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

## Resource Profile: CRD Communication Request

Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-communicationrequest | Version: 2.2.0-snapshot | Highlight text changes?
Standards status: Trial-use Active as of 2026-02-19 | Maturity Level: 1 | Computable Name: CRDCommunicationRequest
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.42.6

This profile specifies constraints on the CommunicationRequest resource to support coverage requirements discovery.

### Usage

CRD Clients SHALL use the CRD CommunicationRequest profile to resolve references to CommunicationRequest resources passed to CRD Servers (e.g. `selections` context references) and to populate `draftOrders` context objects when invoking the following CDS Hooks: §prof-3

- order-select
- order-sign
- order-dispatch

!

Information provided in Must Support elements will commonly be required for CRD Servers to perform coverage requirements discovery.

Usages:

- Use this Profile: CRD CDSHooks Additional Orders Response (Logical Definition), CRD CDSHooks Alternate Request Response (Logical Definition), CRD CDSHooks Coverage Information Response (Logical Definition) and CRD Bundle of Request Resources
- Refer to this Profile: Coverage Information and CRD Communication Request
- CapabilityStatements using this Profile: CRD Client USCDI 1, CRD Client USCDI 3 and CRD Client USCDI 4

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CommunicationRequest |  | 0..* | CommunicationRequest | A request for information to be sent to a receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Coverage-Information | S C | 0..* | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Unique identifier
basedOn | S Σ | 1..1 | Reference(Resource) | Fulfills plan or proposal
replaces | Σ | 0..* | Reference(CRD Communication Request) | Request(s) replaced by this request
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. Example General: draft
subject | S | 1..1 | Reference(CRD Patient) | Focus of message
encounter | Σ | 0..1 | Reference(CRD Encounter) | Encounter created as part of
payload | S | 1..* | BackboneElement | Message payload
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:codeableConcept | S | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D]] | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content[x]"
value[x] |  | 1..1 | CodeableConcept | Value of extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
content[x] |  | 1..1 |  | Message part content
contentString |  |  | string |
contentAttachment |  |  | Attachment |
contentReference |  |  | Reference(Resource) |
occurrence[x] | S Σ | 0..1 |  | When scheduled
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
authoredOn | S Σ | 1..1 | dateTime | When request transitioned to being actionable
requester | S Σ | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who/what is requesting service
recipient | S | 0..* | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message recipient
sender | S Σ | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message sender
reasonCode | S Σ | 0..* | CodeableConcept | Why is communication needed? Binding: ActReason (3.0.0) (example): Codes for describing reasons for the occurrence of a communication.
reasonReference | S Σ | 0..* | Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) | US Core Condition Encounter Diagnosis Profile(7.0.0) | US Core DiagnosticReport Profile for Laboratory Results Reporting(7.0.0) | US Core DiagnosticReport Profile for Report and Note Exchange(7.0.0) | US Core DocumentReference Profile(7.0.0) | Observation) | Why is communication needed?
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
CommunicationRequest.​status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
CommunicationRequest.​reasonCode | Base | example | v3 Code System ActReason | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
crd-ci-q1 | error | CommunicationRequest.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists | `extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()`
crd-ci-q2 | error | CommunicationRequest.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. | `extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()`
crd-ci-q3 | error | CommunicationRequest.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()`
crd-ci-q4 | error | CommunicationRequest.extension:Coverage-Information | 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 | error | CommunicationRequest.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. | `extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()`
crd-ci-q6 | error | CommunicationRequest.extension:Coverage-Information | 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 | error | CommunicationRequest.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present | `extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')`
crd-ci-q8 | error | CommunicationRequest.extension:Coverage-Information | 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()`
dom-2 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | CommunicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CommunicationRequest |  |  | CommunicationRequest |
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Coverage-Information | S | 0..* | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
identifier | S | 0..* | Identifier | Unique identifier
basedOn | S | 1..1 | Reference(Resource) | Fulfills plan or proposal
replaces |  | 0..* | Reference(CRD Communication Request) | Request(s) replaced by this request
status | S | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Example General: draft
doNotPerform |  | 0..0 |  | True if request is prohibiting action
subject | S | 1..1 | Reference(CRD Patient) | Focus of message
encounter |  | 0..1 | Reference(CRD Encounter) | Encounter created as part of
payload | S | 1..* | BackboneElement | Message payload
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:codeableConcept | S | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D]] | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D
value[x] |  | 1..1 | CodeableConcept | Value of extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
occurrence[x] | S | 0..1 | dateTime, Period | When scheduled
