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
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{
"resourceType" : "Task",
"contained" : [
{
"resourceType" : "Patient",
"id" : "patient",
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MB",
"display" : "Member Number"
}
],
"text" : "Member Number"
},
"system" : "http://example.org/cdex/payer/member-ids",
"value" : "Member123"
},
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType",
"code" : "pat",
"display" : "Patient Account Number"
}
],
"text" : "Patient Account Number"
},
"system" : "http://example.org/cdex/provider/patient-ids",
"value" : "PA-123"
}
],
"name" : [
{
"family" : "Shaw",
"given" : [
"Amy"
]
}
],
"birthDate" : "1987-02-20"
},
{
"resourceType" : "PractitionerRole",
"id" : "practitionerrole",
"practitioner" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
}
},
"organization" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1234567893"
}
}
}
],
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "tracking-id",
"display" : "Tracking Id"
}
],
"text" : "Re-Association Tracking Control Number"
},
"system" : "http://example.org/payer",
"value" : "trackingid1012"
}
],
"status" : "requested",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
"code" : "attachment-request-questionnaire"
}
],
"text" : "Attachment Request Questionnaire"
},
"for" : {
"reference" : "#patient"
},
"authoredOn" : "2022-06-17T16:16:06Z",
"lastModified" : "2022-06-17T16:16:06Z",
"requester" : {
"identifier" : {
"system" : "http://example.org/cdex/payer/payer-ids",
"value" : "Payer123"
}
},
"owner" : {
"reference" : "#practitionerrole"
},
"reasonCode" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/claim-use",
"code" : "preauthorization",
"display" : "Preauthorization"
}
],
"text" : "preauthorization"
},
"reasonReference" : {
"identifier" : {
"system" : "http://example.org/cdex/payer/claim-ids",
"value" : "Preauth123"
}
},
"restriction" : {
"period" : {
"end" : "2022-06-21"
}
},
"input" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber",
"valueInteger" : 1
}
],
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
"code" : "questionnaire-context"
}
]
},
"valueCanonical" : "http://example.org/cdex-questionnaire-example1"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
"code" : "payer-url"
}
]
},
"valueUrl" : "http://example.org/cdex/payer/$submit-attachment"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "purpose-of-use"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
"code" : "COVAUTH",
"display" : "coverage authorization"
}
]
}
}
]
}