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 Vision Prescription - Detailed Descriptions

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

Definitions for the profile-visionprescription resource profile

- Key Elements Table
- Differential Table
- Snapshot Table

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

0. VisionPrescription
Definition | An authorization for the provision of glasses and/or contact lenses to a patient.
Short | Prescription for vision correction products for a patient
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. VisionPrescription.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. VisionPrescription.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. VisionPrescription.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 `VisionPrescription.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url value @ value
8. VisionPrescription.extension:Coverage-Information
Slice Name | Coverage-Information
Definition | Indicates coverage information.
Short | Coverage Info
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. VisionPrescription.extension:EncounterCategory
Slice Name | EncounterCategory
Definition | A high-level categorization of the type of request
Short | Encounter Category
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Request Category) (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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. VisionPrescription.extension:EncounterCategory.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())
Slicing | This element introduces a set of slices on `VisionPrescription.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
14. VisionPrescription.extension:EncounterCategory.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/us/davinci-crd/StructureDefinition/ext-request-category`
16. VisionPrescription.extension:EncounterCategory.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from For codes, see ActEncounterCode (3.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0` )
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()))
18. VisionPrescription.extension:ServiceCategory
Slice Name | ServiceCategory
Definition | A high-level categorization of the type of request
Short | Service Category
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Request Category) (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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
20. VisionPrescription.extension:ServiceCategory.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())
Slicing | This element introduces a set of slices on `VisionPrescription.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
22. VisionPrescription.extension:ServiceCategory.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/us/davinci-crd/StructureDefinition/ext-request-category`
24. VisionPrescription.extension:ServiceCategory.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from For codes, see X12 Service Type (required to `http://hl7.org/fhir/us/davinci-crd/ValueSet/X12ServiceType` )
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()))
26. VisionPrescription.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())
28. VisionPrescription.identifier
Definition | A unique identifier assigned to this vision prescription.
Short | Business Identifier for vision prescription
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | false
Requirements | Allows vision prescriptions to be distinguished and referenced.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. VisionPrescription.status
Definition | The status of the resource instance.
Short | active | cancelled | draft | entered-in-error
Comments | This will be 'draft' when using order-select or an initial order-sign, but may be 'active' or other values for order-sign representing edits to the order or for order-dispatch. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/fm-status|4.0.1` ) A code specifying the state of the resource instance.
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
Requirements | Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.
Example | General: draft
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. VisionPrescription.created
Definition | The date this resource was created.
Short | Response creation date
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
Requirements | Need to record a timestamp for use by both the recipient and the issuer.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. VisionPrescription.patient
Definition | A resource reference to the person to whom the vision prescription applies.
Short | Who prescription is for
Control | 1..1
Type | Reference(CRD Patient, Patient)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Needed to identify the patient for whom the vision prescription has been issued.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. VisionPrescription.encounter
Definition | A reference to a resource that identifies the particular occurrence of contact between patient and health care provider during which the prescription was issued.
Short | Created during encounter / admission / stay
Comments | potentially relevant for CRD in some situations.
Control | 0..1
Type | Reference(CRD Encounter, Encounter)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Used in some jurisdictions to link clinical events to claim items.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. VisionPrescription.dateWritten
Definition | The date (and perhaps time) when the prescription was written.
Short | When prescription was authorized
Comments | Jurisdictions determine the valid lifetime of a prescription. Typically vision prescriptions are valid for two years from the date written.
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
Requirements | Need to record a timestamp for use by both the recipient and the issuer.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. VisionPrescription.prescriber
Definition | The healthcare professional responsible for authorizing the prescription.
Short | Who authorized the vision prescription
Control | 1..1
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile, Practitioner, PractitionerRole)
Is Modifier | false
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile)
Summary | true
Requirements | Need to record the authorizing practitioner.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. VisionPrescription.lensSpecification
Definition | Contain the details of the individual lens specifications and serves as the authorization for the fullfillment by certified professionals.
Short | Vision lens authorization
Control | 1..*
Type | BackboneElement
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()))
44. VisionPrescription.lensSpecification.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..*
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 `VisionPrescription.lensSpecification.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
46. VisionPrescription.lensSpecification.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..* This element is affected by the following invariants: ele-1
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()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. VisionPrescription.lensSpecification.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())
50. VisionPrescription.lensSpecification.product
Definition | Identifies the type of vision correction product which is required for the patient.
Short | Product to be supplied
Control | 1..1
