Da Vinci - Coverage Requirements Discovery
​2.2.0-ballot - United States of America flag

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-ballot 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

Logical Model: CRD Metric Data

Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/CRDMetricData Version: 2.2.0-ballot
Standards status: Informative Active as of 2025-10-30 Maturity Level: 1 Computable Name: CRDMetricData
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.42.1

A logical model describing the information that should be captured by CRD implementers about every CRD invocation to support measures evaluating CRD implementation

This model is NOT a FHIR data structure for information exchange. Instead, it is a logical model of the information that SHOULD be collected and maintained for each CRD transaction. While implementers may choose any internal storage format that is appropriate for their system, the information collected should ultimately be mapped to the information model below.

Mapping implementation data to these elements will allow metrics (see the table on the metrics page) to be represented in a way that provides consistent responses to requirements from various interested parties (providers, payers, regulators, quality organizations, certification agencies, states, etc.) by each of the participants in the CRD exchanges.

Usages:

  • This Logical Model is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CRDMetricData 0..* Base CRD Metric Data
... source 1..1 code provider-src | payer-src
Binding: CRD Metric Data Source Value Set (required)
... hookInstance 1..1 string Unique hook invocation id
... hookType 1..1 code order-select | order-sign +
Binding: CDS Hook Types Value Set (extensible)
.... system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value 1..1 string The value that is unique
... groupId 1..1 Identifier Healthcare org of user
.... system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value 1..1 string The value that is unique
... payerId 1..1 Identifier Payer receiving hook
.... system 1..1 uri The namespace for the identifier value
.... value 1..1 string The value that is unique
... requestTime 1..1 instant Time hook initiated
... responseTime 0..1 instant Time of hook response
... httpResponse 1..1 positiveInt e.g. 200
... issue 0..* BackboneElement OperationOutcome info
.... code 1..1 code Error code
Binding: IssueType (required)
.... details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
... tokenUse 1..1 code used | not-used | rejected
Binding: CRD Metric Token Use Value Set (example)
... orderDetail 0..* CodeableConcept Service or product code(s)
Binding: CRD Order Detail Codes Value Set (extensible)
... resources 0..* BackboneElement Resource types accessed
.... type 1..1 code Kind of resource
Binding: ResourceType (required)
.... profile 0..1 canonical(StructureDefinition) Solicited profile
.... count 1..1 positiveInt Number retrieved
.... prefetch 0..1 boolean Retrieved by prefetch?
... response 0..* BackboneElement Returned card/system action
.... type 0..1 code Type of CRD card
Binding: CRD Card Types Value Set (required)
.... focus 0..* code Resource tied to card
.... engagement 0..1 code ignore | accept | override
.... coverageInfo 0..* BackboneElement Coverage information
..... covered 0..1 code covered | not-covered | conditional
Binding: CRD Coverage Information Covered Value Set (required)
..... paNeeded 0..1 code auth-needed | no-auth | satisfied +
Binding: CRD Coverage Information Prior Authorization Value Set (required)
..... docNeeded 0..1 code no-doc | clinical | admin | both +
Binding: CRD Coverage Information Additional Documentation Value Set (required)
..... infoNeeded 0..1 code performer | location | timeframe
Binding: CRD Information Needed Value Set (required)
..... questionnaire 0..* BackboneElement Questionnaire(s) returned
...... reference 1..1 canonical(Questionnaire) Questionnaire url & version
...... adaptive 1..1 boolean Is questionnaire adaptive?
...... response 1..1 boolean Pre-pop response provided?
..... assertionId 1..1 string Id for coverage assertion
..... satisfiedId 0..1 string Id if PA is satisfied
..... businessLine 0..1 CodeableConcept E.g. Medicare Advantage