authoredOn | S | 1..1 | dateTime | When request transitioned to being actionable
requester | S | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who/what is requesting service
recipient | S | 0..* | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message recipient
sender | S | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message sender
reasonCode | S | 0..* | CodeableConcept | Why is communication needed?
reasonReference | S | 0..* | Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) | US Core Condition Encounter Diagnosis Profile(7.0.0) | US Core DiagnosticReport Profile for Laboratory Results Reporting(7.0.0) | US Core DiagnosticReport Profile for Report and Note Exchange(7.0.0) | US Core DocumentReference Profile(7.0.0) | Observation) | Why is communication needed?
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CommunicationRequest |  | 0..* | CommunicationRequest | A request for information to be sent to a receiver
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Coverage-Information | S C | 0..* | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Unique identifier
basedOn | S Σ | 1..1 | Reference(Resource) | Fulfills plan or proposal
replaces | Σ | 0..* | Reference(CRD Communication Request) | Request(s) replaced by this request
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. Example General: draft
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding Description: (example): Codes identifying the reason for the current state of a request.
category |  | 0..* | CodeableConcept | Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instruction, etc.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication request.
medium |  | 0..* | CodeableConcept | A channel of communication Binding: ParticipationMode (3.0.0) (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject | S | 1..1 | Reference(CRD Patient) | Focus of message
about |  | 0..* | Reference(Resource) | Resources that pertain to this communication request
encounter | Σ | 0..1 | Reference(CRD Encounter) | Encounter created as part of
payload | S | 1..* | BackboneElement | Message payload
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:codeableConcept | S | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D]] | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content[x]"
value[x] |  | 1..1 | CodeableConcept | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
content[x] |  | 1..1 |  | Message part content
contentString |  |  | string |
contentAttachment |  |  | Attachment |
contentReference |  |  | Reference(Resource) |
occurrence[x] | S Σ | 0..1 |  | When scheduled
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
authoredOn | S Σ | 1..1 | dateTime | When request transitioned to being actionable
requester | S Σ | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who/what is requesting service
recipient | S | 0..* | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message recipient
sender | S Σ | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message sender
reasonCode | S Σ | 0..* | CodeableConcept | Why is communication needed? Binding: ActReason (3.0.0) (example): Codes for describing reasons for the occurrence of a communication.
reasonReference | S Σ | 0..* | Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) | US Core Condition Encounter Diagnosis Profile(7.0.0) | US Core DiagnosticReport Profile for Laboratory Results Reporting(7.0.0) | US Core DiagnosticReport Profile for Report and Note Exchange(7.0.0) | US Core DocumentReference Profile(7.0.0) | Observation) | Why is communication needed?
note |  | 0..* | Annotation | Comments made about communication request
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
CommunicationRequest.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
CommunicationRequest.​status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
CommunicationRequest.​statusReason | Base | example |  | Not State | Unknown
CommunicationRequest.​category | Base | example | CommunicationCategory | 📍4.0.1 | FHIR Std.
CommunicationRequest.​priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
CommunicationRequest.​medium | Base | example | ParticipationMode | 📍3.0.0 | THO v7.0
CommunicationRequest.​reasonCode | Base | example | v3 Code System ActReason | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
crd-ci-q1 | error | CommunicationRequest.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists | `extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()`
crd-ci-q2 | error | CommunicationRequest.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. | `extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()`
crd-ci-q3 | error | CommunicationRequest.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()`
crd-ci-q4 | error | CommunicationRequest.extension:Coverage-Information | 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 | error | CommunicationRequest.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. | `extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()`
crd-ci-q6 | error | CommunicationRequest.extension:Coverage-Information | 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 | error | CommunicationRequest.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present | `extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')`
crd-ci-q8 | error | CommunicationRequest.extension:Coverage-Information | 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()`
dom-2 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | CommunicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Mandatory: 7 elements
Must-Support: 16 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- CRD Communication Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-communicationrequest)
- CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
- CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)
- CRD Practitioner (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner)
- HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)
- CRD Organization (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization)
- US Core Condition Problems and Health Concerns Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|7.0.0)
