Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions
Page standards status: Informative | Maturity Level: 1 |
Definitions for the PASMetricData logical model.
Guidance on how to interpret the contents of this table can be found here
0. PASMetricData | |
Definition | A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation |
Short | PAS Metric Data |
Logical Model | Instances of this logical model are not marked to be the target of a Reference |
2. PASMetricData.source | |
Definition | A code to indicate which type of system collected the metric data. |
Short | provider | intermediary | payer |
Control | 1..1 |
Binding | The codes SHALL be taken from Metric Data Source (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource ) |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
4. PASMetricData.providerId | |
Definition | The NPI number of the user who initiated the PAS request. |
Short | User invoking hook |
Control | 1..1 |
Type | Identifier |
6. PASMetricData.providerId.system | |
Pattern Value | http://hl7.org/fhir/sid/us-npi |
8. PASMetricData.providerId.value | |
Control | 1..? |
10. PASMetricData.groupId | |
Definition | The NPI of the hospital/clinic/other organization that initiated the PAS request. |
Short | Healthcare org of user |
Control | 1..1 |
Type | Identifier |
12. PASMetricData.groupId.system | |
Pattern Value | http://hl7.org/fhir/sid/us-npi |
14. PASMetricData.groupId.value | |
Control | 1..? |
16. PASMetricData.payerId | |
Definition | The identifier of the payer organization to whom the PAS call was made. |
Short | Payer receiving hook |
Control | 1..1 |
Type | Identifier |
18. PASMetricData.payerId.system | |
Control | 1..? |
20. PASMetricData.payerId.value | |
Control | 1..? |
22. PASMetricData.exchange | |
Definition | Exchanges between providers, intermediares, and payers to support prior authorization. |
Short | Prior Authorization Exchanges |
Control | 1..* |
Type | BackboneElement |
24. PASMetricData.exchange.type | |
Definition | A code indicating the type of exchange |
Short | initial | subsequent | cancel | update | query | initialDocToPayer |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
26. PASMetricData.exchange.with | |
Definition | The destination for the exchange |
Short | provider | intermediary | payer |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
28. PASMetricData.exchange.method | |
Definition | Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set. |
Short | x12 | restful | ihe | direct | other |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
30. PASMetricData.exchange.requestTime | |
Definition | For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer. |
Short | Time exchange initiated |
Control | 1..1 |
Type | instant |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
32. PASMetricData.exchange.responseTime | |
Definition | For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer. |
Short | Time of exchange response |
Control | 0..1 |
Type | instant |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
34. PASMetricData.exchange.httpResponse | |
Definition | What HTTP response code was returned for the exchange invocation. |
Short | e.g. 200 |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
36. PASMetricData.issue | |
Definition | In the event of an HTTP error, if an OperationOutcome was returned, what were the issues. |
Short | OperationOutcome info |
Control | 0..* |
Type | BackboneElement |
38. PASMetricData.issue.code | |
Definition | The issue.code value from the OperationOutcome for this issue. |
Short | Error code |
Control | 1..1 |
Binding | The codes SHALL be taken from IssueType (required to http://hl7.org/fhir/ValueSet/issue-type ) |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
40. PASMetricData.issue.details | |
Definition | The issue.details value from the OperationOutcome for this issue. |
Short | More detailed error code |
Control | 0..1 |
Binding | For example codes, see OperationOutcomeCodes (example to http://hl7.org/fhir/ValueSet/operation-outcome ) |
Type | CodeableConcept |
42. PASMetricData.aaaCodes | |
Definition | Any AAA codes returned during the exchange. |
Short | AAA codes returned |
Control | 0..* |
Type | BackboneElement |
44. PASMetricData.aaaCodes.loopID | |
Definition | X12 loop ID. |
Short | see X12 loop IDs |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
46. PASMetricData.aaaCodes.aaaCode | |
Definition | AAA code returned with response. |
Short | approved | modified | denied |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
48. PASMetricData.itemDetail | |
Definition | Service level detail. One interation of the backbone for each service item in the PA exchange. |
Short | Service level item detail |
Control | 0..* |
Type | BackboneElement |
50. PASMetricData.itemDetail.trn | |
Definition | Service level TRN assigned by the payer if a questionnaire is required. |
Short | Service Level TRN |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
52. PASMetricData.itemDetail.item | |
Definition | The specific procedure, item, medication, appointment, nutrition that is the subject of the order. |
Short | eg. ICD10, HCPCS, NDC |
Control | 1..1 |
Type | CodeableConcept |
54. PASMetricData.itemDetail.assertionId | |
Definition | The unique ID for the order item returned by CRD in the coverage information. |
Short | Unique ID for order item |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
56. PASMetricData.itemDetail.initialSubmissionTime | |
Definition | Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item. |
Short | Date/time of the initial submission of the item |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
