Da Vinci - Coverage Requirements Discovery
2.2.0-snapshot - STU 2.2 Peer Review

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 2.2.0-snapshot 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

## : ServiceRequest example

Page standards status: Informative

Raw xml | Download

    <ServiceRequest xmlns="http://hl7.org/fhir">
      <id value="example"/>
      <language value="en"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><p class="res-header-id"><b>Generated Narrative: ServiceRequest example</b></p><a name="example"> </a><a name="hcexample"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: en</p></div><p><b>basedOn</b>: <a href="http://example.org/fhir/ServiceRequest/someReferral">http://example.org/fhir/ServiceRequest/someReferral</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Order</p><p><b>code</b>: <span title="Codes:{http://snomed.info/sct 25267002}">Implant Pacemaker</span></p><p><b>subject</b>: <a href="Patient-example.html">Amy V. Shaw  Female, DoB: 1987-02-20 ( Medical Record Number: 1032702 (use: usual, ))</a></p><p><b>authoredOn</b>: 2015-03-30</p><p><b>requester</b>: <a href="Practitioner-full.html">Dr. Beverly Crusher</a></p><p><b>performer</b>: <a href="http://example.org/fhir/Practitioner/full2">Dr Cecil Surgeon</a></p><p><b>locationReference</b>: <a href="Location-example.html">Location South Wing, second floor</a></p><p><b>reasonCode</b>: <span title="Codes:{http://snomed.info/sct 48867003}">Bradycardia</span></p></div>
      </text>
      <basedOn>
        <reference value="http://example.org/fhir/ServiceRequest/someReferral"/>
      </basedOn>
      <status value="draft"/>
      <intent value="order"/>
      <code>
        <extension
                   url="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options">
          <valueCodeableConcept>
            <coding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="0795T"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options">
          <valueCodeableConcept>
            <coding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="0796T"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options">
          <valueCodeableConcept>
            <coding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="0797T"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options">
          <valueCodeableConcept>
            <coding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="0804T"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options">
          <valueCodeableConcept>
            <coding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="0823T"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options">
          <valueCodeableConcept>
            <coding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="0915T"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="25267002"/>
          <display value="Insertion of intracardiac pacemaker (procedure)"/>
        </coding>
        <text value="Implant Pacemaker"/>
      </code>
      <subject>🔗
        <reference value="Patient/example"/>
      </subject>
      <authoredOn value="2015-03-30"/>
      <requester>🔗
        <reference value="Practitioner/full"/>
        <display value="Dr. Beverly Crusher"/>
      </requester>
      <performer>
        <reference value="http://example.org/fhir/Practitioner/full2"/>
        <display value="Dr Cecil Surgeon"/>
      </performer>
      <locationReference>🔗
        <reference value="Location/example"/>
      </locationReference>
      <reasonCode>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="48867003"/>
          <display value="Bradycardia"/>
        </coding>
      </reasonCode>
    </ServiceRequest>