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

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Extension: Transmission Identifiers

Context of Use

This extension may be used on the following element(s)

• Element ID: Claim
• Element ID: ClaimResponse

Usage info

Usages:

• Use this Extension: PAS Claim Base and PAS Claim Response Base
• Examples for this Extension: Bundle/ErrorResponseBundleExample, Bundle/PASClaimInquiryResponseBundleExample, Bundle/ReferralAuthorizationBundleExample, Bundle/RejectionResponseBundleExample... Show 3 more, Claim/ReferralAuthorizationExample, ClaimResponse/ErrorResponseExample and Parameters/PASClaimInquiryOperationResponseExample

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description Differentials, Snapshots, and other representations.

• Differential Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Transmission Identifiers
Extension.extension		2..*	Extension	Extension
Extension.Slices for extension				Content/Rules for all slices
Extension.Slices for extension.extension:applicationSenderCode		1..1	Extension	Application Sender's Code (GS02)
Extension.Slices for extension.extension:applicationSenderCode.extension		0..0		Extension
Extension.Slices for extension.extension:applicationSenderCode.url		1..1	uri	"applicationSenderCode"
Extension.Slices for extension.extension:applicationSenderCode.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:applicationReceiverCode		1..1	Extension	Application Receiver's Code (GS03)
Extension.Slices for extension.extension:applicationReceiverCode.extension		0..0		Extension
Extension.Slices for extension.extension:applicationReceiverCode.url		1..1	uri	"applicationReceiverCode"
Extension.Slices for extension.extension:applicationReceiverCode.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:interchangeSenderID		0..1	Extension	Interchange Sender ID (ISA06)
Extension.Slices for extension.extension:interchangeSenderID.extension		0..0		Extension
Extension.Slices for extension.extension:interchangeSenderID.url		1..1	uri	"interchangeSenderID"
Extension.Slices for extension.extension:interchangeSenderID.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:interchangeReceiverID		0..1	Extension	Interchange Receiver ID (ISA08)
Extension.Slices for extension.extension:interchangeReceiverID.extension		0..0		Extension
Extension.Slices for extension.extension:interchangeReceiverID.url		1..1	uri	"interchangeReceiverID"
Extension.Slices for extension.extension:interchangeReceiverID.value[x]		0..1	string	Value of extension
Extension.url		1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers"
Extension.value[x]		0..0		Value of extension
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Transmission Identifiers
Extension.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:applicationSenderCode		1..1	Extension	Application Sender's Code (GS02)
Extension.Slices for extension.extension:applicationSenderCode.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:applicationSenderCode.extension		0..0		Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:applicationSenderCode.url		1..1	uri	"applicationSenderCode"
Extension.Slices for extension.extension:applicationSenderCode.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:applicationReceiverCode		1..1	Extension	Application Receiver's Code (GS03)
Extension.Slices for extension.extension:applicationReceiverCode.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:applicationReceiverCode.extension		0..0		Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:applicationReceiverCode.url		1..1	uri	"applicationReceiverCode"
Extension.Slices for extension.extension:applicationReceiverCode.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:interchangeSenderID		0..1	Extension	Interchange Sender ID (ISA06)
Extension.Slices for extension.extension:interchangeSenderID.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:interchangeSenderID.extension		0..0		Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:interchangeSenderID.url		1..1	uri	"interchangeSenderID"
Extension.Slices for extension.extension:interchangeSenderID.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:interchangeReceiverID		0..1	Extension	Interchange Receiver ID (ISA08)
Extension.Slices for extension.extension:interchangeReceiverID.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:interchangeReceiverID.extension		0..0		Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:interchangeReceiverID.url		1..1	uri	"interchangeReceiverID"
Extension.Slices for extension.extension:interchangeReceiverID.value[x]		0..1	string	Value of extension
Extension.url		1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers"
Documentation for this format

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from Extension

Summary

Complex Extension: Identifiers used for transmission tracking. Used in the X12 GS and ISA header segments.

