Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

## Resource Profile: PdexPriorAuthorization - Mappings

Page standards status: Informative

Mappings for the pdex-priorauthorization resource profile.

#### Mappings to Structures in this Implementation Guide

No Mappings Found

#### Mappings to other Structures

No Mappings Found

#### Other Mappings

Name | Workflow Pattern | FiveWs Pattern Mapping | HL7 v2 Mapping | RIM Mapping
--- | --- | --- | --- | ---
ExplanationOfBenefit | Event |  |  | Entity. Role or Act
id |  |  |  |
meta |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
versionId |  |  |  |
lastUpdated |  |  |  |
source |  |  |  |
Slices for profile |  |  |  |
profile:supportedProfile |  |  |  |
security |  |  |  |
tag |  |  |  |
implicitRules |  |  |  |
language |  |  |  |
text |  |  |  | Act.text?
contained |  |  |  | N/A
Slices for extension |  |  |  |
extension:levelOfServiceType |  |  |  |
modifierExtension |  |  |  | N/A
identifier | Event.identifier | FiveWs.identifier |  |
status | Event.status | FiveWs.status |  |
type | Event.code | FiveWs.class |  |
subType |  | FiveWs.class |  |
use |  | FiveWs.class |  |
patient | Event.subject | FiveWs.subject |  |
billablePeriod |  | FiveWs.done[x] |  |
created | Event.occurrence[x] | FiveWs.recorded |  |
enterer | Event.performer.agent | FiveWs.author |  |
insurer | Event.performer.agent | FiveWs.author |  |
provider |  | FiveWs.source |  |
priority |  |  | Request.priority |
fundsReserveRequested |  |  |  |
fundsReserve |  |  |  |
related |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
claim |  |  |  |
relationship |  |  |  |
reference |  |  |  |
prescription |  |  |  |
originalPrescription |  |  |  |
payee |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
type |  |  |  |
party |  |  |  |
referral |  | FiveWs.cause |  |
facility | Event.performer.location | FiveWs.where[x] |  |
claim |  | FiveWs.why[x] |  |
claimResponse |  |  |  |
outcome |  |  |  |
disposition |  |  |  |
preAuthRef |  |  |  |
preAuthRefPeriod |  |  |  |
careTeam |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
sequence |  |  |  |
provider |  | FiveWs.actor |  |
responsible |  |  |  |
role |  |  |  |
qualification |  |  |  |
supportingInfo |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
sequence |  |  |  |
category |  |  |  |
code |  |  |  |
timing[x] |  |  |  |
value[x] |  |  |  |
reason |  |  |  |
diagnosis |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
sequence |  |  |  |
diagnosis[x] |  |  |  |
type |  |  |  |
onAdmission |  |  |  |
packageCode |  |  |  |
procedure |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
sequence |  |  |  |
type |  |  |  |
date |  |  |  |
procedure[x] |  |  |  |
udi |  |  |  |
precedence |  |  |  |
insurance |  |  | Coverage |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
focal |  |  |  |
coverage |  |  |  |
preAuthRef |  |  |  |
accident |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
date |  |  |  |
type |  |  |  |
location[x] |  |  |  |
item |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:itemTraceNumber |  |  |  |
extension:preAuthIssueDate |  |  |  |
extension:preAuthPeriod |  |  |  |
extension:previousAuthorizationNumber |  |  |  |
extension:administrationReferenceNumber |  |  |  |
extension:authorizedItemDetail |  |  |  |
extension:authorizedProvider |  |  |  |
modifierExtension |  |  |  | N/A
sequence |  |  |  |
careTeamSequence |  |  |  |
diagnosisSequence |  |  |  |
procedureSequence |  |  |  |
informationSequence |  |  |  |
revenue |  |  |  |
category |  |  |  |
productOrService |  |  |  |
modifier |  |  |  |
programCode |  |  |  |
serviced[x] |  | FiveWs.done[x] |  |
location[x] |  | FiveWs.where[x] |  |
quantity |  |  |  |
unitPrice |  |  |  |
factor |  |  |  |
net |  |  |  |
udi |  |  |  |
bodySite |  |  |  |
subSite |  |  |  |
encounter |  |  |  |
noteNumber |  |  |  |
Slices for adjudication |  |  |  |
adjudication:All Slices |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:reviewAction |  |  |  |
extension:adjudicationActionDate |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
reason |  |  |  |
amount |  |  |  |
value |  |  |  |
adjudication:adjudicationamounttype |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:reviewAction |  |  |  |