- US Core Condition Encounter Diagnosis Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis|7.0.0)
- US Core DiagnosticReport Profile for Laboratory Results Reporting (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab|7.0.0)
- US Core DiagnosticReport Profile for Report and Note Exchange (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note|7.0.0)
- US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|7.0.0)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
- Unable to summarise extension http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D (no extension found)
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CommunicationRequest |  | 0..* | CommunicationRequest | A request for information to be sent to a receiver
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Coverage-Information | S C | 0..* | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Unique identifier
basedOn | S Σ | 1..1 | Reference(Resource) | Fulfills plan or proposal
replaces | Σ | 0..* | Reference(CRD Communication Request) | Request(s) replaced by this request
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. Example General: draft
subject | S | 1..1 | Reference(CRD Patient) | Focus of message
encounter | Σ | 0..1 | Reference(CRD Encounter) | Encounter created as part of
payload | S | 1..* | BackboneElement | Message payload
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:codeableConcept | S | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D]] | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content[x]"
value[x] |  | 1..1 | CodeableConcept | Value of extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
content[x] |  | 1..1 |  | Message part content
contentString |  |  | string |
contentAttachment |  |  | Attachment |
contentReference |  |  | Reference(Resource) |
occurrence[x] | S Σ | 0..1 |  | When scheduled
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
authoredOn | S Σ | 1..1 | dateTime | When request transitioned to being actionable
requester | S Σ | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who/what is requesting service
recipient | S | 0..* | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message recipient
sender | S Σ | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message sender
reasonCode | S Σ | 0..* | CodeableConcept | Why is communication needed? Binding: ActReason (3.0.0) (example): Codes for describing reasons for the occurrence of a communication.
reasonReference | S Σ | 0..* | Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) | US Core Condition Encounter Diagnosis Profile(7.0.0) | US Core DiagnosticReport Profile for Laboratory Results Reporting(7.0.0) | US Core DiagnosticReport Profile for Report and Note Exchange(7.0.0) | US Core DocumentReference Profile(7.0.0) | Observation) | Why is communication needed?
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
CommunicationRequest.​status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
CommunicationRequest.​reasonCode | Base | example | v3 Code System ActReason | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
crd-ci-q1 | error | CommunicationRequest.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists | `extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()`
crd-ci-q2 | error | CommunicationRequest.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. | `extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()`
crd-ci-q3 | error | CommunicationRequest.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()`
crd-ci-q4 | error | CommunicationRequest.extension:Coverage-Information | 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 | error | CommunicationRequest.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. | `extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()`
crd-ci-q6 | error | CommunicationRequest.extension:Coverage-Information | 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 | error | CommunicationRequest.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present | `extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')`
crd-ci-q8 | error | CommunicationRequest.extension:Coverage-Information | 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()`
dom-2 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | CommunicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CommunicationRequest |  |  | CommunicationRequest |
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Coverage-Information | S | 0..* | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
identifier | S | 0..* | Identifier | Unique identifier
basedOn | S | 1..1 | Reference(Resource) | Fulfills plan or proposal
replaces |  | 0..* | Reference(CRD Communication Request) | Request(s) replaced by this request
status | S | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Example General: draft
doNotPerform |  | 0..0 |  | True if request is prohibiting action
subject | S | 1..1 | Reference(CRD Patient) | Focus of message
encounter |  | 0..1 | Reference(CRD Encounter) | Encounter created as part of
payload | S | 1..* | BackboneElement | Message payload
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:codeableConcept | S | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D]] | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D
value[x] |  | 1..1 | CodeableConcept | Value of extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
occurrence[x] | S | 0..1 | dateTime, Period | When scheduled
authoredOn | S | 1..1 | dateTime | When request transitioned to being actionable
requester | S | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who/what is requesting service
recipient | S | 0..* | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message recipient
sender | S | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message sender
reasonCode | S | 0..* | CodeableConcept | Why is communication needed?
reasonReference | S | 0..* | Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) | US Core Condition Encounter Diagnosis Profile(7.0.0) | US Core DiagnosticReport Profile for Laboratory Results Reporting(7.0.0) | US Core DiagnosticReport Profile for Report and Note Exchange(7.0.0) | US Core DocumentReference Profile(7.0.0) | Observation) | Why is communication needed?
Documentation for this format

