Da Vinci - Coverage Requirements Discovery
2.2.0-snapshot - STU 2.2 Peer Review 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-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 Vision Prescription - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 1

Definitions for the profile-visionprescription resource profile

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.

ShortPrescription for vision correction products for a patient
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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.

ShortA 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.

Control0..1
Typeuri
Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-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.

ShortContained, 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.

Control0..*
TypeResource
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate Namesinline 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.

ShortExtensionAdditional 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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-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())
SlicingThis 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 NameCoverage-Information
    Definition

    Indicates coverage information.

    ShortCoverage Info
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Coverage Information) (Complex Extension)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-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())
    10. VisionPrescription.extension:EncounterCategory
    Slice NameEncounterCategory
    Definition

    A high-level categorization of the type of request

    ShortEncounter Category
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Request Category) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-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.

    ShortExtensionAdditional 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.

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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())
    SlicingThis 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.

      Shortidentifies 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.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://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).

      ShortValue of extension
      Control0..1
      BindingThe codes SHALL be taken from For codes, see ActEncounterCode (3.0.0)
      (required to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0)
      TypeCodeableConcept, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. VisionPrescription.extension:ServiceCategory
      Slice NameServiceCategory
      Definition

      A high-level categorization of the type of request

      ShortService Category
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Request Category) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-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.

      ShortExtensionAdditional 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.

      Control0..0*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-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())
      SlicingThis 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.

        Shortidentifies 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.

        Control1..1
        Typeuri
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        Fixed Valuehttp://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).

        ShortValue of extension
        Control0..1
        BindingThe codes SHALL be taken from For codes, see X12 Service Type
        (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/X12ServiceType)
        TypeCodeableConcept, 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] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-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).

        ShortExtensions 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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        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 Namesextensions, user content
        Invariantsele-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.

        ShortBusiness Identifier for vision prescription
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Allows vision prescriptions to be distinguished and referenced.

        Invariantsele-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.

        Shortactive | 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.

        Control1..1
        BindingThe codes SHALL be taken from FinancialResourceStatusCodeshttp://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.

        Typecode
        Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        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'.

        ExampleGeneral: draft
        Invariantsele-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.

        ShortResponse creation date
        Control1..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to record a timestamp for use by both the recipient and the issuer.

        Invariantsele-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.

        ShortWho prescription is for
        Control1..1
        TypeReference(CRD Patient, Patient)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Requirements

        Needed to identify the patient for whom the vision prescription has been issued.

        Invariantsele-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.

        ShortCreated during encounter / admission / stay
        Comments

        potentially relevant for CRD in some situations.

        Control0..1
        TypeReference(CRD Encounter, Encounter)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Requirements

        Used in some jurisdictions to link clinical events to claim items.

        Invariantsele-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.

        ShortWhen prescription was authorized
        Comments

        Jurisdictions determine the valid lifetime of a prescription. Typically vision prescriptions are valid for two years from the date written.

        Control1..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Requirements

        Need to record a timestamp for use by both the recipient and the issuer.

        Invariantsele-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.

        ShortWho authorized the vision prescription
        Control1..1
        TypeReference(CRD Practitioner, HRex PractitionerRole Profile, Practitioner, PractitionerRole)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesReference(CRD Practitioner, HRex PractitionerRole Profile)
        Summarytrue
        Requirements

        Need to record the authorizing practitioner.

        Invariantsele-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.

        ShortVision lens authorization
        Control1..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-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.

        ShortExtensionAdditional 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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-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())
        SlicingThis 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 NameBillingOptions
          Definition

          Identifies billing codes that could potentially be used for this clinical code

          ShortExpected Billing Code(s)
          Comments

          This will typically only be populated if the ordering and performing systems are the same

          Control0..*
          This element is affected by the following invariants: ele-1
          TypeExtension(Billing Options) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-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).

          ShortExtensions 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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          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 Namesextensions, user content, modifiers
          Invariantsele-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.

          ShortProduct to be supplied
          Control1..1
          BindingFor example codes, see ExampleVisionPrescriptionProductCodeshttp://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.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Need to identify whether glasses or contacts.

          Invariantsele-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.

