Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU 2.1
Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU 2.1
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
| Page standards status: Trial-use |
This page documents an optional solicited attachments transaction for requesting additional claims or prior authorization data from a Provider using FHIR [Questionnaire].* The Payer uses the Task-based [CDex Task Attachment Request Profile] to request a Provider to complete one or more questionnaires. The Provider launches [Da Vinci DTR] to complete the questionnaires and, as documented in the [Sending Attachments] page, submits the completed questionnaires to the Payer using the $submit-attachment operation. In contrast to [Requesting Attachments Using Attachment Codes], a HIPAA-based request model using attachment codes, it supports using FHIR Questionnaire to define in more detail what data is missing. As a result, it avoids unnecessary documents. In addition, it leverages [Da Vinci DTR] functionality to fill out the FHIR Questionnaire, reducing the time spent reviewing documentation requirements.
* See the [Conforming to CDex Attachments] page for how systems declare what they support for the various actors and roles in CDex Attachments.
Payers can request attachments and additional data for claims and prior authorizations as a FHIR transaction. CDex uses Task to represent both the data request and the returned data and provides information such as why it needs to be completed, who is to complete it, who is asking for it, when it is due, etc. The Provider updates the Task’s status as the task is fulfilled.
The Task Based Approach page documents the general approach to using Task to request data. For requesting attachments using CDex Attachments, review the following sections on the Task Based Approach page:
In the more general CDEX Task Based Approach, the Data Consumer polls or subscribes to Task status updates and pulls the data when the Task is complete. In contrast, for CDEX Attachments, The Provider pushes the data to the Payer-supplied endpoint using the $submit-attachment operation, as documented on the [Sending Attachments] page.
For CDex attachment requests transactions, the Payer SHALL use the [CDex Task Attachment Request Profile] to solicit information from a Provider. For a detailed description of all the mandatory, [must support], and optional elements, as well as formal definitions and profile views, see the CDex Task Data Request Profile page.
In contrast to [Requesting Attachments Using Attachment Codes], when a Payer references one or more FHIR Questionnaires as input parameters, the Task represents a request for the Provider to complete the questionnaires. The [CDex Task Attachment Request Profile] defines a specific Task.code that directs the Provider to launch a [Da Vinci - Documentation Templates and Rules (DTR)] application to use the Payer provided Questionnaires and results from any CQL execution to generate and complete a QuestionnaireResponse. Figure 17 below summarizes the steps for requesting and completing a questionnaire using CDex Attachments and DTR, and the sequence diagram in the following section illustrates these transactions in more detail:
Step 1: The Payer POSTs a Task to the Provider. The Task is a request to complete a questionnaire.
Step 2: If the Task.code is "attachment-request-questionnaire", the Provider launches DTR and shares the Task as a launch parameter (i.e., DTR has access to read and update the Task and access to other resources to complete the QuestionnaireResponse in Step 3)
Step 3: DTR fetches the Task, which contains the link to the Questionnaire. Then, it fetches the Questionnaire (and any CQL rules defined within it) and completes the QuestionnaireResponse. Refer to the [Da Vinci DTR] Implementation Guide for more information on how it generates a QuestionnaireResponse.
Step 4: DTR creates and updates the QuestionnaireResponse directly to the Data Source's FHIR Server and updates Task.output to reference the QuestionnaireResponse it created..
Step 5: When the QuestionnaireResponse is completed, the Provider "pushes" the QuestionnaireResponse directly to the Payer-defined endpoint using the $submit-attachments operation. See the [Sending Attachments] page for Implementation Guide for more information on this transaction.
Step 6: The Provider updates the Task to "completed" when complete - e.g., when the data has been submitted or the information gathered.
The sequence diagram in Figure 18 below depicts the FHIR RESTful transactions and processes involved between the Payer, Provider, and DTR application application needed to request, fill, and return one or more questionnaires using using CDex Attachments. It references a "DTR Launch". If the DTR is a native EHR application, the launch is implementation specific. If DTR is a SMART on FHIR Application, the next ([DTR SMART App Launch]) section documents the launch sequence and parameters.
The sequence diagram in Figure 19 below depicts the transactions between the DTR Client, FHIR Server, and DTR application needed to launch a DTR SMART App.
Preconditions and Assumptions:
Step 1 (Optional): The DTR App registers with DTR Client (may be out of band)
Step 2,3: If the Task.code is "attachment-request-questionnaire" (or "data-request-questionnaire" for the Task Based Approach), a User initiates [Smart Version 2.0.0 EHR launch flow] to launch DTR (for example, clicks a button to launch DTR) and DTR Client sends a launch request to the DTR App
Step 4: The DTR App retrieves the .well-known/smart-configuration from FHIR Server.
Step 5: The DTR App requests an authorization code with the following scopes:
Step 6,7: Assuming the authorization is granted, The DTR app requests an access token
Step 8: The DTR App obtains an access token and the launch contexts in the "fhirContext" array, including a local reference to the Task in step 2.
Step 9: The DTR App uses the Task reference obtained in step 8 to fetch the Task, Questionnaire(s), and other resources it needs to fill out a QuestionnaireResponse(s). See the previous section (or this section on the Task Based Approach page) for more detailed transactions.
The [Requesting Attachments Using Attachment Codes] page documents the data elements needed to associate an attachment to a claim or prior authorization. However, there is no "Attachment Code" Data element when using Questionnaires to collect attachments-related data.
In the following sections, A detailed look at an example Solicited attachment transaction illustrates how:
In this scenario, a Provider creates a prior authorization and sends it to the Payer. The Payer reviews the prior authorization and responds with a request to fill out a questionnaire for attachments-related data using the CDex Attachment Request Profile. After receiving the attachment request, the Provider launches DTR, which completes a QuestionnaireResponse. The Provider returns the QuestionnaireResponse using the $submit-attachment operation, posting it to the endpoint supplied in the request. The flow diagram in figure 20 below illustrates the scenario.
