Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU2 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 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 23 - XML Representation

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<Task xmlns="http://hl7.org/fhir">
  <id value="cdex-task-example23"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Task cdex-task-example23</b></p><a name="cdex-task-example23"> </a><a name="hccdex-task-example23"> </a><a name="cdex-task-example23-en-US"> </a><p><b>identifier</b>: Re-Association Tracking Control Number/trackingid1034</p><p><b>status</b>: Requested</p><p><b>intent</b>: order</p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes attachment-request-questionnaire}">Attachment Request Questionnaire</span></p><p><b>for</b>: <a href="#hccdex-task-example23/patient">Amy Shaw  (no stated gender), DoB: 1987-02-20 ( Patient Account Number: PA-123 (use: usual, ))</a></p><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>: Identifier: <code>http://example.org/cdex/payer/payer-ids</code>/Payer123</p><p><b>owner</b>: <a href="#hccdex-task-example23/practitionerrole">PractitionerRole</a></p><p><b>reasonCode</b>: <span title="Codes:{http://hl7.org/fhir/claim-use preauthorization}">preauthorization</span></p><p><b>reasonReference</b>: Identifier: <code>http://example.org/cdex/payer/claim-ids</code>/Preauth123</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>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes questionnaires-needed}">Questionnaires Needed</span></p><p><b>value</b>: <a href="https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=http://example.org/base_adaptive_questionnaire">http://example.org/base_adaptive_questionnaire</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp signature-flag}">Signature Flag</span></p><p><b>value</b>: true</p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes payer-url}">Payer URL</span></p><p><b>value</b>: <a href="https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&amp;canonical=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>: <span title="Codes:{http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp purpose-of-use}">Purpose Of Use</span></p><p><b>value</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActReason COVAUTH}">coverage authorization</span></p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Patient  #patient</b></p><a name="cdex-task-example23/patient"> </a><a name="hccdex-task-example23/patient"> </a><a name="cdex-task-example23/patient-en-US"> </a><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Amy Shaw  (no stated gender), DoB: 1987-02-20 ( Patient Account Number: PA-123 (use: usual, ))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Other Id (see the one above)">Other Id:</td><td colspan="3">Member Number/Member123 (use: usual, )</td></tr></table></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: PractitionerRole  #practitionerrole</b></p><a name="cdex-task-example23/practitionerrole"> </a><a name="hccdex-task-example23/practitionerrole"> </a><a name="cdex-task-example23/practitionerrole-en-US"> </a><p><b>practitioner</b>: Identifier: <a href="http://terminology.hl7.org/5.3.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/9941339100</p><p><b>organization</b>: Identifier: <a href="http://terminology.hl7.org/5.3.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/1234567893</p></blockquote></div>
  </text>
  <contained>
    <Patient>
      <id value="patient"/>
      <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>
      <identifier>
        <use value="usual"/>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType"/>
            <code value="pat"/>
            <display value="Patient Account Number"/>
          </coding>
          <text value="Patient Account Number"/>
        </type>
        <system value="http://example.org/cdex/provider/patient-ids"/>
        <value value="PA-123"/>
      </identifier>
      <name>
        <family value="Shaw"/>
        <given value="Amy"/>
      </name>
      <birthDate value="1987-02-20"/>
    </Patient>
  </contained>
  <contained>
    <PractitionerRole>
      <id value="practitionerrole"/>
      <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="trackingid1034"/>
  </identifier>
  <status value="requested"/>
  <intent value="order"/>
  <code>
    <coding>
      <system
              value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
      <code value="attachment-request-questionnaire"/>
    </coding>
    <text value="Attachment Request Questionnaire"/>
  </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="preauthorization"/>
      <display value="Preauthorization"/>
    </coding>
    <text value="preauthorization"/>
  </reasonCode>
  <reasonReference>
    <identifier>
      <system value="http://example.org/cdex/payer/claim-ids"/>
      <value value="Preauth123"/>
    </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="questionnaires-needed"/>
      </coding>
    </type>
    <valueCanonical value="http://example.org/base_adaptive_questionnaire"/>
  </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="purpose-of-use"/>
      </coding>
    </type>
    <valueCodeableConcept>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="COVAUTH"/>
        <display value="coverage authorization"/>
      </coding>
    </valueCodeableConcept>
  </input>
</Task>