Binding | For example codes, see ExampleVisionPrescriptionProductCodes http://hl7.org/fhir/ValueSet/vision-product|4.0.1 (example to `http://hl7.org/fhir/ValueSet/vision-product|4.0.1` ) A coded concept describing the vision products.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Need to identify whether glasses or contacts.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. VisionPrescription.lensSpecification.eye
Definition | The eye for which the lens specification applies.
Short | right | left
Comments | May also appear as OD (oculus dexter) for the right eye and OS (oculus siniter) for the left eye.
Control | 1..1
Binding | The codes SHALL be taken from VisionEyes http://hl7.org/fhir/ValueSet/vision-eye-codes|4.0.1 (required to `http://hl7.org/fhir/ValueSet/vision-eye-codes|4.0.1` ) A coded concept listing the eye codes.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Needed to identify which eye the lens specification applies to.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. VisionPrescription.lensSpecification.sphere
Definition | Lens power measured in dioptres (0.25 units).
Short | Power of the lens
Comments | The value is negative for near-sighted and positive for far sighted. Often insurance will not cover a lens with power between +75 and -75.
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. VisionPrescription.lensSpecification.cylinder
Definition | Power adjustment for astigmatism measured in dioptres (0.25 units).
Short | Lens power for astigmatism
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. VisionPrescription.lensSpecification.axis
Definition | Adjustment for astigmatism measured in integer degrees.
Short | Lens meridian which contain no power for astigmatism
Comments | The limits are +180 and -180 degrees.
Control | 0..1
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. VisionPrescription.lensSpecification.prism
Definition | Allows for adjustment on two axis.
Short | Eye alignment compensation
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. VisionPrescription.lensSpecification.prism.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())
64. VisionPrescription.lensSpecification.prism.amount
Definition | Amount of prism to compensate for eye alignment in fractional units.
Short | Amount of adjustment
Control | 1..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. VisionPrescription.lensSpecification.prism.base
Definition | The relative base, or reference lens edge, for the prism.
Short | up | down | in | out
Control | 1..1
Binding | The codes SHALL be taken from VisionBase http://hl7.org/fhir/ValueSet/vision-base-codes|4.0.1 (required to `http://hl7.org/fhir/ValueSet/vision-base-codes|4.0.1` ) A coded concept listing the base codes.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. VisionPrescription.lensSpecification.add
Definition | Power adjustment for multifocal lenses measured in dioptres (0.25 units).
Short | Added power for multifocal levels
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. VisionPrescription.lensSpecification.power
Definition | Contact lens power measured in dioptres (0.25 units).
Short | Contact lens power
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard contact lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. VisionPrescription.lensSpecification.backCurve
Definition | Back curvature measured in millimetres.
Short | Contact lens back curvature
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard contact lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. VisionPrescription.lensSpecification.diameter
Definition | Contact lens diameter measured in millimetres.
Short | Contact lens diameter
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard contact lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. VisionPrescription.lensSpecification.duration
Definition | The recommended maximum wear period for the lens.
Short | Lens wear duration
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Standard contact lens prescription measures.
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. VisionPrescription
2. VisionPrescription.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. VisionPrescription.extension
Slicing | This element introduces a set of slices on `VisionPrescription.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url value @ value
6. VisionPrescription.extension:Coverage-Information
Slice Name | Coverage-Information
Short | Coverage Info
Control | 0..*
Type | Extension(Coverage Information) (Complex Extension)
Must Support | true
8. VisionPrescription.extension:EncounterCategory
Slice Name | EncounterCategory
Short | Encounter Category
Control | 0..1
Type | Extension(Request Category) (Extension Type: CodeableConcept)
Must Support | true
10. VisionPrescription.extension:EncounterCategory.value[x]
Binding | The codes SHALL be taken from ActEncounterCode (3.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0` )
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
12. VisionPrescription.extension:ServiceCategory
Slice Name | ServiceCategory
Short | Service Category
Control | 0..1
Type | Extension(Request Category) (Extension Type: CodeableConcept)
Must Support | true
14. VisionPrescription.extension:ServiceCategory.value[x]
Binding | The codes SHALL be taken from X12 Service Type (required to `http://hl7.org/fhir/us/davinci-crd/ValueSet/X12ServiceType` )
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
16. VisionPrescription.identifier
Note | This is a business identifier, not a resource identifier (see discussion)
Must Support | true
18. VisionPrescription.status
Comments | This will be 'draft' when using order-select or an initial order-sign, but may be 'active' or other values for order-sign representing edits to the order or for order-dispatch.
Must Support | true
Example | General: draft
20. VisionPrescription.created
Must Support | true
22. VisionPrescription.patient
Type | Reference(CRD Patient)
Must Support | true
24. VisionPrescription.encounter
Comments | potentially relevant for CRD in some situations.
Type | Reference(CRD Encounter)
Must Support | true
26. VisionPrescription.dateWritten
Must Support | true
28. VisionPrescription.prescriber
Type | Reference(CRD Practitioner, HRex PractitionerRole Profile)
Must Support | true
Must Support Types | Reference(CRD Practitioner, HRex PractitionerRole Profile)
30. VisionPrescription.lensSpecification
Must Support | true
32. VisionPrescription.lensSpecification.extension
Slicing | This element introduces a set of slices on `VisionPrescription.lensSpecification.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
34. VisionPrescription.lensSpecification.extension:BillingOptions
Slice Name | BillingOptions
Short | Expected Billing Code(s)
Control | 0..*
Type | Extension(Billing Options) (Extension Type: CodeableConcept)
Must Support | true
36. VisionPrescription.lensSpecification.product
Must Support | true
38. VisionPrescription.lensSpecification.eye
Must Support | true
40. VisionPrescription.lensSpecification.sphere
Must Support | true
42. VisionPrescription.lensSpecification.cylinder
Must Support | true
44. VisionPrescription.lensSpecification.axis
Must Support | true
46. VisionPrescription.lensSpecification.prism
Must Support | true
48. VisionPrescription.lensSpecification.prism.amount
Must Support | true
50. VisionPrescription.lensSpecification.prism.base
Must Support | true
52. VisionPrescription.lensSpecification.add
Must Support | true
54. VisionPrescription.lensSpecification.power
Must Support | true
56. VisionPrescription.lensSpecification.backCurve
Must Support | true
58. VisionPrescription.lensSpecification.diameter
Must Support | true
60. VisionPrescription.lensSpecification.duration
Must Support | true