extension:adjudicationActionDate |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
reason |  |  |  |
amount |  |  |  |
value |  |  |  |
adjudication:allowedunits |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:reviewAction |  |  |  |
extension:adjudicationActionDate |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
reason |  |  |  |
amount |  |  |  |
value |  |  |  |
adjudication:denialreason |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:reviewAction |  |  |  |
extension:adjudicationActionDate |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
reason |  |  |  |
amount |  |  |  |
value |  |  |  |
adjudication:consumedunits |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:reviewAction |  |  |  |
extension:adjudicationActionDate |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
reason |  |  |  |
amount |  |  |  |
value |  |  |  |
detail |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
sequence |  |  |  |
revenue |  |  |  |
category |  |  |  |
productOrService |  |  |  |
modifier |  |  |  |
programCode |  |  |  |
quantity |  |  |  |
unitPrice |  |  |  |
factor |  |  |  |
net |  |  |  |
udi |  |  |  |
noteNumber |  |  |  |
adjudication |  |  |  |
subDetail |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
sequence |  |  |  |
revenue |  |  |  |
category |  |  |  |
productOrService |  |  |  |
modifier |  |  |  |
programCode |  |  |  |
quantity |  |  |  |
unitPrice |  |  |  |
factor |  |  |  |
net |  |  |  |
udi |  |  |  |
noteNumber |  |  |  |
adjudication |  |  |  |
addItem |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
itemSequence |  |  |  |
detailSequence |  |  |  |
subDetailSequence |  |  |  |
provider |  | FiveWs.source |  |
productOrService |  |  |  |
modifier |  |  |  |
programCode |  |  |  |
serviced[x] |  | FiveWs.done[x] |  |
location[x] |  | FiveWs.where[x] |  |
quantity |  |  |  |
unitPrice |  |  |  |
factor |  |  |  |
net |  |  |  |
bodySite |  |  |  |
subSite |  |  |  |
noteNumber |  |  |  |
adjudication |  |  |  |
detail |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
productOrService |  |  |  |
modifier |  |  |  |
quantity |  |  |  |
unitPrice |  |  |  |
factor |  |  |  |
net |  |  |  |
noteNumber |  |  |  |
adjudication |  |  |  |
subDetail |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
productOrService |  |  |  |
modifier |  |  |  |
quantity |  |  |  |
unitPrice |  |  |  |
factor |  |  |  |
net |  |  |  |
noteNumber |  |  |  |
adjudication |  |  |  |
Slices for adjudication |  |  |  |
adjudication:All Slices |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:reviewAction |  |  |  |
extension:adjudicationActionDate |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
reason |  |  |  |
amount |  |  |  |
value |  |  |  |
adjudication:adjudicationamounttype |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:reviewAction |  |  |  |
extension:adjudicationActionDate |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
reason |  |  |  |
amount |  |  |  |
value |  |  |  |
adjudication:denialreason |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:reviewAction |  |  |  |
extension:adjudicationActionDate |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
reason |  |  |  |
amount |  |  |  |
value |  |  |  |
total |  |  |  |
id |  |  |  | n/a
Slices for extension |  |  |  |
extension:priorauth-utilization |  |  |  |
modifierExtension |  |  |  | N/A
category |  |  |  |
amount |  |  |  |
payment |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
type |  |  |  |
adjustment |  |  |  |
adjustmentReason |  |  |  |
date |  |  |  |
amount |  |  |  |
identifier |  |  |  |
formCode |  |  |  |
form |  |  |  |
processNote |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
number |  |  |  |
type |  |  |  |
text |  |  |  |
language |  |  |  |
benefitPeriod |  |  |  |
benefitBalance |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
category |  |  |  |
excluded |  |  |  |
name |  |  |  |
description |  |  |  |
network |  |  |  |
unit |  |  |  |
term |  |  |  |
financial |  |  |  |
id |  |  |  | n/a
extension |  |  |  | n/a
modifierExtension |  |  |  | N/A
type |  |  |  |
allowed[x] |  |  |  |
used[x] |  |  |  |
Documentation for this format