58. PASMetricData.itemDetail.finalResponseTime | |
Definition | Date/time that the final result was returned for the specific service item. |
Short | Date/time of final result |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
60. PASMetricData.itemDetail.responsesRequired | |
Definition | Number of responses (initial and any with result pended) for the service item. |
Short | Number of responses |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
62. PASMetricData.itemDetail.aaaCodes | |
Definition | Any AAA codes returned during the exchange. |
Short | AAA codes returned |
Control | 0..* |
Type | BackboneElement |
64. PASMetricData.itemDetail.aaaCodes.loopID | |
Definition | X12 loop ID. |
Short | see X12 loop IDs |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
66. PASMetricData.itemDetail.aaaCodes.aaaCode | |
Definition | AAA error code returned in the response. |
Short | approved | modified | deined |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
68. PASMetricData.itemDetail.locationType | |
Definition | The site where the service will be performed. |
Short | inpatient | outpatient | home |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
70. PASMetricData.itemDetail.result | |
Definition | Final result of the specific service item. |
Short | approved | modified | denied | pended |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
72. PASMetricData.itemDetail.denialReason | |
Definition | A code specifying the reason why the item was denied. |
Short | Denial Reason |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
74. PASMetricData.supportingDoc | |
Definition | The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item. |
Short | Documentation submitted as part of PAS Bundle |
Control | 0..1 |
Type | url |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
76. PASMetricData.requestedDoc | |
Definition | Documentation requested via 278 response. |
Short | Documentation requested via 278 response |
Control | 0..* |
Type | BackboneElement |
78. PASMetricData.requestedDoc.docRequest | |
Definition | Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element. |
Short | Coded requests for additional documentation |
Control | 1..* |
Type | CodeableConcept |
80. PASMetricData.requestedDoc.timeRequested | |
Definition | Date/Time of initial request for this item (may be part of the initial submission or part an update. |
Short | Date/Time of initial request |
Control | 1..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
82. PASMetricData.requestedDoc.timeSubmitted | |
Definition | Date/Time of final result for this item (may be part of the initial submission or part an update. |
Short | Date/Time of final result |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
84. PASMetricData.requestedDoc.submissionMethod | |
Definition | The technical method used to submit the requested additional documentation. |
Short | CDex | portal | fax | x12 | other |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
86. PASMetricData.exceptionSubmission | |
Definition | Indicator that exchange was performed under an exception grant from the National Standard Group. |
Short | True if exchange is based on the exception grant |
Control | 0..1 |
Type | boolean |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
88. PASMetricData.businessLine | |
Definition | A code that indicates which type of insurance the patient is covered by. |
Short | E.g. MedicareAdvantage |
Control | 0..1 |
Type | CodeableConcept |
Guidance on how to interpret the contents of this table can be found here
0. PASMetricData | |
Definition | A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation |
Short | PAS Metric Data |
Control | 0..* |
Is Modifier | false |
Logical Model | Instances of this logical model are not marked to be the target of a Reference |
2. PASMetricData.source | |
Definition | A code to indicate which type of system collected the metric data. |
Short | provider | intermediary | payer |
Control | 1..1 |
Binding | The codes SHALL be taken from Metric Data Source (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource ) |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
4. PASMetricData.providerId | |
Definition | The NPI number of the user who initiated the PAS request. |
Short | User invoking hook |
Control | 1..1 |
Type | Identifier |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
6. PASMetricData.providerId.use | |
Definition | The purpose of this identifier. |
Short | usual | official | temp | secondary | old (If known) |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
8. PASMetricData.providerId.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | The namespace for the identifier value |
Comments | Identifier.system is always case sensitive. |
Control | 0..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Pattern Value | http://hl7.org/fhir/sid/us-npi |
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
10. PASMetricData.providerId.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | The value that is unique |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 10..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Example | <br/><b>General</b>:123456 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
12. PASMetricData.groupId | |
Definition | The NPI of the hospital/clinic/other organization that initiated the PAS request. |
Short | Healthcare org of user |
Control | 1..1 |
Type | Identifier |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
14. PASMetricData.groupId.use | |
Definition | The purpose of this identifier. |
Short | usual | official | temp | secondary | old (If known) |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