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
CRDMetricData.source Base required CRD Metric Data Source Value Set 📦2.2.0-ballot This IG
CRDMetricData.hookType Base extensible CDS Hook Types Value Set 📦2.2.0-ballot This IG
CRDMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
CRDMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.
CRDMetricData.tokenUse Base example CRD Metric Token Use Value Set 📦2.2.0-ballot This IG
CRDMetricData.orderDetail Base extensible CRD Order Detail Codes Value Set 📦2.2.0-ballot This IG
CRDMetricData.resources.​type Base required ResourceType 📦4.0.1 FHIR Std.
CRDMetricData.response.​type Base required CRD Card Types Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.covered Base required CRD Coverage Information Covered Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.paNeeded Base required CRD Coverage Information Prior Authorization Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.docNeeded Base required CRD Coverage Information Additional Documentation Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.infoNeeded Base required CRD Information Needed Value Set 📦2.2.0-ballot This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CRDMetricData 0..* Base CRD Metric Data
... source 1..1 code provider-src | payer-src
Binding: CRD Metric Data Source Value Set (required)
... hookInstance 1..1 string Unique hook invocation id
... hookType 1..1 code order-select | order-sign +
Binding: CDS Hook Types Value Set (extensible)
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... groupId 1..1 Identifier Healthcare org of user
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... payerId 1..1 Identifier Payer receiving hook
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... requestTime 1..1 instant Time hook initiated
... responseTime 0..1 instant Time of hook response
... httpResponse 1..1 positiveInt e.g. 200
... issue 0..* BackboneElement OperationOutcome info
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 code Error code
Binding: IssueType (required)
.... details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
... tokenUse 1..1 code used | not-used | rejected
Binding: CRD Metric Token Use Value Set (example)
... orderDetail 0..* CodeableConcept Service or product code(s)
Binding: CRD Order Detail Codes Value Set (extensible)
... resources 0..* BackboneElement Resource types accessed
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 code Kind of resource
Binding: ResourceType (required)
.... profile 0..1 canonical(StructureDefinition) Solicited profile
.... count 1..1 positiveInt Number retrieved
.... prefetch 0..1 boolean Retrieved by prefetch?
... response 0..* BackboneElement Returned card/system action
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 0..1 code Type of CRD card
Binding: CRD Card Types Value Set (required)
.... focus 0..* code Resource tied to card
.... engagement 0..1 code ignore | accept | override
.... coverageInfo 0..* BackboneElement Coverage information
..... @id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... covered 0..1 code covered | not-covered | conditional
Binding: CRD Coverage Information Covered Value Set (required)
..... paNeeded 0..1 code auth-needed | no-auth | satisfied +
Binding: CRD Coverage Information Prior Authorization Value Set (required)
..... docNeeded 0..1 code no-doc | clinical | admin | both +
Binding: CRD Coverage Information Additional Documentation Value Set (required)
..... infoNeeded 0..1 code performer | location | timeframe
Binding: CRD Information Needed Value Set (required)
..... questionnaire 0..* BackboneElement Questionnaire(s) returned
...... @id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... reference 1..1 canonical(Questionnaire) Questionnaire url & version
...... adaptive 1..1 boolean Is questionnaire adaptive?
...... response 1..1 boolean Pre-pop response provided?
..... assertionId 1..1 string Id for coverage assertion
..... satisfiedId 0..1 string Id if PA is satisfied
..... businessLine 0..1 CodeableConcept E.g. Medicare Advantage

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CRDMetricData.source Base required CRD Metric Data Source Value Set 📦2.2.0-ballot This IG
CRDMetricData.hookType Base extensible CDS Hook Types Value Set 📦2.2.0-ballot This IG
CRDMetricData.providerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CRDMetricData.providerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
CRDMetricData.groupId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CRDMetricData.groupId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
CRDMetricData.payerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CRDMetricData.payerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
CRDMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
CRDMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.
CRDMetricData.tokenUse Base example CRD Metric Token Use Value Set 📦2.2.0-ballot This IG
CRDMetricData.orderDetail Base extensible CRD Order Detail Codes Value Set 📦2.2.0-ballot This IG
CRDMetricData.resources.​type Base required ResourceType 📦4.0.1 FHIR Std.
CRDMetricData.response.​type Base required CRD Card Types Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.covered Base required CRD Coverage Information Covered Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.paNeeded Base required CRD Coverage Information Prior Authorization Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.docNeeded Base required CRD Coverage Information Additional Documentation Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.infoNeeded Base required CRD Information Needed Value Set 📦2.2.0-ballot This IG

