Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2.1 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 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

Resource Profile: PAS CommunicationRequest

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest Version: 2.1.0
Standards status: Trial-use Maturity Level: 3 Computable Name: PASCommunicationRequest
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.53

PAS constraints on CommunicationRequest resource mandating support for elements relevant to the prior authorization response

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from CommunicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest CommunicationRequest
... identifier S 0..* Identifier Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
... status 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
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.

... 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)
.... content[x] S 1..1 string Message part content
... requester S 0..1 Reference(PAS Insurer Organization) Who/what is requesting service
... recipient S 0..* Reference(PAS Practitioner | PAS Organization Base Profile) Message recipient
... sender S 0..1 Reference(PAS Requestor Organization) Message sender

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
CommunicationRequest.categoryrequiredhttps://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
CommunicationRequest.mediumextensiblePASCommunicationRequestMedium
http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium
from this IG

 

Other representations of profile: CSV, Excel, Schematron