Da Vinci Clinical Data Exchange (CDex), published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ecdx/ and changes regularly. See the Directory of published versions
Page standards status: Informative |
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Task ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "cdex-task-example23"] ; #
fhir:meta [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/instance-name"^^xsd:anyURI ] ;
fhir:value [ fhir:v "CDex Task Example 23" ] ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/instance-description"^^xsd:anyURI ] ;
fhir:value [ fhir:v "**Request Additional Data using an Adaptive Questionnaire:** Prior Authorization Attachment Request with a POU of \"coverage authorization\" sent by payer to a provider requesting an adaptive questionnaire be completed." ] ] ) ;
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-task-attachment-request"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-task-attachment-request> ] )
] ; #
fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b><a name=\"cdex-task-example23\"> </a><a name=\"hccdex-task-example23\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceTask "cdex-task-example23" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-cdex-task-attachment-request.html\">CDex Task Attachment Request Profile</a></p></div><p><b>identifier</b>: Re-Association Tracking Control Number/trackingid1034</p><p><b>status</b>: requested</p><p><b>intent</b>: order</p><p><b>code</b>: Attachment Request Questionnaire <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/davinci-pas/STU2/CodeSystem-PASTempCodes.html\">PAS Temporary Codes</a>#attachment-request-questionnaire)</span></p><p><b>for</b>: <a name=\"hcpatient\"> </a></p><blockquote><p/><p><a name=\"patient\"> </a></p><p><a name=\"hcpatient\"> </a></p><p><b>identifier</b>: Member Number/Member123 (use: usual), Patient Account Number/PA-123 (use: usual)</p><p><b>name</b>: Amy Shaw </p><p><b>birthDate</b>: 1987-02-20</p></blockquote><p><b>authoredOn</b>: 2022-06-17 16:16:06+0000</p><p><b>lastModified</b>: 2022-06-17 16:16:06+0000</p><p><b>requester</b>: <span><code>http://example.org/cdex/payer/payer-ids</code>/Payer123</span></p><p><b>owner</b>: <a name=\"hcpractitionerrole\"> </a></p><blockquote><p/><p><a name=\"practitionerrole\"> </a></p><p><a name=\"hcpractitionerrole\"> </a></p><p><b>practitioner</b>: <span><a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/9941339100</span></p><p><b>organization</b>: <span><a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567893</span></p></blockquote><p><b>reasonCode</b>: preauthorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-claim-use.html\">Use</a>#preauthorization "Preauthorization")</span></p><p><b>reasonReference</b>: <span><code>http://example.org/cdex/payer/claim-ids</code>/Preauth123</span></p><h3>Restrictions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Period</b></td></tr><tr><td style=\"display: none\">*</td><td>?? --> 2022-06-21</td></tr></table><blockquote><p><b>input</b></p><p><b>PALineNumber</b>: 1</p><p><b>type</b>: Questionnaires Needed <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/davinci-pas/STU2/CodeSystem-PASTempCodes.html\">PAS Temporary Codes</a>#questionnaires-needed)</span></p><p><b>value</b>: <a href=\"http://example.org/base_adaptive_questionnaire\">http://example.org/base_adaptive_questionnaire</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Signature Flag <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#signature-flag)</span></p><p><b>value</b>: true</p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Payer URL <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/us/davinci-pas/STU2/CodeSystem-PASTempCodes.html\">PAS Temporary Codes</a>#payer-url)</span></p><p><b>value</b>: <a href=\"http://example.org/cdex/payer/$submit-attachment\">http://example.org/cdex/payer/$submit-attachment</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Purpose Of Use <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#purpose-of-use)</span></p><p><b>value</b>: coverage authorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActReason.html\">ActReason</a>#COVAUTH)</span></p></blockquote><hr/><blockquote><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\"><b>Amy Shaw </b> (no stated gender), DoB: 1987-02-20 ( Member Number/Member123 (use: usual))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Other Id (see the one above)\">Other Id:</td><td colspan=\"3\">Patient Account Number/PA-123 (use: usual)</td></tr></table></blockquote><hr/><blockquote><p><b>Generated Narrative: PractitionerRole #practitionerrole</b><a name=\"practitionerrole\"> </a><a name=\"hcpractitionerrole\"> </a></p><p><b>practitioner</b>: <span><a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/9941339100</span></p><p><b>organization</b>: <span><a href=\"http://terminology.hl7.org/5.3.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567893</span></p></blockquote></div>"
