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

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• Detailed Descriptions
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Resource Profile: CRD Encounter

This profile specifies additional extensions and constraints on the US Core Encounter profile to support coverage requirements discovery.

Usage:

• Refer to this Resource Profile: CRD Communication Request, CRD Device Request, CRD Encounter, CRD Medication Request... Show 4 more, CRD Nutrition Order, CRD Service Request, CRD Questionnaire Task and CRD Vision Prescription
• CapabilityStatements using this Resource Profile: CRD Client USCDI 1, CRD Client USCDI 3 and CRD Client USCDI 4

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USCoreEncounterProfile(7.0.0)	An interaction during which services are provided to the patient This profile also complies with the profiles US Core Encounter Profile (6.1.0) and US Core Encounter Profile (3.1.1) 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
meta	SΣ	0..1	Meta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
lastUpdated	SΣ	0..1	instant	When the resource last changed ele-1: All FHIR elements must have a @value or children
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	Identifier(s) by which this encounter is known ele-1: All FHIR elements must have a @value or children
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
system	SΣ	1..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. ele-1: All FHIR elements must have a @value or children
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter. ele-1: All FHIR elements must have a @value or children
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type ele-1: All FHIR elements must have a @value or children
serviceType	SΣ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided. ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(CRD Patient)	The patient or group present at the encounter ele-1: All FHIR elements must have a @value or children
basedOn		0..*	Reference(CRD Service Request)	The ServiceRequest that initiated this encounter ele-1: All FHIR elements must have a @value or children
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter 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
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter. ele-1: All FHIR elements must have a @value or children
period	S	0..1	Period	Period of time during the encounter that the participant participated ele-1: All FHIR elements must have a @value or children
individual	SΣ	0..1	Reference(US Core Practitioner Profile(7.0.0))	Persons involved in the encounter other than the patient ele-1: All FHIR elements must have a @value or children
appointment	SΣ	0..*	Reference(CRD Appointment with Order | CRD Appointment without Order)	The appointment that scheduled this encounter ele-1: All FHIR elements must have a @value or children
period	S	0..1	Period	The start and end time of the encounter ele-1: All FHIR elements must have a @value or children
length	S	0..1	Duration	Quantity of time the encounter lasted (less time absent) ele-1: All FHIR elements must have a @value or children
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place. ele-1: All FHIR elements must have a @value or children
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) | US Core Condition Encounter Diagnosis Profile(7.0.0))	Reason the encounter takes place (reference) ele-1: All FHIR elements must have a @value or children
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter 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
condition	SΣ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter ele-1: All FHIR elements must have a @value or children
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service 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
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17 ele-1: All FHIR elements must have a @value or children
location	S	0..*	BackboneElement	List of locations where the patient has been 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
location	S	1..1	Reference(CRD Location)	Location the encounter takes place ele-1: All FHIR elements must have a @value or children
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location. ele-1: All FHIR elements must have a @value or children
period	S	0..1	Period	Time period during which the patient was present at the location ele-1: All FHIR elements must have a @value or children
serviceProvider	S	0..1	Reference(US Core Organization Profile(7.0.0))	The organization (facility) responsible for this encounter ele-1: All FHIR elements must have a @value or children
partOf		0..1	Reference(CRD Encounter)	Another Encounter this encounter is part of ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type from the FHIR Standard
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
crd-ci-q1	error	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	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	Encounter	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	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	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()

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints
Encounter			USCoreEncounterProfile(7.0.0)	This profile also complies with the profiles US Core Encounter Profile (6.1.0) and US Core Encounter Profile (3.1.1)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Coverage-Information	S	0..*	(Complex)	CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
serviceType	S	0..1	CodeableConcept	Specific type of service
subject		1..1	Reference(CRD Patient)	The patient or group present at the encounter
basedOn		0..*	Reference(CRD Service Request)	The ServiceRequest that initiated this encounter
participant
individual		0..1	Reference(US Core Practitioner Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))	Persons involved in the encounter other than the patient
appointment	S	0..*	Reference(CRD Appointment with Order | CRD Appointment without Order)	The appointment that scheduled this encounter
length	S	0..1	Duration	Quantity of time the encounter lasted (less time absent)
diagnosis	S	0..*	BackboneElement	The list of diagnosis relevant to this encounter
condition	S	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
location
location		1..1	Reference(CRD Location)	Location the encounter takes place
status	S	0..1	code	planned | active | reserved | completed
period	S	0..1	Period	Time period during which the patient was present at the location
partOf		0..1	Reference(CRD Encounter)	Another Encounter this encounter is part of
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USCoreEncounterProfile(7.0.0)	An interaction during which services are provided to the patient This profile also complies with the profiles US Core Encounter Profile (6.1.0) and US Core Encounter Profile (3.1.1)
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	When the resource last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Coverage-Information	SC	0..*	(Complex)	CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information 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
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
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	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	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)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType	SΣ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(CRD Patient)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(CRD Service Request)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))	Persons involved in the encounter other than the patient
appointment	SΣ	0..*	Reference(CRD Appointment with Order | CRD Appointment without Order)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
length	S	0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) S | US Core Condition Encounter Diagnosis Profile(7.0.0) S | US Core Procedure Profile(7.0.0) | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17
location	S	0..*	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(CRD Location)	Location the encounter takes place
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period	S	0..1	Period	Time period during which the patient was present at the location
serviceProvider	S	0..1	Reference(US Core Organization Profile(7.0.0))	The organization (facility) responsible for this encounter
partOf		0..1	Reference(CRD Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Encounter.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type from the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role from the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source from the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet from the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy from the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
crd-ci-q1	error	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	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	Encounter	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	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	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()

