Da Vinci Clinical Data Exchange (CDex)
2.1.0-preview - CI Build United States of America flag

Da Vinci Clinical Data Exchange (CDex), published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ecdx/ and changes regularly. See the Directory of published versions

: CDex Task Example 19 - XML Representation

Page standards status: Informative

Raw xml | Download



<Task xmlns="http://hl7.org/fhir">
  <id value="cdex-task-example19"/>
  <meta>
    <extension url="http://hl7.org/fhir/StructureDefinition/instance-name">
      <valueString value="CDex Task Example 19"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/instance-description">
      <valueMarkdown
                     value="**Claim Attachment Request Example:**   Claim Attachment Request sent by payer to a provider requesting a signed Progress note (H&amp;P) note"/>
    </extension>
    <profile
             value="http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-task-attachment-request"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Task</b><a name="cdex-task-example19"> </a><a name="hccdex-task-example19"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">ResourceTask &quot;cdex-task-example19&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-cdex-task-attachment-request.html">CDex Task Attachment Request Profile</a></p></div><p><b>identifier</b>: Re-Association Tracking Control Number/trackingid123</p><p><b>status</b>: requested</p><p><b>intent</b>: order</p><p><b>code</b>: Coded Attachment Request <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/us/davinci-pas/STU2/CodeSystem-PASTempCodes.html">PAS Temporary Codes</a>#attachment-request-code)</span></p><p><b>for</b>: <a name="hcpatient"> </a></p><blockquote><p/><p><a name="patient"> </a></p><p><a name="hcpatient"> </a></p><p><b>identifier</b>: Member Number/Member123 (use: usual)</p><p><b>name</b>: Amy Shaw </p><p><b>birthDate</b>: 1987-02-20</p></blockquote><p><b>authoredOn</b>: 2022-06-17 16:16:06+0000</p><p><b>lastModified</b>: 2022-06-17 16:16:06+0000</p><p><b>requester</b>: <span><code>http://example.org/cdex/payer/payer-ids</code>/Payer123</span></p><p><b>owner</b>: <a name="hcpractitionerrole"> </a></p><blockquote><p/><p><a name="practitionerrole"> </a></p><p><a name="hcpractitionerrole"> </a></p><p><b>practitioner</b>: <span><a href="http://terminology.hl7.org/5.3.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/9941339100</span></p><p><b>organization</b>: <span><a href="http://terminology.hl7.org/5.3.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/1234567893</span></p></blockquote><p><b>reasonCode</b>: claim <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4/codesystem-claim-use.html">Use</a>#claim &quot;Claim&quot;)</span></p><p><b>reasonReference</b>: <span><code>http://example.org/cdex/payer/claim-ids</code>/Claim123</span></p><h3>Restrictions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Period</b></td></tr><tr><td style="display: none">*</td><td>?? --&gt; 2022-06-21</td></tr></table><blockquote><p><b>input</b></p><p><b>PALineNumber</b>: 1</p><p><b>type</b>: Attachments Needed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/us/davinci-pas/STU2/CodeSystem-PASTempCodes.html">PAS Temporary Codes</a>#attachments-needed)</span></p><p><b>value</b>: Progress note <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#11506-3)</span></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Signature Flag <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cdex-temp.html">CDex Temporary Code System</a>#signature-flag)</span></p><p><b>value</b>: true</p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Payer URL <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/us/davinci-pas/STU2/CodeSystem-PASTempCodes.html">PAS Temporary Codes</a>#payer-url)</span></p><p><b>value</b>: <a href="http://example.org/cdex/payer/$submit-attachment">http://example.org/cdex/payer/$submit-attachment</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Service Date <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cdex-temp.html">CDex Temporary Code System</a>#service-date)</span></p><p><b>value</b>: 2022-06-13</p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Purpose Of Use <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cdex-temp.html">CDex Temporary Code System</a>#purpose-of-use)</span></p><p><b>value</b>: claim attachment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html">ActReason</a>#CLMATTCH)</span></p></blockquote><hr/><blockquote><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b>Amy Shaw </b> (no stated gender), DoB: 1987-02-20 ( Member Number/Member123 (use: usual))</p><hr/></blockquote><hr/><blockquote><p><b>Generated Narrative: PractitionerRole #practitionerrole</b><a name="practitionerrole"> </a><a name="hcpractitionerrole"> </a></p><p><b>practitioner</b>: <span><a href="http://terminology.hl7.org/5.3.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/9941339100</span></p><p><b>organization</b>: <span><a href="http://terminology.hl7.org/5.3.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/1234567893</span></p></blockquote></div>
