Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2 United States of America flag

Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

Logical Model: PASMetricData - Detailed Descriptions

Page standards status: Informative Maturity Level: 1

Definitions for the PASMetricData logical model.

Guidance on how to interpret the contents of this table can be found here

0. PASMetricData
Definition

A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation

ShortPAS Metric Data
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. PASMetricData.source
Definition

A code to indicate which type of system collected the metric data.

Shortprovider | intermediary | payer
Control1..1
BindingThe codes SHALL be taken from Metric Data Source
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. PASMetricData.providerId
Definition

The NPI number of the user who initiated the PAS request.

ShortUser invoking hook
Control1..1
TypeIdentifier
6. PASMetricData.providerId.system
Pattern Valuehttp://hl7.org/fhir/sid/us-npi
8. PASMetricData.providerId.value
Control1..?
10. PASMetricData.groupId
Definition

The NPI of the hospital/clinic/other organization that initiated the PAS request.

ShortHealthcare org of user
Control1..1
TypeIdentifier
12. PASMetricData.groupId.system
Pattern Valuehttp://hl7.org/fhir/sid/us-npi
14. PASMetricData.groupId.value
Control1..?
16. PASMetricData.payerId
Definition

The identifier of the payer organization to whom the PAS call was made.

ShortPayer receiving hook
Control1..1
TypeIdentifier
18. PASMetricData.payerId.system
Control1..?
20. PASMetricData.payerId.value
Control1..?
22. PASMetricData.exchange
Definition

Exchanges between providers, intermediares, and payers to support prior authorization.

ShortPrior Authorization Exchanges
Control1..*
TypeBackboneElement
24. PASMetricData.exchange.type
Definition

A code indicating the type of exchange

Shortinitial | subsequent | cancel | update | query | initialDocToPayer
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
26. PASMetricData.exchange.with
Definition

The destination for the exchange

Shortprovider | intermediary | payer
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
28. PASMetricData.exchange.method
Definition

Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set.

Shortx12 | restful | ihe | direct | other
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
30. PASMetricData.exchange.requestTime
Definition

For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer.

ShortTime exchange initiated
Control1..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
32. PASMetricData.exchange.responseTime
Definition

For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer.

ShortTime of exchange response
Control0..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
34. PASMetricData.exchange.httpResponse
Definition

What HTTP response code was returned for the exchange invocation.

Shorte.g. 200
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
36. PASMetricData.issue
Definition

In the event of an HTTP error, if an OperationOutcome was returned, what were the issues.

ShortOperationOutcome info
Control0..*
TypeBackboneElement
38. PASMetricData.issue.code
Definition

The issue.code value from the OperationOutcome for this issue.

ShortError code
Control1..1
BindingThe codes SHALL be taken from IssueType
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
40. PASMetricData.issue.details
Definition

The issue.details value from the OperationOutcome for this issue.

ShortMore detailed error code
Control0..1
BindingFor example codes, see OperationOutcomeCodes
TypeCodeableConcept
42. PASMetricData.aaaCodes
Definition

Any AAA codes returned during the exchange.

ShortAAA codes returned
Control0..*
TypeBackboneElement
44. PASMetricData.aaaCodes.loopID
Definition

X12 loop ID.

Shortsee X12 loop IDs
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
46. PASMetricData.aaaCodes.aaaCode
Definition

AAA code returned with response.

Shortapproved | modified | denied
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
48. PASMetricData.itemDetail
Definition

Service level detail. One interation of the backbone for each service item in the PA exchange.

ShortService level item detail
Control0..*
TypeBackboneElement
50. PASMetricData.itemDetail.trn
Definition

Service level TRN assigned by the payer if a questionnaire is required.

ShortService Level TRN
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. PASMetricData.itemDetail.item
Definition

The specific procedure, item, medication, appointment, nutrition that is the subject of the order.

Shorteg. ICD10, HCPCS, NDC
Control1..1
TypeCodeableConcept
54. PASMetricData.itemDetail.assertionId
Definition

The unique ID for the order item returned by CRD in the coverage information.

ShortUnique ID for order item
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
56. PASMetricData.itemDetail.initialSubmissionTime
Definition

Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item.

ShortDate/time of the initial submission of the item
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. PASMetricData.itemDetail.finalResponseTime
Definition

Date/time that the final result was returned for the specific service item.

