Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0-preview - STU 2 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 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

Resource Profile: PAS Device Request

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-devicerequest Version: 2.1.0-preview
Standards status: Trial-use Maturity Level: 3 Computable Name: PASDeviceRequest

PAS constraints on DeviceRequest resource mandating support for elements relevant to the devices being requested on a prior authorization request

Usage:

Formal Views of Profile Content

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

This structure is derived from DeviceRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..* DeviceRequest Medical device request
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... coverage S 0..1 (Complex) CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... intent S 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Fixed Value: order
... code[x] S 1..1 CodeableConcept Device requested
Binding: X12 278 Requested Service Type (required)
... occurrence[x] S 0..1 PASTiming A timing schedule that specifies an event that may occur multiple times

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
DeviceRequest.code[x]requiredX12278RequestedServiceType
http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..* DeviceRequest Medical device request
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... coverage SC 0..1 (Complex) CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
crd-ci-q1: Questionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' should not exist.
crd-ci-q3: If 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.


Fixed Value: order
... code[x] SΣ 1..1 CodeableConcept Device requested
Binding: X12 278 Requested Service Type (required)
... subject SΣ 1..1 Reference(PAS Beneficiary Patient) Focus of request
... occurrence[x] S 0..1 PASTiming A timing schedule that specifies an event that may occur multiple times

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DeviceRequest.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
DeviceRequest.intentrequiredFixed Value: order
http://hl7.org/fhir/ValueSet/request-intent|4.0.1
from the FHIR Standard
DeviceRequest.code[x]requiredX12278RequestedServiceType
http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..* DeviceRequest Medical device request
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... coverage SC 0..1 (Complex) CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
crd-ci-q1: Questionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' should not exist.
crd-ci-q3: If 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Request identifier
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(Resource) What request fulfills
... priorRequest Σ 0..* Reference(Resource) What request replaces
... groupIdentifier Σ 0..1 Identifier Identifier of composite request
... status ?!Σ 0..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.

... intent ?!SΣ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.


Fixed Value: order
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... code[x] SΣ 1..1 CodeableConcept Device requested
Binding: X12 278 Requested Service Type (required)
... parameter 0..* BackboneElement Device details
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 0..1 CodeableConcept Device detail
Binding Description (No ValueSet): (example): A code that identifies the device detail.

.... value[x] 0..1 Value of detail
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
... subject SΣ 1..1 Reference(PAS Beneficiary Patient) Focus of request
... encounter Σ 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] S 0..1 PASTiming A timing schedule that specifies an event that may occur multiple times
... authoredOn Σ 0..1 dateTime When recorded
... requester Σ 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Who/what is requesting diagnostics
... performerType Σ 0..1 CodeableConcept Filler role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer Σ 0..1 Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested Filler
... reasonCode Σ 0..* CodeableConcept Coded Reason for request
Binding: Condition/Problem/DiagnosisCodes (example): Diagnosis or problem codes justifying the reason for requesting the device.


... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Linked Reason for request
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... note 0..* Annotation Notes or comments
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DeviceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
DeviceRequest.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
DeviceRequest.intentrequiredFixed Value: order
http://hl7.org/fhir/ValueSet/request-intent|4.0.1
from the FHIR Standard
DeviceRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
DeviceRequest.code[x]requiredX12278RequestedServiceType
http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType
from this IG
DeviceRequest.parameter.codeexample
DeviceRequest.performerTypeexampleParticipantRoles
http://hl7.org/fhir/ValueSet/participant-role
from the FHIR Standard
DeviceRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard

This structure is derived from DeviceRequest

Differential View

This structure is derived from DeviceRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..* DeviceRequest Medical device request
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... coverage S 0..1 (Complex) CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... intent S 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Fixed Value: order
... code[x] S 1..1 CodeableConcept Device requested
Binding: X12 278 Requested Service Type (required)
... occurrence[x] S 0..1 PASTiming A timing schedule that specifies an event that may occur multiple times

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
DeviceRequest.code[x]requiredX12278RequestedServiceType
http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..* DeviceRequest Medical device request
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... coverage SC 0..1 (Complex) CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
crd-ci-q1: Questionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' should not exist.
crd-ci-q3: If 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.


Fixed Value: order
... code[x] SΣ 1..1 CodeableConcept Device requested
Binding: X12 278 Requested Service Type (required)
... subject SΣ 1..1 Reference(PAS Beneficiary Patient) Focus of request
... occurrence[x] S 0..1 PASTiming A timing schedule that specifies an event that may occur multiple times

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DeviceRequest.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
DeviceRequest.intentrequiredFixed Value: order
http://hl7.org/fhir/ValueSet/request-intent|4.0.1
from the FHIR Standard
DeviceRequest.code[x]requiredX12278RequestedServiceType
http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType
from this IG

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..* DeviceRequest Medical device request
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... coverage SC 0..1 (Complex) CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
crd-ci-q1: Questionnaire and QuestionnaireResponse are only allowed when doc-needed exists and not equal to 'no-doc'
crd-ci-q2: If covered is set to 'not-covered', then 'pa-needed' should not exist.
crd-ci-q3: If 'info-needed' exists, then at least one of 'covered', 'pa-needed', or 'doc-needed' must be 'conditional'.
crd-ci-q4: If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'PA'.
crd-ci-q5: 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Request identifier
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(Resource) What request fulfills
... priorRequest Σ 0..* Reference(Resource) What request replaces
... groupIdentifier Σ 0..1 Identifier Identifier of composite request
... status ?!Σ 0..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.

... intent ?!SΣ 1..1 code proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.


Fixed Value: order
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... code[x] SΣ 1..1 CodeableConcept Device requested
Binding: X12 278 Requested Service Type (required)
... parameter 0..* BackboneElement Device details
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code 0..1 CodeableConcept Device detail
Binding Description (No ValueSet): (example): A code that identifies the device detail.

.... value[x] 0..1 Value of detail
..... valueCodeableConcept CodeableConcept
..... valueQuantity Quantity
..... valueRange Range
..... valueBoolean boolean
... subject SΣ 1..1 Reference(PAS Beneficiary Patient) Focus of request
... encounter Σ 0..1 Reference(Encounter) Encounter motivating request
... occurrence[x] S 0..1 PASTiming A timing schedule that specifies an event that may occur multiple times
... authoredOn Σ 0..1 dateTime When recorded
... requester Σ 0..1 Reference(Device | Practitioner | PractitionerRole | Organization) Who/what is requesting diagnostics
... performerType Σ 0..1 CodeableConcept Filler role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer Σ 0..1 Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested Filler
... reasonCode Σ 0..* CodeableConcept Coded Reason for request
Binding: Condition/Problem/DiagnosisCodes (example): Diagnosis or problem codes justifying the reason for requesting the device.


... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Linked Reason for request
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... note 0..* Annotation Notes or comments
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
DeviceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
DeviceRequest.statusrequiredRequestStatus
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
DeviceRequest.intentrequiredFixed Value: order
http://hl7.org/fhir/ValueSet/request-intent|4.0.1
from the FHIR Standard
DeviceRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
DeviceRequest.code[x]requiredX12278RequestedServiceType
http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType
from this IG
DeviceRequest.parameter.codeexample
DeviceRequest.performerTypeexampleParticipantRoles
http://hl7.org/fhir/ValueSet/participant-role
from the FHIR Standard
DeviceRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard

This structure is derived from DeviceRequest

 

Other representations of profile: CSV, Excel, Schematron