Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.1 - STU 2.2 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 2.2.1 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

Logical Model: PAS Metric Data

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/PASMetricData Version: 2.2.1
Standards status: Informative Maturity Level: 1 Computable Name: PASMetricData
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.1

A logical model describing the information that ought to be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation

Usages:

  • This Logical Model is not used by any profiles in this Specification

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

This structure is derived from Base

NameFlagsCard.TypeDescription & Constraints    Filter: doco
PASMetricData 0..* Base PAS Metric Data
PASMetricData.source 1..1 code provider | intermediary | payer
Binding: MetricDataSource (2.2.1) (required)
PASMetricData.providerId 1..1 Identifier User invoking hook
PASMetricData.providerId.system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
PASMetricData.providerId.value 1..1 string The value that is unique
PASMetricData.groupId 1..1 Identifier Healthcare org of user
PASMetricData.groupId.system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
PASMetricData.groupId.value 1..1 string The value that is unique
PASMetricData.payerId.system 1..1 uri The namespace for the identifier value
PASMetricData.payerId.value 1..1 string The value that is unique
PASMetricData.exchange 1..* BackboneElement Prior Authorization Exchanges
PASMetricData.exchange.type 1..1 code initial | subsequent | cancel | update | query | initialDocToPayer
PASMetricData.exchange.with 0..1 code provider | intermediary | payer
PASMetricData.exchange.method 1..1 code x12 | restful | ihe | direct | other
PASMetricData.exchange.requestTime 1..1 instant Time exchange initiated
PASMetricData.exchange.responseTime 0..1 instant Time of exchange response
PASMetricData.exchange.httpResponse 1..1 code e.g. 200
PASMetricData.issue 0..* BackboneElement OperationOutcome info
PASMetricData.issue.code 1..1 code Error code
Binding: IssueType (required)
PASMetricData.issue.details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
PASMetricData.aaaCodes 0..* BackboneElement AAA codes returned
PASMetricData.aaaCodes.loopID 1..1 code see X12 loop IDs
PASMetricData.aaaCodes.aaaCode 1..1 code approved | modified | denied
PASMetricData.itemDetail 0..* BackboneElement Service level item detail
PASMetricData.itemDetail.trn 0..1 integer Service Level TRN
PASMetricData.itemDetail.item 1..1 CodeableConcept eg. ICD10, HCPCS, NDC
PASMetricData.itemDetail.assertionId 0..1 string Unique ID for order item
PASMetricData.itemDetail.initialSubmissionTime 0..1 dateTime Date/time of the initial submission of the item
PASMetricData.itemDetail.finalResponseTime 0..1 dateTime Date/time of final result
PASMetricData.itemDetail.responsesRequired 0..1 integer Number of responses
PASMetricData.itemDetail.aaaCodes 0..* BackboneElement AAA codes returned
PASMetricData.itemDetail.aaaCodes.loopID 1..1 code see X12 loop IDs
PASMetricData.itemDetail.aaaCodes.aaaCode 1..1 code approved | modified | deined
PASMetricData.itemDetail.locationType 0..1 code inpatient | outpatient | home
PASMetricData.itemDetail.result 0..1 code approved | modified | denied | pended | cancelled
PASMetricData.itemDetail.denialReason 0..1 code Denial Reason
PASMetricData.supportingDoc 0..1 url Documentation submitted as part of PAS Bundle
PASMetricData.requestedDoc 0..* BackboneElement Documentation requested via 278 response
PASMetricData.requestedDoc.docRequest 1..* CodeableConcept Coded requests for additional documentation
PASMetricData.requestedDoc.timeRequested 1..1 dateTime Date/Time of initial request
PASMetricData.requestedDoc.timeSubmitted 0..1 dateTime Date/Time of final result
PASMetricData.requestedDoc.submissionMethod 0..1 code CDex | portal | fax | x12 | other
PASMetricData.exceptionSubmission 0..1 boolean True if exchange is based on the exception grant
PASMetricData.businessLine 0..1 CodeableConcept E.g. MedicareAdvantage

