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 2.2.1 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
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
<http://hl7.org/fhir/Parameters/PASClaimInquiryOperationResponseExample> a fhir:Parameters ;
fhir:nodeRole fhir:treeRoot ;
fhir:Resource.id [ fhir:value "PASClaimInquiryOperationResponseExample"] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:Parameters.parameter [
fhir:index -1 ;
fhir:Parameters.parameter.name [ fhir:value "responseBundle" ] ;
fhir:Parameters.parameter.resource [
a fhir:Bundle ;
fhir:Resource.id [ fhir:value "PASClaimInquiryResponseBundleExample" ] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-response-bundle" ;
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-response-bundle>
]
] ;
fhir:Resource.language [ fhir:value "en" ] ;
fhir:Bundle.identifier [
fhir:Identifier.system [ fhir:value "http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER" ] ;
fhir:Identifier.value [ fhir:value "5269367" ]
] ;
fhir:Bundle.type [ fhir:value "collection" ] ;
fhir:Bundle.timestamp [ fhir:value "2005-05-02T11:01:00+05:00"^^xsd:dateTime ] ;
fhir:Bundle.entry [
fhir:index -1 ;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/ClaimResponse/PASClaimInquiryResponseExample" ] ;
fhir:Bundle.entry.resource <http://example.org/fhir/ClaimResponse/PASClaimInquiryResponseExample>
], [
fhir:index -1 ;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Organization/UMOExample" ] ;
fhir:Bundle.entry.resource <http://example.org/fhir/Organization/UMOExample>
], [
fhir:index -1 ;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Organization/InsurerExample" ] ;
fhir:Bundle.entry.resource <http://example.org/fhir/Organization/InsurerExample>
], [
fhir:index -1 ;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Coverage/InsuranceExample" ] ;
fhir:Bundle.entry.resource <http://example.org/fhir/Coverage/InsuranceExample>
], [
fhir:index -1 ;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Patient/SubscriberExample" ] ;
fhir:Bundle.entry.resource <http://example.org/fhir/Patient/SubscriberExample>
], [
fhir:index -1 ;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Claim/ReferralAuthorizationExample" ] ;
fhir:Bundle.entry.resource <http://example.org/fhir/Claim/ReferralAuthorizationExample>
]
]
] .
<http://example.org/fhir/ClaimResponse/PASClaimInquiryResponseExample> a fhir:ClaimResponse ;
fhir:Resource.id [ fhir:value "PASClaimInquiryResponseExample"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse" ;
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse>
]
] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:ClaimResponse.identifier [
fhir:index -1 ;
fhir:Identifier.system [ fhir:value "http://example.org/PATIENT_EVENT_TRACE_NUMBER" ] ;
fhir:Identifier.value [ fhir:value "111099" ] ;
fhir:Identifier.assigner [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://example.org/USER_ASSIGNED" ] ;
fhir:Identifier.value [ fhir:value "9012345678" ]
]
]
] ;
fhir:ClaimResponse.status [ fhir:value "active"] ;
fhir:ClaimResponse.type [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ;
fhir:Coding.code [ fhir:value "professional" ]
]
] ;
fhir:ClaimResponse.use [ fhir:value "preauthorization"] ;
fhir:ClaimResponse.patient [
fhir:link <http://hl7.org/fhir/Patient/SubscriberExample> ;
fhir:Reference.reference [ fhir:value "Patient/SubscriberExample" ]
] ;
fhir:ClaimResponse.created [ fhir:value "2019-07-20T11:01:00+05:00"^^xsd:dateTime] ;
fhir:ClaimResponse.insurer [
fhir:link <http://hl7.org/fhir/Organization/InsurerExample> ;
fhir:Reference.reference [ fhir:value "Organization/InsurerExample" ]
] ;
fhir:ClaimResponse.request [
fhir:link <http://hl7.org/fhir/Claim/ReferralAuthorizationExample> ;
fhir:Reference.reference [ fhir:value "Claim/ReferralAuthorizationExample" ]
] ;
fhir:ClaimResponse.outcome [ fhir:value "complete"] ;
fhir:ClaimResponse.item [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "provider" ] ;
fhir:Extension.valueReference [
fhir:link <http://hl7.org/fhir/Practitioner/ReferralPractitionerExample> ;
fhir:Reference.reference [ fhir:value "Practitioner/ReferralPractitionerExample" ]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/98" ] ;
fhir:Coding.code [ fhir:value "P3" ]
]
]
] ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemRequestedServiceDate" ] ;
fhir:Extension.valuePeriod [
fhir:Period.start [ fhir:value "2005-05-02"^^xsd:date ] ;
fhir:Period.end [ fhir:value "2005-06-02"^^xsd:date ]
]
] ;
fhir:ClaimResponse.item.itemSequence [ fhir:value "1"^^xsd:positiveInteger ] ;
fhir:ClaimResponse.item.adjudication [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "number" ] ;
fhir:Extension.valueString [ fhir:value "AUTH0001" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/306" ] ;
fhir:Coding.code [ fhir:value "A1" ] ;
fhir:Coding.display [ fhir:value "Certified in total" ]
]
]
] ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction" ]
] ;
fhir:ClaimResponse.item.adjudication.category [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ;
fhir:Coding.code [ fhir:value "submitted" ]
]
]
]
] ;
fhir:ClaimResponse.insurance [
fhir:index -1 ;
fhir:ClaimResponse.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
fhir:ClaimResponse.insurance.focal [ fhir:value "true"^^xsd:boolean ] ;
fhir:ClaimResponse.insurance.coverage [
fhir:link <http://hl7.org/fhir/Coverage/InsuranceExample> ;
fhir:Reference.reference [ fhir:value "Coverage/InsuranceExample" ]
]
] .
