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: CRDDeviceRequest - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 3

Definitions for the profile-devicerequest resource profile.

Guidance on how to interpret the contents of this table can be found here

0. DeviceRequest
2. DeviceRequest.extension
SlicingThis element introduces a set of slices on DeviceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. DeviceRequest.extension:Coverage-Information
    Slice NameCoverage-Information
    Control0..*
    TypeExtension(Coverage Information) (Complex Extension)
    Must Supporttrue
    6. DeviceRequest.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Must Supporttrue
    8. DeviceRequest.basedOn
    Must Supporttrue
    10. DeviceRequest.status
    Comments

    This will be 'draft' when using order-select or an initial order-sign, but may be 'active' or other values for order-sign representing edits to the order or for order-dispatch.

    Control1..?
    Must Supporttrue
    Example<br/><b>General</b>:draft
    12. DeviceRequest.code[x]
    BindingUnless not suitable, these codes SHALL be taken from CRD Device Request Codes Value Set
    (extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/deviceRequest)
    TypeChoice of: Reference(CRD Device), CodeableConcept
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    14. DeviceRequest.parameter
    Must Supporttrue
    16. DeviceRequest.subject
    TypeReference(CRD Patient)
    Must Supporttrue
    18. DeviceRequest.encounter
    Comments

    potentially relevant for CRD in some situations.

    TypeReference(CRD Encounter)
    20. DeviceRequest.occurrence[x]
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Must Supporttrue
    22. DeviceRequest.authoredOn
    Control1..?
    Must Supporttrue
    24. DeviceRequest.requester
    Control1..?
    TypeReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
    Must Supporttrue
    Must Support TypesReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
    26. DeviceRequest.performer
    TypeReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
    Must Supporttrue
    Must Support TypesReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
    28. DeviceRequest.reasonCode
    Must Supporttrue
    30. DeviceRequest.reasonReference
    Comments

    potentially relevant for CRD in some situations.

    Must Supporttrue

    Guidance on how to interpret the contents of this table can be found here

    0. DeviceRequest
    Definition

    Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

    ShortMedical device request
    Control0..*
    Is Modifierfalse
    Summaryfalse
    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
    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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
    dom-6: A resource should have narrative for robust management (text.`div`.exists())
    2. DeviceRequest.implicitRules
    Definition

    A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

    ShortA set of rules under which this content was created
    Comments

    Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

    Control0..1
    Typeuri
    Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    4. DeviceRequest.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on DeviceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 6. DeviceRequest.extension:Coverage-Information
      Slice NameCoverage-Information
      Definition

      Indicates coverage information.

      ShortCoverageInfo
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(Coverage Information) (Complex Extension)
      Is Modifierfalse
      Must Supporttrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      crd-ci-q1: Questionnaire is only allowed when doc-needed exists (extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists())
      crd-ci-q2: 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: '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: 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: '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: 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: 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'))
      8. DeviceRequest.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      10. DeviceRequest.identifier
      Definition

      Identifiers assigned to this order by the orderer or by the receiver.

      ShortExternal Request identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. DeviceRequest.basedOn
      Definition

      Plan/proposal/order fulfilled by this request.

      ShortWhat request fulfills
      Control0..*
      TypeReference(Resource)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      14. DeviceRequest.status
      Definition

      The status of the request.

      Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
      Comments

      This will be 'draft' when using order-select or an initial order-sign, but may be 'active' or other values for order-sign representing edits to the order or for order-dispatch.


      This element is labeled as a modifier because the status contains the codes cancelled and entered-in-error that mark the request as not currently valid.

      Control10..1
      BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

      Codes representing the status of the request.

      Typecode
      Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Example<br/><b>General</b>:draft
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. DeviceRequest.intent
      Definition

      Whether the request is a proposal, plan, an original order or a reflex order.

      Shortproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
      Control1..1
      BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
      (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

      The kind of diagnostic request.

      Typecode
      Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. DeviceRequest.code[x]
      Definition

      The details of the device to be used.

      ShortDevice requested
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see CRD Device Request Codes Value Sethttp://hl7.org/fhir/ValueSet/device-kind
      (extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/deviceRequest)
      TypeChoice of: Reference(CRD Device, Device), CodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. DeviceRequest.parameter
      Definition

      Specific parameters for the ordered item. For example, the prism value for lenses.

      ShortDevice details
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. DeviceRequest.parameter.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      24. DeviceRequest.subject
      Definition

      The patient who will use the device.