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

0. VisionPrescription
Definition | An authorization for the provision of glasses and/or contact lenses to a patient.
Short | Prescription for vision correction products for a patient
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. VisionPrescription.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. VisionPrescription.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. VisionPrescription.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. VisionPrescription.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. VisionPrescription.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. VisionPrescription.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. VisionPrescription.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 `VisionPrescription.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url value @ value
16. VisionPrescription.extension:Coverage-Information
Slice Name | Coverage-Information
Definition | Indicates coverage information.
Short | Coverage Info
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. VisionPrescription.extension:EncounterCategory
Slice Name | EncounterCategory
Definition | A high-level categorization of the type of request
Short | Encounter Category
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Request Category) (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()`)
20. VisionPrescription.extension:EncounterCategory.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
22. VisionPrescription.extension:EncounterCategory.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 `VisionPrescription.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
24. VisionPrescription.extension:EncounterCategory.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/us/davinci-crd/StructureDefinition/ext-request-category`
26. VisionPrescription.extension:EncounterCategory.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from ActEncounterCode (3.0.0) (required to `http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0` )
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())`)
28. VisionPrescription.extension:ServiceCategory
Slice Name | ServiceCategory
Definition | A high-level categorization of the type of request
Short | Service Category
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Request Category) (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()`)
30. VisionPrescription.extension:ServiceCategory.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
32. VisionPrescription.extension:ServiceCategory.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 `VisionPrescription.extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
34. VisionPrescription.extension:ServiceCategory.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/us/davinci-crd/StructureDefinition/ext-request-category`
36. VisionPrescription.extension:ServiceCategory.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | Value of extension
Control | 0..1
Binding | The codes SHALL be taken from X12 Service Type (required to `http://hl7.org/fhir/us/davinci-crd/ValueSet/X12ServiceType` )
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())`)
38. VisionPrescription.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()`)
40. VisionPrescription.identifier
Definition | A unique identifier assigned to this vision prescription.
Short | Business Identifier for vision prescription
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | false
Requirements | Allows vision prescriptions to be distinguished and referenced.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. VisionPrescription.status
Definition | The status of the resource instance.
Short | active | cancelled | draft | entered-in-error
Comments | This will be 'draft' when using order-select or an initial order-sign, but may be 'active' or other values for order-sign representing edits to the order or for order-dispatch.
Control | 1..1
Binding | The codes SHALL be taken from FinancialResourceStatusCodes (required to `http://hl7.org/fhir/ValueSet/fm-status|4.0.1` ) A code specifying the state of the resource instance.
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
Requirements | Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.
Example | General: draft
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. VisionPrescription.created
Definition | The date this resource was created.
Short | Response creation date
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
Requirements | Need to record a timestamp for use by both the recipient and the issuer.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. VisionPrescription.patient
Definition | A resource reference to the person to whom the vision prescription applies.
Short | Who prescription is for
Control | 1..1
Type | Reference(CRD Patient)
Is Modifier | false
Must Support | true
Summary | true
Requirements | Needed to identify the patient for whom the vision prescription has been issued.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. VisionPrescription.encounter
Definition | A reference to a resource that identifies the particular occurrence of contact between patient and health care provider during which the prescription was issued.
Short | Created during encounter / admission / stay
Comments | potentially relevant for CRD in some situations.
Control | 0..1
Type | Reference(CRD Encounter)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Used in some jurisdictions to link clinical events to claim items.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. VisionPrescription.dateWritten
Definition | The date (and perhaps time) when the prescription was written.
Short | When prescription was authorized
Comments | Jurisdictions determine the valid lifetime of a prescription. Typically vision prescriptions are valid for two years from the date written.
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
Requirements | Need to record a timestamp for use by both the recipient and the issuer.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. VisionPrescription.prescriber
Definition | The healthcare professional responsible for authorizing the prescription.
Short | Who authorized the vision prescription