ShortDate/time of final result
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
60. PASMetricData.itemDetail.responsesRequired
Definition

Number of responses (initial and any with result pended) for the service item.

ShortNumber of responses
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
62. PASMetricData.itemDetail.aaaCodes
Definition

Any AAA codes returned during the exchange.

ShortAAA codes returned
Control0..*
TypeBackboneElement
64. PASMetricData.itemDetail.aaaCodes.loopID
Definition

X12 loop ID.

Shortsee X12 loop IDs
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
66. PASMetricData.itemDetail.aaaCodes.aaaCode
Definition

AAA error code returned in the response.

Shortapproved | modified | deined
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
68. PASMetricData.itemDetail.locationType
Definition

The site where the service will be performed.

Shortinpatient | outpatient | home
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
70. PASMetricData.itemDetail.result
Definition

Final result of the specific service item.

Shortapproved | modified | denied | pended
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
72. PASMetricData.itemDetail.denialReason
Definition

A code specifying the reason why the item was denied.

ShortDenial Reason
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
74. PASMetricData.supportingDoc
Definition

The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item.

ShortDocumentation submitted as part of PAS Bundle
Control0..1
Typeurl
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
76. PASMetricData.requestedDoc
Definition

Documentation requested via 278 response.

ShortDocumentation requested via 278 response
Control0..*
TypeBackboneElement
78. PASMetricData.requestedDoc.docRequest
Definition

Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element.

ShortCoded requests for additional documentation
Control1..*
TypeCodeableConcept
80. PASMetricData.requestedDoc.timeRequested
Definition

Date/Time of initial request for this item (may be part of the initial submission or part an update.

ShortDate/Time of initial request
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
82. PASMetricData.requestedDoc.timeSubmitted
Definition

Date/Time of final result for this item (may be part of the initial submission or part an update.

ShortDate/Time of final result
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
84. PASMetricData.requestedDoc.submissionMethod
Definition

The technical method used to submit the requested additional documentation.

ShortCDex | portal | fax | x12 | other
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
86. PASMetricData.exceptionSubmission
Definition

Indicator that exchange was performed under an exception grant from the National Standard Group.

ShortTrue if exchange is based on the exception grant
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
88. PASMetricData.businessLine
Definition

A code that indicates which type of insurance the patient is covered by.

ShortE.g. MedicareAdvantage
Control0..1
TypeCodeableConcept

Guidance on how to interpret the contents of this table can be found here

0. PASMetricData
Definition

A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation

ShortPAS Metric Data
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. PASMetricData.source
Definition

A code to indicate which type of system collected the metric data.

Shortprovider | intermediary | payer
Control1..1
BindingThe codes SHALL be taken from Metric Data Source
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. PASMetricData.providerId
Definition

The NPI number of the user who initiated the PAS request.

ShortUser invoking hook
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. PASMetricData.providerId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. PASMetricData.providerId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valuehttp://hl7.org/fhir/sid/us-npi
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. PASMetricData.providerId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. PASMetricData.groupId
Definition

The NPI of the hospital/clinic/other organization that initiated the PAS request.

ShortHealthcare org of user
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. PASMetricData.groupId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. PASMetricData.groupId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valuehttp://hl7.org/fhir/sid/us-npi
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. PASMetricData.groupId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. PASMetricData.payerId
Definition

The identifier of the payer organization to whom the PAS call was made.

ShortPayer receiving hook
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. PASMetricData.payerId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. PASMetricData.payerId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. PASMetricData.payerId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. PASMetricData.exchange
Definition

Exchanges between providers, intermediares, and payers to support prior authorization.

ShortPrior Authorization Exchanges
Control1..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. PASMetricData.exchange.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
32. PASMetricData.exchange.type
Definition

A code indicating the type of exchange

Shortinitial | subsequent | cancel | update | query | initialDocToPayer
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
34. PASMetricData.exchange.with
Definition

The destination for the exchange

Shortprovider | intermediary | payer
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
36. PASMetricData.exchange.method
Definition

Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set.

Shortx12 | restful | ihe | direct | other
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
38. PASMetricData.exchange.requestTime
Definition

For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer.

ShortTime exchange initiated
Control1..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
40. PASMetricData.exchange.responseTime
Definition

For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer.

