Da Vinci Prior Authorization Support (PAS) FHIR IG
2.0.1 - 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 2.0.1 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: 2.0.1
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..*DeviceRequestMedical device request
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... coverage S0..1(Complex)CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... intent 1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Fixed Value: order
... subject S1..1Reference(PAS Beneficiary Patient)Focus of request
... occurrence[x] S0..1PASTimingA timing schedule that specifies an event that may occur multiple times

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
DeviceRequest.code[x]requiredX12278RequestedServiceType
NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..*DeviceRequestMedical device request
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... coverage SC0..1(Complex)CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... status ?!Σ0..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.

... intent ?!Σ1..1codeproposal | 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] SΣ1..1CodeableConceptDevice requested
Binding: X12 278 Requested Service Type (required)
... subject SΣ1..1Reference(PAS Beneficiary Patient)Focus of request
... occurrence[x] S0..1PASTimingA timing schedule that specifies an event that may occur multiple times

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
DeviceRequest.statusrequiredRequestStatus
DeviceRequest.intentrequiredFixed Value: order
DeviceRequest.code[x]requiredX12278RequestedServiceType
NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..*DeviceRequestMedical device request
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... coverage SC0..1(Complex)CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Request identifier
... instantiatesCanonical Σ0..*canonical(ActivityDefinition | PlanDefinition)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(Resource)What request fulfills
... priorRequest Σ0..*Reference(Resource)What request replaces
... groupIdentifier Σ0..1IdentifierIdentifier of composite request
... status ?!Σ0..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.

... intent ?!Σ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.


Fixed Value: order
... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... code[x] SΣ1..1CodeableConceptDevice requested
Binding: X12 278 Requested Service Type (required)
... parameter 0..*BackboneElementDevice details
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code 0..1CodeableConceptDevice detail
Binding: (unbound) (example): A code that identifies the device detail.

.... value[x] 0..1Value of detail
..... valueCodeableConceptCodeableConcept
..... valueQuantityQuantity
..... valueRangeRange
..... valueBooleanboolean
... subject SΣ1..1Reference(PAS Beneficiary Patient)Focus of request
... encounter Σ0..1Reference(Encounter)Encounter motivating request
... occurrence[x] S0..1PASTimingA timing schedule that specifies an event that may occur multiple times
... authoredOn Σ0..1dateTimeWhen recorded
... requester Σ0..1Reference(Device | Practitioner | PractitionerRole | Organization)Who/what is requesting diagnostics
... performerType Σ0..1CodeableConceptFiller role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer Σ0..1Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)Requested Filler
... reasonCode Σ0..*CodeableConceptCoded Reason for request
Binding: Condition/Problem/DiagnosisCodes (example): Diagnosis or problem codes justifying the reason for requesting the device.


... reasonReference Σ0..*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..*AnnotationNotes or comments
... relevantHistory 0..*Reference(Provenance)Request provenance

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
DeviceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
DeviceRequest.statusrequiredRequestStatus
DeviceRequest.intentrequiredFixed Value: order
DeviceRequest.priorityrequiredRequestPriority
DeviceRequest.code[x]requiredX12278RequestedServiceType
DeviceRequest.parameter.codeexample
DeviceRequest.performerTypeexampleParticipantRoles
DeviceRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes

This structure is derived from DeviceRequest

Differential View

This structure is derived from DeviceRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..*DeviceRequestMedical device request
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... coverage S0..1(Complex)CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... intent 1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Fixed Value: order
... subject S1..1Reference(PAS Beneficiary Patient)Focus of request
... occurrence[x] S0..1PASTimingA timing schedule that specifies an event that may occur multiple times

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
DeviceRequest.code[x]requiredX12278RequestedServiceType

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..*DeviceRequestMedical device request
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... coverage SC0..1(Complex)CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... status ?!Σ0..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.

... intent ?!Σ1..1codeproposal | 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] SΣ1..1CodeableConceptDevice requested
Binding: X12 278 Requested Service Type (required)
... subject SΣ1..1Reference(PAS Beneficiary Patient)Focus of request
... occurrence[x] S0..1PASTimingA timing schedule that specifies an event that may occur multiple times

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
DeviceRequest.statusrequiredRequestStatus
DeviceRequest.intentrequiredFixed Value: order
DeviceRequest.code[x]requiredX12278RequestedServiceType

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. DeviceRequest 0..*DeviceRequestMedical device request
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... Slices for extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... coverage SC0..1(Complex)CoverageInfo
URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Request identifier
... instantiatesCanonical Σ0..*canonical(ActivityDefinition | PlanDefinition)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(Resource)What request fulfills
... priorRequest Σ0..*Reference(Resource)What request replaces
... groupIdentifier Σ0..1IdentifierIdentifier of composite request
... status ?!Σ0..1codedraft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): Codes representing the status of the request.

... intent ?!Σ1..1codeproposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of diagnostic request.


Fixed Value: order
... priority Σ0..1coderoutine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

... code[x] SΣ1..1CodeableConceptDevice requested
Binding: X12 278 Requested Service Type (required)
... parameter 0..*BackboneElementDevice details
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code 0..1CodeableConceptDevice detail
Binding: (unbound) (example): A code that identifies the device detail.

.... value[x] 0..1Value of detail
..... valueCodeableConceptCodeableConcept
..... valueQuantityQuantity
..... valueRangeRange
..... valueBooleanboolean
... subject SΣ1..1Reference(PAS Beneficiary Patient)Focus of request
... encounter Σ0..1Reference(Encounter)Encounter motivating request
... occurrence[x] S0..1PASTimingA timing schedule that specifies an event that may occur multiple times
... authoredOn Σ0..1dateTimeWhen recorded
... requester Σ0..1Reference(Device | Practitioner | PractitionerRole | Organization)Who/what is requesting diagnostics
... performerType Σ0..1CodeableConceptFiller role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

... performer Σ0..1Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)Requested Filler
... reasonCode Σ0..*CodeableConceptCoded Reason for request
Binding: Condition/Problem/DiagnosisCodes (example): Diagnosis or problem codes justifying the reason for requesting the device.


... reasonReference Σ0..*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..*AnnotationNotes or comments
... relevantHistory 0..*Reference(Provenance)Request provenance

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
DeviceRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
DeviceRequest.statusrequiredRequestStatus
DeviceRequest.intentrequiredFixed Value: order
DeviceRequest.priorityrequiredRequestPriority
DeviceRequest.code[x]requiredX12278RequestedServiceType
DeviceRequest.parameter.codeexample
DeviceRequest.performerTypeexampleParticipantRoles
DeviceRequest.reasonCodeexampleCondition/Problem/DiagnosisCodes

This structure is derived from DeviceRequest

 

Other representations of profile: CSV, Excel, Schematron