          Shortright | left
          Comments

          May also appear as OD (oculus dexter) for the right eye and OS (oculus siniter) for the left eye.

          Control1..1
          BindingThe codes SHALL be taken from VisionEyeshttp://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.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Needed to identify which eye the lens specification applies to.

          Invariantsele-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).

          ShortPower 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.

          Control0..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard lens prescription measures.

          Invariantsele-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).

          ShortLens power for astigmatism
          Control0..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard lens prescription measures.

          Invariantsele-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.

          ShortLens meridian which contain no power for astigmatism
          Comments

          The limits are +180 and -180 degrees.

          Control0..1
          Typeinteger
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard lens prescription measures.

          Invariantsele-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.

          ShortEye alignment compensation
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard lens prescription measures.

          Invariantsele-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).

          ShortExtensions 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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          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 Namesextensions, user content, modifiers
          Invariantsele-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.

          ShortAmount of adjustment
          Control1..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard lens prescription measures.

          Invariantsele-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.

          Shortup | down | in | out
          Control1..1
          BindingThe codes SHALL be taken from VisionBasehttp://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.

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard lens prescription measures.

          Invariantsele-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).

          ShortAdded power for multifocal levels
          Control0..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard lens prescription measures.

          Invariantsele-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).

          ShortContact lens power
          Control0..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard contact lens prescription measures.

          Invariantsele-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.

          ShortContact lens back curvature
          Control0..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard contact lens prescription measures.

          Invariantsele-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.

          ShortContact lens diameter
          Control0..1
          Typedecimal
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard contact lens prescription measures.

          Invariantsele-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.

          ShortLens wear duration
          Control0..1
          TypeQuantity(SimpleQuantity)
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Standard contact lens prescription measures.

          Invariantsele-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 Supporttrue
          4. VisionPrescription.extension
          SlicingThis 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 NameCoverage-Information
            ShortCoverage Info
            Control0..*
            TypeExtension(Coverage Information) (Complex Extension)
            Must Supporttrue
            8. VisionPrescription.extension:EncounterCategory
            Slice NameEncounterCategory
            ShortEncounter Category
            Control0..1
            TypeExtension(Request Category) (Extension Type: CodeableConcept)
            Must Supporttrue
            10. VisionPrescription.extension:EncounterCategory.value[x]
            BindingThe codes SHALL be taken from ActEncounterCode (3.0.0)
            (required to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            12. VisionPrescription.extension:ServiceCategory
            Slice NameServiceCategory
            ShortService Category
            Control0..1
            TypeExtension(Request Category) (Extension Type: CodeableConcept)
            Must Supporttrue
            14. VisionPrescription.extension:ServiceCategory.value[x]
            BindingThe codes SHALL be taken from X12 Service Type
            (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/X12ServiceType)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            16. VisionPrescription.identifier
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Must Supporttrue
            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 Supporttrue
            ExampleGeneral: draft
            20. VisionPrescription.created
            Must Supporttrue
            22. VisionPrescription.patient
            TypeReference(CRD Patient)
            Must Supporttrue
            24. VisionPrescription.encounter
            Comments

            potentially relevant for CRD in some situations.

            TypeReference(CRD Encounter)
            Must Supporttrue
            26. VisionPrescription.dateWritten
            Must Supporttrue
            28. VisionPrescription.prescriber
            TypeReference(CRD Practitioner, HRex PractitionerRole Profile)
            Must Supporttrue
            Must Support TypesReference(CRD Practitioner, HRex PractitionerRole Profile)
            30. VisionPrescription.lensSpecification
            Must Supporttrue
            32. VisionPrescription.lensSpecification.extension
            SlicingThis 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 NameBillingOptions
              ShortExpected Billing Code(s)
              Control0..*
              TypeExtension(Billing Options) (Extension Type: CodeableConcept)
              Must Supporttrue
              36. VisionPrescription.lensSpecification.product
              Must Supporttrue
              38. VisionPrescription.lensSpecification.eye
              Must Supporttrue
              40. VisionPrescription.lensSpecification.sphere
              Must Supporttrue
              42. VisionPrescription.lensSpecification.cylinder
              Must Supporttrue
              44. VisionPrescription.lensSpecification.axis
              Must Supporttrue
              46. VisionPrescription.lensSpecification.prism
              Must Supporttrue
              48. VisionPrescription.lensSpecification.prism.amount
              Must Supporttrue
              50. VisionPrescription.lensSpecification.prism.base
              Must Supporttrue
              52. VisionPrescription.lensSpecification.add
              Must Supporttrue
              54. VisionPrescription.lensSpecification.power
              Must Supporttrue
              56. VisionPrescription.lensSpecification.backCurve
              Must Supporttrue
              58. VisionPrescription.lensSpecification.diameter
              Must Supporttrue
              60. VisionPrescription.lensSpecification.duration
              Must Supporttrue