] ; #
fhir:contained ( [
a fhir:Patient ;
fhir:id [ fhir:v "patient" ] ;
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-patient-demographics"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-patient-demographics> ] ) ] ;
( fhir:identifier [
fhir:use [ fhir:v "usual" ] ;
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ] ;
fhir:display [ fhir:v "Member Number" ] ] ) ;
fhir:text [ fhir:v "Member Number" ] ] ;
fhir:system [ fhir:v "http://example.org/cdex/payer/member-ids"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Member123" ] ] [
fhir:use [ fhir:v "usual" ] ;
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType"^^xsd:anyURI ] ;
fhir:code [ fhir:v "pat" ] ;
fhir:display [ fhir:v "Patient Account Number" ] ] ) ;
fhir:text [ fhir:v "Patient Account Number" ] ] ;
fhir:system [ fhir:v "http://example.org/cdex/provider/patient-ids"^^xsd:anyURI ] ;
fhir:value [ fhir:v "PA-123" ] ] ) ;
( fhir:name [
fhir:family [ fhir:v "Shaw" ] ;
( fhir:given [ fhir:v "Amy" ] ) ] ) ;
fhir:birthDate [ fhir:v "1987-02-20"^^xsd:date ]
] [
a fhir:PractitionerRole ;
fhir:id [ fhir:v "practitionerrole" ] ;
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-practitionerrole"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-practitionerrole> ] ) ] ;
fhir:practitioner [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "9941339100" ] ] ] ;
fhir:organization [
fhir:identifier [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1234567893" ] ] ]
] ) ; #
fhir:identifier ( [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"^^xsd:anyURI ] ;
fhir:code [ fhir:v "tracking-id" ] ;
fhir:display [ fhir:v "Tracking Id" ] ] ) ;
fhir:text [ fhir:v "Re-Association Tracking Control Number" ] ] ;
fhir:system [ fhir:v "http://example.org/payer"^^xsd:anyURI ] ;
fhir:value [ fhir:v "trackingid1034" ]
] ) ; #
fhir:status [ fhir:v "requested"] ; #
fhir:intent [ fhir:v "order"] ; #
fhir:code [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "attachment-request-questionnaire" ] ] ) ;
fhir:text [ fhir:v "Attachment Request Questionnaire" ]
] ; #
fhir:for [
fhir:reference [ fhir:v "#patient" ]
] ; #
fhir:authoredOn [ fhir:v "2022-06-17T16:16:06Z"^^xsd:dateTime] ; #
fhir:lastModified [ fhir:v "2022-06-17T16:16:06Z"^^xsd:dateTime] ; #
fhir:requester [
fhir:identifier [
fhir:system [ fhir:v "http://example.org/cdex/payer/payer-ids"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Payer123" ] ]
] ; #
fhir:owner [
fhir:reference [ fhir:v "#practitionerrole" ]
] ; #
fhir:reasonCode [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/claim-use"^^xsd:anyURI ] ;
fhir:code [ fhir:v "preauthorization" ] ;
fhir:display [ fhir:v "Preauthorization" ] ] ) ;
fhir:text [ fhir:v "preauthorization" ]
] ; #
fhir:reasonReference [
fhir:identifier [
fhir:system [ fhir:v "http://example.org/cdex/payer/claim-ids"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Preauth123" ] ]
] ; #
fhir:restriction [
fhir:period [
fhir:end [ fhir:v "2022-06-21"^^xsd:date ] ]
] ; #
fhir:input ( [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1"^^xsd:integer ] ] ) ;
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "questionnaires-needed" ] ] ) ] ;
fhir:value [
fhir:v "http://example.org/base_adaptive_questionnaire"^^xsd:anyURI ;
fhir:link <http://example.org/base_adaptive_questionnaire> ]
] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"^^xsd:anyURI ] ;
fhir:code [ fhir:v "signature-flag" ] ] ) ] ;
fhir:value [ fhir:v "true"^^xsd:boolean ]
] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "payer-url" ] ] ) ] ;
fhir:value [ fhir:v "http://example.org/cdex/payer/$submit-attachment"^^xsd:anyURI ]
] [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"^^xsd:anyURI ] ;
fhir:code [ fhir:v "purpose-of-use" ] ] ) ] ;
fhir:value [
a fhir:CodeableConcept ;
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActReason"^^xsd:anyURI ] ;
fhir:code [ fhir:v "COVAUTH" ] ;
fhir:display [ fhir:v "coverage authorization" ] ] ) ]
] ) . #
IG © 2024+ HL7 International / Payer/Provider Information Exchange Work Group. Package hl7.fhir.us.davinci-cdex#2.1.0-preview based on FHIR 4.0.1. Generated 2024-05-17
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