Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2
Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - STU 2
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
| Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest | Version: 2.0.1 | |||
| Standards status: Trial-use | Maturity Level: 3 | Computable Name: PASCommunicationRequest | ||
PAS constraints on CommunicationRequest resource mandating support for elements relevant to the prior authorization response
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from CommunicationRequest
| Path | Conformance | ValueSet |
| CommunicationRequest.category | required | https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 |
| CommunicationRequest.medium | extensible | PASCommunicationRequestMedium |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  CommunicationRequest | 0..* | CommunicationRequest | A request for information to be sent to a receiver | |
  implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
 modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
 identifier | SΣ | 0..* | Identifier | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number). |
| status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. Fixed Value: active |
| category | S | 0..* | CodeableConcept | Message category Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. |
| doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action |
| medium | S | 0..* | CodeableConcept | A channel of communication Binding: PAS Communication Medium Value Set (extensible) |
 payload | S | 0..* | BackboneElement | Message payload |
  Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
 serviceLineNumber | S | 0..1 | positiveInt | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber |
| communicatedDiagnosis | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis Binding: X12 278 Diagnosis Code Value Set (required) |
| contentModifier | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier Binding: X12 278 Diagnosis Information Type (required) |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
 content[x] | S | 1..1 | string | Message part content |
 requester | SΣ | 0..1 | Reference(PAS Insurer Organization) | Who/what is requesting service |
| recipient | S | 0..* | Reference(PAS Practitioner | PAS Organization Base Profile) | Message recipient |
| sender | SΣ | 0..1 | Reference(PAS Requestor Organization) | Message sender |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| CommunicationRequest.status | required | Fixed Value: active |
| CommunicationRequest.category | required | https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 |
| CommunicationRequest.medium | extensible | PASCommunicationRequestMedium |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| CommunicationRequest | 0..* | CommunicationRequest | A request for information to be sent to a receiver | |||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | SΣ | 0..* | Identifier | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number). | ||||
| basedOn | Σ | 0..* | Reference(Resource) | Fulfills plan or proposal | ||||
| replaces | Σ | 0..* | Reference(CommunicationRequest) | Request(s) replaced by this request | ||||
| groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of | ||||
| status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. Fixed Value: active | ||||
| statusReason | 0..1 | CodeableConcept | Reason for current status Binding: (unbound) (example): Codes identifying the reason for the current state of a request. | |||||
| category | S | 0..* | CodeableConcept | Message category Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. | ||||
| priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication request. | ||||
| doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action | ||||
| medium | S | 0..* | CodeableConcept | A channel of communication Binding: PAS Communication Medium Value Set (extensible) | ||||
| subject | 0..1 | Reference(Patient | Group) | Focus of message | |||||
| about | 0..* | Reference(Resource) | Resources that pertain to this communication request | |||||
| encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of | ||||
| payload | S | 0..* | BackboneElement | Message payload | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| serviceLineNumber | S | 0..1 | positiveInt | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber | ||||
| communicatedDiagnosis | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis Binding: X12 278 Diagnosis Code Value Set (required) | ||||
| contentModifier | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier Binding: X12 278 Diagnosis Information Type (required) | ||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| content[x] | S | 1..1 | string | Message part content | ||||
 occurrence[x] | Σ | 0..1 | When scheduled | |||||
| occurrenceDateTime | dateTime | |||||||
| occurrencePeriod | Period | |||||||
| authoredOn | Σ | 0..1 | dateTime | When request transitioned to being actionable | ||||
| requester | SΣ | 0..1 | Reference(PAS Insurer Organization) | Who/what is requesting service | ||||
| recipient | S | 0..* | Reference(PAS Practitioner | PAS Organization Base Profile) | Message recipient | ||||
| sender | SΣ | 0..1 | Reference(PAS Requestor Organization) | Message sender | ||||
| reasonCode | Σ | 0..* | CodeableConcept | Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication. | ||||
| reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Why is communication needed? | ||||
| note | 0..* | Annotation | Comments made about communication request | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | ||||
| CommunicationRequest.language | preferred | CommonLanguages
| ||||
| CommunicationRequest.status | required | Fixed Value: active | ||||
| CommunicationRequest.statusReason | example | |||||
| CommunicationRequest.category | required | https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 | ||||
| CommunicationRequest.priority | required | RequestPriority | ||||
| CommunicationRequest.medium | extensible | PASCommunicationRequestMedium | ||||
| CommunicationRequest.reasonCode | example | ActReason |