16. PASMetricData.groupId.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | The namespace for the identifier value |
Comments | Identifier.system is always case sensitive. |
Control | 0..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Pattern Value | http://hl7.org/fhir/sid/us-npi |
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
18. PASMetricData.groupId.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | The value that is unique |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 10..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Example | <br/><b>General</b>:123456 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
20. PASMetricData.payerId | |
Definition | The identifier of the payer organization to whom the PAS call was made. |
Short | Payer receiving hook |
Control | 1..1 |
Type | Identifier |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
22. PASMetricData.payerId.use | |
Definition | The purpose of this identifier. |
Short | usual | official | temp | secondary | old (If known) |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
24. PASMetricData.payerId.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | The namespace for the identifier value |
Comments | Identifier.system is always case sensitive. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
26. PASMetricData.payerId.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | The value that is unique |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 10..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Example | <br/><b>General</b>:123456 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
28. PASMetricData.exchange | |
Definition | Exchanges between providers, intermediares, and payers to support prior authorization. |
Short | Prior Authorization Exchanges |
Control | 1..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
30. PASMetricData.exchange.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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()) |
32. PASMetricData.exchange.type | |
Definition | A code indicating the type of exchange |
Short | initial | subsequent | cancel | update | query | initialDocToPayer |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
34. PASMetricData.exchange.with | |
Definition | The destination for the exchange |
Short | provider | intermediary | payer |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
36. PASMetricData.exchange.method | |
Definition | Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set. |
Short | x12 | restful | ihe | direct | other |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
38. PASMetricData.exchange.requestTime | |
Definition | For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer. |
Short | Time exchange initiated |
Control | 1..1 |
Type | instant |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
40. PASMetricData.exchange.responseTime | |
Definition | For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer. |
Short | Time of exchange response |
Control | 0..1 |
Type | instant |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
42. PASMetricData.exchange.httpResponse | |
Definition | What HTTP response code was returned for the exchange invocation. |
Short | e.g. 200 |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
44. PASMetricData.issue | |
Definition | In the event of an HTTP error, if an OperationOutcome was returned, what were the issues. |
Short | OperationOutcome info |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
46. PASMetricData.issue.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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()) |
48. PASMetricData.issue.code | |
Definition | The issue.code value from the OperationOutcome for this issue. |
Short | Error code |
Control | 1..1 |
Binding | The codes SHALL be taken from IssueType (required to http://hl7.org/fhir/ValueSet/issue-type ) |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
50. PASMetricData.issue.details | |
Definition | The issue.details value from the OperationOutcome for this issue. |
Short | More detailed error code |
Control | 0..1 |
Binding | For example codes, see OperationOutcomeCodes (example to http://hl7.org/fhir/ValueSet/operation-outcome ) |
Type | CodeableConcept |
52. PASMetricData.aaaCodes | |
Definition | Any AAA codes returned during the exchange. |
Short | AAA codes returned |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
54. PASMetricData.aaaCodes.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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()) |
56. PASMetricData.aaaCodes.loopID | |
Definition | X12 loop ID. |
Short | see X12 loop IDs |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
58. PASMetricData.aaaCodes.aaaCode | |
Definition | AAA code returned with response. |
Short | approved | modified | denied |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
60. PASMetricData.itemDetail | |
Definition | Service level detail. One interation of the backbone for each service item in the PA exchange. |
Short | Service level item detail |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
62. PASMetricData.itemDetail.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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. PASMetricData.itemDetail.trn | |
Definition | Service level TRN assigned by the payer if a questionnaire is required. |
Short | Service Level TRN |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
66. PASMetricData.itemDetail.item | |
Definition | The specific procedure, item, medication, appointment, nutrition that is the subject of the order. |
Short | eg. ICD10, HCPCS, NDC |