Constraints

Id Grade Path(s) Description Expression
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: 4 elements(16 nested mandatory elements)

Maturity: 1

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CRDMetricData 0..* Base CRD Metric Data
... source 1..1 code provider-src | payer-src
Binding: CRD Metric Data Source Value Set (required)
... hookInstance 1..1 string Unique hook invocation id
... hookType 1..1 code order-select | order-sign +
Binding: CDS Hook Types Value Set (extensible)
.... system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value 1..1 string The value that is unique
... groupId 1..1 Identifier Healthcare org of user
.... system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value 1..1 string The value that is unique
... payerId 1..1 Identifier Payer receiving hook
.... system 1..1 uri The namespace for the identifier value
.... value 1..1 string The value that is unique
... requestTime 1..1 instant Time hook initiated
... responseTime 0..1 instant Time of hook response
... httpResponse 1..1 positiveInt e.g. 200
... issue 0..* BackboneElement OperationOutcome info
.... code 1..1 code Error code
Binding: IssueType (required)
.... details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
... tokenUse 1..1 code used | not-used | rejected
Binding: CRD Metric Token Use Value Set (example)
... orderDetail 0..* CodeableConcept Service or product code(s)
Binding: CRD Order Detail Codes Value Set (extensible)
... resources 0..* BackboneElement Resource types accessed
.... type 1..1 code Kind of resource
Binding: ResourceType (required)
.... profile 0..1 canonical(StructureDefinition) Solicited profile
.... count 1..1 positiveInt Number retrieved
.... prefetch 0..1 boolean Retrieved by prefetch?
... response 0..* BackboneElement Returned card/system action
.... type 0..1 code Type of CRD card
Binding: CRD Card Types Value Set (required)
.... focus 0..* code Resource tied to card
.... engagement 0..1 code ignore | accept | override
.... coverageInfo 0..* BackboneElement Coverage information
..... covered 0..1 code covered | not-covered | conditional
Binding: CRD Coverage Information Covered Value Set (required)
..... paNeeded 0..1 code auth-needed | no-auth | satisfied +
Binding: CRD Coverage Information Prior Authorization Value Set (required)
..... docNeeded 0..1 code no-doc | clinical | admin | both +
Binding: CRD Coverage Information Additional Documentation Value Set (required)
..... infoNeeded 0..1 code performer | location | timeframe
Binding: CRD Information Needed Value Set (required)
..... questionnaire 0..* BackboneElement Questionnaire(s) returned
...... reference 1..1 canonical(Questionnaire) Questionnaire url & version
...... adaptive 1..1 boolean Is questionnaire adaptive?
...... response 1..1 boolean Pre-pop response provided?
..... assertionId 1..1 string Id for coverage assertion
..... satisfiedId 0..1 string Id if PA is satisfied
..... businessLine 0..1 CodeableConcept E.g. Medicare Advantage

