Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-snapshot - STU 2.2 - Public Review 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 2.2.0-snapshot 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: PAS Metric Data

2.2.0-snapshot
Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/PASMetricData Version:
Standards status: Informative Draft as of 2026-01-30 Maturity Level: 1 Computable Name: PASMetricData
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.1

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

Usages:

  • This Logical Model is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PASMetricData 0..* Base PAS Metric Data
... source 1..1 code provider | intermediary | payer
Binding: MetricDataSource (2.2.0-snapshot) (required)
... providerId 1..1 Identifier User invoking hook
.... system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value 1..1 string The value that is unique
... groupId 1..1 Identifier Healthcare org of user
.... system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value 1..1 string The value that is unique
.... system 1..1 uri The namespace for the identifier value
.... value 1..1 string The value that is unique
... exchange 1..* BackboneElement Prior Authorization Exchanges
.... type 1..1 code initial | subsequent | cancel | update | query | initialDocToPayer
.... with 0..1 code provider | intermediary | payer
.... method 1..1 code x12 | restful | ihe | direct | other
.... requestTime 1..1 instant Time exchange initiated
.... responseTime 0..1 instant Time of exchange response
.... httpResponse 1..1 code e.g. 200
... issue 0..* BackboneElement OperationOutcome info
.... code 1..1 code Error code
Binding: IssueType (required)
.... details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
... aaaCodes 0..* BackboneElement AAA codes returned
.... loopID 1..1 code see X12 loop IDs
.... aaaCode 1..1 code approved | modified | denied
... itemDetail 0..* BackboneElement Service level item detail
.... trn 0..1 integer Service Level TRN
.... item 1..1 CodeableConcept eg. ICD10, HCPCS, NDC
.... assertionId 0..1 string Unique ID for order item
.... initialSubmissionTime 0..1 dateTime Date/time of the initial submission of the item
.... finalResponseTime 0..1 dateTime Date/time of final result
.... responsesRequired 0..1 integer Number of responses
.... aaaCodes 0..* BackboneElement AAA codes returned
..... loopID 1..1 code see X12 loop IDs
..... aaaCode 1..1 code approved | modified | deined
.... locationType 0..1 code inpatient | outpatient | home
.... result 0..1 code approved | modified | denied | pended | cancelled
.... denialReason 0..1 code Denial Reason
... supportingDoc 0..1 url Documentation submitted as part of PAS Bundle
... requestedDoc 0..* BackboneElement Documentation requested via 278 response
.... docRequest 1..* CodeableConcept Coded requests for additional documentation
.... timeRequested 1..1 dateTime Date/Time of initial request
.... timeSubmitted 0..1 dateTime Date/Time of final result
.... submissionMethod 0..1 code CDex | portal | fax | x12 | other
... exceptionSubmission 0..1 boolean True if exchange is based on the exception grant
... businessLine 0..1 CodeableConcept E.g. MedicareAdvantage

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
PASMetricData.source Base required Metric Data Source 📍2.2.0-snapshot This IG
PASMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
PASMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PASMetricData 0..* Base PAS Metric Data
... source 1..1 code provider | intermediary | payer
Binding: MetricDataSource (2.2.0-snapshot) (required)
... providerId 1..1 Identifier User invoking hook
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... groupId 1..1 Identifier Healthcare org of user
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... exchange 1..* BackboneElement Prior Authorization Exchanges
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 code initial | subsequent | cancel | update | query | initialDocToPayer
.... with 0..1 code provider | intermediary | payer
.... method 1..1 code x12 | restful | ihe | direct | other
.... requestTime 1..1 instant Time exchange initiated
.... responseTime 0..1 instant Time of exchange response
.... httpResponse 1..1 code e.g. 200
... issue 0..* BackboneElement OperationOutcome info
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 code Error code
Binding: IssueType (required)
.... details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
... aaaCodes 0..* BackboneElement AAA codes returned
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... loopID 1..1 code see X12 loop IDs
.... aaaCode 1..1 code approved | modified | denied
... itemDetail 0..* BackboneElement Service level item detail
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... trn 0..1 integer Service Level TRN
.... item 1..1 CodeableConcept eg. ICD10, HCPCS, NDC
.... assertionId 0..1 string Unique ID for order item
.... initialSubmissionTime 0..1 dateTime Date/time of the initial submission of the item
.... finalResponseTime 0..1 dateTime Date/time of final result
.... responsesRequired 0..1 integer Number of responses
.... aaaCodes 0..* BackboneElement AAA codes returned
..... @id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... loopID 1..1 code see X12 loop IDs
..... aaaCode 1..1 code approved | modified | deined
.... locationType 0..1 code inpatient | outpatient | home
.... result 0..1 code approved | modified | denied | pended | cancelled
.... denialReason 0..1 code Denial Reason
... supportingDoc 0..1 url Documentation submitted as part of PAS Bundle
... requestedDoc 0..* BackboneElement Documentation requested via 278 response
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... docRequest 1..* CodeableConcept Coded requests for additional documentation
.... timeRequested 1..1 dateTime Date/Time of initial request
.... timeSubmitted 0..1 dateTime Date/Time of final result
.... submissionMethod 0..1 code CDex | portal | fax | x12 | other
... exceptionSubmission 0..1 boolean True if exchange is based on the exception grant
... businessLine 0..1 CodeableConcept E.g. MedicareAdvantage