Control | 1..1 |
Type | CodeableConcept |
68. PASMetricData.itemDetail.assertionId | |
Definition | The unique ID for the order item returned by CRD in the coverage information. |
Short | Unique ID for order item |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
70. PASMetricData.itemDetail.initialSubmissionTime | |
Definition | Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item. |
Short | Date/time of the initial submission of the item |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
72. PASMetricData.itemDetail.finalResponseTime | |
Definition | Date/time that the final result was returned for the specific service item. |
Short | Date/time of final result |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
74. PASMetricData.itemDetail.responsesRequired | |
Definition | Number of responses (initial and any with result pended) for the service item. |
Short | Number of responses |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
76. PASMetricData.itemDetail.aaaCodes | |
Definition | Any AAA codes returned during the exchange. |
Short | AAA codes returned |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
78. PASMetricData.itemDetail.aaaCodes.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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. PASMetricData.itemDetail.aaaCodes.loopID | |
Definition | X12 loop ID. |
Short | see X12 loop IDs |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
82. PASMetricData.itemDetail.aaaCodes.aaaCode | |
Definition | AAA error code returned in the response. |
Short | approved | modified | deined |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
84. PASMetricData.itemDetail.locationType | |
Definition | The site where the service will be performed. |
Short | inpatient | outpatient | home |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
86. PASMetricData.itemDetail.result | |
Definition | Final result of the specific service item. |
Short | approved | modified | denied | pended |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
88. PASMetricData.itemDetail.denialReason | |
Definition | A code specifying the reason why the item was denied. |
Short | Denial Reason |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
90. PASMetricData.supportingDoc | |
Definition | The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item. |
Short | Documentation submitted as part of PAS Bundle |
Control | 0..1 |
Type | url |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
92. PASMetricData.requestedDoc | |
Definition | Documentation requested via 278 response. |
Short | Documentation requested via 278 response |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
94. PASMetricData.requestedDoc.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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()) |
96. PASMetricData.requestedDoc.docRequest | |
Definition | Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element. |
Short | Coded requests for additional documentation |
Control | 1..* |
Type | CodeableConcept |
98. PASMetricData.requestedDoc.timeRequested | |
Definition | Date/Time of initial request for this item (may be part of the initial submission or part an update. |
Short | Date/Time of initial request |
Control | 1..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
100. PASMetricData.requestedDoc.timeSubmitted | |
Definition | Date/Time of final result for this item (may be part of the initial submission or part an update. |
Short | Date/Time of final result |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
102. PASMetricData.requestedDoc.submissionMethod | |
Definition | The technical method used to submit the requested additional documentation. |
Short | CDex | portal | fax | x12 | other |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
104. PASMetricData.exceptionSubmission | |
Definition | Indicator that exchange was performed under an exception grant from the National Standard Group. |
Short | True if exchange is based on the exception grant |
Control | 0..1 |
Type | boolean |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
106. PASMetricData.businessLine | |
Definition | A code that indicates which type of insurance the patient is covered by. |
Short | E.g. MedicareAdvantage |
Control | 0..1 |
Type | CodeableConcept |
Guidance on how to interpret the contents of this table can be found here
0. PASMetricData | |
Definition | A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation |
Short | PAS Metric Data |
Control | 0..* |
Is Modifier | false |
Logical Model | Instances of this logical model are not marked to be the target of a Reference |
2. PASMetricData.source | |
Definition | A code to indicate which type of system collected the metric data. |
Short | provider | intermediary | payer |
Control | 1..1 |
Binding | The codes SHALL be taken from Metric Data Source (required to http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource ) |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
4. PASMetricData.providerId | |
Definition | The NPI number of the user who initiated the PAS request. |
Short | User invoking hook |
Control | 1..1 |
Type | Identifier |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
6. PASMetricData.providerId.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
8. PASMetricData.providerId.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.providerId.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
10. PASMetricData.providerId.use | |
Definition | The purpose of this identifier. |
Short | usual | official | temp | secondary | old (If known) |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUse (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