In addition to the information needed to submit and associate the attachments to the claim successfully, the Payer supplies the following details about what information is necessary to complete the adjudication of the claim:
The table below summarizes the mapping between the CDex Request Attachment Profile elements and the $submit-attachment parameters:
| Data Element | CDex $submit-attachment Parameter | CDex Request Attachment Task Profile Element |
|---|---|---|
| Tracking ID | TrackingId | Task.identifier |
| Use | AttachTo | Task.reasonCode |
| Payer ID | PayerId | Task.requester.identifier |
| Payer URL | (operation endpoint) | "PayerUrl" Task.input |
| Organization ID | OrganizationId | PractitionerRole.practitioner.identifier |
| Provider ID | ProviderId | PractitionerRole.organization.identifier |
| Line Item(s) | Attachment.LineItem | “AttachmentsNeeded” Task.input.extension |
| Attachment Code | Attachment.Code | “AttachmentsNeeded” Task.input |
| Date of Service | ServiceDate | “service-date” Task.input |
| Member ID | MemberId | Patient.identifier |
| Questionnaire | - | “QuestionnaireContext” Task.input |
| QuestionnaireResponse | Attachment.Content | - |
The data element mapping table is available as a CSV and Excel file.
In the first FHIR transaction, the Payer POSTs the CDex Task Attachment Request Profile to the Provider endpoint.
POST [base]/Task
Request Body
0 {
1 "resourceType" : "Task",
The following data elements are used to verify the patient's identity. (This guide does not cover how the Provider system verifies the patient's identity.) They are communicated in a contained Patient resource using the [CDex Patient Demographics Profile]. The contained Patient is referenced in Task.for.reference using a fixed reference value of "#patient".
| Data | HRex Patient Demographics Profile. |
|---|---|
| Member ID or Patient Account No.* | Patient.identifier |
| Patient Name | Patient.name |
| Patient DOB (optional) | Patient.birthDate |
* Patient Account Number is a Provider assigned identifier
2 "contained" : [{
3 "resourceType" : "Patient",
4 "id" : "patient",
5 "identifier" : [{
6 "use" : "usual",
7 "type" : {
8 "coding" : [{
9 "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
10 "code" : "MB",
11 "display" : "Member Number"
12 }],
13 "text" : "Member Number"
14 },
15 "system" : "http://example.org/cdex/payer/member-ids",
16 "value" : "Member123"
17 },
18 {
19 "use" : "usual",
20 "type" : {
21 "coding" : [{
22 "system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType",
23 "code" : "pat",
24 "display" : "Patient Account Number"
25 }],
26 "text" : "Patient Account Number"
27 },
28 "system" : "http://example.org/cdex/provider/patient-ids",
29 "value" : "PA-123"
30 }],
31 "name" : [{
32 "family" : "Shaw",
33 "given" : ["Amy"]
34 }],
35 "birthDate" : "1987-02-20"
36 },
The Payer communicates the provider ID as either a unique organization/location identifier (e.g., Type 2 NPI), unique provider identifier (e.g., Type 1 NPI), or both in a contained PractitionerRole resource using the [CDex PractitionerRole Profile]. This contained PractitionerRole is referenced in Task.owner.reference using a fixed reference value of "#practitionerrole".
37 {
38 "resourceType" : "PractitionerRole",
39 "id" : "practitionerrole",
40 "practitioner" : {
41 "identifier" : {
42 "system" : "http://hl7.org/fhir/sid/us-npi",
43 "value" : "9941339100"
44 }
45 },
46 "organization" : {
47 "identifier" : {
48 "system" : "http://hl7.org/fhir/sid/us-npi",
49 "value" : "1234567893"
50 }
51 }
The mandatory Task.identifier tracking-id slice element represents the Payer tracking identifier. The tracking-id (the "re-association tracking control number") is an identifier that ties the attachments back to the claim or prior authorization. The Provider will echo it back to the Payer when submitting the attachments.
53 "identifier" : [{
54 "type" : {
55 "coding" : [{
56 "system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
57 "code" : "tracking-id",
58 "display" : "Tracking Id"
59 }],
60 "text" : "Re-Association Tracking Control Number"
61 },
62 "system" : "http://example.org/payer",
63 "value" : "trackingid1012"
64 }],
These required Task infrastructure elements:
Task.statusTask.intentconvey the task status and the intent of the request. The Task.status value of "request" is typical when POSTing the Task-based attachment request. The status will change as the Task moves through the workflow based on the [Task state machine]. Task.intent is fixed to "order".
65 "status" : "requested",
66 "intent" : "order",
The Task.code communicates that the Payer is requesting attachments for a claim or prior authorization using a code or data request questionnaire. If the code is "attachment-request-code", the provider system returns attachment(s) identified by the attachment code(s) in the "code" input parameter. If the code is "attachment-request-questionnaire", as it is in this scenario, the provider system uses Documentation Templates and Rules (DTR) to complete the Questionnaire referenced in the "questionnaire" input parameter. The provider system uses the $submit-attachment operation to return the information to the endpoint provided in the Task.input "payer-url" parameter.
67 "code" : {
68 "coding" : [{
69 "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
70 "code" : "attachment-request-questionnaire"
71 }],
72 "text" : "Attachment Request Questionnaire"
73 },
The attachment request will be directed to the same Provider who submitted the claim or prior authorization. Business identifiers are used to identify the Patient, the Payer, and the Provider who submitted the claim, and these identifiers are echoed back to the Payer when submitting the attachments.
As discussed above, the patient ID is in the contained Patient resource, referenced by the Task.for element, and the provider ID is in the contained PractitionerRole resource, referenced by the Task.owner element. The provider ID can be a Practitioner identifier (i.e., a Type1 NPI), the Practitioner's Organization identifier (i.e., a Type2 NPI), or both.