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
CRDMetricData.source Base required CRD Metric Data Source Value Set 📦2.2.0-ballot This IG
CRDMetricData.hookType Base extensible CDS Hook Types Value Set 📦2.2.0-ballot This IG
CRDMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
CRDMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.
CRDMetricData.tokenUse Base example CRD Metric Token Use Value Set 📦2.2.0-ballot This IG
CRDMetricData.orderDetail Base extensible CRD Order Detail Codes Value Set 📦2.2.0-ballot This IG
CRDMetricData.resources.​type Base required ResourceType 📦4.0.1 FHIR Std.
CRDMetricData.response.​type Base required CRD Card Types Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.covered Base required CRD Coverage Information Covered Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.paNeeded Base required CRD Coverage Information Prior Authorization Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.docNeeded Base required CRD Coverage Information Additional Documentation Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.infoNeeded Base required CRD Information Needed Value Set 📦2.2.0-ballot This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CRDMetricData 0..* Base CRD Metric Data
... source 1..1 code provider-src | payer-src
Binding: CRD Metric Data Source Value Set (required)
... hookInstance 1..1 string Unique hook invocation id
... hookType 1..1 code order-select | order-sign +
Binding: CDS Hook Types Value Set (extensible)
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... groupId 1..1 Identifier Healthcare org of user
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... payerId 1..1 Identifier Payer receiving hook
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
.... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
.... system Σ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
.... value Σ 1..1 string The value that is unique
Example General: 123456
.... period Σ 0..1 Period Time period when id is/was valid for use
.... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... requestTime 1..1 instant Time hook initiated
... responseTime 0..1 instant Time of hook response
... httpResponse 1..1 positiveInt e.g. 200
... issue 0..* BackboneElement OperationOutcome info
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 1..1 code Error code
Binding: IssueType (required)
.... details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
... tokenUse 1..1 code used | not-used | rejected
Binding: CRD Metric Token Use Value Set (example)
... orderDetail 0..* CodeableConcept Service or product code(s)
Binding: CRD Order Detail Codes Value Set (extensible)
... resources 0..* BackboneElement Resource types accessed
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 1..1 code Kind of resource
Binding: ResourceType (required)
.... profile 0..1 canonical(StructureDefinition) Solicited profile
.... count 1..1 positiveInt Number retrieved
.... prefetch 0..1 boolean Retrieved by prefetch?
... response 0..* BackboneElement Returned card/system action
.... @id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 0..1 code Type of CRD card
Binding: CRD Card Types Value Set (required)
.... focus 0..* code Resource tied to card
.... engagement 0..1 code ignore | accept | override
.... coverageInfo 0..* BackboneElement Coverage information
..... @id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... covered 0..1 code covered | not-covered | conditional
Binding: CRD Coverage Information Covered Value Set (required)
..... paNeeded 0..1 code auth-needed | no-auth | satisfied +
Binding: CRD Coverage Information Prior Authorization Value Set (required)
..... docNeeded 0..1 code no-doc | clinical | admin | both +
Binding: CRD Coverage Information Additional Documentation Value Set (required)
..... infoNeeded 0..1 code performer | location | timeframe
Binding: CRD Information Needed Value Set (required)
..... questionnaire 0..* BackboneElement Questionnaire(s) returned
...... @id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
...... reference 1..1 canonical(Questionnaire) Questionnaire url & version
...... adaptive 1..1 boolean Is questionnaire adaptive?
...... response 1..1 boolean Pre-pop response provided?
..... assertionId 1..1 string Id for coverage assertion
..... satisfiedId 0..1 string Id if PA is satisfied
..... businessLine 0..1 CodeableConcept E.g. Medicare Advantage

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
CRDMetricData.source Base required CRD Metric Data Source Value Set 📦2.2.0-ballot This IG
CRDMetricData.hookType Base extensible CDS Hook Types Value Set 📦2.2.0-ballot This IG
CRDMetricData.providerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CRDMetricData.providerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
CRDMetricData.groupId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CRDMetricData.groupId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
CRDMetricData.payerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
CRDMetricData.payerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
CRDMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
CRDMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.
CRDMetricData.tokenUse Base example CRD Metric Token Use Value Set 📦2.2.0-ballot This IG
CRDMetricData.orderDetail Base extensible CRD Order Detail Codes Value Set 📦2.2.0-ballot This IG
CRDMetricData.resources.​type Base required ResourceType 📦4.0.1 FHIR Std.
CRDMetricData.response.​type Base required CRD Card Types Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.covered Base required CRD Coverage Information Covered Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.paNeeded Base required CRD Coverage Information Prior Authorization Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.docNeeded Base required CRD Coverage Information Additional Documentation Value Set 📦2.2.0-ballot This IG
CRDMetricData.response.​coverageInfo.infoNeeded Base required CRD Information Needed Value Set 📦2.2.0-ballot This IG

Constraints

Id Grade Path(s) Description Expression
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: 4 elements(16 nested mandatory elements)

Maturity: 1

 

Other representations of profile: CSV, Excel