Bidirectional Services eReferral (BSeR), published by HL7 Public Health Working Group. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/bser/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: BSeR Referral Service Request

This ServiceRequest profile represents a BSeR request for a referral.

Usage:

• Refer to this Resource Profile: BSeR Referral Feedback Composition and BSeR Referral Task
• Examples for this Resource Profile: ServiceRequest/servicerequest-bser-referral-servicerequest-arthritis and ServiceRequest/servicerequest-bser-referral-servicerequest-early-childhood

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from ReferralServiceRequest

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest			ReferralServiceRequest
requester		1..1	Reference(US Core PractitionerRole Profile)	Referral Initiator
performer		0..1	Reference(US Core PractitionerRole Profile | US Core Organization Profile)	Referral Recipient
reasonCode		0..*	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
Slices for supportingInfo				Content/Rules for all slices
supportingInfo:consentSupportingInfo		0..*	Reference(BSeR Patient Consent)	Additional clinical information
supportingInfo:bundleSupportingInfo		0..*	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.46 from https://vsac.nlm.nih.gov

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ReferralServiceRequest	A request for a service to be performed prr-1: orderDetail SHALL only be present if code is present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
pertainsToGoal	S	0..*	Reference(Goal)	Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier	SΣ	1..1	Identifier	Identifiers assigned to this order
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
value	SΣ	1..1	string	The value that is unique Example General: 123456
assigner	SΣ	0..1	Reference(US Core Organization Profile)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier	SΣ	0..1	Identifier	Identifiers assigned to this order
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
value	SΣ	1..1	string	The value that is unique Example General: 123456
assigner	SΣ	0..1	Reference(US Core Organization Profile)	Organization that issued id (may be just text)
basedOn	SΣ	0..*	Reference(Referral Service Request)	What request fulfills
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Fixed Value: order
Slices for category	SΣ	1..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	Classification of service Binding: US Core ServiceRequest Category Codes (required)
priority	SΣ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	Referral or specific type of referral Binding: US Core Procedure Codes (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		When service should occur
occurrencePeriod			Period
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	1..1	Reference(US Core PractitionerRole Profile)	Referral Initiator
performer	SΣ	0..1	Reference(US Core PractitionerRole Profile | US Core Organization Profile)	Referral Recipient
reasonCode	SΣ	0..*	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
text	SΣ	1..1	string	set to the reason if there is no code otherwise set this field to the description of the code
reasonReference	SΣ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:insuranceCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
Slices for supportingInfo	S	0..*	Reference(Resource)	Additional clinical information Slice: Unordered, Open by profile:resolve()
supportingInfo:consentSupportingInfo	S	0..*	Reference(BSeR Patient Consent)	Additional clinical information
supportingInfo:bundleSupportingInfo	S	0..*	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
note	S	0..*	Annotation	Comments
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.type	extensible	Pattern: PLAC http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.type	extensible	Pattern: FILL http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
ServiceRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	Fixed Value: order http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	example	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
ServiceRequest.code	extensible	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.46 from https://vsac.nlm.nih.gov

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ReferralServiceRequest	A request for a service to be performed prr-1: orderDetail SHALL only be present if code is present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
pertainsToGoal	S	0..*	Reference(Goal)	Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier	SΣ	1..1	Identifier	Identifiers assigned to this order
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	SΣ	0..1	Reference(US Core Organization Profile)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier	SΣ	0..1	Identifier	Identifiers assigned to this order
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	SΣ	0..1	Reference(US Core Organization Profile)	Organization that issued id (may be just text)
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	SΣ	0..*	Reference(Referral Service Request)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Fixed Value: order
Slices for category	SΣ	1..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	Classification of service Binding: US Core ServiceRequest Category Codes (required)
priority	SΣ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	Referral or specific type of referral Binding: US Core Procedure Codes (extensible)
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	SΣ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	SΣ	0..1		When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	1..1	Reference(US Core PractitionerRole Profile)	Referral Initiator
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	SΣ	0..1	Reference(US Core PractitionerRole Profile | US Core Organization Profile)	Referral Recipient
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	SΣ	0..*	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
text	SΣ	1..1	string	set to the reason if there is no code otherwise set this field to the description of the code
reasonReference	SΣ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:insuranceCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
Slices for supportingInfo	S	0..*	Reference(Resource)	Additional clinical information Slice: Unordered, Open by profile:resolve()
supportingInfo:consentSupportingInfo	S	0..*	Reference(BSeR Patient Consent)	Additional clinical information
supportingInfo:bundleSupportingInfo	S	0..*	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note	S	0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.type	extensible	Pattern: PLAC http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.type	extensible	Pattern: FILL http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
ServiceRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	Fixed Value: order http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	example	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
ServiceRequest.code	extensible	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes http://hl7.org/fhir/ValueSet/servicerequest-orderdetail from the FHIR Standard
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
ServiceRequest.performerType	example	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.46 from https://vsac.nlm.nih.gov
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

This structure is derived from ReferralServiceRequest

Summary

Structures

This structure refers to these other structures:

• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• BSeR Patient Consent (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-PatientConsent)
• BSeR Referral Request Document Bundle (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRequestDocumentBundle)