• applicationSenderCode: string: An Extension
• applicationReceiverCode: string: An Extension
• interchangeSenderID: string: An Extension
• interchangeReceiverID: string: An Extension

Maturity: 4

Differential View

This structure is derived from Extension

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Transmission Identifiers
Extension.extension		2..*	Extension	Extension
Extension.Slices for extension				Content/Rules for all slices
Extension.Slices for extension.extension:applicationSenderCode		1..1	Extension	Application Sender's Code (GS02)
Extension.Slices for extension.extension:applicationSenderCode.extension		0..0		Extension
Extension.Slices for extension.extension:applicationSenderCode.url		1..1	uri	"applicationSenderCode"
Extension.Slices for extension.extension:applicationSenderCode.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:applicationReceiverCode		1..1	Extension	Application Receiver's Code (GS03)
Extension.Slices for extension.extension:applicationReceiverCode.extension		0..0		Extension
Extension.Slices for extension.extension:applicationReceiverCode.url		1..1	uri	"applicationReceiverCode"
Extension.Slices for extension.extension:applicationReceiverCode.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:interchangeSenderID		0..1	Extension	Interchange Sender ID (ISA06)
Extension.Slices for extension.extension:interchangeSenderID.extension		0..0		Extension
Extension.Slices for extension.extension:interchangeSenderID.url		1..1	uri	"interchangeSenderID"
Extension.Slices for extension.extension:interchangeSenderID.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:interchangeReceiverID		0..1	Extension	Interchange Receiver ID (ISA08)
Extension.Slices for extension.extension:interchangeReceiverID.extension		0..0		Extension
Extension.Slices for extension.extension:interchangeReceiverID.url		1..1	uri	"interchangeReceiverID"
Extension.Slices for extension.extension:interchangeReceiverID.value[x]		0..1	string	Value of extension
Extension.url		1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers"
Extension.value[x]		0..0		Value of extension
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Extension		0..*	Extension	Transmission Identifiers
Extension.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:applicationSenderCode		1..1	Extension	Application Sender's Code (GS02)
Extension.Slices for extension.extension:applicationSenderCode.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:applicationSenderCode.extension		0..0		Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:applicationSenderCode.url		1..1	uri	"applicationSenderCode"
Extension.Slices for extension.extension:applicationSenderCode.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:applicationReceiverCode		1..1	Extension	Application Receiver's Code (GS03)
Extension.Slices for extension.extension:applicationReceiverCode.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:applicationReceiverCode.extension		0..0		Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:applicationReceiverCode.url		1..1	uri	"applicationReceiverCode"
Extension.Slices for extension.extension:applicationReceiverCode.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:interchangeSenderID		0..1	Extension	Interchange Sender ID (ISA06)
Extension.Slices for extension.extension:interchangeSenderID.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:interchangeSenderID.extension		0..0		Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:interchangeSenderID.url		1..1	uri	"interchangeSenderID"
Extension.Slices for extension.extension:interchangeSenderID.value[x]		0..1	string	Value of extension
Extension.Slices for extension.extension:interchangeReceiverID		0..1	Extension	Interchange Receiver ID (ISA08)
Extension.Slices for extension.extension:interchangeReceiverID.id		0..1	string	Unique id for inter-element referencing
Extension.Slices for extension.extension:interchangeReceiverID.extension		0..0		Extension Slice: Unordered, Open by value:url Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
Extension.Slices for extension.extension:interchangeReceiverID.url		1..1	uri	"interchangeReceiverID"
Extension.Slices for extension.extension:interchangeReceiverID.value[x]		0..1	string	Value of extension
Extension.url		1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers"
Documentation for this format

Constraints

Id

Grade

Path(s)

Description

Expression

This structure is derived from Extension

Summary

Complex Extension: Identifiers used for transmission tracking. Used in the X12 GS and ISA header segments.

• applicationSenderCode: string: An Extension
• applicationReceiverCode: string: An Extension
• interchangeSenderID: string: An Extension
• interchangeReceiverID: string: An Extension

Maturity: 4

Other representations of profile: CSV, Excel, Schematron