This page is part of the FHIR Implementation Guide for ABDM (v6.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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Resource Profile: CoverageEligibilityRequest - Mappings

Draft as of 2025-03-18

Mappings for the CoverageEligibilityRequest resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

CoverageEligibilityRequest
CoverageEligibilityRequest	Request
identifier	Request.identifier
status	Request.status
priority	Request.priority
patient	Request.subject
created	Request.authoredOn
provider	Request.requester
insurer	Request.performer
item
provider	Request.requester

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

CoverageEligibilityRequest
CoverageEligibilityRequest
identifier	FiveWs.identifier
status	FiveWs.status
priority	FiveWs.class
purpose	FiveWs.class
patient	FiveWs.subject[x], FiveWs.subject
serviced[x]	FiveWs.done[x]
created	FiveWs.recorded
enterer	FiveWs.author
provider	FiveWs.source
insurer	FiveWs.who
facility	FiveWs.where[x]
item
provider	FiveWs.source

Mappings for HL7 v2 Mapping (http://hl7.org/v2)

CoverageEligibilityRequest
CoverageEligibilityRequest
item
category
coding	C*E.1-8, C*E.10-22
system	C*E.3
version	C*E.7
code	C*E.1
display	C*E.2 - but note this is not well followed
userSelected	Sometimes implied by being first
text	C*E.9. But note many systems use C*E.2 for this
productOrService
coding	C*E.1-8, C*E.10-22
system	C*E.3
version	C*E.7
code	C*E.1
display	C*E.2 - but note this is not well followed
userSelected	Sometimes implied by being first
text	C*E.9. But note many systems use C*E.2 for this
diagnosis	Request.reasonReference

Mappings for RIM Mapping (http://hl7.org/v3)

CoverageEligibilityRequest
CoverageEligibilityRequest	Entity. Role, or Act
text	Act.text?
contained	N/A
extension	N/A
modifierExtension	N/A
supportingInfo
id	n/a
extension	n/a
modifierExtension	N/A
insurance
id	n/a
extension	n/a
modifierExtension	N/A
item
id	n/a
extension	n/a
modifierExtension	N/A
category
id	n/a
extension	n/a
coding	union(., ./translation)
id	n/a
extension	n/a
system	./codeSystem
version	./codeSystemVersion
code	./code
display	CV.displayName
userSelected	CD.codingRationale
text	./originalText[mediaType/code="text/plain"]/data
productOrService
id	n/a
extension	n/a
coding	union(., ./translation)
id	n/a
extension	n/a
system	./codeSystem
version	./codeSystemVersion
code	./code
display	CV.displayName
userSelected	CD.codingRationale
text	./originalText[mediaType/code="text/plain"]/data
diagnosis
id	n/a
extension	n/a
modifierExtension	N/A