Colorado BHA FHIR Implementation Guide
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Colorado BHA FHIR Implementation Guide, published by Colorado Behavioral Health Administration. This guide is not an authorized publication; it is the continuous build for version 0.3.0-current built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CoBHA/CoBHRM-FHIR-IG/ and changes regularly. See the Directory of published versions

Example QuestionnaireResponse: Example Substance Use Disorder Questionnaire Responses

Page standards status: Informative
LinkIDTextDefinitionAnswerdoco
BHASubstanceUseDisorderQuestionnaireResponseExampleQuestionnaire:BHA Substance Use Disorder Questionnaire
BHASubstanceUseDisorderQuestionnaireResponseExample / lastUpdated2025-10-28T18:30:40-07:00
BHASubstanceUseDisorderQuestionnaireResponseExample / ASAM_LEVEL_OF_CAREASAM Level of Care: the ASAM Level of Care must match the LADDERS Provider/Clinic's ASAM Level of CareBHA ASAM Levels of Care: 3.1 (ASAM Level 3.1 - Clinically Managed Low-Intensity Residential Services)
BHASubstanceUseDisorderQuestionnaireResponseExample / PRIMARY_SUBSTANCE_USEPrimary Substance UseBHA Substance Use Codes: 1 (Alcohol)
BHASubstanceUseDisorderQuestionnaireResponseExample / PRIMARY_LAST_USED_30_DAYSTimes Used Primary Substance in Last 30 Days3
BHASubstanceUseDisorderQuestionnaireResponseExample / PRIMARY_ROUTE_OF_USERoute of Use of Primary SubstancesBHA Substance Use Route of Administration Codes: 1 (Oral)
BHASubstanceUseDisorderQuestionnaireResponseExample / PRIMARY_START_AGEAge of First Use of Primary Substances28
BHASubstanceUseDisorderQuestionnaireResponseExample / SECONDARY_SUBSTANCE_USESecondary Substance UseBHA Substance Use Codes: 6 (Other tranquilizer)
BHASubstanceUseDisorderQuestionnaireResponseExample / SECONDARY_LAST_USED_30_DAYSTimes Used Secondary Substance in Last 30 Days4
BHASubstanceUseDisorderQuestionnaireResponseExample / SECONDARY_ROUTE_OF_USERoute of Use of Secondary SubstancesBHA Substance Use Route of Administration Codes: 3 (Inhalation (nose/mouth))
BHASubstanceUseDisorderQuestionnaireResponseExample / SECONDARY_START_AGEAge of First Use of Secondary Substances28
BHASubstanceUseDisorderQuestionnaireResponseExample / TERTIARY_SUBSTANCE_USETertiary Substance UseBHA Substance Use Codes: 10 (Other stimulants)
BHASubstanceUseDisorderQuestionnaireResponseExample / TERTIARY_LAST_USED_30_DAYSTimes Used Tertiary Substance in Last 30 Days2
BHASubstanceUseDisorderQuestionnaireResponseExample / TERTIARY_ROUTE_OF_USERoute of Use of Tertiary SubstanceBHA Substance Use Route of Administration Codes: 1 (Oral)
BHASubstanceUseDisorderQuestionnaireResponseExample / TERTIARY_START_AGEAge of First Use of Tertiary Substance29
BHASubstanceUseDisorderQuestionnaireResponseExample / episodeOfCareEpisode of Care InformationEpisodeOfCare: status = finished; type = Substance Use Disorder; period = 2024-01-01 --> 2024-01-15

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