This structure is derived from CommunicationRequest
Summary
Must-Support: 11 elements
Fixed Value: 1 element
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 3
Differential View
This structure is derived from CommunicationRequest
| Path | Conformance | ValueSet |
| CommunicationRequest.category | required | https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 |
| CommunicationRequest.medium | extensible | PASCommunicationRequestMedium |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CommunicationRequest | 0..* | CommunicationRequest | A request for information to be sent to a receiver | |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| identifier | SΣ | 0..* | Identifier | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number). |
| status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. Fixed Value: active |
| category | S | 0..* | CodeableConcept | Message category Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. |
| doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action |
| medium | S | 0..* | CodeableConcept | A channel of communication Binding: PAS Communication Medium Value Set (extensible) |
| payload | S | 0..* | BackboneElement | Message payload |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| serviceLineNumber | S | 0..1 | positiveInt | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber |
| communicatedDiagnosis | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis Binding: X12 278 Diagnosis Code Value Set (required) |
| contentModifier | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier Binding: X12 278 Diagnosis Information Type (required) |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| content[x] | S | 1..1 | string | Message part content |
| requester | SΣ | 0..1 | Reference(PAS Insurer Organization) | Who/what is requesting service |
| recipient | S | 0..* | Reference(PAS Practitioner | PAS Organization Base Profile) | Message recipient |
| sender | SΣ | 0..1 | Reference(PAS Requestor Organization) | Message sender |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| CommunicationRequest.status | required | Fixed Value: active |
| CommunicationRequest.category | required | https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 |
| CommunicationRequest.medium | extensible | PASCommunicationRequestMedium |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| CommunicationRequest | 0..* | CommunicationRequest | A request for information to be sent to a receiver | |||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | SΣ | 0..* | Identifier | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number). | ||||
| basedOn | Σ | 0..* | Reference(Resource) | Fulfills plan or proposal | ||||
| replaces | Σ | 0..* | Reference(CommunicationRequest) | Request(s) replaced by this request | ||||
| groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of | ||||
| status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. Fixed Value: active | ||||
| statusReason | 0..1 | CodeableConcept | Reason for current status Binding: (unbound) (example): Codes identifying the reason for the current state of a request. | |||||
| category | S | 0..* | CodeableConcept | Message category Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. | ||||
| priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication request. | ||||
| doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action | ||||
| medium | S | 0..* | CodeableConcept | A channel of communication Binding: PAS Communication Medium Value Set (extensible) | ||||
| subject | 0..1 | Reference(Patient | Group) | Focus of message | |||||
| about | 0..* | Reference(Resource) | Resources that pertain to this communication request | |||||
| encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of | ||||
| payload | S | 0..* | BackboneElement | Message payload | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| serviceLineNumber | S | 0..1 | positiveInt | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber | ||||
| communicatedDiagnosis | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis Binding: X12 278 Diagnosis Code Value Set (required) | ||||
| contentModifier | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier Binding: X12 278 Diagnosis Information Type (required) | ||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| content[x] | S | 1..1 | string | Message part content | ||||
| occurrence[x] | Σ | 0..1 | When scheduled | |||||
| occurrenceDateTime | dateTime | |||||||
| occurrencePeriod | Period | |||||||
| authoredOn | Σ | 0..1 | dateTime | When request transitioned to being actionable | ||||
| requester | SΣ | 0..1 | Reference(PAS Insurer Organization) | Who/what is requesting service | ||||
| recipient | S | 0..* | Reference(PAS Practitioner | PAS Organization Base Profile) | Message recipient | ||||
| sender | SΣ | 0..1 | Reference(PAS Requestor Organization) | Message sender | ||||
| reasonCode | Σ | 0..* | CodeableConcept | Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication. | ||||
| reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Why is communication needed? | ||||
| note | 0..* | Annotation | Comments made about communication request | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet / Code | ||||
| CommunicationRequest.language | preferred | CommonLanguages
| ||||
| CommunicationRequest.status | required | Fixed Value: active | ||||
| CommunicationRequest.statusReason | example | |||||
| CommunicationRequest.category | required | https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 | ||||
| CommunicationRequest.priority | required | RequestPriority | ||||
| CommunicationRequest.medium | extensible | PASCommunicationRequestMedium | ||||
| CommunicationRequest.reasonCode | example | ActReason |
This structure is derived from CommunicationRequest
Summary
Must-Support: 11 elements
Fixed Value: 1 element
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Maturity: 3
Other representations of profile: CSV, Excel, Schematron
IG © 2020+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pas#2.0.1 based on FHIR 4.0.1. Generated 2024-01-08
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