  </text>
  <contained>
    <Patient>
      <id value="patient"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-patient-demographics"/>
      </meta>
      <identifier>
        <use value="usual"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
            <code value="MB"/>
            <display value="Member Number"/>
          </coding>
          <text value="Member Number"/>
        </type>
        <system value="http://example.org/cdex/payer/member-ids"/>
        <value value="Member123"/>
      </identifier>
      <name>
        <family value="Shaw"/>
        <given value="Amy"/>
      </name>
      <birthDate value="1987-02-20"/>
    </Patient>
  </contained>
  <contained>
    <PractitionerRole>
      <id value="practitionerrole"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-practitionerrole"/>
      </meta>
      <practitioner>
        <identifier>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="9941339100"/>
        </identifier>
      </practitioner>
      <organization>
        <identifier>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="1234567893"/>
        </identifier>
      </organization>
    </PractitionerRole>
  </contained>
  <identifier>
    <type>
      <coding>
        <system
                value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
        <code value="tracking-id"/>
        <display value="Tracking Id"/>
      </coding>
      <text value="Re-Association Tracking Control Number"/>
    </type>
    <system value="http://example.org/payer"/>
    <value value="trackingid123"/>
  </identifier>
  <status value="requested"/>
  <intent value="order"/>
  <code>
    <coding>
      <system
              value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
      <code value="attachment-request-code"/>
    </coding>
    <text value="Coded Attachment Request"/>
  </code>
  <for>
    <reference value="#patient"/>
  </for>
  <authoredOn value="2022-06-17T16:16:06Z"/>
  <lastModified value="2022-06-17T16:16:06Z"/>
  <requester>
    <identifier>
      <system value="http://example.org/cdex/payer/payer-ids"/>
      <value value="Payer123"/>
    </identifier>
  </requester>
  <owner>
    <reference value="#practitionerrole"/>
  </owner>
  <reasonCode>
    <coding>
      <system value="http://hl7.org/fhir/claim-use"/>
      <code value="claim"/>
      <display value="Claim"/>
    </coding>
    <text value="claim"/>
  </reasonCode>
  <reasonReference>
    <identifier>
      <system value="http://example.org/cdex/payer/claim-ids"/>
      <value value="Claim123"/>
    </identifier>
  </reasonReference>
  <restriction>
    <period>
      <end value="2022-06-21"/>
    </period>
  </restriction>
  <input>
    <extension
               url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber">
      <valueInteger value="1"/>
    </extension>
    <type>
      <coding>
        <system
                value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
        <code value="attachments-needed"/>
      </coding>
    </type>
    <valueCodeableConcept>
      <coding>
        <system value="http://loinc.org"/>
        <code value="11506-3"/>
        <display value="Progress note"/>
      </coding>
      <text value="Progress note"/>
    </valueCodeableConcept>
  </input>
  <input>
    <type>
      <coding>
        <system
                value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
        <code value="signature-flag"/>
      </coding>
    </type>
    <valueBoolean value="true"/>
  </input>
  <input>
    <type>
      <coding>
        <system
                value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
        <code value="payer-url"/>
      </coding>
    </type>
    <valueUrl value="http://example.org/cdex/payer/$submit-attachment"/>
  </input>
  <input>
    <type>
      <coding>
        <system
                value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
        <code value="service-date"/>
      </coding>
    </type>
    <valueDate value="2022-06-13"/>
  </input>
  <input>
    <type>
      <coding>
        <system
                value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
        <code value="purpose-of-use"/>
      </coding>
    </type>
    <valueCodeableConcept>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="CLMATTCH"/>
        <display value="claim attachment"/>
      </coding>
    </valueCodeableConcept>
  </input>
</Task>