Da Vinci - Coverage Requirements Discovery
2.1.0 - STU 2.1
Da Vinci - Coverage Requirements Discovery
2.1.0 - STU 2.1
Da Vinci - Coverage Requirements Discovery, 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-crd/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-communicationrequest | Version: 2.1.0 | |||
| Standards status: Trial-use | Maturity Level: 1 | Computable Name: CRDCommunicationRequest | ||
| Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.42.6 | ||||
This profile specifies constraints on the CommunicationRequest resource to support coverage requirements discovery.
CRD Clients SHALL use this profile to resolve references to CommunicationRequest resources passed to CRD Servers (e.g. selections context references) and to populate draftOrders context objects when invoking the when invoking the following CDS Hooks:
Information provided in Must Support elements will commonly be required for CRD Servers to perform coverage requirements discovery.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  CommunicationRequest |
0..* | CommunicationRequest | A request for information to be sent to a receiver dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management | |
  implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children |
  Slices for extension |
0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
   Coverage-Information |
SC | 0..* | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both crd-ci-q1: Questionnaire is only allowed when doc-needed exists crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' must not exist. crd-ci-q3: 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'withpa'. crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. crd-ci-q6: If 'info-needed' is Other, then reason must be specified crd-ci-q7: If reason.coding is present and is not from the extensible value set, then reason.text must be present |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
 identifier |
SΣ | 0..* | Identifier | Unique identifier ele-1: All FHIR elements must have a @value or children |
 basedOn |
SΣ | 1..1 | Reference(Resource) | Fulfills plan or proposal ele-1: All FHIR elements must have a @value or children |
| replaces |
Σ | 0..* | Reference(CRD Communication Request) | Request(s) replaced by this request ele-1: All FHIR elements must have a @value or children |
| status |
?!SΣ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. ele-1: All FHIR elements must have a @value or children Example General: draft |
| subject |
S | 1..1 | Reference(CRD Patient) | Focus of message ele-1: All FHIR elements must have a @value or children |
| encounter |
Σ | 0..1 | Reference(CRD Encounter) | Encounter created as part of ele-1: All FHIR elements must have a @value or children |
| payload |
S | 1..* | BackboneElement | Message payload ele-1: All FHIR elements must have a @value or children |
| Slices for extension |
1..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both | |
 extension:codeableConcept |
S | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D]] | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
  extension |
0..0 | |||
| url |
1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content[x]" | |
 value[x] |
1..1 | CodeableConcept | Value of extension ele-1: All FHIR elements must have a @value or children | |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both |
  content[x] |
1..1 | Message part content ele-1: All FHIR elements must have a @value or children | ||
| contentString |
string | |||
| contentAttachment |
Attachment | |||
 contentReference |
Reference(Resource) | |||
| occurrence[x] |
SΣ | 0..1 | When scheduled ele-1: All FHIR elements must have a @value or children | |
| occurrenceDateTime |
dateTime | |||
| occurrencePeriod |
Period | |||
| authoredOn |
SΣ | 1..1 | dateTime | When request transitioned to being actionable ele-1: All FHIR elements must have a @value or children |
| requester |
SΣ | 1..1 | Reference(US Core Practitioner Profile(7.0.0) | HRex PractitionerRole Profile) | Who/what is requesting service ele-1: All FHIR elements must have a @value or children |
| recipient |
S | 0..* | Reference(US Core Practitioner Profile(7.0.0) | HRex PractitionerRole Profile | CRD Organization) | Message recipient ele-1: All FHIR elements must have a @value or children |
| sender |
SΣ | 0..1 | Reference(US Core Practitioner Profile(7.0.0) | HRex PractitionerRole Profile | CRD Organization) | Message sender ele-1: All FHIR elements must have a @value or children |
| reasonCode |
SΣ | 0..* | CodeableConcept | Why is communication needed? Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication. ele-1: All FHIR elements must have a @value or children |
| reasonReference |
SΣ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Why is communication needed? ele-1: All FHIR elements must have a @value or children |
| Documentation for this format | ||||
| Path | Conformance | ValueSet | URI |
| CommunicationRequest.status | required | RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1from the FHIR Standard | |
| CommunicationRequest.reasonCode | example | ActReasonhttp://terminology.hl7.org/ValueSet/v3-ActReason |
| Id | Grade | Path(s) | Details | Requirements |
| crd-ci-q1 | error | CommunicationRequest.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists : extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists() | |
| crd-ci-q2 | error | CommunicationRequest.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. : extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not() | |
| crd-ci-q3 | error | CommunicationRequest.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. : extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists() | |
| crd-ci-q4 | error | CommunicationRequest.extension:Coverage-Information | If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'withpa'. : extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa') | |
| crd-ci-q5 | error | CommunicationRequest.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. : extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists() | |
| crd-ci-q6 | error | CommunicationRequest.extension:Coverage-Information | If 'info-needed' is Other, then reason must be specified : extension.where(url = 'info-needed' and value = 'Other').exists() implies extension.where(url = 'reason').exists() | |
| crd-ci-q7 | error | CommunicationRequest.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present : extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons') | |
| dom-2 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() | |
| dom-4 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() | |
| dom-5 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | CommunicationRequest | A resource should have narrative for robust management : text.`div`.exists() | |
| 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() |
Other representations of profile: CSV, Excel, Schematron
IG © 2019+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-crd#2.1.0 based on FHIR 4.0.1. Generated 2025-02-26
Links: Table of Contents |
QA Report
| Version History |
|
Propose a change
