC Number SHALL be submitted for Medicare patients. for SSN the ID @root SHALL be 2.16.840.1.113883.4.1 where
57the HIC id/@root shall be 2.16.840.1.113883.3.249.13 CQ-216"RoleCode" in the downloadable resource-->
58<!-- in this case theextension is the patients SSN for a medicare patient so it is the same each time for one patient-->
59<id root="2.16.840.1.113883.4.1" extension="@@SSN@@"/>
60<!--The covered party in tha policy activity SHOULD contain exactly one particpant/participantRole/code for self, family etc from the valuse set PolicyOrPrograCoverageRoleType 2.16.840.1.113883.1.11.19809 CQ-217,218-->
61<code code="SELF" codeSystem="2.16.840.1.113883.5.111" displayName="Self"/>
62</participantRole>
63</participant>
64</act>
65</entryRelationship>
66</act>
67</entry>
68</section>
69</component>
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