(note the various Task dates in the request fragment below)
| Actor | CDex Request Attachment Task Profile Element |
|---|---|
| payer ID | Task.requester.identifier |
| provider ID | (contained)PractitionerRole.practitioner. identifier or PractitionerRole.Organization.identifier |
| patient member ID or Patient Account No | (contained)Patient.identifier |
74 "for" : {
75 "reference" : "#patient"
76 },
77 "authoredOn" : "2022-06-17T16:16:06Z",
78 "lastModified" : "2022-06-17T16:16:06Z",
79 "requester" : {
80 "identifier" : {
81 "system" : "http://example.org/cdex/payer/payer-ids",
82 "value" : "Payer123"
83 }
84 },
85 "owner" : {
86 "reference" : "#practitionerrole"
87 },
The Task communicates whether the attachments are for a claim or prior authorization, and the Payer identifies the claim or prior authorization with its business identifier.
| Data | CDex Request Attachment Task Profile Element |
|---|---|
| Claim or Prior Authorization | Task.reasonCode |
| Claim or Prior Authorization ID | Task.reasonReference.identifier |
88 "reasonCode" : {
89 "coding" : [{
90 "system" : "http://hl7.org/fhir/claim-use",
91 "code" : "preauthorization",
92 "display" : "Preauthorization"
93 }],
94 "text" : "preauthorization"
95 },
96 "reasonReference" : {
97 "identifier" : {
98 "system" : "http://example.org/cdex/payer/claim-ids",
99 "value" : "Preauth123"
100 }
101 },
102 "restriction" : {
103 "period" : {
The Payer communicates the due date for submitting the attachment in the Task.restriction.period element. Note that Task.restriction.period.end represents the time when the Provider should have submitted the attachments.
102 "restriction" : {
103 "period" : {
104 "end" : "2022-06-21"
105 }
106 },
In this scenario, the Payer supplies the URL of a questionnaire (FHIR Questionnaire) to communicate what attachments-related data is needed. They may also provide the line item numbers to match the attachment to a line item in the claim or prior authorization. This information is represented in the "questionnaire" Task.input element. The Provider launches the Documentation Templates and Rules (DTR) application to complete the Questionnaire. The code snippet below contains a URL to a Home Oxygen Therapy Questionnaire.
107 "input" : [{
108 "extension" : [{
109 "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber",
110 "valueInteger" : 1
111 }],
112 "type" : {
113 "coding" : [{
114 "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
115 "code" : "questionnaire-context"
116 }]
117 },
118 "valueCanonical" : "http://example.org/cdex-questionnaire-example1"
119 },
The Payer supplies the URL endpoint in the Task.input "payer-url" parameter. The Provider System uses this endpoint for the $submit-attachment operation to send the completed QuestionnaireResponse. Note that it is not necessarily a FHIR RESTful server endpoint.
120 {
121 "type" : {
122 "coding" : [{
123 "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
124 "code" : "payer-url"
125 }]
126 },
127 "valueUrl" : "http://example.org/cdex/payer/$submit-attachment"
128 },
129 {
130 "type" : {
This optional Task.input element represents the request's purpose of use (POU). This example supports a request for prior authorization, "COVAUTH". When requesting attachments for a claim, it would be "CLMATTCH".
129 {
130 "type" : {
131 "coding" : [{
132 "system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
133 "code" : "purpose-of-use"
134 }]
135 },
136 "valueCodeableConcept" : {
137 "coding" : [{
138 "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
139 "code" : "COVAUTH",
140 "display" : "coverage authorization"
141 }]
142 }
143 }]
144 }
The Payer used a Questionnaire to ask for specific attachments-related data. They indicated it with a Task.code "attachment-request-questionnaire" and supplied the URL of the questionnaire (FHIR Questionnaire) as an input parameter. Becasue these conditions are met, the Payer launches [Da Vinci DTR], a SMART on FHIR App or native EHR application. If the Provider launches a DTR within an EHR native application, skip to the step DTR App Updates Task below. If the Provider Launches DTR as a SMART on FHIR Application, it follows the [DTR SMART App Launch] with the Task as the launch content. The next several steps describe the DTR SMART App functionality.
A reference to the Task is passed to the DTR App as part of the DTR launch. The DTR App fetches the Task and inspects it for the Questionnaire URL.
Request
GET [base]/Task/cdex-task-example22
Response Body
0 {
1 "resourceType" : "Task",
...
112 "type" : {
113 "coding" : [{
114 "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
115 "code" : "questionnaire-context"
116 }]
117 },
118 "valueCanonical" : "http://example.org/cdex-questionnaire-example1"
119 },
....
Upon discovery of the Questionnaire URL, the DTR App fetches the Questionnaire.
