Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2
Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2
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
| Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction | Version: 2.1.0 | |||
| Standards status: Trial-use | Maturity Level: 3 | Computable Name: ReviewAction | ||
The details of the review action that is necessary for the authorization.
Context of Use
This extension may be used on the following element(s):
Usage info
Usage:
Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.
This structure is derived from Extension
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Extension |
0..* | Extension | Extension | |
  Slices for extension |
Content/Rules for all slices | |||
   code |
0..1 | CodeableConcept | Healthcare Services Outcome URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode Binding: https://valueset.x12.org/x217/005010/response/2000F/HCR/1/01/00/306 (required): Codes indicating type of action. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. | |
 extension:number |
0..1 | Extension | Item Level Review Number | |
   extension |
0..0 | |||
| url |
1..1 | uri | "number" | |
  value[x] |
0..1 | string | Value of extension | |
| extension:reasonCode |
0..* | Extension | Certification Action Code: indicates the reason for the approved, denied, or pended services | |
| extension |
0..0 | |||
| url |
1..1 | uri | "reasonCode" | |
 value[x] |
0..1 | CodeableConcept | Value of extension Binding: X12 278 Review Decision Reason Codes (required) | |
 extension:secondSurgicalOpinionFlag |
0..1 | Extension | Whether a second surgical opinion is need for approval | |
 extension |
0..0 | |||
| url |
1..1 | uri | "secondSurgicalOpinionFlag" | |
| value[x] |
0..1 | boolean | Value of extension | |
 url |
1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction" | |
 value[x] |
0..0 | |||
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Extension |
0..* | Extension | Extension | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| Slices for extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| code |
0..1 | CodeableConcept | Healthcare Services Outcome URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode Binding: https://valueset.x12.org/x217/005010/response/2000F/HCR/1/01/00/306 (required): Codes indicating type of action. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. | |
| extension:number |
0..1 | Extension | Item Level Review Number | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "number" | |
| value[x] |
0..1 | string | Value of extension | |
| extension:reasonCode |
0..* | Extension | Certification Action Code: indicates the reason for the approved, denied, or pended services | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "reasonCode" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: X12 278 Review Decision Reason Codes (required) | |
| extension:secondSurgicalOpinionFlag |
0..1 | Extension | Whether a second surgical opinion is need for approval | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "secondSurgicalOpinionFlag" | |
| value[x] |
0..1 | boolean | Value of extension | |
| url |
1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction" | |
| Documentation for this format | ||||
This structure is derived from Extension
Summary
Complex Extension: The details of the review action that is necessary for the authorization.
Maturity: 3
Differential View
This structure is derived from Extension
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Extension |
0..* | Extension | Extension | |
| Slices for extension |
Content/Rules for all slices | |||
| code |
0..1 | CodeableConcept | Healthcare Services Outcome URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode Binding: https://valueset.x12.org/x217/005010/response/2000F/HCR/1/01/00/306 (required): Codes indicating type of action. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. | |
| extension:number |
0..1 | Extension | Item Level Review Number | |
| extension |
0..0 | |||
| url |
1..1 | uri | "number" | |
| value[x] |
0..1 | string | Value of extension | |
| extension:reasonCode |
0..* | Extension | Certification Action Code: indicates the reason for the approved, denied, or pended services | |
| extension |
0..0 | |||
| url |
1..1 | uri | "reasonCode" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: X12 278 Review Decision Reason Codes (required) | |
| extension:secondSurgicalOpinionFlag |
0..1 | Extension | Whether a second surgical opinion is need for approval | |
| extension |
0..0 | |||
| url |
1..1 | uri | "secondSurgicalOpinionFlag" | |
| value[x] |
0..1 | boolean | Value of extension | |
| url |
1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction" | |
| value[x] |
0..0 | |||
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Extension |
0..* | Extension | Extension | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| Slices for extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| code |
0..1 | CodeableConcept | Healthcare Services Outcome URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode Binding: https://valueset.x12.org/x217/005010/response/2000F/HCR/1/01/00/306 (required): Codes indicating type of action. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. | |
| extension:number |
0..1 | Extension | Item Level Review Number | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "number" | |
| value[x] |
0..1 | string | Value of extension | |
| extension:reasonCode |
0..* | Extension | Certification Action Code: indicates the reason for the approved, denied, or pended services | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "reasonCode" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: X12 278 Review Decision Reason Codes (required) | |
| extension:secondSurgicalOpinionFlag |
0..1 | Extension | Whether a second surgical opinion is need for approval | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "secondSurgicalOpinionFlag" | |
| value[x] |
0..1 | boolean | Value of extension | |
| url |
1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction" | |
| Documentation for this format | ||||
Other representations of profile: CSV, Excel, Schematron
| Path | Conformance | ValueSet | URI |
| Extension.extension:reasonCode.value[x] | required | X12278ReviewDecisionReasonCode (a valid code from https://codesystem.x12.org/external/886)http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278ReviewDecisionReasonCodefrom this IG |
IG © 2020+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pas#2.1.0 based on FHIR 4.0.1. Generated 2024-11-19
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