<http://hl7.org/fhir/Patient/SubscriberExample> a fhir:Patient .
<http://hl7.org/fhir/Organization/InsurerExample> a fhir:Organization .
<http://hl7.org/fhir/Claim/ReferralAuthorizationExample> a fhir:Claim .
<http://hl7.org/fhir/Practitioner/ReferralPractitionerExample> a fhir:Practitioner .
<http://hl7.org/fhir/Coverage/InsuranceExample> a fhir:Coverage .
<http://example.org/fhir/Organization/UMOExample> a fhir:Organization ;
fhir:Resource.id [ fhir:value "UMOExample"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor" ;
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor>
]
] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:Organization.identifier [
fhir:index -1 ;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "8189991234" ]
] ;
fhir:Organization.active [ fhir:value "true"^^xsd:boolean] ;
fhir:Organization.type [
fhir:index -1 ;
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/98" ] ;
fhir:Coding.code [ fhir:value "X3" ]
]
] ;
fhir:Organization.name [ fhir:value "DR. JOE SMITH CORPORATION"] ;
fhir:Organization.address [
fhir:index -1 ;
fhir:Address.line [
fhir:value "111 1ST STREET" ;
fhir:index -1
] ;
fhir:Address.city [ fhir:value "SAN DIEGO" ] ;
fhir:Address.state [ fhir:value "CA" ] ;
fhir:Address.postalCode [ fhir:value "92101" ] ;
fhir:Address.country [ fhir:value "US" ]
] .
<http://example.org/fhir/Organization/InsurerExample> a fhir:Organization ;
fhir:Resource.id [ fhir:value "InsurerExample"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer" ;
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer>
]
] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:Organization.identifier [
fhir:index -1 ;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
fhir:Identifier.value [ fhir:value "1234567893" ]
] ;
fhir:Organization.active [ fhir:value "true"^^xsd:boolean] ;
fhir:Organization.type [
fhir:index -1 ;
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/98" ] ;
fhir:Coding.code [ fhir:value "PR" ]
]
] ;
fhir:Organization.name [ fhir:value "MARYLAND CAPITAL INSURANCE COMPANY"] .
<http://example.org/fhir/Coverage/InsuranceExample> a fhir:Coverage ;
fhir:Resource.id [ fhir:value "InsuranceExample"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage" ;
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage>
]
] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:Coverage.identifier [
fhir:index -1 ;
fhir:Identifier.type [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ] ;
fhir:Coding.code [ fhir:value "MB" ]
]
]
] ;
fhir:Coverage.status [ fhir:value "active"] ;
fhir:Coverage.subscriberId [ fhir:value "1122334455"] ;
fhir:Coverage.beneficiary [
fhir:link <http://hl7.org/fhir/Patient/SubscriberExample> ;
fhir:Reference.reference [ fhir:value "Patient/SubscriberExample" ]
] ;
fhir:Coverage.relationship [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/subscriber-relationship" ] ;
fhir:Coding.code [ fhir:value "self" ]
], [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/1069" ] ;
fhir:Coding.code [ fhir:value "18" ]
]
] ;
fhir:Coverage.payor [
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/Organization/InsurerExample> ;
fhir:Reference.reference [ fhir:value "Organization/InsurerExample" ]
] .