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
PASMetricData.source Base required Metric Data Source 📍2.2.0-snapshot This IG
PASMetricData.providerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.providerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.groupId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.groupId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.payerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.payerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
PASMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Mandatory: 4 elements(17 nested mandatory elements)

Maturity: 1

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PASMetricData 0..* Base PAS Metric Data
... source 1..1 code provider | intermediary | payer
Binding: MetricDataSource (2.2.0-snapshot) (required)
... providerId 1..1 Identifier User invoking hook
.... system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value 1..1 string The value that is unique
... groupId 1..1 Identifier Healthcare org of user
.... system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value 1..1 string The value that is unique
.... system 1..1 uri The namespace for the identifier value
.... value 1..1 string The value that is unique
... exchange 1..* BackboneElement Prior Authorization Exchanges
.... type 1..1 code initial | subsequent | cancel | update | query | initialDocToPayer
.... with 0..1 code provider | intermediary | payer
.... method 1..1 code x12 | restful | ihe | direct | other
.... requestTime 1..1 instant Time exchange initiated
.... responseTime 0..1 instant Time of exchange response
.... httpResponse 1..1 code e.g. 200
... issue 0..* BackboneElement OperationOutcome info
.... code 1..1 code Error code
Binding: IssueType (required)
.... details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
... aaaCodes 0..* BackboneElement AAA codes returned
.... loopID 1..1 code see X12 loop IDs
.... aaaCode 1..1 code approved | modified | denied
... itemDetail 0..* BackboneElement Service level item detail
.... trn 0..1 integer Service Level TRN
.... item 1..1 CodeableConcept eg. ICD10, HCPCS, NDC
.... assertionId 0..1 string Unique ID for order item
.... initialSubmissionTime 0..1 dateTime Date/time of the initial submission of the item
.... finalResponseTime 0..1 dateTime Date/time of final result
.... responsesRequired 0..1 integer Number of responses
.... aaaCodes 0..* BackboneElement AAA codes returned
..... loopID 1..1 code see X12 loop IDs
..... aaaCode 1..1 code approved | modified | deined
.... locationType 0..1 code inpatient | outpatient | home
.... result 0..1 code approved | modified | denied | pended | cancelled
.... denialReason 0..1 code Denial Reason
... supportingDoc 0..1 url Documentation submitted as part of PAS Bundle
... requestedDoc 0..* BackboneElement Documentation requested via 278 response
.... docRequest 1..* CodeableConcept Coded requests for additional documentation
.... timeRequested 1..1 dateTime Date/Time of initial request
.... timeSubmitted 0..1 dateTime Date/Time of final result
.... submissionMethod 0..1 code CDex | portal | fax | x12 | other
... exceptionSubmission 0..1 boolean True if exchange is based on the exception grant
... businessLine 0..1 CodeableConcept E.g. MedicareAdvantage

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
PASMetricData.source Base required Metric Data Source 📍2.2.0-snapshot This IG
PASMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
PASMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PASMetricData 0..* Base PAS Metric Data
... source 1..1 code provider | intermediary | payer
Binding: MetricDataSource (2.2.0-snapshot) (required)
... providerId 1..1 Identifier User invoking hook
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... groupId 1..1 Identifier Healthcare org of user
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... exchange 1..* BackboneElement Prior Authorization Exchanges
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 code initial | subsequent | cancel | update | query | initialDocToPayer
.... with 0..1 code provider | intermediary | payer
.... method 1..1 code x12 | restful | ihe | direct | other
.... requestTime 1..1 instant Time exchange initiated
.... responseTime 0..1 instant Time of exchange response
.... httpResponse 1..1 code e.g. 200
... issue 0..* BackboneElement OperationOutcome info
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 code Error code
Binding: IssueType (required)
.... details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
... aaaCodes 0..* BackboneElement AAA codes returned
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... loopID 1..1 code see X12 loop IDs
.... aaaCode 1..1 code approved | modified | denied
... itemDetail 0..* BackboneElement Service level item detail
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... trn 0..1 integer Service Level TRN
.... item 1..1 CodeableConcept eg. ICD10, HCPCS, NDC
.... assertionId 0..1 string Unique ID for order item
.... initialSubmissionTime 0..1 dateTime Date/time of the initial submission of the item
.... finalResponseTime 0..1 dateTime Date/time of final result
.... responsesRequired 0..1 integer Number of responses
.... aaaCodes 0..* BackboneElement AAA codes returned
..... @id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... loopID 1..1 code see X12 loop IDs
..... aaaCode 1..1 code approved | modified | deined
.... locationType 0..1 code inpatient | outpatient | home
.... result 0..1 code approved | modified | denied | pended | cancelled
.... denialReason 0..1 code Denial Reason
... supportingDoc 0..1 url Documentation submitted as part of PAS Bundle
... requestedDoc 0..* BackboneElement Documentation requested via 278 response
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... docRequest 1..* CodeableConcept Coded requests for additional documentation
.... timeRequested 1..1 dateTime Date/Time of initial request
.... timeSubmitted 0..1 dateTime Date/Time of final result
.... submissionMethod 0..1 code CDex | portal | fax | x12 | other
... exceptionSubmission 0..1 boolean True if exchange is based on the exception grant
... businessLine 0..1 CodeableConcept E.g. MedicareAdvantage

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
PASMetricData.source Base required Metric Data Source 📍2.2.0-snapshot This IG
PASMetricData.providerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.providerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.groupId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.groupId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.payerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.payerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
PASMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Mandatory: 4 elements(17 nested mandatory elements)

Maturity: 1

 

Other representations of profile: CSV, Excel