12. PASMetricData.providerId.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Short | Description of identifier |
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
Control | 0..1 |
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type )A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | Allows users to make use of identifiers when the identifier system is not known. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
14. PASMetricData.providerId.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | The namespace for the identifier value |
Comments | Identifier.system is always case sensitive. |
Control | 0..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Pattern Value | http://hl7.org/fhir/sid/us-npi |
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
16. PASMetricData.providerId.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | The value that is unique |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 1..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Example | <br/><b>General</b>:123456 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
18. PASMetricData.providerId.period | |
Definition | Time period during which identifier is/was valid for use. |
Short | Time period when id is/was valid for use |
Control | 0..1 |
Type | Period |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
20. PASMetricData.providerId.assigner | |
Definition | Organization that issued/manages the identifier. |
Short | Organization that issued id (may be just text) |
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
Control | 0..1 |
Type | Reference(Organization) |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
22. PASMetricData.groupId | |
Definition | The NPI of the hospital/clinic/other organization that initiated the PAS request. |
Short | Healthcare org of user |
Control | 1..1 |
Type | Identifier |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
24. PASMetricData.groupId.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
26. PASMetricData.groupId.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.groupId.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
28. PASMetricData.groupId.use | |
Definition | The purpose of this identifier. |
Short | usual | official | temp | secondary | old (If known) |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUse (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
30. PASMetricData.groupId.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Short | Description of identifier |
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
Control | 0..1 |
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type )A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | Allows users to make use of identifiers when the identifier system is not known. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
32. PASMetricData.groupId.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | The namespace for the identifier value |
Comments | Identifier.system is always case sensitive. |
Control | 0..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Pattern Value | http://hl7.org/fhir/sid/us-npi |
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
34. PASMetricData.groupId.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | The value that is unique |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 1..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Example | <br/><b>General</b>:123456 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
36. PASMetricData.groupId.period | |
Definition | Time period during which identifier is/was valid for use. |
Short | Time period when id is/was valid for use |
Control | 0..1 |
Type | Period |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
38. PASMetricData.groupId.assigner | |
Definition | Organization that issued/manages the identifier. |
Short | Organization that issued id (may be just text) |
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
Control | 0..1 |
Type | Reference(Organization) |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
40. PASMetricData.payerId | |
Definition | The identifier of the payer organization to whom the PAS call was made. |
Short | Payer receiving hook |
Control | 1..1 |
Type | Identifier |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
42. PASMetricData.payerId.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
44. PASMetricData.payerId.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.payerId.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
46. PASMetricData.payerId.use | |
Definition | The purpose of this identifier. |
Short | usual | official | temp | secondary | old (If known) |
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUse (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
48. PASMetricData.payerId.type | |
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. |
Short | Description of identifier |
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. |
Control | 0..1 |
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type )A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | Allows users to make use of identifiers when the identifier system is not known. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
50. PASMetricData.payerId.system | |
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | The namespace for the identifier value |
Comments | Identifier.system is always case sensitive. |
Control | 1..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
52. PASMetricData.payerId.value | |
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | The value that is unique |