ShortTime of exchange response
Control0..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
42. PASMetricData.exchange.httpResponse
Definition

What HTTP response code was returned for the exchange invocation.

Shorte.g. 200
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
44. PASMetricData.issue
Definition

In the event of an HTTP error, if an OperationOutcome was returned, what were the issues.

ShortOperationOutcome info
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. PASMetricData.issue.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. PASMetricData.issue.code
Definition

The issue.code value from the OperationOutcome for this issue.

ShortError code
Control1..1
BindingThe codes SHALL be taken from IssueType
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
50. PASMetricData.issue.details
Definition

The issue.details value from the OperationOutcome for this issue.

ShortMore detailed error code
Control0..1
BindingFor example codes, see OperationOutcomeCodes
TypeCodeableConcept
52. PASMetricData.aaaCodes
Definition

Any AAA codes returned during the exchange.

ShortAAA codes returned
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. PASMetricData.aaaCodes.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
56. PASMetricData.aaaCodes.loopID
Definition

X12 loop ID.

Shortsee X12 loop IDs
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
58. PASMetricData.aaaCodes.aaaCode
Definition

AAA code returned with response.

Shortapproved | modified | denied
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
60. PASMetricData.itemDetail
Definition

Service level detail. One interation of the backbone for each service item in the PA exchange.

ShortService level item detail
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. PASMetricData.itemDetail.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
64. PASMetricData.itemDetail.trn
Definition

Service level TRN assigned by the payer if a questionnaire is required.

ShortService Level TRN
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
66. PASMetricData.itemDetail.item
Definition

The specific procedure, item, medication, appointment, nutrition that is the subject of the order.

Shorteg. ICD10, HCPCS, NDC
Control1..1
TypeCodeableConcept
68. PASMetricData.itemDetail.assertionId
Definition

The unique ID for the order item returned by CRD in the coverage information.

ShortUnique ID for order item
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
70. PASMetricData.itemDetail.initialSubmissionTime
Definition

Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item.

ShortDate/time of the initial submission of the item
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
72. PASMetricData.itemDetail.finalResponseTime
Definition

Date/time that the final result was returned for the specific service item.

ShortDate/time of final result
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
74. PASMetricData.itemDetail.responsesRequired
Definition

Number of responses (initial and any with result pended) for the service item.

ShortNumber of responses
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
76. PASMetricData.itemDetail.aaaCodes
Definition

Any AAA codes returned during the exchange.

ShortAAA codes returned
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. PASMetricData.itemDetail.aaaCodes.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
80. PASMetricData.itemDetail.aaaCodes.loopID
Definition

X12 loop ID.

Shortsee X12 loop IDs
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
82. PASMetricData.itemDetail.aaaCodes.aaaCode
Definition

AAA error code returned in the response.

Shortapproved | modified | deined
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
84. PASMetricData.itemDetail.locationType
Definition

The site where the service will be performed.

Shortinpatient | outpatient | home
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
86. PASMetricData.itemDetail.result
Definition

Final result of the specific service item.

Shortapproved | modified | denied | pended
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
88. PASMetricData.itemDetail.denialReason
Definition

A code specifying the reason why the item was denied.

ShortDenial Reason
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
90. PASMetricData.supportingDoc
Definition

The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item.

ShortDocumentation submitted as part of PAS Bundle
Control0..1
Typeurl
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
92. PASMetricData.requestedDoc
Definition

Documentation requested via 278 response.

ShortDocumentation requested via 278 response
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. PASMetricData.requestedDoc.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
96. PASMetricData.requestedDoc.docRequest
Definition

Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element.

ShortCoded requests for additional documentation
Control1..*
TypeCodeableConcept
98. PASMetricData.requestedDoc.timeRequested
Definition

Date/Time of initial request for this item (may be part of the initial submission or part an update.

ShortDate/Time of initial request
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
100. PASMetricData.requestedDoc.timeSubmitted
Definition

Date/Time of final result for this item (may be part of the initial submission or part an update.

ShortDate/Time of final result
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
102. PASMetricData.requestedDoc.submissionMethod
Definition

The technical method used to submit the requested additional documentation.

ShortCDex | portal | fax | x12 | other
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
104. PASMetricData.exceptionSubmission
Definition

Indicator that exchange was performed under an exception grant from the National Standard Group.