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
PASMetricData.source Base required Metric Data Source 📍2.2.1 This IG
PASMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
PASMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.
NameFlagsCard.TypeDescription & Constraints    Filter: doco
PASMetricData 0..* Base PAS Metric Data
PASMetricData.source 1..1 code provider | intermediary | payer
Binding: MetricDataSource (2.2.1) (required)
PASMetricData.providerId 1..1 Identifier User invoking hook
PASMetricData.providerId.@id 0..1 string Unique id for inter-element referencing
PASMetricData.providerId.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.providerId.use This element is a modifier element. This element is included in summaries. 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
PASMetricData.providerId.type This element is included in summaries. 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
PASMetricData.providerId.system This element is included in summaries. 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
PASMetricData.providerId.value This element is included in summaries. 1..1 string The value that is unique
Example General: 123456
PASMetricData.providerId.period This element is included in summaries. 0..1 Period Time period when id is/was valid for use
PASMetricData.providerId.assigner This element is included in summaries. 0..1 Reference(Organization) Organization that issued id (may be just text)
PASMetricData.groupId 1..1 Identifier Healthcare org of user
PASMetricData.groupId.@id 0..1 string Unique id for inter-element referencing
PASMetricData.groupId.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.groupId.use This element is a modifier element. This element is included in summaries. 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
PASMetricData.groupId.type This element is included in summaries. 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
PASMetricData.groupId.system This element is included in summaries. 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
PASMetricData.groupId.value This element is included in summaries. 1..1 string The value that is unique
Example General: 123456
PASMetricData.groupId.period This element is included in summaries. 0..1 Period Time period when id is/was valid for use
PASMetricData.groupId.assigner This element is included in summaries. 0..1 Reference(Organization) Organization that issued id (may be just text)
PASMetricData.payerId 1..1 Identifier Payer receiving hook
PASMetricData.payerId.@id 0..1 string Unique id for inter-element referencing
PASMetricData.payerId.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.payerId.use This element is a modifier element. This element is included in summaries. 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
PASMetricData.payerId.type This element is included in summaries. 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
PASMetricData.payerId.system This element is included in summaries. 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
PASMetricData.payerId.value This element is included in summaries. 1..1 string The value that is unique
Example General: 123456
PASMetricData.payerId.period This element is included in summaries. 0..1 Period Time period when id is/was valid for use
PASMetricData.payerId.assigner This element is included in summaries. 0..1 Reference(Organization) Organization that issued id (may be just text)
PASMetricData.exchange 1..* BackboneElement Prior Authorization Exchanges
PASMetricData.exchange.@id 0..1 string Unique id for inter-element referencing
PASMetricData.exchange.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.exchange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.exchange.type 1..1 code initial | subsequent | cancel | update | query | initialDocToPayer
PASMetricData.exchange.with 0..1 code provider | intermediary | payer
PASMetricData.exchange.method 1..1 code x12 | restful | ihe | direct | other
PASMetricData.exchange.requestTime 1..1 instant Time exchange initiated
PASMetricData.exchange.responseTime 0..1 instant Time of exchange response
PASMetricData.exchange.httpResponse 1..1 code e.g. 200
PASMetricData.issue 0..* BackboneElement OperationOutcome info
PASMetricData.issue.@id 0..1 string Unique id for inter-element referencing
PASMetricData.issue.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.issue.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.issue.code 1..1 code Error code
Binding: IssueType (required)
PASMetricData.issue.details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
PASMetricData.aaaCodes 0..* BackboneElement AAA codes returned
PASMetricData.aaaCodes.@id 0..1 string Unique id for inter-element referencing
PASMetricData.aaaCodes.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.aaaCodes.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.aaaCodes.loopID 1..1 code see X12 loop IDs
PASMetricData.aaaCodes.aaaCode 1..1 code approved | modified | denied
PASMetricData.itemDetail 0..* BackboneElement Service level item detail
PASMetricData.itemDetail.@id 0..1 string Unique id for inter-element referencing
PASMetricData.itemDetail.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.itemDetail.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.itemDetail.trn 0..1 integer Service Level TRN
PASMetricData.itemDetail.item 1..1 CodeableConcept eg. ICD10, HCPCS, NDC
PASMetricData.itemDetail.assertionId 0..1 string Unique ID for order item
PASMetricData.itemDetail.initialSubmissionTime 0..1 dateTime Date/time of the initial submission of the item
PASMetricData.itemDetail.finalResponseTime 0..1 dateTime Date/time of final result
PASMetricData.itemDetail.responsesRequired 0..1 integer Number of responses
PASMetricData.itemDetail.aaaCodes 0..* BackboneElement AAA codes returned
PASMetricData.itemDetail.aaaCodes.@id 0..1 string Unique id for inter-element referencing
PASMetricData.itemDetail.aaaCodes.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.itemDetail.aaaCodes.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.itemDetail.aaaCodes.loopID 1..1 code see X12 loop IDs
PASMetricData.itemDetail.aaaCodes.aaaCode 1..1 code approved | modified | deined
PASMetricData.itemDetail.locationType 0..1 code inpatient | outpatient | home
PASMetricData.itemDetail.result 0..1 code approved | modified | denied | pended | cancelled
PASMetricData.itemDetail.denialReason 0..1 code Denial Reason
PASMetricData.supportingDoc 0..1 url Documentation submitted as part of PAS Bundle
PASMetricData.requestedDoc 0..* BackboneElement Documentation requested via 278 response
PASMetricData.requestedDoc.@id 0..1 string Unique id for inter-element referencing
PASMetricData.requestedDoc.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.requestedDoc.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.requestedDoc.docRequest 1..* CodeableConcept Coded requests for additional documentation
PASMetricData.requestedDoc.timeRequested 1..1 dateTime Date/Time of initial request
PASMetricData.requestedDoc.timeSubmitted 0..1 dateTime Date/Time of final result
PASMetricData.requestedDoc.submissionMethod 0..1 code CDex | portal | fax | x12 | other
PASMetricData.exceptionSubmission 0..1 boolean True if exchange is based on the exception grant
PASMetricData.businessLine 0..1 CodeableConcept E.g. MedicareAdvantage