Request
GET http://example.org/FHIR/Questionnare/cdex-questionnaire-example1
Response Body
0 {
1 "resourceType" : "Questionnaire",
2 "id" : "cdex-questionnaire-example1",
3 "text" : {
4 "status" : "extensions",
5 "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire cdex-questionnaire-example1</b></p><a name=\"cdex-questionnaire-example1\"> </a><a name=\"hccdex-questionnaire-example1\"> </a><a name=\"cdex-questionnaire-example1-en-US\"> </a><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> HomeOxygenTherapyQuestionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://example.org/cdex-questionnaire-example1#2.1.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> 1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 2</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Order Reason</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.2\">4 options</a></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.2\"> </a><p><b>Answer options for 2 </b></p><ul><li style=\"font-size: 11px\">http://example.org#1 ("Initial or original order for certification")</li><li style=\"font-size: 11px\">http://example.org#2 ("Change in status")</li><li style=\"font-size: 11px\">http://example.org#3 ("Revision or change in equipment")</li><li style=\"font-size: 11px\">http://example.org#4 ("Replacement")</li></ul></div>"
6 },
7 "url" : "http://example.org/cdex-questionnaire-example1",
8 "identifier" : [{
9 "system" : "urn:ietf:rfc:3986",
10 "value" : "urn:oid:2.16.840.1.113883.4.642.40.21.35.1"
11 }],
12 "version" : "2.1.0",
13 "name" : "HomeOxygenTherapyQuestionnaire",
14 "title" : "Home Oxygen Therapy Questionnaire",
15 "status" : "active",
16 "subjectType" : ["Patient"],
17 "date" : "2022-01-17",
18 "publisher" : "HL7 International / Payer/Provider Information Exchange Work Group",
19 "contact" : [{
20 "name" : "HL7 International / Payer/Provider Information Exchange Work Group",
21 "telecom" : [{
22 "system" : "url",
23 "value" : "http://www.hl7.org/Special/committees/claims"
24 },
25 {
26 "system" : "email",
27 "value" : "pie@lists.hl7.org"
28 }]
29 }],
30 "jurisdiction" : [{
31 "coding" : [{
32 "system" : "urn:iso:std:iso:3166",
33 "code" : "US"
34 }]
35 }],
36 "copyright" : "Used by permission of HL7 International all rights reserved Creative Commons License",
37 "item" : [{
38 "linkId" : "1",
39 "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
40 "type" : "text",
41 "required" : true
42 },
43 {
44 "linkId" : "2",
45 "text" : "Order Reason",
46 "type" : "choice",
47 "required" : true,
48 "answerOption" : [{
49 "valueCoding" : {
50 "system" : "http://example.org",
51 "code" : "1",
52 "display" : "Initial or original order for certification"
53 }
54 },
55 {
56 "valueCoding" : {
57 "system" : "http://example.org",
58 "code" : "2",
59 "display" : "Change in status"
60 }
61 },
62 {
63 "valueCoding" : {
64 "system" : "http://example.org",
65 "code" : "3",
66 "display" : "Revision or change in equipment"
67 }
68 },
69 {
70 "valueCoding" : {
71 "system" : "http://example.org",
72 "code" : "4",
73 "display" : "Replacement"
74 }
75 }]
76 }]
77 }
To complete the Questionnaire, the DTR App retrieves FHIR resources from EHRs, runs rules (such as [CQL]) for form population, and completes a QuestionnaireResponse. See the [Da Vinci DTR] Implementation Guide for more information.
The completed QuestionnaireResponse is saved in the Provider's FHIR Server.
Request
POST [base]/$QuestionnaireResponse
Request Body
0 {
1 "resourceType" : "QuestionnaireResponse",
2 "questionnaire" : "http://example.org/cdex-questionnaire-example1",
3 "status" : "completed",
4 "subject" : {
5 "identifier" : {
6 "use" : "usual",
7 "type" : {
8 "coding" : [{
9 "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
10 "code" : "MB",
11 "display" : "Member Number"
12 }],
13 "text" : "Member Number"
14 },
15 "system" : "http://example.org/cdex/payer/member-ids",
16 "value" : "Member123"
17 },
18 "display" : "Amy Shaw"
19 },
20 "authored" : "2022-06-17",
21 "author" : {
22 "identifier" : {
23 "system" : "http://hl7.org/fhir/sid/us-npi",
24 "value" : "9941339100"
25 }
26 },
27 "item" : [{
28 "linkId" : "1",
29 "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
30 "answer" : [{
31 "valueString" : "Examplitis"
32 }]
33 },
34 {
35 "linkId" : "2",
36 "text" : "Order Reason",
37 "answer" : [{
38 "valueCoding" : {
39 "system" : "http://example.org",
40 "code" : "4",
41 "display" : "Replacement"
42 }
43 }]
44 }]
45 }
The DTR SMART App or EHR native application Updates Task.output to Reference the completed QuestionnaireResponse.
PUT [base]/Task/cdex-task-example-22
Request Body
0 {
1 "resourceType": "Task",
2 "id": "cdex-task-example22",
...
202 "output": [
203 {
204 "type": {
205 "coding": [
206 {
207 "system": "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
208 "code": "questionnaire-response"
209 }
210 ]
211 },
212 "valueReference": {
213 "reference": "QuestionnaireResponse/cdex-questionnaireresponse-example1"
214 }
215 }
216 ]
When the Task is completed, the Provider POSTs the $submit-attachment operation and its payload to the Payer's endpoint communicated in the Task.input "payer-url" parameter. The operation payload contains the completed QuestionnaireResponse(s) and echoes many data elements sent in the request. The table in the introduction to this section summarizes the mapping between the CDex Request Attachment Profile elements and the $submit-attachment parameters. The documentation below describes and demonstrates the $submit-attachment parameters.
| Data Element | CDex Request Attachment Task Profile Element | CDex #submit-attachment Parameter |
|---|---|---|
| Payer URL | "payer-url"Task.input | (operation endpoint) |
Request
POST [base]/$submit-attachment
Request Body
The attachments and metadata needed to associate the attachment to the claim or prior authorization are in the $submit-attachment payload, a [Parameters] resource.
0 {
1 "resourceType" : "Parameters",
2 "parameter" : [{
The TrackingId parameter represents the identifier that ties the attachments to the claim or prior authorization. It is often referred to as the "re-association tracking control number". The operation must indicate whether the attachments are for claim or prior authorization. These data elements are taken from the CDex request as follows:
| Data Element | CDex Request Attachment Task Profile Element | CDex #submit-attachment Parameter |
|---|---|---|
| TrackingID | Task.identifier | TrackingId |
| Use | Task.reasonCode | AttachTo |
3 "name" : "TrackingId",
4 "valueIdentifier" : {
5 "system" : "http://example.org/payer",
6 "value" : "trackingid1012"
7 }
8 },
9 {
10 "name" : "AttachTo",
11 "valueCode" : "preauthorization"
12 },
13 {
As documented above, The Payer uses business identifiers to identify itself, the Patient, the Provider (i.e., the practitioner), and the Organization (i.e., the provider organization) who submitted the claim or prior authorization. The Provider uses these same identifiers when submitting the attachments.