      ShortFocus of request
      Control1..1
      TypeReference(CRD Patient, Patient, Group, Location, Device)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. DeviceRequest.encounter
      Definition

      An encounter that provides additional context in which this request is made.

      ShortEncounter motivating request
      Comments

      potentially relevant for CRD in some situations.

      Control0..1
      TypeReference(CRD Encounter, Encounter)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. DeviceRequest.occurrence[x]
      Definition

      The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013".

      ShortDesired time or schedule for use
      Control0..1
      TypeChoice of: dateTime, Period, Timing
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. DeviceRequest.authoredOn
      Definition

      When the request transitioned to being actionable.

      ShortWhen recorded
      Control10..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. DeviceRequest.requester
      Definition

      The individual who initiated the request and has responsibility for its activation.

      ShortWho/what is requesting diagnostics
      Control10..1
      TypeReference(US Core Practitioner Profile, HRex PractitionerRole Profile, Device, Practitioner, PractitionerRole, Organization)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. DeviceRequest.performer
      Definition

      The desired performer for doing the diagnostic testing.

      ShortRequested Filler
      Control0..1
      TypeReference(US Core Practitioner Profile, HRex PractitionerRole Profile, Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. DeviceRequest.reasonCode
      Definition

      Reason or justification for the use of this device.

      ShortCoded Reason for request
      Control0..*
      BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code
      (example to http://hl7.org/fhir/ValueSet/condition-code)

      Diagnosis or problem codes justifying the reason for requesting the device.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. DeviceRequest.reasonReference
      Definition

      Reason or justification for the use of this device.

      ShortLinked Reason for request
      Comments

      potentially relevant for CRD in some situations.

      Control0..*
      TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. DeviceRequest
      Definition

      Represents a request for a patient to employ a medical device. The device may be an implantable device, or an external assistive device, such as a walker.

      ShortMedical device request
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. DeviceRequest.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. DeviceRequest.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. DeviceRequest.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. DeviceRequest.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. DeviceRequest.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. DeviceRequest.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. DeviceRequest.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on DeviceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. DeviceRequest.extension:Coverage-Information
        Slice NameCoverage-Information
        Definition

        Indicates coverage information.

        ShortCoverageInfo
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Coverage Information) (Complex Extension)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        crd-ci-q1: Questionnaire is only allowed when doc-needed exists (extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists())
        crd-ci-q2: 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: '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: 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: '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: 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: 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'))
        18. DeviceRequest.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. DeviceRequest.identifier
        Definition

        Identifiers assigned to this order by the orderer or by the receiver.

        ShortExternal Request identifier
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. DeviceRequest.instantiatesCanonical
        Definition

        The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

        ShortInstantiates FHIR protocol or definition
        Comments

        Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

        Control0..*
        Typecanonical(ActivityDefinition, PlanDefinition)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. DeviceRequest.instantiatesUri
        Definition

        The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this DeviceRequest.

        ShortInstantiates external protocol or definition
        Comments

        This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

        Control0..*
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. DeviceRequest.basedOn
        Definition

        Plan/proposal/order fulfilled by this request.

        ShortWhat request fulfills
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. DeviceRequest.priorRequest
        Definition

        The request takes the place of the referenced completed or terminated request(s).

        ShortWhat request replaces
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. DeviceRequest.groupIdentifier
        Definition

        Composite request this is part of.

        ShortIdentifier of composite request
        Control0..1
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. DeviceRequest.status
        Definition

        The status of the request.

        Shortdraft | active | on-hold | revoked | completed | entered-in-error | unknown
        Comments

        This will be 'draft' when using order-select or an initial order-sign, but may be 'active' or other values for order-sign representing edits to the order or for order-dispatch.

        Control1..1
        BindingThe codes SHALL be taken from RequestStatus
        (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

        Codes representing the status of the request.

        Typecode
        Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Example<br/><b>General</b>:draft
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. DeviceRequest.intent
        Definition

        Whether the request is a proposal, plan, an original order or a reflex order.

        Shortproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
        Control1..1
        BindingThe codes SHALL be taken from RequestIntent
        (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

        The kind of diagnostic request.

        Typecode
        Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. DeviceRequest.priority
        Definition

        Indicates how quickly the {{title}} should be addressed with respect to other requests.