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
CommunicationRequest |  | 0..* | CommunicationRequest | A request for information to be sent to a receiver
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:Coverage-Information | S C | 0..* | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Unique identifier
basedOn | S Σ | 1..1 | Reference(Resource) | Fulfills plan or proposal
replaces | Σ | 0..* | Reference(CRD Communication Request) | Request(s) replaced by this request
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of the communication request. Example General: draft
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding Description: (example): Codes identifying the reason for the current state of a request.
category |  | 0..* | CodeableConcept | Message category Binding: CommunicationCategory (example): Codes for general categories of communications such as alerts, instruction, etc.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Codes indicating the relative importance of a communication request.
medium |  | 0..* | CodeableConcept | A channel of communication Binding: ParticipationMode (3.0.0) (example): Codes for communication mediums such as phone, fax, email, in person, etc.
subject | S | 1..1 | Reference(CRD Patient) | Focus of message
about |  | 0..* | Reference(Resource) | Resources that pertain to this communication request
encounter | Σ | 0..1 | Reference(CRD Encounter) | Encounter created as part of
payload | S | 1..* | BackboneElement | Message payload
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:codeableConcept | S | 1..1 | ?gen-e1? [CanonicalType[http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D]] | Optional Extensions Element URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content[x]"
value[x] |  | 1..1 | CodeableConcept | Value of extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
content[x] |  | 1..1 |  | Message part content
contentString |  |  | string |
contentAttachment |  |  | Attachment |
contentReference |  |  | Reference(Resource) |
occurrence[x] | S Σ | 0..1 |  | When scheduled
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
authoredOn | S Σ | 1..1 | dateTime | When request transitioned to being actionable
requester | S Σ | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who/what is requesting service
recipient | S | 0..* | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message recipient
sender | S Σ | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S | CRD Organization S) | Message sender
reasonCode | S Σ | 0..* | CodeableConcept | Why is communication needed? Binding: ActReason (3.0.0) (example): Codes for describing reasons for the occurrence of a communication.
reasonReference | S Σ | 0..* | Reference(US Core Condition Problems and Health Concerns Profile(7.0.0) | US Core Condition Encounter Diagnosis Profile(7.0.0) | US Core DiagnosticReport Profile for Laboratory Results Reporting(7.0.0) | US Core DiagnosticReport Profile for Report and Note Exchange(7.0.0) | US Core DocumentReference Profile(7.0.0) | Observation) | Why is communication needed?
note |  | 0..* | Annotation | Comments made about communication request
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
CommunicationRequest.​language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
CommunicationRequest.​status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
CommunicationRequest.​statusReason | Base | example |  | Not State | Unknown
CommunicationRequest.​category | Base | example | CommunicationCategory | 📍4.0.1 | FHIR Std.
CommunicationRequest.​priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
CommunicationRequest.​medium | Base | example | ParticipationMode | 📍3.0.0 | THO v7.0
CommunicationRequest.​reasonCode | Base | example | v3 Code System ActReason | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
crd-ci-q1 | error | CommunicationRequest.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists | `extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()`
crd-ci-q2 | error | CommunicationRequest.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. | `extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()`
crd-ci-q3 | error | CommunicationRequest.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()`
crd-ci-q4 | error | CommunicationRequest.extension:Coverage-Information | 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 | error | CommunicationRequest.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. | `extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()`
crd-ci-q6 | error | CommunicationRequest.extension:Coverage-Information | 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 | error | CommunicationRequest.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present | `extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')`
crd-ci-q8 | error | CommunicationRequest.extension:Coverage-Information | 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()`
dom-2 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | CommunicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | CommunicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | CommunicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Mandatory: 7 elements
Must-Support: 16 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- CRD Communication Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-communicationrequest)
- CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
- CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)
- CRD Practitioner (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner)
- HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)
- CRD Organization (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization)
- US Core Condition Problems and Health Concerns Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns|7.0.0)
- US Core Condition Encounter Diagnosis Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-encounter-diagnosis|7.0.0)
- US Core DiagnosticReport Profile for Laboratory Results Reporting (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab|7.0.0)
- US Core DiagnosticReport Profile for Report and Note Exchange (http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note|7.0.0)
- US Core DocumentReference Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference|7.0.0)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
- Unable to summarise extension http://hl7.org/fhir/5.0/StructureDefinition/extension-CommunicationRequest.payload.content%5Bx%5D (no extension found)
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options

Maturity: 1

Other representations of profile: CSV, Excel, Schematron