<http://example.org/fhir/Patient/SubscriberExample> a fhir:Patient ;
fhir:Resource.id [ fhir:value "SubscriberExample"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber" ;
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber>
]
] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:DomainResource.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/584" ] ;
fhir:Coding.code [ fhir:value "RU" ]
]
]
] ;
fhir:Patient.identifier [
fhir:index -1 ;
fhir:Identifier.system [ fhir:value "http://example.org/MIN" ] ;
fhir:Identifier.value [ fhir:value "12345678901" ]
] ;
fhir:Patient.name [
fhir:index -1 ;
fhir:HumanName.family [ fhir:value "SMITH" ] ;
fhir:HumanName.given [
fhir:value "JOE" ;
fhir:index -1
]
] ;
fhir:Patient.gender [ fhir:value "male"] .
<http://example.org/fhir/Claim/ReferralAuthorizationExample> a fhir:Claim ;
fhir:Resource.id [ fhir:value "ReferralAuthorizationExample"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim" ;
fhir:index -1 ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim>
]
] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:DomainResource.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-levelOfServiceCode" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/1338" ] ;
fhir:Coding.code [ fhir:value "U" ] ;
fhir:Coding.display [ fhir:value "Urgent" ]
]
]
], [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "applicationSenderCode" ] ;
fhir:Extension.valueString [ fhir:value "PROVIDERAPP" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "applicationReceiverCode" ] ;
fhir:Extension.valueString [ fhir:value "PAYERAPP" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "interchangeSenderID" ] ;
fhir:Extension.valueString [ fhir:value "PROVIDERID" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "interchangeReceiverID" ] ;
fhir:Extension.valueString [ fhir:value "PAYERID" ]
] ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers" ]
] ;
fhir:Claim.identifier [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://www.usps.com/" ] ;
fhir:Coding.code [ fhir:value "MA" ]
]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment" ] ;
fhir:Extension.valueString [ fhir:value "223412" ]
] ;
fhir:Identifier.system [ fhir:value "urn:trnorg:9012345678" ] ;
fhir:Identifier.value [ fhir:value "111099" ] ;
fhir:Identifier.assigner [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://example.org/USER_ASSIGNED" ] ;
fhir:Identifier.value [ fhir:value "9012345678" ]
]
]
] ;
fhir:Claim.status [ fhir:value "active"] ;
fhir:Claim.type [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ;
fhir:Coding.code [ fhir:value "professional" ]
]
] ;
fhir:Claim.use [ fhir:value "preauthorization"] ;
fhir:Claim.patient [
fhir:link <http://hl7.org/fhir/Patient/SubscriberExample> ;
fhir:Reference.reference [ fhir:value "Patient/SubscriberExample" ]
] ;
fhir:Claim.created [ fhir:value "2005-05-02T11:01:00+05:00"^^xsd:dateTime] ;
fhir:Claim.insurer [
fhir:link <http://hl7.org/fhir/Organization/InsurerExample> ;
fhir:Reference.reference [ fhir:value "Organization/InsurerExample" ]
] ;
fhir:Claim.provider [
fhir:link <http://hl7.org/fhir/Organization/UMOExample> ;
fhir:Reference.reference [ fhir:value "Organization/UMOExample" ]
] ;
fhir:Claim.priority [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ] ;
fhir:Coding.code [ fhir:value "normal" ]
]
] ;
fhir:Claim.careTeam [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope" ] ;
fhir:Extension.valueBoolean [ fhir:value "true"^^xsd:boolean ]
] ;
fhir:Claim.careTeam.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
fhir:Claim.careTeam.provider [
fhir:link <http://hl7.org/fhir/PractitionerRole/ReferralPractitionerRoleExample> ;
fhir:Reference.reference [ fhir:value "PractitionerRole/ReferralPractitionerRoleExample" ]
]
] ;
fhir:Claim.supportingInfo [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "reportTypeCode" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/755" ] ;
fhir:Coding.code [ fhir:value "PY" ] ;
fhir:Coding.display [ fhir:value "Physician's Report" ]
]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "transmissionMethod" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/756" ] ;
fhir:Coding.code [ fhir:value "EL" ] ;
fhir:Coding.display [ fhir:value "Electronically Only" ]
]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "controlNumber" ] ;
fhir:Extension.valueString [ fhir:value "111222" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "description" ] ;
