Da Vinci - Coverage Requirements Discovery
2.1.0 - STU 2.1 United States of America flag

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

Resource Profile: CRD Vision Prescription

Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-visionprescription Version: 2.1.0
Standards status: Trial-use Maturity Level: 1 Computable Name: CRDVisionPrescription
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.42.19

This profile defines an initial profile on the VisionPrescription resource to support coverage requirements discovery.

Usage


CRD Clients SHALL use this profile to resolve references to VisionPrescription 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.

NOTE: This profile is not currently based on US Core because US Core does not yet profile the VisionPrescription resource. If a future version of US-Core adds support for the resource, this profile will be revised to extend the US Core profile.

Usage:

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraintsdoco
.. VisionPrescription 0..* VisionPrescription Prescription for vision correction products for a patient
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) Coverage Info
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
... status ?!SΣ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.


ele-1: All FHIR elements must have a @value or children
Example General: draft
... created SΣ 1..1 dateTime Response creation date
ele-1: All FHIR elements must have a @value or children
... patient SΣ 1..1 Reference(CRD Patient) Who prescription is for
ele-1: All FHIR elements must have a @value or children
... encounter S 0..1 Reference(CRD Encounter) Created during encounter / admission / stay
ele-1: All FHIR elements must have a @value or children
... dateWritten SΣ 1..1 dateTime When prescription was authorized
ele-1: All FHIR elements must have a @value or children
... prescriber SΣ 1..1 Reference(US Core Practitioner Profile(7.0.0) | HRex PractitionerRole Profile) Who authorized the vision prescription
ele-1: All FHIR elements must have a @value or children
... lensSpecification SΣ 1..* BackboneElement Vision lens authorization
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
.... product SΣ 1..1 CodeableConcept Product to be supplied
Binding: ExampleVisionPrescriptionProductCodes (example): A coded concept describing the vision products.


ele-1: All FHIR elements must have a @value or children
.... eye SΣ 1..1 code right | left
Binding: VisionEyes (required): A coded concept listing the eye codes.


ele-1: All FHIR elements must have a @value or children
.... sphere S 0..1 decimal Power of the lens
ele-1: All FHIR elements must have a @value or children
.... cylinder S 0..1 decimal Lens power for astigmatism
ele-1: All FHIR elements must have a @value or children
.... axis S 0..1 integer Lens meridian which contain no power for astigmatism
ele-1: All FHIR elements must have a @value or children
.... prism S 0..* BackboneElement Eye alignment compensation
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
..... amount S 1..1 decimal Amount of adjustment
ele-1: All FHIR elements must have a @value or children
..... base S 1..1 code up | down | in | out
Binding: VisionBase (required): A coded concept listing the base codes.


ele-1: All FHIR elements must have a @value or children
.... add S 0..1 decimal Added power for multifocal levels
ele-1: All FHIR elements must have a @value or children
.... power S 0..1 decimal Contact lens power
ele-1: All FHIR elements must have a @value or children
.... backCurve S 0..1 decimal Contact lens back curvature
ele-1: All FHIR elements must have a @value or children
.... diameter S 0..1 decimal Contact lens diameter
ele-1: All FHIR elements must have a @value or children
.... duration S 0..1 SimpleQuantity Lens wear duration
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
VisionPrescription.statusrequiredFinancialResourceStatusCodes
http://hl7.org/fhir/ValueSet/fm-status|4.0.1
from the FHIR Standard
VisionPrescription.lensSpecification.productexampleExampleVisionPrescriptionProductCodes
http://hl7.org/fhir/ValueSet/vision-product
from the FHIR Standard
VisionPrescription.lensSpecification.eyerequiredVisionEyes
http://hl7.org/fhir/ValueSet/vision-eye-codes|4.0.1
from the FHIR Standard
VisionPrescription.lensSpecification.prism.baserequiredVisionBase
http://hl7.org/fhir/ValueSet/vision-base-codes|4.0.1
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
crd-ci-q1errorVisionPrescription.extension:Coverage-InformationQuestionnaire is only allowed when doc-needed exists
: extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()
crd-ci-q2errorVisionPrescription.extension:Coverage-InformationIf 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-q3errorVisionPrescription.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-q4errorVisionPrescription.extension:Coverage-InformationIf '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-q5errorVisionPrescription.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-q6errorVisionPrescription.extension:Coverage-InformationIf '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-q7errorVisionPrescription.extension:Coverage-InformationIf 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-2errorVisionPrescriptionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorVisionPrescriptionIf 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-4errorVisionPrescriptionIf 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-5errorVisionPrescriptionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceVisionPrescriptionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron