Da Vinci - Coverage Requirements Discovery
2.2.1 - STU 2.2

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 2.2.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-crd/ and changes regularly. See the Directory of published versions

## Resource Profile: CRD Communication Request - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 1

Definitions for the profile-communicationrequest resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

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

0. CommunicationRequest
Definition | A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.
Short | A request for information to be sent to a receiver
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-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. CommunicationRequest.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. CommunicationRequest.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.
Short | Contained, inline Resources
Comments | Any references found in this resource, with the exception of 'Patient' could potentially be resource-specific and thus transmitted as contained resources. 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.
Control | 0..*
Type | Resource
Is Modifier | false
Must Support | true
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
6. CommunicationRequest.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.
Short | ExtensionAdditional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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())
Slicing | This element introduces a set of slices on `CommunicationRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
8. CommunicationRequest.extension:Coverage-Information
Slice Name | Coverage-Information
Definition | Indicates coverage information.
Short | CoverageInfo
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Coverage Information) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-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', 'noauth', or 'not-covered', then 'Doc-purpose' cannot be 'withpa'. (`extension.where(url = 'pa-needed' and (value = 'satisfied' or value = 'noauth' or value = 'not-covered')) 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 OTH, then reason must be specified (`extension.where(url = 'info-needed' and value = 'OTH').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')`) crd-ci-q8: If doc-purpose is present with a value other than 'conditional', then reason must be present (`extension.where(url = 'doc-purpose' and value != 'conditional').exists() implies extension.where(url = 'reason').exists()`) crd-ci-q9: If any of 'covered', 'pa-needed', or 'doc-needed' is set to 'indeterminate', then reason must be present to explain the issue that is preventing the payer from making a coverage determination. (`extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'indeterminate').count() >= 1 implies extension.where(url = 'reason').exists()`)
10. CommunicationRequest.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-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())
12. CommunicationRequest.identifier
Definition | Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Short | Unique identifier
Comments | 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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. CommunicationRequest.basedOn
Definition | A plan or proposal that is fulfilled in whole or in part by this request.
Short | Fulfills plan or proposal
Control | 10..1*
Type | Reference(Resource)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.
Alternate Names | fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. CommunicationRequest.replaces
Definition | Completed or terminated request(s) whose function is taken by this new request.
Short | Request(s) replaced by this request
Comments | potentially relevant for CRD in some situations. The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.
Control | 0..*
Type | Reference(CRD Communication Request, CommunicationRequest)
Is Modifier | false
Summary | true
Requirements | Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.
Alternate Names | supersedes, prior
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. CommunicationRequest.status
Definition | The status of the proposal or order.
Short | draft | 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, for order-dispatch or when referenced by an appointment.
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/request-status|4.0.1` ) The status of the communication request.
Type | code
Is Modifier | true because This element is labelled 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: draft
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. CommunicationRequest.doNotPerform
Definition | If true indicates that the CommunicationRequest is asking for the specified action to not occur.
Short | True if request is prohibiting action
Comments | The attributes provided with the request qualify what is not to be done.
Control | 0..01
Type | boolean
Is Modifier | true because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | prohibited
Meaning if Missing | If do not perform is not specified, the request is a positive request e.g. "do perform"
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. CommunicationRequest.subject
Definition | The patient or group that is the focus of this communication request.
Short | Focus of message
Control | 10..1
Type | Reference(CRD Patient, Patient, Group)
Is Modifier | false
Must Support | true
Summary | false
Alternate Names | patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. CommunicationRequest.encounter
Definition | The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.
Short | Encounter created as part of
Comments | potentially relevant for CRD in some situations. This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
Control | 0..1
Type | Reference(CRD Encounter, Encounter)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. CommunicationRequest.payload
Definition | Text, attachment(s), or resource(s) to be communicated to the recipient.
Short | Message payload
Control | 10..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. CommunicationRequest.payload.extension
Definition | An Extension 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.
Short | ExtensionAdditional 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.
Control | 10..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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())
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
30. CommunicationRequest.payload.extension:codeableConcept
Slice Name | codeableConcept
Definition | R5: `CommunicationRequest.payload.content[x]` additional types (CodeableConcept)
Short | R5: content additional types
Comments | If the actual communication request being authored is conveying resources or an attachment, the CRD client SHALL either determine a coded way to indicate what information sharing is being requested or shall omit sharing the CommunicationRequest - i.e. do not bother calling the hook service.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(R5: content additional types) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-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()`) ele-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())
32. CommunicationRequest.payload.extension:codeableConcept.extension
Definition | An Extension 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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`) ele-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())
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
34. CommunicationRequest.payload.extension:codeableConcept.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content`
36. CommunicationRequest.payload.extension:codeableConcept.value[x]
Definition | The communicated content (or for multi-part communications, one portion of the communication). Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Message part contentValue of extension
Comments | The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate. If the content isn't codified, contentCodeableConcept.text can be used. When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.
Control | 10..1
Type | CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. CommunicationRequest.payload.extension:codeableConcept.value[x].extension:BillingOptions
Slice Name | BillingOptions
Definition | Identifies billing codes that could potentially be used for this clinical code
Short | Expected Billing Code(s)
Comments | This will typically only be populated if the ordering and performing systems are the same
Control | 0..*
Type | Extension(Billing Options) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-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())
40. CommunicationRequest.payload.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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())
42. CommunicationRequest.payload.content[x]
Definition | The communicated content (or for multi-part communications, one portion of the communication).
Short | Message part content
Control | 1..1
Type | Choice of: string, Attachment, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. CommunicationRequest.occurrence[x]
Definition | The time when this communication is to occur.
Short | When scheduled
Control | 0..1
Type | Choice of: dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Alternate Names | timing
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. CommunicationRequest.authoredOn
Definition | For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.
Short | When request transitioned to being actionable
Control | 10..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Alternate Names | createdOn
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. CommunicationRequest.requester
Definition | The device, individual, or organization who initiated the request and has responsibility for its activation.
Short | Who/what is requesting service
Control | 10..1
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifier | false
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile)
Summary | true
Alternate Names | author
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. CommunicationRequest.recipient
Definition | The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.
Short | Message recipient
Control | 0..*
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Group, CareTeam, HealthcareService)
Is Modifier | false
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. CommunicationRequest.sender
Definition | The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.
Short | Message sender
Control | 0..1
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService)
Is Modifier | false
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. CommunicationRequest.reasonCode
Definition | Describes why the request is being made in coded or textual form.
Short | Why is communication needed?
Comments | Textual reasons can be captured using reasonCode.text.
Control | 0..*
Binding | For example codes, see ActReason (3.0.0)http://terminology.hl7.org/ValueSet/v3-ActReason (example to `http://terminology.hl7.org/ValueSet/v3-ActReason|3.0.0` ) Codes for describing reasons for the occurrence of a communication.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. CommunicationRequest.reasonReference
Definition | Indicates another resource whose existence justifies this request.
Short | Why is communication needed?
Comments | Observations SHOULD use US Core profiles when applicable, but not all relevant observations have appropriate US Core profiles (and there are too many to practically list all US Core profiles).
Control | 0..*
Type | Reference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core DiagnosticReport Profile for Laboratory Results Reporting, US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile, Observation, Condition, Observation, DiagnosticReport, DocumentReference)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-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 foundhere

0. CommunicationRequest
2. CommunicationRequest.contained
Comments | Any references found in this resource, with the exception of 'Patient' could potentially be resource-specific and thus transmitted as contained resources.
Must Support | true
4. CommunicationRequest.extension
Slicing | This element introduces a set of slices on `CommunicationRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. CommunicationRequest.extension:Coverage-Information
Slice Name | Coverage-Information
Control | 0..*
Type | Extension(Coverage Information) (Complex Extension)
Must Support | true
8. CommunicationRequest.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Must Support | true
10. CommunicationRequest.basedOn
Control | 1..1
Must Support | true
12. CommunicationRequest.replaces
Comments | potentially relevant for CRD in some situations.
Type | Reference(CRD Communication Request)
14. CommunicationRequest.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, for order-dispatch or when referenced by an appointment.
Must Support | true
Example | General: draft
16. CommunicationRequest.doNotPerform
Control | 0..0
18. CommunicationRequest.subject
Control | 1..?
Type | Reference(CRD Patient)
Must Support | true
20. CommunicationRequest.encounter
Comments | potentially relevant for CRD in some situations.
Type | Reference(CRD Encounter)
22. CommunicationRequest.payload
Control | 1..?
Must Support | true
24. CommunicationRequest.payload.extension
Control | 1..?
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
26. CommunicationRequest.payload.extension:codeableConcept
Slice Name | codeableConcept
Comments | If the actual communication request being authored is conveying resources or an attachment, the CRD client SHALL either determine a coded way to indicate what information sharing is being requested or shall omit sharing the CommunicationRequest - i.e. do not bother calling the hook service.
Control | 1..1
Type | Extension(R5: content additional types) (Extension Type: CodeableConcept)
Must Support | true
28. CommunicationRequest.payload.extension:codeableConcept.extension
Control | 0..0
30. CommunicationRequest.payload.extension:codeableConcept.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
32. CommunicationRequest.payload.extension:codeableConcept.value[x].extension:BillingOptions
Slice Name | BillingOptions
Short | Expected Billing Code(s)
Control | 0..*
Type | Extension(Billing Options) (Extension Type: CodeableConcept)
Must Support | true
34. CommunicationRequest.occurrence[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Must Support | true
36. CommunicationRequest.authoredOn
Control | 1..?
Must Support | true
38. CommunicationRequest.requester
Control | 1..?
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile)
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile)
40. CommunicationRequest.recipient
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
42. CommunicationRequest.sender
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
44. CommunicationRequest.reasonCode
Must Support | true
46. CommunicationRequest.reasonReference
Comments | Observations SHOULD use US Core profiles when applicable, but not all relevant observations have appropriate US Core profiles (and there are too many to practically list all US Core profiles).
Type | Reference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core DiagnosticReport Profile for Laboratory Results Reporting, US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile, Observation)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles

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

0. CommunicationRequest
Definition | A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.
Short | A request for information to be sent to a receiver
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-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. CommunicationRequest.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical 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.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. CommunicationRequest.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.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. CommunicationRequest.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.
Short | A 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.
Control | 0..1
Type | uri
Is Modifier | true 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 Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. CommunicationRequest.language
Definition | The base language in which the resource is written.
Short | Language 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).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. CommunicationRequest.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.
Short | Text 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.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. CommunicationRequest.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.
Short | Contained, inline Resources
Comments | Any references found in this resource, with the exception of 'Patient' could potentially be resource-specific and thus transmitted as contained resources.
Control | 0..*
Type | Resource
Is Modifier | false
Must Support | true
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. CommunicationRequest.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `CommunicationRequest.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. CommunicationRequest.extension:Coverage-Information
Slice Name | Coverage-Information
Definition | Indicates coverage information.
Short | CoverageInfo
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(Coverage Information) (Complex Extension)
Is Modifier | false
Must Support | true
Invariants | ele-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', 'noauth', or 'not-covered', then 'Doc-purpose' cannot be 'withpa'. (`extension.where(url = 'pa-needed' and (value = 'satisfied' or value = 'noauth' or value = 'not-covered')) 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 OTH, then reason must be specified (`extension.where(url = 'info-needed' and value = 'OTH').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')`) crd-ci-q8: If doc-purpose is present with a value other than 'conditional', then reason must be present (`extension.where(url = 'doc-purpose' and value != 'conditional').exists() implies extension.where(url = 'reason').exists()`) crd-ci-q9: If any of 'covered', 'pa-needed', or 'doc-needed' is set to 'indeterminate', then reason must be present to explain the issue that is preventing the payer from making a coverage determination. (`extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'indeterminate').count() >= 1 implies extension.where(url = 'reason').exists()`)
18. CommunicationRequest.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
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 Names | extensions, user content
Invariants | ele-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. CommunicationRequest.identifier
Definition | Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Short | Unique identifier
Comments | 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.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. CommunicationRequest.basedOn
Definition | A plan or proposal that is fulfilled in whole or in part by this request.
Short | Fulfills plan or proposal
Control | 1..1
Type | Reference(Resource)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.
Alternate Names | fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. CommunicationRequest.replaces
Definition | Completed or terminated request(s) whose function is taken by this new request.
Short | Request(s) replaced by this request
Comments | potentially relevant for CRD in some situations.
Control | 0..*
Type | Reference(CRD Communication Request)
Is Modifier | false
Summary | true
Requirements | Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.
Alternate Names | supersedes, prior
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. CommunicationRequest.groupIdentifier
Definition | A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.
Short | Composite request this is part of
Comments | Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Alternate Names | grouperId
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. CommunicationRequest.status
Definition | The status of the proposal or order.
Short | draft | 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, for order-dispatch or when referenced by an appointment.
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus (required to `http://hl7.org/fhir/ValueSet/request-status|4.0.1` ) The status of the communication request.
Type | code
Is Modifier | true because This element is labelled 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 Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Example | General: draft
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. CommunicationRequest.statusReason
Definition | Captures the reason for the current state of the CommunicationRequest.
Short | Reason for current status
Comments | This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].
Control | 0..1
Binding | Codes identifying the reason for the current state of a request.
Type | CodeableConcept
Is Modifier | false
Summary | false
Alternate Names | Suspended Reason, Cancelled Reason
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. CommunicationRequest.category
Definition | The type of message to be sent such as alert, notification, reminder, instruction, etc.
Short | Message category
Comments | There may be multiple axes of categorization and one communication request may serve multiple purposes.
Control | 0..*
Binding | For example codes, see CommunicationCategory (example to `http://hl7.org/fhir/ValueSet/communication-category|4.0.1` ) Codes for general categories of communications such as alerts, instruction, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. CommunicationRequest.priority
Definition | Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.
Short | routine | urgent | asap | stat
Control | 0..1
Binding | The codes SHALL be taken from RequestPriority (required to `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` ) Codes indicating the relative importance of a communication request.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Meaning if Missing | If missing, this task should be performed with normal priority
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. CommunicationRequest.doNotPerform
Definition | If true indicates that the CommunicationRequest is asking for the specified action to not occur.
Short | True if request is prohibiting action
Comments | The attributes provided with the request qualify what is not to be done.
Control | 0..0
Type | boolean
Is Modifier | true because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | prohibited
Meaning if Missing | If do not perform is not specified, the request is a positive request e.g. "do perform"
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. CommunicationRequest.medium
Definition | A channel that was used for this communication (e.g. email, fax).
Short | A channel of communication
Control | 0..*
Binding | For example codes, see ParticipationMode (3.0.0) (example to `http://terminology.hl7.org/ValueSet/v3-ParticipationMode|3.0.0` ) Codes for communication mediums such as phone, fax, email, in person, etc.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. CommunicationRequest.subject
Definition | The patient or group that is the focus of this communication request.
Short | Focus of message
Control | 1..1
Type | Reference(CRD Patient)
Is Modifier | false
Must Support | true
Summary | false
Alternate Names | patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. CommunicationRequest.about
Definition | Other resources that pertain to this communication request and to which this communication request should be associated.
Short | Resources that pertain to this communication request
Comments | Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. CommunicationRequest.encounter
Definition | The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.
Short | Encounter created as part of
Comments | potentially relevant for CRD in some situations.
Control | 0..1
Type | Reference(CRD Encounter)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. CommunicationRequest.payload
Definition | Text, attachment(s), or resource(s) to be communicated to the recipient.
Short | Message payload
Control | 1..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. CommunicationRequest.payload.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
50. CommunicationRequest.payload.extension
Definition | An Extension
Short | Extension
Control | 1..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
52. CommunicationRequest.payload.extension:codeableConcept
Slice Name | codeableConcept
Definition | R5: `CommunicationRequest.payload.content[x]` additional types (CodeableConcept)
Short | R5: content additional types
Comments | If the actual communication request being authored is conveying resources or an attachment, the CRD client SHALL either determine a coded way to indicate what information sharing is being requested or shall omit sharing the CommunicationRequest - i.e. do not bother calling the hook service.
Control | 1..1 This element is affected by the following invariants: ele-1
Type | Extension(R5: content additional types) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-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()`)
54. CommunicationRequest.payload.extension:codeableConcept.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
56. CommunicationRequest.payload.extension:codeableConcept.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
58. CommunicationRequest.payload.extension:codeableConcept.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content`
60. CommunicationRequest.payload.extension:codeableConcept.value[x]
Definition | The communicated content (or for multi-part communications, one portion of the communication).
Short | Message part content
Comments | The content can be codified or textual. As an example of codified content, when working with machine generated communications, the payload may be drawn from a finite, terminology defined set of communications, especially for short, status update kinds of communications where more of a natural language approach isn't appropriate. If the content isn't codified, contentCodeableConcept.text can be used. When using contentCodeableConcept, the CodeableConcept is what is being communicated and is not a categorization of the content.
Control | 1..1
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. CommunicationRequest.payload.extension:codeableConcept.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
64. CommunicationRequest.payload.extension:codeableConcept.value[x].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.
Short | Additional 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.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
66. CommunicationRequest.payload.extension:codeableConcept.value[x].extension:BillingOptions
Slice Name | BillingOptions
Definition | Identifies billing codes that could potentially be used for this clinical code
Short | Expected Billing Code(s)
Comments | This will typically only be populated if the ordering and performing systems are the same
Control | 0..*
Type | Extension(Billing Options) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-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()`)
68. CommunicationRequest.payload.extension:codeableConcept.value[x].coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 0..*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. CommunicationRequest.payload.extension:codeableConcept.value[x].text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. CommunicationRequest.payload.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).
Short | Extensions 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.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
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 Names | extensions, user content, modifiers
Invariants | ele-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()`)
74. CommunicationRequest.payload.content[x]
Definition | The communicated content (or for multi-part communications, one portion of the communication).
Short | Message part content
Control | 1..1
Type | Choice of: string, Attachment, Reference(Resource)
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. CommunicationRequest.occurrence[x]
Definition | The time when this communication is to occur.
Short | When scheduled
Control | 0..1
Type | Choice of: dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Alternate Names | timing
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. CommunicationRequest.authoredOn
Definition | For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.
Short | When request transitioned to being actionable
Control | 1..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Alternate Names | createdOn
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. CommunicationRequest.requester
Definition | The device, individual, or organization who initiated the request and has responsibility for its activation.
Short | Who/what is requesting service
Control | 1..1
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile)
Is Modifier | false
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile)
Summary | true
Alternate Names | author
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. CommunicationRequest.recipient
Definition | The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.
Short | Message recipient
Control | 0..*
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
Is Modifier | false
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. CommunicationRequest.sender
Definition | The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.
Short | Message sender
Control | 0..1
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
Is Modifier | false
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile, CRD Organization)
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. CommunicationRequest.reasonCode
Definition | Describes why the request is being made in coded or textual form.
Short | Why is communication needed?
Comments | Textual reasons can be captured using reasonCode.text.
Control | 0..*
Binding | For example codes, see ActReason (3.0.0) (example to `http://terminology.hl7.org/ValueSet/v3-ActReason|3.0.0` ) Codes for describing reasons for the occurrence of a communication.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. CommunicationRequest.reasonReference
Definition | Indicates another resource whose existence justifies this request.
Short | Why is communication needed?
Comments | Observations SHOULD use US Core profiles when applicable, but not all relevant observations have appropriate US Core profiles (and there are too many to practically list all US Core profiles).
Control | 0..*
Type | Reference(US Core Condition Problems and Health Concerns Profile, US Core Condition Encounter Diagnosis Profile, US Core DiagnosticReport Profile for Laboratory Results Reporting, US Core DiagnosticReport Profile for Report and Note Exchange, US Core DocumentReference Profile, Observation)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. CommunicationRequest.note
Definition | Comments made about the request by the requester, sender, recipient, subject or other participants.
Short | Comments made about communication request
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)