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 1..1 |
Type | string |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Example | <br/><b>General</b>:123456 |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
54. PASMetricData.payerId.period | |
Definition | Time period during which identifier is/was valid for use. |
Short | Time period when id is/was valid for use |
Control | 0..1 |
Type | Period |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
56. PASMetricData.payerId.assigner | |
Definition | Organization that issued/manages the identifier. |
Short | Organization that issued id (may be just text) |
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
Control | 0..1 |
Type | Reference(Organization) |
Is Modifier | false |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
58. PASMetricData.exchange | |
Definition | Exchanges between providers, intermediares, and payers to support prior authorization. |
Short | Prior Authorization Exchanges |
Control | 1..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
60. PASMetricData.exchange.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
62. PASMetricData.exchange.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.exchange.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
64. PASMetricData.exchange.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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() ) |
66. PASMetricData.exchange.type | |
Definition | A code indicating the type of exchange |
Short | initial | subsequent | cancel | update | query | initialDocToPayer |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
68. PASMetricData.exchange.with | |
Definition | The destination for the exchange |
Short | provider | intermediary | payer |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
70. PASMetricData.exchange.method | |
Definition | Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set. |
Short | x12 | restful | ihe | direct | other |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
72. PASMetricData.exchange.requestTime | |
Definition | For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer. |
Short | Time exchange initiated |
Control | 1..1 |
Type | instant |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
74. PASMetricData.exchange.responseTime | |
Definition | For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer. |
Short | Time of exchange response |
Control | 0..1 |
Type | instant |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
76. PASMetricData.exchange.httpResponse | |
Definition | What HTTP response code was returned for the exchange invocation. |
Short | e.g. 200 |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
78. PASMetricData.issue | |
Definition | In the event of an HTTP error, if an OperationOutcome was returned, what were the issues. |
Short | OperationOutcome info |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
80. PASMetricData.issue.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
82. PASMetricData.issue.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.issue.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
84. PASMetricData.issue.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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() ) |
86. PASMetricData.issue.code | |
Definition | The issue.code value from the OperationOutcome for this issue. |
Short | Error code |
Control | 1..1 |
Binding | The codes SHALL be taken from IssueType (required to http://hl7.org/fhir/ValueSet/issue-type ) |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
88. PASMetricData.issue.details | |
Definition | The issue.details value from the OperationOutcome for this issue. |
Short | More detailed error code |
Control | 0..1 |
Binding | For example codes, see OperationOutcomeCodes (example to http://hl7.org/fhir/ValueSet/operation-outcome ) |
Type | CodeableConcept |
90. PASMetricData.aaaCodes | |
Definition | Any AAA codes returned during the exchange. |
Short | AAA codes returned |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
92. PASMetricData.aaaCodes.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
94. PASMetricData.aaaCodes.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.aaaCodes.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
96. PASMetricData.aaaCodes.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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() ) |
98. PASMetricData.aaaCodes.loopID | |
Definition | X12 loop ID. |
Short | see X12 loop IDs |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
100. PASMetricData.aaaCodes.aaaCode | |
Definition | AAA code returned with response. |
Short | approved | modified | denied |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
102. PASMetricData.itemDetail | |
Definition | Service level detail. One interation of the backbone for each service item in the PA exchange. |
Short | Service level item detail |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
104. PASMetricData.itemDetail.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
106. PASMetricData.itemDetail.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.itemDetail.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
108. PASMetricData.itemDetail.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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() ) |
110. PASMetricData.itemDetail.trn | |
Definition | Service level TRN assigned by the payer if a questionnaire is required. |
Short | Service Level TRN |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
112. PASMetricData.itemDetail.item | |
Definition | The specific procedure, item, medication, appointment, nutrition that is the subject of the order. |