ShortTrue if exchange is based on the exception grant
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
106. PASMetricData.businessLine
Definition

A code that indicates which type of insurance the patient is covered by.

ShortE.g. MedicareAdvantage
Control0..1
TypeCodeableConcept

Guidance on how to interpret the contents of this table can be found here

0. PASMetricData
Definition

A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation

ShortPAS Metric Data
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. PASMetricData.source
Definition

A code to indicate which type of system collected the metric data.

Shortprovider | intermediary | payer
Control1..1
BindingThe codes SHALL be taken from Metric Data Source
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
4. PASMetricData.providerId
Definition

The NPI number of the user who initiated the PAS request.

ShortUser invoking hook
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. PASMetricData.providerId.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
8. PASMetricData.providerId.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.providerId.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
10. PASMetricData.providerId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. PASMetricData.providerId.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. PASMetricData.providerId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valuehttp://hl7.org/fhir/sid/us-npi
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. PASMetricData.providerId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. PASMetricData.providerId.period
Definition

Time period during which identifier is/was valid for use.

ShortTime period when id is/was valid for use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. PASMetricData.providerId.assigner
Definition

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. PASMetricData.groupId
Definition

The NPI of the hospital/clinic/other organization that initiated the PAS request.

ShortHealthcare org of user
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. PASMetricData.groupId.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
26. PASMetricData.groupId.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.groupId.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
28. PASMetricData.groupId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. PASMetricData.groupId.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. PASMetricData.groupId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Pattern Valuehttp://hl7.org/fhir/sid/us-npi
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. PASMetricData.groupId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. PASMetricData.groupId.period
Definition

Time period during which identifier is/was valid for use.

ShortTime period when id is/was valid for use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. PASMetricData.groupId.assigner
Definition

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. PASMetricData.payerId
Definition

The identifier of the payer organization to whom the PAS call was made.

ShortPayer receiving hook
Control1..1
TypeIdentifier
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. PASMetricData.payerId.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
44. PASMetricData.payerId.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.payerId.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
46. PASMetricData.payerId.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. PASMetricData.payerId.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. PASMetricData.payerId.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control1..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. PASMetricData.payerId.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. PASMetricData.payerId.period
Definition

Time period during which identifier is/was valid for use.

ShortTime period when id is/was valid for use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. PASMetricData.payerId.assigner
Definition

Organization that issued/manages the identifier.

ShortOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. PASMetricData.exchange
Definition

Exchanges between providers, intermediares, and payers to support prior authorization.

ShortPrior Authorization Exchanges
Control1..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. PASMetricData.exchange.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
62. PASMetricData.exchange.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.exchange.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
64. PASMetricData.exchange.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
66. PASMetricData.exchange.type
Definition

A code indicating the type of exchange

Shortinitial | subsequent | cancel | update | query | initialDocToPayer
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
68. PASMetricData.exchange.with
Definition

The destination for the exchange

Shortprovider | intermediary | payer
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
70. PASMetricData.exchange.method
Definition

Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set.

Shortx12 | restful | ihe | direct | other
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
72. PASMetricData.exchange.requestTime
Definition

For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer.

ShortTime exchange initiated
Control1..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
74. PASMetricData.exchange.responseTime
Definition

For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer.

ShortTime of exchange response
Control0..1
Typeinstant
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
76. PASMetricData.exchange.httpResponse
Definition

What HTTP response code was returned for the exchange invocation.

Shorte.g. 200
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
78. PASMetricData.issue
Definition

In the event of an HTTP error, if an OperationOutcome was returned, what were the issues.

ShortOperationOutcome info
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. PASMetricData.issue.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
82. PASMetricData.issue.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.issue.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
84. PASMetricData.issue.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
86. PASMetricData.issue.code
Definition

The issue.code value from the OperationOutcome for this issue.

ShortError code
Control1..1
BindingThe codes SHALL be taken from IssueType
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
88. PASMetricData.issue.details
Definition

The issue.details value from the OperationOutcome for this issue.

ShortMore detailed error code
Control0..1
BindingFor example codes, see OperationOutcomeCodes
TypeCodeableConcept
90. PASMetricData.aaaCodes
Definition

Any AAA codes returned during the exchange.