| Data Element | CDex Request Attachment Task Profile Element | CDex #submit-attachment Parameter |
|---|---|---|
| Payer ID | Task.requester.identifier | PayerId |
| Organization ID | PractitionerRole.organization.identifier | OrganizationId |
| Provider ID | PractitionerRole.practitioner.identifier | ProviderId |
| Member ID | Patient.identifier | MemberId |
14 "name" : "PayerId",
15 "valueIdentifier" : {
16 "system" : "http://example.org/cdex/payer/payer-ids",
17 "value" : "payer123"
18 }
19 },
20 {
21 "name" : "OrganizationId",
22 "valueIdentifier" : {
23 "system" : "http://hl7.org/fhir/sid/us-npi",
24 "value" : "1234567893"
25 }
26 },
27 {
28 "name" : "ProviderId",
29 "valueIdentifier" : {
30 "system" : "http://hl7.org/fhir/sid/us-npi",
31 "value" : "9941339100"
32 }
33 },
34 {
35 "name" : "MemberId",
36 "valueIdentifier" : {
37 "system" : "http://example.org/cdex/payer/member-ids",
38 "value" : "Member123"
39 }
40 },
41 {
The completed QuestionnaireResponse and line item numbers are communicated as "Attachment" parameter parts. The QuestionnaireResponse is in the Attachment.Content parameter part as an inline FHIR resource, and the line item numbers associated with it are sent in the Attachment.LineItem parameter part.
| Data Element | CDex Request Attachment Task Profile Element | CDex #submit-attachment Parameter |
|---|---|---|
| line item(s) | “code”Task.input.extension | Attachment.LineItem |
| QuestionnaireResponse | - | Attachment.content |
42 "name" : "Attachment",
43 "part" : [{
44 "name" : "LineItem",
45 "valueString" : "1"
46 },
47 {
48 "name" : "Content",
49 "resource" : {
50 "resourceType" : "QuestionnaireResponse",
51 "id" : "cdex-questionnaireresponse-example1",
52 "questionnaire" : "http://example.org/cdex-questionnaire-example1",
53 "status" : "completed",
54 "subject" : {
55 "identifier" : {
56 "use" : "usual",
57 "type" : {
58 "coding" : [{
59 "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
60 "code" : "MB",
61 "display" : "Member Number"
62 }],
63 "text" : "Member Number"
64 },
65 "system" : "http://example.org/cdex/payer/member-ids",
66 "value" : "Member123"
67 },
68 "display" : "Amy Shaw"
69 },
70 "authored" : "2022-06-17",
71 "author" : {
72 "identifier" : {
73 "system" : "http://hl7.org/fhir/sid/us-npi",
74 "value" : "9941339100"
75 }
76 },
77 "item" : [{
78 "linkId" : "1",
79 "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
80 "answer" : [{
81 "valueString" : "Examplitis"
82 }]
83 },
84 {
85 "linkId" : "2",
86 "text" : "Order Reason",
87 "answer" : [{
88 "valueCoding" : {
89 "system" : "http://example.org",
90 "code" : "4",
91 "display" : "Replacement"
92 }
93 }]
94 }]
95 }
96 }]
97 }]
98 }
The example below shows the complete solicited attachment transaction. A Payer uses the CDex Task Attachment Request Profile to request the attachment using an attachment code, and the Provider uses the $submit-attachment operation to submit the attachments to the Payer:
Request
POST [base]/Task
Request Headers
Accept: application/fhir+json
Content-Type: application/fhir+json
...(other headers)
Request Body
{
"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"
}]
}
}]
}
Response Headers
HTTP/1.1 200 OK
Server: CDEX Example Provider Server
Location: http://example.org/FHIR/Task/cdex-task-example22/_history/1
...(other headers)
If the Provider Launches DTR as a SMART on FHIR Application in SMART’s EHR launch flow, proceed to step 3 If the Provider launches a DTR within an EHR native application, skip to step 7
Request
GET [base]/Task/cdex-task-example22
Response Headers
HTTP/1.1 200 OK
Server: CDEX Example Provider Server
Location: http://example.org/FHIR/Task/cdex-task-example22/_history/1
...(other headers)
Response Body
{
"resourceType" : "Task",
"id" : "cdex-task-example22",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Task cdex-task-example22</b></p><a name=\"cdex-task-example22\"> </a><a name=\"hccdex-task-example22\"> </a><a name=\"cdex-task-example22-en-US\"> </a><p><b>identifier</b>: Re-Association Tracking Control Number/trackingid1012</p><p><b>status</b>: In Progress</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-example22/patient\">Amy Shaw (no stated gender), DoB: 1987-02-20 ( Patient Account Number:\u00a0PA-123\u00a0(use:\u00a0usual,\u00a0))</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-example22/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>?? --> 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 questionnaire-context}\">questionnaire-context</span></p><p><b>value</b>: <a href=\"Questionnaire-cdex-questionnaire-example1.html\">Home Oxygen Therapy Questionnaire</a></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.v610@6.1.0&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-example22/patient\"> </a><a name=\"hccdex-task-example22/patient\"> </a><a name=\"cdex-task-example22/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:\u00a0PA-123\u00a0(use:\u00a0usual,\u00a0))</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\u00a0(use:\u00a0usual,\u00a0)</td></tr></table></blockquote><hr/><blockquote><p class=\"res-header-id\"><b>Generated Narrative: PractitionerRole #practitionerrole</b></p><a name=\"cdex-task-example22/practitionerrole\"> </a><a name=\"hccdex-task-example22/practitionerrole\"> </a><a name=\"cdex-task-example22/practitionerrole-en-US\"> </a><p><b>practitioner</b>: Identifier: <a href=\"http://terminology.hl7.org/5.5.0/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/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567893</p></blockquote></div>"
},
"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" : "in-progress",
"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",
"_valueCanonical" : {
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/display",
"valueString" : "Home Oxygen Therapy Questionnaire"
}]
}
},
{
"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"
}]
}
}]
}
Request
GET http://example.org/FHIR/Questionnare/cdex-questionnaire-example1
Response Headers