        Shortroutine | urgent | asap | stat
        Control0..1
        BindingThe codes SHALL be taken from RequestPriority
        (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

        Identifies the level of importance to be assigned to actioning the request.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Meaning if MissingIf missing, normal priority
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. DeviceRequest.code[x]
        Definition

        The details of the device to be used.

        ShortDevice requested
        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from CRD Device Request Codes Value Set
        (extensible to http://hl7.org/fhir/us/davinci-crd/ValueSet/deviceRequest)
        TypeChoice of: Reference(CRD Device), CodeableConcept
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. DeviceRequest.parameter
        Definition

        Specific parameters for the ordered item. For example, the prism value for lenses.

        ShortDevice details
        Control0..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. DeviceRequest.parameter.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        44. DeviceRequest.parameter.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        46. DeviceRequest.parameter.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        48. DeviceRequest.parameter.code
        Definition

        A code or string that identifies the device detail being asserted.

        ShortDevice detail
        Control0..1
        Binding

        A code that identifies the device detail.

        TypeCodeableConcept
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. DeviceRequest.parameter.value[x]
        Definition

        The value of the device detail.

        ShortValue of detail
        Comments

        Range means device should have a value that falls somewhere within the specified range.

        Control0..1
        TypeChoice of: CodeableConcept, Quantity, Range, boolean
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. DeviceRequest.subject
        Definition

        The patient who will use the device.

        ShortFocus of request
        Control1..1
        TypeReference(CRD Patient)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. DeviceRequest.encounter
        Definition

        An encounter that provides additional context in which this request is made.

        ShortEncounter motivating request
        Comments

        potentially relevant for CRD in some situations.

        Control0..1
        TypeReference(CRD Encounter)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. DeviceRequest.occurrence[x]
        Definition

        The timing schedule for the use of the device. The Schedule data type allows many different expressions, for example. "Every 8 hours"; "Three times a day"; "1/2 an hour before breakfast for 10 days from 23-Dec 2011:"; "15 Oct 2013, 17 Oct 2013 and 1 Nov 2013".

        ShortDesired time or schedule for use
        Control0..1
        TypeChoice of: dateTime, Period, Timing
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. DeviceRequest.authoredOn
        Definition

        When the request transitioned to being actionable.

        ShortWhen recorded
        Control1..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. DeviceRequest.requester
        Definition

        The individual who initiated the request and has responsibility for its activation.

        ShortWho/what is requesting diagnostics
        Control1..1
        TypeReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. DeviceRequest.performerType
        Definition

        Desired type of performer for doing the diagnostic testing.

        ShortFiller role
        Control0..1
        BindingFor example codes, see ParticipantRoles
        (example to http://hl7.org/fhir/ValueSet/participant-role)

        Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

        TypeCodeableConcept
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. DeviceRequest.performer
        Definition

        The desired performer for doing the diagnostic testing.

        ShortRequested Filler
        Control0..1
        TypeReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesReference(US Core Practitioner Profile, HRex PractitionerRole Profile)
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. DeviceRequest.reasonCode
        Definition

        Reason or justification for the use of this device.

        ShortCoded Reason for request
        Control0..*
        BindingFor example codes, see Condition/Problem/DiagnosisCodes
        (example to http://hl7.org/fhir/ValueSet/condition-code)

        Diagnosis or problem codes justifying the reason for requesting the device.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. DeviceRequest.reasonReference
        Definition

        Reason or justification for the use of this device.

        ShortLinked Reason for request
        Comments

        potentially relevant for CRD in some situations.

        Control0..*
        TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. DeviceRequest.insurance
        Definition

        Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be required for delivering the requested service.

        ShortAssociated insurance coverage
        Control0..*
        TypeReference(Coverage, ClaimResponse)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. DeviceRequest.supportingInfo
        Definition

        Additional clinical information about the patient that may influence the request fulfilment. For example, this may include where on the subject's body the device will be used (i.e. the target site).

        ShortAdditional clinical information
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Summaryfalse
        Requirements

        Knowing where the device is targeted is important for tracking if multiple sites are possible.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. DeviceRequest.note
        Definition

        Details about this request that were not represented at all or sufficiently in one of the attributes provided in a class. These may include for example a comment, an instruction, or a note associated with the statement.

        ShortNotes or comments
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. DeviceRequest.relevantHistory
        Definition

        Key events in the history of the request.

        ShortRequest provenance
        Comments

        This might not include provenances for all versions of the request - only those deemed "relevant" or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a "relevant" change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

        Control0..*
        TypeReference(Provenance)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))