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
PASMetricData.source Base required Metric Data Source 📍2.2.1 This IG
PASMetricData.providerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.providerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.groupId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.groupId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.payerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.payerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
PASMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression

This structure is derived from Base

Summary

Mandatory: 4 elements(17 nested mandatory elements)

Maturity: 1

Differential View

This structure is derived from Base

NameFlagsCard.TypeDescription & Constraints    Filter: doco
PASMetricData 0..* Base PAS Metric Data
PASMetricData.source 1..1 code provider | intermediary | payer
Binding: MetricDataSource (2.2.1) (required)
PASMetricData.providerId 1..1 Identifier User invoking hook
PASMetricData.providerId.system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
PASMetricData.providerId.value 1..1 string The value that is unique
PASMetricData.groupId 1..1 Identifier Healthcare org of user
PASMetricData.groupId.system 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
PASMetricData.groupId.value 1..1 string The value that is unique
PASMetricData.payerId 1..1 Identifier Payer receiving hook
PASMetricData.payerId.system 1..1 uri The namespace for the identifier value
PASMetricData.payerId.value 1..1 string The value that is unique
PASMetricData.exchange 1..* BackboneElement Prior Authorization Exchanges
PASMetricData.exchange.type 1..1 code initial | subsequent | cancel | update | query | initialDocToPayer
PASMetricData.exchange.with 0..1 code provider | intermediary | payer
PASMetricData.exchange.method 1..1 code x12 | restful | ihe | direct | other
PASMetricData.exchange.requestTime 1..1 instant Time exchange initiated
PASMetricData.exchange.responseTime 0..1 instant Time of exchange response
PASMetricData.exchange.httpResponse 1..1 code e.g. 200
PASMetricData.issue 0..* BackboneElement OperationOutcome info
PASMetricData.issue.code 1..1 code Error code
Binding: IssueType (required)
PASMetricData.issue.details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
PASMetricData.aaaCodes 0..* BackboneElement AAA codes returned
PASMetricData.aaaCodes.loopID 1..1 code see X12 loop IDs
PASMetricData.aaaCodes.aaaCode 1..1 code approved | modified | denied
PASMetricData.itemDetail 0..* BackboneElement Service level item detail
PASMetricData.itemDetail.trn 0..1 integer Service Level TRN
PASMetricData.itemDetail.item 1..1 CodeableConcept eg. ICD10, HCPCS, NDC
PASMetricData.itemDetail.assertionId 0..1 string Unique ID for order item
PASMetricData.itemDetail.initialSubmissionTime 0..1 dateTime Date/time of the initial submission of the item
PASMetricData.itemDetail.finalResponseTime 0..1 dateTime Date/time of final result
PASMetricData.itemDetail.responsesRequired 0..1 integer Number of responses
PASMetricData.itemDetail.aaaCodes 0..* BackboneElement AAA codes returned
PASMetricData.itemDetail.aaaCodes.loopID 1..1 code see X12 loop IDs
PASMetricData.itemDetail.aaaCodes.aaaCode 1..1 code approved | modified | deined
PASMetricData.itemDetail.locationType 0..1 code inpatient | outpatient | home
PASMetricData.itemDetail.result 0..1 code approved | modified | denied | pended | cancelled
PASMetricData.itemDetail.denialReason 0..1 code Denial Reason
PASMetricData.supportingDoc 0..1 url Documentation submitted as part of PAS Bundle
PASMetricData.requestedDoc 0..* BackboneElement Documentation requested via 278 response
PASMetricData.requestedDoc.docRequest 1..* CodeableConcept Coded requests for additional documentation
PASMetricData.requestedDoc.timeRequested 1..1 dateTime Date/Time of initial request
PASMetricData.requestedDoc.timeSubmitted 0..1 dateTime Date/Time of final result
PASMetricData.requestedDoc.submissionMethod 0..1 code CDex | portal | fax | x12 | other
PASMetricData.exceptionSubmission 0..1 boolean True if exchange is based on the exception grant
PASMetricData.businessLine 0..1 CodeableConcept E.g. MedicareAdvantage