HTTP/1.1 200 OK
Server: CDEX Example Provider Server
Location: http://example.org/FHIR/Questionnare/cdex-questionnaire-example1
...(other headers)
Response Body
{
"resourceType" : "Questionnaire",
"id" : "cdex-questionnaire-example1",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire cdex-questionnaire-example1</b></p><a name=\"cdex-questionnaire-example1\"> </a><a name=\"hccdex-questionnaire-example1\"> </a><a name=\"cdex-questionnaire-example1-en-US\"> </a><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description & Constraints</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> HomeOxygenTherapyQuestionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://example.org/cdex-questionnaire-example1#2.1.0</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" id=\"item.1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-text.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"text\" class=\"hierarchy\"/> 1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-text\">text</a></td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.2\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> 2</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Order Reason</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">1..1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.2\">4 options</a></td></tr>\r\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.2\"> </a><p><b>Answer options for 2 </b></p><ul><li style=\"font-size: 11px\">http://example.org#1 ("Initial or original order for certification")</li><li style=\"font-size: 11px\">http://example.org#2 ("Change in status")</li><li style=\"font-size: 11px\">http://example.org#3 ("Revision or change in equipment")</li><li style=\"font-size: 11px\">http://example.org#4 ("Replacement")</li></ul></div>"
},
"url" : "http://example.org/cdex-questionnaire-example1",
"identifier" : [{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.40.21.35.1"
}],
"version" : "2.1.0",
"name" : "HomeOxygenTherapyQuestionnaire",
"title" : "Home Oxygen Therapy Questionnaire",
"status" : "active",
"subjectType" : ["Patient"],
"date" : "2022-01-17",
"publisher" : "HL7 International / Payer/Provider Information Exchange Work Group",
"contact" : [{
"name" : "HL7 International / Payer/Provider Information Exchange Work Group",
"telecom" : [{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/claims"
},
{
"system" : "email",
"value" : "pie@lists.hl7.org"
}]
}],
"jurisdiction" : [{
"coding" : [{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}]
}],
"copyright" : "Used by permission of HL7 International all rights reserved Creative Commons License",
"item" : [{
"linkId" : "1",
"text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
"type" : "text",
"required" : true
},
{
"linkId" : "2",
"text" : "Order Reason",
"type" : "choice",
"required" : true,
"answerOption" : [{
"valueCoding" : {
"system" : "http://example.org",
"code" : "1",
"display" : "Initial or original order for certification"
}
},
{
"valueCoding" : {
"system" : "http://example.org",
"code" : "2",
"display" : "Change in status"
}
},
{
"valueCoding" : {
"system" : "http://example.org",
"code" : "3",
"display" : "Revision or change in equipment"
}
},
{
"valueCoding" : {
"system" : "http://example.org",
"code" : "4",
"display" : "Replacement"
}
}]
}]
}
Request
POST [base]/QuestionnaireResponse
Request Headers
Accept: application/fhir+json
Content-Type: application/fhir+json
...(other headers)
Request Body
{
"resourceType" : "QuestionnaireResponse",
"id" : "cdex-questionnaireresponse-example1",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse cdex-questionnaireresponse-example1</b></p><a name=\"cdex-questionnaireresponse-example1\"> </a><a name=\"hccdex-questionnaireresponse-example1\"> </a><a name=\"cdex-questionnaireresponse-example1-en-US\"> </a><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Definition</a></th><th style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Answer</a><span style=\"float: right\"><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireResponseRoot\" class=\"hierarchy\"/> cdex-questionnaireresponse-example1</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire:<a href=\"Questionnaire-cdex-questionnaire-example1.html\">Home Oxygen Therapy Questionnaire</a></td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> 1</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)</td><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Examplitis</td></tr>\r\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> 2</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Order Reason</td><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><span><span>example.org 4: Replacement</span></span></td></tr>\r\n<tr><td colspan=\"4\" class=\"hierarchy\"><br/><a href=\"http://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64,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\" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"
},
"questionnaire" : "http://example.org/cdex-questionnaire-example1",
"status" : "completed",
"subject" : {
"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"
},
"display" : "Amy Shaw"
},
"authored" : "2022-06-17",
"author" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
}
},
"item" : [{
"linkId" : "1",
"text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
"answer" : [{
"valueString" : "Examplitis"
}]
},
{
"linkId" : "2",
"text" : "Order Reason",
"answer" : [{
"valueCoding" : {
"system" : "http://example.org",
"code" : "4",
"display" : "Replacement"
}
}]
}]
}
Response Headers
HTTP/1.1 200 OK
Server: CDEX Example Provider Server
Location: http://example.org/FHIR/QuestionnaireResponse/cdex-questionnaireresponse-inline-example1/_history/1
...(other headers)
Request
PUT [base]/Task/cdex-task-example-22
Request Headers
Accept: application/fhir+json
Content-Type: application/fhir+json
...(other headers)
Request Body
{
"resourceType": "Task",
"id": "cdex-task-example22",
"meta": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/instance-name",