fhir:Extension.valueString [ fhir:value "A procedure note included to provide details of what has been tried before the referral." ]
] ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation" ]
] ;
fhir:Claim.supportingInfo.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes" ] ;
fhir:Coding.code [ fhir:value "additionalInformation" ]
]
] ;
fhir:Claim.supportingInfo.valueReference [
fhir:link <http://hl7.org/fhir/DocumentReference/DocumentReferenceExample> ;
fhir:Reference.reference [ fhir:value "DocumentReference/DocumentReferenceExample" ]
]
] ;
fhir:Claim.diagnosis [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate" ] ;
fhir:Extension.valueDate [ fhir:value "2021-05-10"^^xsd:date ]
] ;
fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
fhir:Claim.diagnosis.diagnosisCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/sid/icd-10-cm" ] ;
fhir:Coding.code [ fhir:value "G89.4" ]
]
]
] ;
fhir:Claim.insurance [
fhir:index -1 ;
fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ] ;
fhir:Claim.insurance.coverage [
fhir:link <http://hl7.org/fhir/Coverage/InsuranceExample> ;
fhir:Reference.reference [ fhir:value "Coverage/InsuranceExample" ]
]
] ;
fhir:Claim.item [
fhir:index -1 ;
fhir:Element.extension [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/1525" ] ;
fhir:Coding.code [ fhir:value "SC" ] ;
fhir:Coding.display [ fhir:value "Specialty Care Review" ]
]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/1322" ] ;
fhir:Coding.code [ fhir:value "I" ] ;
fhir:Coding.display [ fhir:value "Initial" ]
]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber" ] ;
fhir:Extension.valueIdentifier [
fhir:Identifier.system [ fhir:value "http://example.org/ITEM_TRACE_NUMBER" ] ;
fhir:Identifier.value [ fhir:value "1122334" ]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizationNumber" ] ;
fhir:Extension.valueString [ fhir:value "1122445" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber" ] ;
fhir:Extension.valueString [ fhir:value "9988311" ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService" ] ;
fhir:Extension.valueReference [
fhir:link <http://hl7.org/fhir/ServiceRequest/ReferralRequestExample> ;
fhir:Reference.reference [ fhir:value "ServiceRequest/ReferralRequestExample" ]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator" ] ;
fhir:Extension.valueBoolean [ fhir:value "false"^^xsd:boolean ]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/1345" ] ;
fhir:Coding.code [ fhir:value "2" ] ;
fhir:Coding.display [ fhir:value "Newly Admitted" ]
]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare" ] ;
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/1337" ] ;
fhir:Coding.code [ fhir:value "2" ] ;
fhir:Coding.display [ fhir:value "Intermediate Care Facility (ICF)" ]
]
]
], [
fhir:index -1 ;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit" ] ;
fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
] ;
fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
fhir:Claim.item.careTeamSequence [
fhir:value "1"^^xsd:positiveInteger ;
fhir:index -1
] ;
fhir:Claim.item.diagnosisSequence [
fhir:value "1"^^xsd:positiveInteger ;
fhir:index -1
] ;
fhir:Claim.item.category [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/1365" ] ;
fhir:Coding.code [ fhir:value "3" ] ;
fhir:Coding.display [ fhir:value "Consultation" ]
]
] ;
fhir:Claim.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/1365" ] ;
fhir:Coding.code [ fhir:value "3" ] ;
fhir:Coding.display [ fhir:value "Consultation" ]
]
] ;
fhir:Claim.item.locationCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index -1 ;
fhir:Coding.system [ fhir:value "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set" ] ;
fhir:Coding.code [ fhir:value "11" ]
]
]
] .
<http://hl7.org/fhir/Organization/UMOExample> a fhir:Organization .
<http://hl7.org/fhir/PractitionerRole/ReferralPractitionerRoleExample> a fhir:PractitionerRole .
<http://hl7.org/fhir/DocumentReference/DocumentReferenceExample> a fhir:DocumentReference .
<http://hl7.org/fhir/ServiceRequest/ReferralRequestExample> a fhir:ServiceRequest .
# - ontology header ------------------------------------------------------------
<http://hl7.org/fhir/Parameters/PASClaimInquiryOperationResponseExample.ttl> a owl:Ontology ;
owl:imports fhir:fhir.ttl ;
owl:versionIRI <http://build.fhir.org/Parameters/PASClaimInquiryOperationResponseExample.ttl> .
IG © 2020+ HL7 International / Financial Management.
Package hl7.fhir.us.davinci-pas#2.2.1 based on FHIR 4.0.1.
Generated
2026-08-28
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