Short | eg. ICD10, HCPCS, NDC |
Control | 1..1 |
Type | CodeableConcept |
114. PASMetricData.itemDetail.assertionId | |
Definition | The unique ID for the order item returned by CRD in the coverage information. |
Short | Unique ID for order item |
Control | 0..1 |
Type | string |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
116. PASMetricData.itemDetail.initialSubmissionTime | |
Definition | Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item. |
Short | Date/time of the initial submission of the item |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
118. PASMetricData.itemDetail.finalResponseTime | |
Definition | Date/time that the final result was returned for the specific service item. |
Short | Date/time of final result |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
120. PASMetricData.itemDetail.responsesRequired | |
Definition | Number of responses (initial and any with result pended) for the service item. |
Short | Number of responses |
Control | 0..1 |
Type | integer |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
122. PASMetricData.itemDetail.aaaCodes | |
Definition | Any AAA codes returned during the exchange. |
Short | AAA codes returned |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
124. PASMetricData.itemDetail.aaaCodes.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
126. PASMetricData.itemDetail.aaaCodes.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.itemDetail.aaaCodes.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
128. PASMetricData.itemDetail.aaaCodes.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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() ) |
130. PASMetricData.itemDetail.aaaCodes.loopID | |
Definition | X12 loop ID. |
Short | see X12 loop IDs |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
132. PASMetricData.itemDetail.aaaCodes.aaaCode | |
Definition | AAA error code returned in the response. |
Short | approved | modified | deined |
Control | 1..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
134. PASMetricData.itemDetail.locationType | |
Definition | The site where the service will be performed. |
Short | inpatient | outpatient | home |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
136. PASMetricData.itemDetail.result | |
Definition | Final result of the specific service item. |
Short | approved | modified | denied | pended |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
138. PASMetricData.itemDetail.denialReason | |
Definition | A code specifying the reason why the item was denied. |
Short | Denial Reason |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
140. PASMetricData.supportingDoc | |
Definition | The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item. |
Short | Documentation submitted as part of PAS Bundle |
Control | 0..1 |
Type | url |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
142. PASMetricData.requestedDoc | |
Definition | Documentation requested via 278 response. |
Short | Documentation requested via 278 response |
Control | 0..* |
Type | BackboneElement |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |
144. PASMetricData.requestedDoc.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Short | Unique id for inter-element referencing |
Control | 0..1 |
Type | string |
Is Modifier | false |
XML Format | In the XML format, this property is represented as an attribute. |
Summary | false |
146. PASMetricData.requestedDoc.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. |
Short | Additional 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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | ele-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() ) |
Slicing | This element introduces a set of slices on PASMetricData.requestedDoc.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
148. PASMetricData.requestedDoc.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). |
Short | Extensions 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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | ele-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() ) |
150. PASMetricData.requestedDoc.docRequest | |
Definition | Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element. |
Short | Coded requests for additional documentation |
Control | 1..* |
Type | CodeableConcept |
152. PASMetricData.requestedDoc.timeRequested | |
Definition | Date/Time of initial request for this item (may be part of the initial submission or part an update. |
Short | Date/Time of initial request |
Control | 1..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
154. PASMetricData.requestedDoc.timeSubmitted | |
Definition | Date/Time of final result for this item (may be part of the initial submission or part an update. |
Short | Date/Time of final result |
Control | 0..1 |
Type | dateTime |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
156. PASMetricData.requestedDoc.submissionMethod | |
Definition | The technical method used to submit the requested additional documentation. |
Short | CDex | portal | fax | x12 | other |
Control | 0..1 |
Type | code |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
158. PASMetricData.exceptionSubmission | |
Definition | Indicator that exchange was performed under an exception grant from the National Standard Group. |
Short | True if exchange is based on the exception grant |
Control | 0..1 |
Type | boolean |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
160. PASMetricData.businessLine | |
Definition | A code that indicates which type of insurance the patient is covered by. |
Short | E.g. MedicareAdvantage |
Control | 0..1 |
Type | CodeableConcept |