DocumentInformation - Da Vinci Prior Authorization Support (PAS) FHIR IG v2.2.0-ballot

Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot United States of America flag

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 2.2.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

Extension: DocumentInformation

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation		Version: 2.2.0-ballot
Standards status: Trial-use	Maturity Level: 3	Computable Name: DocumentInformation
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.80

Information about the document being included such as the type, transmission method, and identifier.

Context of Use

This extension may be used on the following element(s)

Element ID: Claim.supportingInfo

Usage info

Usages:

Use this Extension: PAS Claim Update and PAS Claim
Examples for this Extension: Bundle/ErrorResponseBundleExample, Bundle/PASClaimInquiryResponseBundleExample, Bundle/ReferralAuthorizationBundleExample, Bundle/RejectionResponseBundleExample and Claim/ReferralAuthorizationExample

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

Differential Table
Snapshot Table
Statistics/References
All

This structure is derived from Extension

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Extension	0..*	Extension	Extension
extension	1..*	Extension	Extension
Slices for extension			Content/Rules for all slices
extension:reportTypeCode	1..1	Extension	The type of additional information being provided
extension	0..0
url	1..1	uri	"reportTypeCode"
value[x]	0..1	CodeableConcept	Value of extension Binding: PAS PWK01 Attachment Report Type Code Value Set (required)
extension:transmissionMethod	0..1	Extension	How the additional information is being provided
extension	0..0
url	1..1	uri	"transmissionMethod"
value[x]	0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 (required)
extension:controlNumber	0..1	Extension	A control number that identifies the document
extension	0..0
url	1..1	uri	"controlNumber"
value[x]	0..1	string	Value of extension
extension:description	0..1	Extension	Special information about the additional information provided
extension	0..0
url	1..1	uri	"description"
value[x]	0..1	string	Value of extension
url	1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
value[x]	0..0
Documentation for this format

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Extension	0..*	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
Slices for extension	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:reportTypeCode	1..1	Extension	The type of additional information being provided
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"reportTypeCode"
value[x]	0..1	CodeableConcept	Value of extension Binding: PAS PWK01 Attachment Report Type Code Value Set (required)
extension:transmissionMethod	0..1	Extension	How the additional information is being provided
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"transmissionMethod"
value[x]	0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 (required)
extension:controlNumber	0..1	Extension	A control number that identifies the document
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"controlNumber"
value[x]	0..1	string	Value of extension
extension:description	0..1	Extension	Special information about the additional information provided
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"description"
value[x]	0..1	string	Value of extension
url	1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Information about the document being included such as the type, transmission method, and identifier.

reportTypeCode: CodeableConcept: An Extension
transmissionMethod: CodeableConcept: An Extension
controlNumber: string: An Extension
description: string: An Extension

Maturity: 3

Differential View

This structure is derived from Extension

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Extension	0..*	Extension	Extension
extension	1..*	Extension	Extension
Slices for extension			Content/Rules for all slices
extension:reportTypeCode	1..1	Extension	The type of additional information being provided
extension	0..0
url	1..1	uri	"reportTypeCode"
value[x]	0..1	CodeableConcept	Value of extension Binding: PAS PWK01 Attachment Report Type Code Value Set (required)
extension:transmissionMethod	0..1	Extension	How the additional information is being provided
extension	0..0
url	1..1	uri	"transmissionMethod"
value[x]	0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 (required)
extension:controlNumber	0..1	Extension	A control number that identifies the document
extension	0..0
url	1..1	uri	"controlNumber"
value[x]	0..1	string	Value of extension
extension:description	0..1	Extension	Special information about the additional information provided
extension	0..0
url	1..1	uri	"description"
value[x]	0..1	string	Value of extension
url	1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
value[x]	0..0
Documentation for this format

Snapshot View

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Extension	0..*	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
Slices for extension	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:reportTypeCode	1..1	Extension	The type of additional information being provided
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"reportTypeCode"
value[x]	0..1	CodeableConcept	Value of extension Binding: PAS PWK01 Attachment Report Type Code Value Set (required)
extension:transmissionMethod	0..1	Extension	How the additional information is being provided
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"transmissionMethod"
value[x]	0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 (required)
extension:controlNumber	0..1	Extension	A control number that identifies the document
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"controlNumber"
value[x]	0..1	string	Value of extension
extension:description	0..1	Extension	Special information about the additional information provided
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"description"
value[x]	0..1	string	Value of extension
url	1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Information about the document being included such as the type, transmission method, and identifier.

reportTypeCode: CodeableConcept: An Extension
transmissionMethod: CodeableConcept: An Extension
controlNumber: string: An Extension
description: string: An Extension

Maturity: 3

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

Path	Conformance	ValueSet	URI
Extension.extension:reportTypeCode.value[x]	required	PASPWK01AttachmentReportTypeCodeValueSet(a valid code from `https://codesystem.x12.org/005010/755`) `http://hl7.org/fhir/us/davinci-pas/ValueSet/pas-pwk01-attachment-report-type-code` From this IG
Extension.extension:transmissionMethod.value[x]	required	https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 `https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756`

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

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IG © 2020+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pas#2.2.0-ballot based on FHIR 4.0.1. Generated 2025-07-29
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