              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.

              ShortPrescription for vision correction products for a patient
              Control0..*
              Is Modifierfalse
              Summaryfalse
              Invariantsdom-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.

              ShortLogical 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.

              Control0..1
              Typeid
              Is Modifierfalse
              Summarytrue
              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.

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Is Modifierfalse
              Summarytrue
              Invariantsele-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.

              ShortA 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.

              Control0..1
              Typeuri
              Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-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.

              ShortLanguage 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).

              Control0..1
              BindingThe codes SHOULD be taken from CommonLanguages
              (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

              A human language.

              Additional BindingsPurpose
              AllLanguagesMax Binding
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-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.

              ShortText 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.

              Control0..1
              TypeNarrative
              Is Modifierfalse
              Summaryfalse
              Alternate Namesnarrative, html, xhtml, display
              Invariantsele-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.

              ShortContained, 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.

              Control0..*
              TypeResource
              Is Modifierfalse
              Must Supporttrue
              Summaryfalse
              Alternate Namesinline resources, anonymous resources, contained resources
              14. VisionPrescription.extension
              Definition

              An Extension

              ShortExtension
              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Invariantsele-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())
              SlicingThis 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 NameCoverage-Information
                Definition

                Indicates coverage information.

                ShortCoverage Info
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(Coverage Information) (Complex Extension)
                Is Modifierfalse
                Must Supporttrue
                Invariantsele-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())
                18. VisionPrescription.extension:EncounterCategory
                Slice NameEncounterCategory
                Definition

                A high-level categorization of the type of request

                ShortEncounter Category
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Request Category) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-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.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                22. VisionPrescription.extension:EncounterCategory.extension
                Definition

                An Extension

                ShortExtension
                Control0..0
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-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())
                SlicingThis 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.

                  Shortidentifies 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.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuehttp://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).

                  ShortValue of extension
                  Control0..1
                  BindingThe codes SHALL be taken from ActEncounterCode (3.0.0)
                  (required to http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|3.0.0)
                  TypeCodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  28. VisionPrescription.extension:ServiceCategory
                  Slice NameServiceCategory
                  Definition

                  A high-level categorization of the type of request

                  ShortService Category
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Request Category) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-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.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  32. VisionPrescription.extension:ServiceCategory.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..0
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-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())
                  SlicingThis 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.

                    Shortidentifies 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.

                    Control1..1
                    Typeuri
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    Fixed Valuehttp://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).

                    ShortValue of extension
                    Control0..1
                    BindingThe codes SHALL be taken from X12 Service Type
                    (required to http://hl7.org/fhir/us/davinci-crd/ValueSet/X12ServiceType)
                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-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).

                    ShortExtensions 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.

                    Control0..*
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                    Summaryfalse
                    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 Namesextensions, user content
                    Invariantsele-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.

                    ShortBusiness Identifier for vision prescription
                    NoteThis is a business identifier, not a resource identifier (see discussion)
                    Control0..*
                    TypeIdentifier
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Allows vision prescriptions to be distinguished and referenced.

                    Invariantsele-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.

                    Shortactive | 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.

                    Control1..1
                    BindingThe 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.

                    Typecode
                    Is Modifiertrue 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 ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    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'.

                    ExampleGeneral: draft
                    Invariantsele-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.

                    ShortResponse creation date
                    Control1..1
                    TypedateTime
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to record a timestamp for use by both the recipient and the issuer.