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
Requirements | Need to record the authorizing practitioner.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. VisionPrescription.lensSpecification
Definition | Contain the details of the individual lens specifications and serves as the authorization for the fullfillment by certified professionals.
Short | Vision lens authorization
Control | 1..*
Type | BackboneElement
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. VisionPrescription.lensSpecification.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
58. VisionPrescription.lensSpecification.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 `VisionPrescription.lensSpecification.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
60. VisionPrescription.lensSpecification.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..* This element is affected by the following invariants: ele-1
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()`)
62. VisionPrescription.lensSpecification.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()`)
64. VisionPrescription.lensSpecification.product
Definition | Identifies the type of vision correction product which is required for the patient.
Short | Product to be supplied
Control | 1..1
Binding | For example codes, see ExampleVisionPrescriptionProductCodes (example to `http://hl7.org/fhir/ValueSet/vision-product|4.0.1` ) A coded concept describing the vision products.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | true
Requirements | Need to identify whether glasses or contacts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. VisionPrescription.lensSpecification.eye
Definition | The eye for which the lens specification applies.
Short | right | left
Comments | May also appear as OD (oculus dexter) for the right eye and OS (oculus siniter) for the left eye.
Control | 1..1
Binding | The codes SHALL be taken from VisionEyes (required to `http://hl7.org/fhir/ValueSet/vision-eye-codes|4.0.1` ) A coded concept listing the eye codes.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | true
Requirements | Needed to identify which eye the lens specification applies to.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. VisionPrescription.lensSpecification.sphere
Definition | Lens power measured in dioptres (0.25 units).
Short | Power of the lens
Comments | The value is negative for near-sighted and positive for far sighted. Often insurance will not cover a lens with power between +75 and -75.
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. VisionPrescription.lensSpecification.cylinder
Definition | Power adjustment for astigmatism measured in dioptres (0.25 units).
Short | Lens power for astigmatism
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. VisionPrescription.lensSpecification.axis
Definition | Adjustment for astigmatism measured in integer degrees.
Short | Lens meridian which contain no power for astigmatism
Comments | The limits are +180 and -180 degrees.
Control | 0..1
Type | integer
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. VisionPrescription.lensSpecification.prism
Definition | Allows for adjustment on two axis.
Short | Eye alignment compensation
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. VisionPrescription.lensSpecification.prism.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
78. VisionPrescription.lensSpecification.prism.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()`)
80. VisionPrescription.lensSpecification.prism.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()`)
82. VisionPrescription.lensSpecification.prism.amount
Definition | Amount of prism to compensate for eye alignment in fractional units.
Short | Amount of adjustment
Control | 1..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. VisionPrescription.lensSpecification.prism.base
Definition | The relative base, or reference lens edge, for the prism.
Short | up | down | in | out
Control | 1..1
Binding | The codes SHALL be taken from VisionBase (required to `http://hl7.org/fhir/ValueSet/vision-base-codes|4.0.1` ) A coded concept listing the base codes.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
86. VisionPrescription.lensSpecification.add
Definition | Power adjustment for multifocal lenses measured in dioptres (0.25 units).
Short | Added power for multifocal levels
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
88. VisionPrescription.lensSpecification.power
Definition | Contact lens power measured in dioptres (0.25 units).
Short | Contact lens power
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard contact lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
90. VisionPrescription.lensSpecification.backCurve
Definition | Back curvature measured in millimetres.
Short | Contact lens back curvature
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard contact lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. VisionPrescription.lensSpecification.diameter
Definition | Contact lens diameter measured in millimetres.
Short | Contact lens diameter
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Requirements | Standard contact lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. VisionPrescription.lensSpecification.duration
Definition | The recommended maximum wear period for the lens.
Short | Lens wear duration
Control | 0..1
Type | Quantity(SimpleQuantity)
Is Modifier | false
Must Support | true
Summary | false
Requirements | Standard contact lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. VisionPrescription.lensSpecification.color
Definition | Special color or pattern.
Short | Color required
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Standard contact lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. VisionPrescription.lensSpecification.brand
Definition | Brand recommendations or restrictions.
Short | Brand required
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. VisionPrescription.lensSpecification.note
Definition | Notes for special requirements such as coatings and lens materials.
Short | Notes for coatings
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Requirements | Standard lens prescription measures.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)