"valueString": "Inline Task Example22 Updateid"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/instance-description",
"valueMarkdown": "Task example used to create inline scenarios for this guide"
}
],
"profile": [
"http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-task-attachment-request"
]
},
"contained": [
{
"resourceType": "Patient",
"id": "patient",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-patient-demographics"
]
},
"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",
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-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": "in-progress",
"intent": "order",
"code": {
"coding": [
{
"system": "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code": "attachment-request-questionnaire"
}
],
"text": "Attachment Request Questionnaire"
},
"for": {
"reference": "#patient"
},
"authoredOn": "2022-06-17T16:16:06+00:00",
"lastModified": "2022-06-17T16:17:06+00:00",
"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/uv/sdc/CodeSystem/temp",
"code": "questionnaire"
}
]
},
"questionnaire" : "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"
}
]
}
}
],
"output": [
{
"type": {
"coding": [
{
"system": "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
"code": "questionnaire-response"
}
]
},
"valueReference": {
"reference": "QuestionnaireResponse/cdex-questionnaireresponse-example1"
}
}
]
}
Response Headers
HTTP/1.1 200 OK
Server: CDEX Example Provider Server
Location: http://example.org/FHIR/Task/cdex-task-example22/_history/2
...(other headers)
$submit-attachment Operation to Payer endpointRequest
POST [base]/$submit-attachment
Request Headers
Request Headers
Accept: application/fhir+json
Content-Type: application/fhir+json
...(other headers)
Request Body
{
"resourceType" : "Parameters",
"parameter" : [{
"name" : "TrackingId",
"valueIdentifier" : {
"system" : "http://example.org/payer",
"value" : "trackingid1012"
}
},
{
"name" : "AttachTo",
"valueCode" : "preauthorization"
},
{
"name" : "PayerId",
"valueIdentifier" : {
"system" : "http://example.org/cdex/payer/payer-ids",
"value" : "payer123"
}
},
{
"name" : "OrganizationId",
"valueIdentifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1234567893"
}
},
{
"name" : "ProviderId",
"valueIdentifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
}
},
{
"name" : "MemberId",
"valueIdentifier" : {
"system" : "http://example.org/cdex/payer/member-ids",
"value" : "Member123"
}
},
{
"name" : "Attachment",
"part" : [{
"name" : "LineItem",
"valueString" : "1"
},
{
"name" : "Content",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "cdex-questionnaireresponse-example1",
"questionnaire" : "http://example.org/cdex-questionnaire-example1",
"status" : "completed",
"subject" : {
"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"
},
"display" : "Amy Shaw"
},
"authored" : "2022-06-17",
"author" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
}
},
"item" : [{
"linkId" : "1",
"text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
"answer" : [{
"valueString" : "Examplitis"
}]
},
{
"linkId" : "2",
"text" : "Order Reason",
"answer" : [{
"valueCoding" : {
"system" : "http://example.org",
"code" : "4",
"display" : "Replacement"
}
}]
}]
}
}]
}]
}
Response Headers
HTTP/1.1 200 OK
Server: CDEX Example Payer Server
Content-Type: application/fhir+json;charset=utf-8
...(other headers)
Refer to the Signatures section on the Sending Attachments page.
[Da Vinci Prior Authorization Support (PAS)]:
[CDex Work Queue Value Set]: ValueSet-cdex-work-queue.html
[What is Signed]: signatures.html#what-is-signed
[Signatures for Task Based Requests]: task-based-approach.html#signatures
[X12]: https://x12.org/
[X12 transactions]: https://x12.org/
[X12 Transaction Sets]: https://x12.org/products/transaction-sets
[HEDIS]: https://en.wikipedia.org/wiki/Healthcare_Effectiveness_Data_and_Information_Set
[Specification]: specification.html
[$match]: http://hl7.org/fhir/R4/patient-operation-match.html
[Coverage]: http://hl7.org/fhir/R4/coverage.html
[FHIR RESTful Search syntax]: http://hl7.org/fhir/R4/search.html#Introduction
[DocumentReference]: http://hl7.org/fhir/R4/documentreference.html
[FHIR Signature]: http://hl7.org/fhir/R4/datatypes.html#signature
[Bundle.signature]: http://hl7.org/fhir/R4/bundle-definitions.html#Bundle.signature
[enveloped signature]: http://www.w3.org/TR/xmldsig-core/#def-SignatureEnveloped
[(Verification Signature)]: http://hl7.org/fhir/R4/valueset-signature-type.html
[FHIR Document]: http://hl7.org/fhir/R4/documents.html
[RFC 7515]: https://tools.ietf.org/html/rfc7515
[JSON Signature rules]: http://hl7.org/fhir/R4/datatypes.html#JSON
[RFC 7515: JSON Web Signature (JWS)]: https://tools.ietf.org/html/rfc7515
[Detached]: https://tools.ietf.org/html/rfc7515#appendix-F
[Canonical JSON]: http://hl7.org/fhir/R4/json.html#canonical
[JWS JSON Serialization]: https://datatracker.ietf.org/doc/html/rfc7515#section-3.2
[X.509 certificates]: https://www.itu.int/rec/T-REC-X.509
[RFC 7518]: https://tools.ietf.org/html/rfc7518
[RFC 7517]: https://tools.ietf.org/html/rfc7517
[RFC 8785]: https://datatracker.ietf.org/doc/rfc8785
[self-signed certificates]: https://en.wikipedia.org/wiki/Self-signed_certificate
[Signed SearchSet Bundle Example]: signed-searchset-bundle-example.html
[Signed Document Bundle Example]: signed-document-bundle-example.html
[FHIR-36158]: https://jira.hl7.org/browse/FHIR-36158
[Solicited and Unsolicited Attachments]: solicited-unsolicited-attachments.html
[Sending Attachments]: sending-attachments.html
[Requesting Attachments Using Attachment Codes]: requesting-attachments-code.html
[Requesting Attachments Using Questionnaires]: requesting-attachments-questionnaire.html
[Using Questionnaire as Task Input]: task-based-approach.html#using-questionnaire-as-task-input
[Using CDex Attachments with DaVinci PAS]: burden-reduction.html
[CDex Task Attachment Request Profile]: StructureDefinition-cdex-task-attachment-request.html