                    Invariantsele-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.

                    ShortWho prescription is for
                    Control1..1
                    TypeReference(CRD Patient)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Needed to identify the patient for whom the vision prescription has been issued.

                    Invariantsele-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.

                    ShortCreated during encounter / admission / stay
                    Comments

                    potentially relevant for CRD in some situations.

                    Control0..1
                    TypeReference(CRD Encounter)
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Used in some jurisdictions to link clinical events to claim items.

                    Invariantsele-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.

                    ShortWhen prescription was authorized
                    Comments

                    Jurisdictions determine the valid lifetime of a prescription. Typically vision prescriptions are valid for two years from the date written.

                    Control1..1
                    TypedateTime
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Need to record a timestamp for use by both the recipient and the issuer.

                    Invariantsele-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.

                    ShortWho authorized the vision prescription
                    Control1..1
                    TypeReference(CRD Practitioner, HRex PractitionerRole Profile)
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesReference(CRD Practitioner, HRex PractitionerRole Profile)
                    Summarytrue
                    Requirements

                    Need to record the authorizing practitioner.

                    Invariantsele-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.

                    ShortVision lens authorization
                    Control1..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Invariantsele-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.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    58. VisionPrescription.lensSpecification.extension
                    Definition

                    An Extension

                    ShortExtension
                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-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())
                    SlicingThis 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 NameBillingOptions
                      Definition

                      Identifies billing codes that could potentially be used for this clinical code

                      ShortExpected Billing Code(s)
                      Comments

                      This will typically only be populated if the ordering and performing systems are the same

                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension(Billing Options) (Extension Type: CodeableConcept)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-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).

                      ShortExtensions 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.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      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 Namesextensions, user content, modifiers
                      Invariantsele-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.

                      ShortProduct to be supplied
                      Control1..1
                      BindingFor example codes, see ExampleVisionPrescriptionProductCodes
                      (example to http://hl7.org/fhir/ValueSet/vision-product|4.0.1)

                      A coded concept describing the vision products.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Need to identify whether glasses or contacts.

                      Invariantsele-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.

                      Shortright | left
                      Comments

                      May also appear as OD (oculus dexter) for the right eye and OS (oculus siniter) for the left eye.

                      Control1..1
                      BindingThe 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.

                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Needed to identify which eye the lens specification applies to.

                      Invariantsele-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).

                      ShortPower 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.

                      Control0..1
                      Typedecimal
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-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).

                      ShortLens power for astigmatism
                      Control0..1
                      Typedecimal
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-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.

                      ShortLens meridian which contain no power for astigmatism
                      Comments

                      The limits are +180 and -180 degrees.

                      Control0..1
                      Typeinteger
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-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.

                      ShortEye alignment compensation
                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-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.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      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.

                      ShortAdditional 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.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-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).

                      ShortExtensions 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.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      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 Namesextensions, user content, modifiers
                      Invariantsele-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.

                      ShortAmount of adjustment
                      Control1..1
                      Typedecimal
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-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.

                      Shortup | down | in | out
                      Control1..1
                      BindingThe 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.

                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-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).

                      ShortAdded power for multifocal levels
                      Control0..1
                      Typedecimal
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-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).

                      ShortContact lens power
                      Control0..1
                      Typedecimal
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard contact lens prescription measures.

                      Invariantsele-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.

                      ShortContact lens back curvature
                      Control0..1
                      Typedecimal
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard contact lens prescription measures.

                      Invariantsele-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.

                      ShortContact lens diameter
                      Control0..1
                      Typedecimal
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard contact lens prescription measures.

                      Invariantsele-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.

                      ShortLens wear duration
                      Control0..1
                      TypeQuantity(SimpleQuantity)
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Standard contact lens prescription measures.

                      Invariantsele-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.

                      ShortColor required
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Requirements

                      Standard contact lens prescription measures.

                      Invariantsele-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.

                      ShortBrand required
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-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.

                      ShortNotes for coatings
                      Control0..*
                      TypeAnnotation
                      Is Modifierfalse
                      Summaryfalse
                      Requirements

                      Standard lens prescription measures.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))