Differential View

This structure is derived from ReferralServiceRequest

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest			ReferralServiceRequest
requester		1..1	Reference(US Core PractitionerRole Profile)	Referral Initiator
performer		0..1	Reference(US Core PractitionerRole Profile | US Core Organization Profile)	Referral Recipient
reasonCode		0..*	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
Slices for supportingInfo				Content/Rules for all slices
supportingInfo:consentSupportingInfo		0..*	Reference(BSeR Patient Consent)	Additional clinical information
supportingInfo:bundleSupportingInfo		0..*	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.46 from https://vsac.nlm.nih.gov

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ReferralServiceRequest	A request for a service to be performed prr-1: orderDetail SHALL only be present if code is present
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
pertainsToGoal	S	0..*	Reference(Goal)	Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier	SΣ	1..1	Identifier	Identifiers assigned to this order
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
value	SΣ	1..1	string	The value that is unique Example General: 123456
assigner	SΣ	0..1	Reference(US Core Organization Profile)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier	SΣ	0..1	Identifier	Identifiers assigned to this order
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
value	SΣ	1..1	string	The value that is unique Example General: 123456
assigner	SΣ	0..1	Reference(US Core Organization Profile)	Organization that issued id (may be just text)
basedOn	SΣ	0..*	Reference(Referral Service Request)	What request fulfills
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Fixed Value: order
Slices for category	SΣ	1..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	Classification of service Binding: US Core ServiceRequest Category Codes (required)
priority	SΣ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	Referral or specific type of referral Binding: US Core Procedure Codes (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		When service should occur
occurrencePeriod			Period
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	1..1	Reference(US Core PractitionerRole Profile)	Referral Initiator
performer	SΣ	0..1	Reference(US Core PractitionerRole Profile | US Core Organization Profile)	Referral Recipient
reasonCode	SΣ	0..*	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
text	SΣ	1..1	string	set to the reason if there is no code otherwise set this field to the description of the code
reasonReference	SΣ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:insuranceCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
Slices for supportingInfo	S	0..*	Reference(Resource)	Additional clinical information Slice: Unordered, Open by profile:resolve()
supportingInfo:consentSupportingInfo	S	0..*	Reference(BSeR Patient Consent)	Additional clinical information
supportingInfo:bundleSupportingInfo	S	0..*	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
note	S	0..*	Annotation	Comments
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.type	extensible	Pattern: PLAC http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.type	extensible	Pattern: FILL http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
ServiceRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	Fixed Value: order http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	example	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
ServiceRequest.code	extensible	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.46 from https://vsac.nlm.nih.gov

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ReferralServiceRequest	A request for a service to be performed prr-1: orderDetail SHALL only be present if code is present
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
pertainsToGoal	S	0..*	Reference(Goal)	Pertains to SDOH goal URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	1..*	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier	SΣ	1..1	Identifier	Identifiers assigned to this order
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	SΣ	0..1	Reference(US Core Organization Profile)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier	SΣ	0..1	Identifier	Identifiers assigned to this order
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	SΣ	0..1	Reference(US Core Organization Profile)	Organization that issued id (may be just text)
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	SΣ	0..*	Reference(Referral Service Request)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Fixed Value: order
Slices for category	SΣ	1..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	Classification of service Binding: US Core ServiceRequest Category Codes (required)
priority	SΣ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	Referral or specific type of referral Binding: US Core Procedure Codes (extensible)
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	SΣ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	SΣ	0..1		When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	1..1	Reference(US Core PractitionerRole Profile)	Referral Initiator
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	SΣ	0..1	Reference(US Core PractitionerRole Profile | US Core Organization Profile)	Referral Recipient
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	SΣ	0..*	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
text	SΣ	1..1	string	set to the reason if there is no code otherwise set this field to the description of the code
reasonReference	SΣ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:insuranceCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
Slices for supportingInfo	S	0..*	Reference(Resource)	Additional clinical information Slice: Unordered, Open by profile:resolve()
supportingInfo:consentSupportingInfo	S	0..*	Reference(BSeR Patient Consent)	Additional clinical information
supportingInfo:bundleSupportingInfo	S	0..*	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note	S	0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.type	extensible	Pattern: PLAC http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.type	extensible	Pattern: FILL http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
ServiceRequest.status	required	RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 from the FHIR Standard
ServiceRequest.intent	required	Fixed Value: order http://hl7.org/fhir/ValueSet/request-intent|4.0.1 from the FHIR Standard
ServiceRequest.category	example	ServiceRequestCategoryCodes http://hl7.org/fhir/ValueSet/servicerequest-category from the FHIR Standard
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category
ServiceRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
ServiceRequest.code	extensible	USCoreProcedureCodes http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes http://hl7.org/fhir/ValueSet/servicerequest-orderdetail from the FHIR Standard
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
ServiceRequest.performerType	example	ParticipantRoles http://hl7.org/fhir/ValueSet/participant-role from the FHIR Standard
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1099.46 from https://vsac.nlm.nih.gov
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard

This structure is derived from ReferralServiceRequest

Summary

Structures

This structure refers to these other structures:

• US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• BSeR Patient Consent (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-PatientConsent)
• BSeR Referral Request Document Bundle (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRequestDocumentBundle)

Other representations of profile: CSV, Excel, Schematron