This structure is derived from USCoreEncounterProfile

Summary

Must-Support: 8 elements

Structures

This structure refers to these other structures:

• CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
• CRD Service Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest)
• CRD Appointment with Order (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-with-order)
• CRD Appointment without Order (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-no-order)
• CRD Location (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-location)
• CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information

Maturity: 3

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USCoreEncounterProfile(7.0.0)	An interaction during which services are provided to the patient This profile also complies with the profiles US Core Encounter Profile (6.1.0) and US Core Encounter Profile (3.1.1) 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
meta	SΣ	0..1	Meta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
lastUpdated	SΣ	0..1	instant	When the resource last changed ele-1: All FHIR elements must have a @value or children
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	Identifier(s) by which this encounter is known ele-1: All FHIR elements must have a @value or children
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children
system	SΣ	1..1	uri	The namespace for the identifier value ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique ele-1: All FHIR elements must have a @value or children Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. ele-1: All FHIR elements must have a @value or children
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter. ele-1: All FHIR elements must have a @value or children
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type ele-1: All FHIR elements must have a @value or children
serviceType	SΣ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided. ele-1: All FHIR elements must have a @value or children
subject	SΣ	1..1	Reference(CRD Patient)	The patient or group present at the encounter ele-1: All FHIR elements must have a @value or children
basedOn		0..*	Reference(CRD Service Request)	The ServiceRequest that initiated this encounter ele-1: All FHIR elements must have a @value or children
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter 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
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter. ele-1: All FHIR elements must have a @value or children
period	S	0..1	Period	Period of time during the encounter that the participant participated ele-1: All FHIR elements must have a @value or children
individual	SΣ	0..1	Reference(US Core Practitioner Profile(7.0.0))	Persons involved in the encounter other than the patient ele-1: All FHIR elements must have a @value or children
appointment	SΣ	0..*	Reference(CRD Appointment with Order | CRD Appointment without Order)	The appointment that scheduled this encounter ele-1: All FHIR elements must have a @value or children
period	S	0..1	Period	The start and end time of the encounter ele-1: All FHIR elements must have a @value or children
length	S	0..1	Duration	Quantity of time the encounter lasted (less time absent) ele-1: All FHIR elements must have a @value or children
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place. ele-1: All FHIR elements must have a @value or children
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) | US Core Condition Encounter Diagnosis Profile(7.0.0))	Reason the encounter takes place (reference) ele-1: All FHIR elements must have a @value or children
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter 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
condition	SΣ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter ele-1: All FHIR elements must have a @value or children
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service 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
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17 ele-1: All FHIR elements must have a @value or children
location	S	0..*	BackboneElement	List of locations where the patient has been 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
location	S	1..1	Reference(CRD Location)	Location the encounter takes place ele-1: All FHIR elements must have a @value or children
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location. ele-1: All FHIR elements must have a @value or children
period	S	0..1	Period	Time period during which the patient was present at the location ele-1: All FHIR elements must have a @value or children
serviceProvider	S	0..1	Reference(US Core Organization Profile(7.0.0))	The organization (facility) responsible for this encounter ele-1: All FHIR elements must have a @value or children
partOf		0..1	Reference(CRD Encounter)	Another Encounter this encounter is part of ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type from the FHIR Standard
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
crd-ci-q1	error	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	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	Encounter	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	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	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()