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
PASMetricData.source Base required Metric Data Source 📍2.2.1 This IG
PASMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
PASMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: doco
PASMetricData 0..* Base PAS Metric Data
PASMetricData.source 1..1 code provider | intermediary | payer
Binding: MetricDataSource (2.2.1) (required)
PASMetricData.providerId 1..1 Identifier User invoking hook
PASMetricData.providerId.@id 0..1 string Unique id for inter-element referencing
PASMetricData.providerId.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.providerId.use This element is a modifier element. This element is included in summaries. 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
PASMetricData.providerId.type This element is included in summaries. 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
PASMetricData.providerId.system This element is included in summaries. 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
PASMetricData.providerId.value This element is included in summaries. 1..1 string The value that is unique
Example General: 123456
PASMetricData.providerId.period This element is included in summaries. 0..1 Period Time period when id is/was valid for use
PASMetricData.providerId.assigner This element is included in summaries. 0..1 Reference(Organization) Organization that issued id (may be just text)
PASMetricData.groupId 1..1 Identifier Healthcare org of user
PASMetricData.groupId.@id 0..1 string Unique id for inter-element referencing
PASMetricData.groupId.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.groupId.use This element is a modifier element. This element is included in summaries. 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
PASMetricData.groupId.type This element is included in summaries. 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
PASMetricData.groupId.system This element is included in summaries. 0..1 uri The namespace for the identifier value
Required Pattern: http://hl7.org/fhir/sid/us-npi
PASMetricData.groupId.value This element is included in summaries. 1..1 string The value that is unique
Example General: 123456
PASMetricData.groupId.period This element is included in summaries. 0..1 Period Time period when id is/was valid for use
PASMetricData.groupId.assigner This element is included in summaries. 0..1 Reference(Organization) Organization that issued id (may be just text)
PASMetricData.payerId 1..1 Identifier Payer receiving hook
PASMetricData.payerId.@id 0..1 string Unique id for inter-element referencing
PASMetricData.payerId.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.payerId.use This element is a modifier element. This element is included in summaries. 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
PASMetricData.payerId.type This element is included in summaries. 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
PASMetricData.payerId.system This element is included in summaries. 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
PASMetricData.payerId.value This element is included in summaries. 1..1 string The value that is unique
Example General: 123456
PASMetricData.payerId.period This element is included in summaries. 0..1 Period Time period when id is/was valid for use
PASMetricData.payerId.assigner This element is included in summaries. 0..1 Reference(Organization) Organization that issued id (may be just text)
PASMetricData.exchange 1..* BackboneElement Prior Authorization Exchanges
PASMetricData.exchange.@id 0..1 string Unique id for inter-element referencing
PASMetricData.exchange.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.exchange.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.exchange.type 1..1 code initial | subsequent | cancel | update | query | initialDocToPayer
PASMetricData.exchange.with 0..1 code provider | intermediary | payer
PASMetricData.exchange.method 1..1 code x12 | restful | ihe | direct | other
PASMetricData.exchange.requestTime 1..1 instant Time exchange initiated
PASMetricData.exchange.responseTime 0..1 instant Time of exchange response
PASMetricData.exchange.httpResponse 1..1 code e.g. 200