ShortAAA codes returned
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. PASMetricData.aaaCodes.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
94. PASMetricData.aaaCodes.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.aaaCodes.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
96. PASMetricData.aaaCodes.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
98. PASMetricData.aaaCodes.loopID
Definition

X12 loop ID.

Shortsee X12 loop IDs
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
100. PASMetricData.aaaCodes.aaaCode
Definition

AAA code returned with response.

Shortapproved | modified | denied
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
102. PASMetricData.itemDetail
Definition

Service level detail. One interation of the backbone for each service item in the PA exchange.

ShortService level item detail
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. PASMetricData.itemDetail.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
106. PASMetricData.itemDetail.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.itemDetail.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
108. PASMetricData.itemDetail.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
110. PASMetricData.itemDetail.trn
Definition

Service level TRN assigned by the payer if a questionnaire is required.

ShortService Level TRN
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
112. PASMetricData.itemDetail.item
Definition

The specific procedure, item, medication, appointment, nutrition that is the subject of the order.

Shorteg. ICD10, HCPCS, NDC
Control1..1
TypeCodeableConcept
114. PASMetricData.itemDetail.assertionId
Definition

The unique ID for the order item returned by CRD in the coverage information.

ShortUnique ID for order item
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
116. PASMetricData.itemDetail.initialSubmissionTime
Definition

Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item.

ShortDate/time of the initial submission of the item
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
118. PASMetricData.itemDetail.finalResponseTime
Definition

Date/time that the final result was returned for the specific service item.

ShortDate/time of final result
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
120. PASMetricData.itemDetail.responsesRequired
Definition

Number of responses (initial and any with result pended) for the service item.

ShortNumber of responses
Control0..1
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
122. PASMetricData.itemDetail.aaaCodes
Definition

Any AAA codes returned during the exchange.

ShortAAA codes returned
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. PASMetricData.itemDetail.aaaCodes.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
126. PASMetricData.itemDetail.aaaCodes.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.itemDetail.aaaCodes.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
128. PASMetricData.itemDetail.aaaCodes.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
130. PASMetricData.itemDetail.aaaCodes.loopID
Definition

X12 loop ID.

Shortsee X12 loop IDs
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
132. PASMetricData.itemDetail.aaaCodes.aaaCode
Definition

AAA error code returned in the response.

Shortapproved | modified | deined
Control1..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
134. PASMetricData.itemDetail.locationType
Definition

The site where the service will be performed.

Shortinpatient | outpatient | home
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
136. PASMetricData.itemDetail.result
Definition

Final result of the specific service item.

Shortapproved | modified | denied | pended
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
138. PASMetricData.itemDetail.denialReason
Definition

A code specifying the reason why the item was denied.

ShortDenial Reason
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
140. PASMetricData.supportingDoc
Definition

The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item.

ShortDocumentation submitted as part of PAS Bundle
Control0..1
Typeurl
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
142. PASMetricData.requestedDoc
Definition

Documentation requested via 278 response.

ShortDocumentation requested via 278 response
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. PASMetricData.requestedDoc.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
146. PASMetricData.requestedDoc.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PASMetricData.requestedDoc.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
148. PASMetricData.requestedDoc.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
150. PASMetricData.requestedDoc.docRequest
Definition

Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element.

ShortCoded requests for additional documentation
Control1..*
TypeCodeableConcept
152. PASMetricData.requestedDoc.timeRequested
Definition

Date/Time of initial request for this item (may be part of the initial submission or part an update.

ShortDate/Time of initial request
Control1..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
154. PASMetricData.requestedDoc.timeSubmitted
Definition

Date/Time of final result for this item (may be part of the initial submission or part an update.

ShortDate/Time of final result
Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
156. PASMetricData.requestedDoc.submissionMethod
Definition

The technical method used to submit the requested additional documentation.

ShortCDex | portal | fax | x12 | other
Control0..1
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
158. PASMetricData.exceptionSubmission
Definition

Indicator that exchange was performed under an exception grant from the National Standard Group.

ShortTrue if exchange is based on the exception grant
Control0..1
Typeboolean
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
160. PASMetricData.businessLine
Definition

A code that indicates which type of insurance the patient is covered by.

ShortE.g. MedicareAdvantage
Control0..1
TypeCodeableConcept