[LOINC attachment codes]: https://loinc.org/attachments/
[Parameters]: http://hl7.org/fhir/R4/parameters.html
[CDex Patient Demographics Profile]: StructureDefinition-cdex-patient-demographics.html
[CDex Claim Use Value Set]: ValueSet-cdex-claim-use.html
[Prior-Auth AttachmentRequest Example]: Task-cdex-task-example20.html
[Claim AttachmentRequest Example]: Task-cdex-task-example19.html
[CDex Temporary Code System]: CodeSystem-cdex-temp.html
[NHIN Purpose Of Use Code System]: http://hl7.org/fhir/R4/codesystem-nhin-purposeofuse.html
[LOINC Document Ontology]: https://loinc.org/document-ontology/
[CDex Signature Bundle Profile]: StructureDefinition-cdex-signature-bundle.html
[FHIR RESTful search]: http://hl7.org/fhir/R4/http.html#search
[FHIR RESTful read]: http://hl7.org/fhir/R4/http.html#read
[Change Log]: changes.html
[CDex Parameters Example1]: Parameters-cdex-parameters-example1.html
[CDex Parameters Example2]: Parameters-cdex-parameters-example2.html
[CDex Parameters Example3]: Parameters-cdex-parameters-example3.html
[CDex Parameters Example4]: Parameters-cdex-parameters-example4.html
[validating profiles and resources]: http://hl7.org/fhir/R4/validation.html
[ImplementationGuide]: http://hl7.org/fhir/R4/implementationguide.html
[CDex ImplementationGuide Resource]: ImplementationGuide-hl7.fhir.us.davinci-cdex.html
[Da Vinci DTR]: http://hl7.org/fhir/us/davinci-dtr/2.1.0-preview
[Questionnaire]: http://hl7.org/fhir/R4/questionnaire.html
[Smart Version 2.0.0 EHR launch flow]: https://hl7.org/fhir/smart-app-launch/app-launch.html#launch-app-ehr-launch
[Using Da Vinci DTR to Complete the Questionnaire]: requesting-attachments-questionnaire.html#using-da-vinci-dtr-to-complete-the-questionnaire
[Conforming to CDex Attachments]: attachments-conformance.html
[Request for Additional Information]: /additionalinfo.html
[SDC Questionnaire Response Profile]:http://hl7.org/fhir/uv/sdc/STU3StructureDefinition-sdc-questionnaireresponse.html
[SDC Adaptive Questionnaire Response Profile]:http://hl7.org/fhir/uv/sdc/STU3StructureDefinition-sdc-questionnaireresponse-adapt.html
[45 CFR 164.506 Treatment, Payment, and Health Care Operations (TPO)]: https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.506
[must support]: http://hl7.org/fhir/us/davinci-hrex/STU1.1/conformance.html
[DTR SMART App Launch]: requesting-attachments-questionnaire.html#dtr-smart-app-launch
[Conforming to CDex Task Based Approach]: task-based-conformance.html
[Signature Extension]: http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature
[DTR Standard Questionnaire]: http://hl7.org/fhir/us/davinci-dtr/2.1.0-previewStructureDefinition-dtr-std-questionnaire.html
[signatureRequired]: http://hl7.org/fhir/StructureDefinition/questionnaire-signatureRequired
[CDex Signature Profile]: StructureDefinition-cdex-signature.html
[CDex SDC QuestionnaireResponse Profile]: StructureDefinition-cdex-sdc-questionnaireresponse.html
[QuestionnaireResponse]: http://hl7.org/fhir/R4/questionnaireresponse.html
[Topic-Based Subscriptions Framework]: http://hl7.org/fhir/2022Sep/subscriptions.html
[C-CDA on FHIR Documents]: http://www.hl7.org/fhir/us/ccda/index.html
[FHIR Conformance]: http://hl7.org/fhir/R4/conformance-rules.html#conflang
[Must Support]: http://hl7.org/fhir/R4/profiling.html#mustsupport
[modifier elements]: http://hl7.org/fhir/R4/conformance-rules.html#isModifier
[CDex PractitionerRole Profile]: StructureDefinition-cdex-practitionerrole.html
[CDex Task Update]: SubscriptionTopic-cdex-task-update.html
[Subscription R5 Backport Implementation Guide]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1
[SubscriptionTopic]: https://hl7.org/fhir/R4B/subscriptiontopic.html
[CapabilityStatement SubscriptionTopic Canonical]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1/StructureDefinition-capabilitystatement-subscriptiontopic-canonical.html
[Conformance in FHIR R4]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1/conformance.html#conformance-in-fhir-r4
[R4/B Topic-Based Subscription Profile]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1/StructureDefinition-backport-subscription.html
[R4 Topic-Based Subscription Notification Bundle]: http://hl7.org/fhir/uv/subscriptions-backport/STU1.1/StructureDefinition-backport-subscription-notification-r4.html
[HRex Task Status ValueSet]: http://hl7.org/fhir/us/davinci-hrex/STU1.1/ValueSet-hrex-task-status.html
[Task.businessStatus]: http://hl7.org/fhir/R4/task-definitions.html#Task.businessStatus
[Benefits]: task-based-approach.html#benefits
[Task Inputs and Outputs]: task-based-approach.html#task-inputs-and-outputs
[Purpose of Use]: task-based-approach.html#purpose-of-use
[Task Reason]: task-based-approach.html#task-reason
[Discovery of Identifiers]: task-based-approach.html#discovery-of-identifiers
[Task State Machine]: task-based-approach.html#task-state-machine
[Approaches to Exchanging FHIR Data]: https://hl7.org/fhir/R5/exchanging.html
[PAS Claim Response Bundle]: /StructureDefinition-profile-pas-response-bundle.html
[PAS Task]: /StructureDefinition-profile-task.html
[Patient Matching]: https://hl7.org/fhir/us/identity-matching/patient-matching.html
[Guidance on Identity Assurance]: https://hl7.org/fhir/us/identity-matching/guidance-on-identity-assurance.html
[Interoperable Digital Identity and Patient Matching]: https://hl7.org/fhir/us/identity-matching/index.html
[CQL]: https://cql.hl7.org/
[Da Vinci Use Cases]: https://confluence.hl7.org/display/DVP/Da+Vinci+Use+Cases
[FHIR R4 core]: http://hl7.org/fhir/R4/fhir-spec.zip
[FHIR core downloads]: http://hl7.org/fhir/R4/downloads.html
[validator]: https://fhir.github.io/latest-ig-validator/org.hl7.fhir.validator.jar
[instructions on how to use it]: https://confluence.hl7.org/display/FHIR/Using+the+FHIR+Validator
IG © 2024+ HL7 International / Payer/Provider Information Exchange Work Group. Package hl7.fhir.us.davinci-cdex#2.1.0 based on FHIR 4.0.1. Generated 2024-12-17
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