Differential View

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints
Encounter			USCoreEncounterProfile(7.0.0)	This profile also complies with the profiles US Core Encounter Profile (6.1.0) and US Core Encounter Profile (3.1.1)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Coverage-Information	S	0..*	(Complex)	CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
serviceType	S	0..1	CodeableConcept	Specific type of service
subject		1..1	Reference(CRD Patient)	The patient or group present at the encounter
basedOn		0..*	Reference(CRD Service Request)	The ServiceRequest that initiated this encounter
participant
individual		0..1	Reference(US Core Practitioner Profile(7.0.0) | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))	Persons involved in the encounter other than the patient
appointment	S	0..*	Reference(CRD Appointment with Order | CRD Appointment without Order)	The appointment that scheduled this encounter
length	S	0..1	Duration	Quantity of time the encounter lasted (less time absent)
diagnosis	S	0..*	BackboneElement	The list of diagnosis relevant to this encounter
condition	S	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
location
location		1..1	Reference(CRD Location)	Location the encounter takes place
status	S	0..1	code	planned | active | reserved | completed
period	S	0..1	Period	Time period during which the patient was present at the location
partOf		0..1	Reference(CRD Encounter)	Another Encounter this encounter is part of
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USCoreEncounterProfile(7.0.0)	An interaction during which services are provided to the patient This profile also complies with the profiles US Core Encounter Profile (6.1.0) and US Core Encounter Profile (3.1.1)
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	SΣ	0..1	instant	When the resource last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
Coverage-Information	SC	0..*	(Complex)	CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information 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
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
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	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	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)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType	SΣ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(CRD Patient)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(CRD Service Request)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile(7.0.0) S | US Core PractitionerRole Profile(7.0.0) | US Core RelatedPerson Profile(7.0.0))	Persons involved in the encounter other than the patient
appointment	SΣ	0..*	Reference(CRD Appointment with Order | CRD Appointment without Order)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
length	S	0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) S | US Core Condition Encounter Diagnosis Profile(7.0.0) S | US Core Procedure Profile(7.0.0) | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: US Core Discharge Disposition (preferred): National Uniform Billing Committee, manual UB-04, UB form locator 17
location	S	0..*	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(CRD Location)	Location the encounter takes place
status	S	0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period	S	0..1	Period	Time period during which the patient was present at the location
serviceProvider	S	0..1	Reference(US Core Organization Profile(7.0.0))	The organization (facility) responsible for this encounter
partOf		0..1	Reference(CRD Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Encounter.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
Encounter.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
Encounter.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Encounter.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Encounter.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.statusHistory.status	required	EncounterStatus http://hl7.org/fhir/ValueSet/encounter-status|4.0.1 from the FHIR Standard
Encounter.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode http://terminology.hl7.org/ValueSet/v3-ActEncounterCode
Encounter.type	extensible	USCoreEncounterType http://hl7.org/fhir/us/core/ValueSet/us-core-encounter-type
Encounter.serviceType	example	ServiceType http://hl7.org/fhir/ValueSet/service-type from the FHIR Standard
Encounter.priority	example	ActPriority http://terminology.hl7.org/ValueSet/v3-ActPriority
Encounter.participant.type	extensible	ParticipantType http://hl7.org/fhir/ValueSet/encounter-participant-type from the FHIR Standard
Encounter.reasonCode	preferred	EncounterReasonCodes http://hl7.org/fhir/ValueSet/encounter-reason from the FHIR Standard
Encounter.diagnosis.use	preferred	DiagnosisRole http://hl7.org/fhir/ValueSet/diagnosis-role from the FHIR Standard
Encounter.hospitalization.admitSource	preferred	AdmitSource http://hl7.org/fhir/ValueSet/encounter-admit-source from the FHIR Standard
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator http://terminology.hl7.org/ValueSet/v2-0092
Encounter.hospitalization.dietPreference	example	Diet http://hl7.org/fhir/ValueSet/encounter-diet from the FHIR Standard
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy http://hl7.org/fhir/ValueSet/encounter-special-courtesy from the FHIR Standard
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements http://hl7.org/fhir/ValueSet/encounter-special-arrangements from the FHIR Standard
Encounter.hospitalization.dischargeDisposition	preferred	USCoreDischargeDisposition http://hl7.org/fhir/us/core/ValueSet/us-core-discharge-disposition
Encounter.location.status	required	EncounterLocationStatus http://hl7.org/fhir/ValueSet/encounter-location-status|4.0.1 from the FHIR Standard
Encounter.location.physicalType	example	LocationType http://hl7.org/fhir/ValueSet/location-physical-type from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
crd-ci-q1	error	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter.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	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	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	Encounter	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	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	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()

This structure is derived from USCoreEncounterProfile

Summary

Must-Support: 8 elements

Structures

This structure refers to these other structures:

• CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
• CRD Service Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest)
• CRD Appointment with Order (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-with-order)
• CRD Appointment without Order (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-appointment-no-order)
• CRD Location (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-location)
• CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information

Maturity: 3

Other representations of profile: CSV, Excel, Schematron