PASMetricData.issue 0..* BackboneElement OperationOutcome info
PASMetricData.issue.@id 0..1 string Unique id for inter-element referencing
PASMetricData.issue.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.issue.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.issue.code 1..1 code Error code
Binding: IssueType (required)
PASMetricData.issue.details 0..1 CodeableConcept More detailed error code
Binding: OperationOutcomeCodes (example)
PASMetricData.aaaCodes 0..* BackboneElement AAA codes returned
PASMetricData.aaaCodes.@id 0..1 string Unique id for inter-element referencing
PASMetricData.aaaCodes.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.aaaCodes.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.aaaCodes.loopID 1..1 code see X12 loop IDs
PASMetricData.aaaCodes.aaaCode 1..1 code approved | modified | denied
PASMetricData.itemDetail 0..* BackboneElement Service level item detail
PASMetricData.itemDetail.@id 0..1 string Unique id for inter-element referencing
PASMetricData.itemDetail.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.itemDetail.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.itemDetail.trn 0..1 integer Service Level TRN
PASMetricData.itemDetail.item 1..1 CodeableConcept eg. ICD10, HCPCS, NDC
PASMetricData.itemDetail.assertionId 0..1 string Unique ID for order item
PASMetricData.itemDetail.initialSubmissionTime 0..1 dateTime Date/time of the initial submission of the item
PASMetricData.itemDetail.finalResponseTime 0..1 dateTime Date/time of final result
PASMetricData.itemDetail.responsesRequired 0..1 integer Number of responses
PASMetricData.itemDetail.aaaCodes 0..* BackboneElement AAA codes returned
PASMetricData.itemDetail.aaaCodes.@id 0..1 string Unique id for inter-element referencing
PASMetricData.itemDetail.aaaCodes.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.itemDetail.aaaCodes.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.itemDetail.aaaCodes.loopID 1..1 code see X12 loop IDs
PASMetricData.itemDetail.aaaCodes.aaaCode 1..1 code approved | modified | deined
PASMetricData.itemDetail.locationType 0..1 code inpatient | outpatient | home
PASMetricData.itemDetail.result 0..1 code approved | modified | denied | pended | cancelled
PASMetricData.itemDetail.denialReason 0..1 code Denial Reason
PASMetricData.supportingDoc 0..1 url Documentation submitted as part of PAS Bundle
PASMetricData.requestedDoc 0..* BackboneElement Documentation requested via 278 response
PASMetricData.requestedDoc.@id 0..1 string Unique id for inter-element referencing
PASMetricData.requestedDoc.extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
PASMetricData.requestedDoc.modifierExtension This element is a modifier element. This element is included in summaries. 0..* Extension Extensions that cannot be ignored even if unrecognized
PASMetricData.requestedDoc.docRequest 1..* CodeableConcept Coded requests for additional documentation
PASMetricData.requestedDoc.timeRequested 1..1 dateTime Date/Time of initial request
PASMetricData.requestedDoc.timeSubmitted 0..1 dateTime Date/Time of final result
PASMetricData.requestedDoc.submissionMethod 0..1 code CDex | portal | fax | x12 | other
PASMetricData.exceptionSubmission 0..1 boolean True if exchange is based on the exception grant
PASMetricData.businessLine 0..1 CodeableConcept E.g. MedicareAdvantage

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
PASMetricData.source Base required Metric Data Source 📍2.2.1 This IG
PASMetricData.providerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.providerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.groupId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.groupId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.payerId.​use Base required IdentifierUse 📍4.0.1 FHIR Std.
PASMetricData.payerId.​type Base extensible IdentifierType 📍4.0.1 FHIR Std.
PASMetricData.issue.​code Base required IssueType 📦4.0.1 FHIR Std.
PASMetricData.issue.​details Base example Operation Outcome Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression

This structure is derived from Base

Summary

Mandatory: 4 elements(17 nested mandatory elements)

Maturity: 1

 

Other representations of profile: CSV, Excel