Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot

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 2.2.0-ballot 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: PASCommunicationRequest - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 3

Definitions for the profile-communicationrequest resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. CommunicationRequest
Definition | A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.
Short | A request for information to be sent to a receiver
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. CommunicationRequest.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. CommunicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. CommunicationRequest.identifier
Definition | Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Short | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).Unique identifier
Comments | This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. CommunicationRequest.status
Definition | The status of the proposal or order.
Short | draft | active | on-hold | revoked | completed | entered-in-error | unknown
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus http://hl7.org/fhir/ValueSet/request-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/request-status|4.0.1` ) The status of the communication request.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Fixed Value | `active`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. CommunicationRequest.category
Definition | The type of message to be sent such as alert, notification, reminder, instruction, etc.
Short | Message category
Comments | There may be multiple axes of categorization and one communication request may serve multiple purposes.
Control | 0..*
Binding | The codes SHALL be taken from For example codes, see https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 http://hl7.org/fhir/ValueSet/communication-category (required to `https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755` ) Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions. Codes for general categories of communications such as alerts, instruction, etc.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. CommunicationRequest.doNotPerform
Definition | If true indicates that the CommunicationRequest is asking for the specified action to not occur.
Short | True if request is prohibiting action
Comments | The attributes provided with the request qualify what is not to be done.
Control | 0..1
Type | boolean
Is Modifier | true because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | prohibited
Meaning if Missing | If do not perform is not specified, the request is a positive request e.g. "do perform"
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. CommunicationRequest.medium
Definition | A channel that was used for this communication (e.g. email, fax).
Short | A channel of communication
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see PAS Communication Medium Value Set http://terminology.hl7.org/ValueSet/v3-ParticipationMode (extensible to `http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. CommunicationRequest.payload
Definition | Text, attachment(s), or resource(s) to be communicated to the recipient.
Short | Message payload
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. CommunicationRequest.payload.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
20. CommunicationRequest.payload.extension:serviceLineNumber
Slice Name | serviceLineNumber
Definition | A number that links the content being requested with the claim item number.
Short | Extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ServiceLineNumber) (Extension Type: positiveInt)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
22. CommunicationRequest.payload.extension:communicatedDiagnosis
Slice Name | communicatedDiagnosis
Definition | A code representing the diagnosis that is the subject of the communication
Short | Extension
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CommunicatedDiagnosis) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
24. CommunicationRequest.payload.extension:contentModifier
Slice Name | contentModifier
Definition | A code representing a modifier of the content being requested
Short | Extension
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(ContentModifier) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
26. CommunicationRequest.payload.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
28. CommunicationRequest.payload.content[x]
Definition | The communicated content (or for multi-part communications, one portion of the communication).
Short | Message part content
Control | 1..1
Binding | The codes SHALL be taken from For codes, see LOINC valid-hl7-attachment-requests (required to `http://loinc.org/vs/valid-hl7-attachment-requests` )
Type | string, Reference(Resource), Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. CommunicationRequest.requester
Definition | The device, individual, or organization who initiated the request and has responsibility for its activation.
Short | Who/what is requesting service
Control | 0..1
Type | Reference(PAS Insurer Organization, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
Is Modifier | false
Must Support | true
Summary | true
Alternate Names | author
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. CommunicationRequest.recipient
Definition | The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.
Short | Message recipient
Control | 0..*
Type | Reference(PAS Practitioner, PAS Organization Base Profile, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Group, CareTeam, HealthcareService)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. CommunicationRequest.sender
Definition | The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.
Short | Message sender
Control | 0..1
Type | Reference(PAS Requestor Organization, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. CommunicationRequest
2. CommunicationRequest.identifier
Short | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
Note | This is a business identifier, not a resource identifier (see discussion)
Must Support | true
4. CommunicationRequest.status
Fixed Value | `active`
6. CommunicationRequest.category
Binding | The codes SHALL be taken from https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required to `https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755` ) Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.
Must Support | true
8. CommunicationRequest.medium
Binding | Unless not suitable, these codes SHALL be taken from PAS Communication Medium Value Set (extensible to `http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium` )
Must Support | true
10. CommunicationRequest.payload
Must Support | true
12. CommunicationRequest.payload.extension
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
14. CommunicationRequest.payload.extension:serviceLineNumber
Slice Name | serviceLineNumber
Control | 0..1
Type | Extension(ServiceLineNumber) (Extension Type: positiveInt)
Must Support | true
16. CommunicationRequest.payload.extension:communicatedDiagnosis
Slice Name | communicatedDiagnosis
Control | 0..*
Type | Extension(CommunicatedDiagnosis) (Extension Type: CodeableConcept)
Must Support | true
18. CommunicationRequest.payload.extension:contentModifier
Slice Name | contentModifier
Control | 0..*
Type | Extension(ContentModifier) (Extension Type: CodeableConcept)
Must Support | true
20. CommunicationRequest.payload.content[x]
Binding | The codes SHALL be taken from LOINC valid-hl7-attachment-requests (required to `http://loinc.org/vs/valid-hl7-attachment-requests` )
Type | string, Reference(Resource), Attachment
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
22. CommunicationRequest.requester
Type | Reference(PAS Insurer Organization)
Must Support | true
24. CommunicationRequest.recipient
Type | Reference(PAS Practitioner, PAS Organization Base Profile)
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
26. CommunicationRequest.sender
Type | Reference(PAS Requestor Organization)
Must Support | true

Guidance on how to interpret the contents of this table can be foundhere

0. CommunicationRequest
Definition | A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.
Short | A request for information to be sent to a receiver
Control | 0..*
Is Modifier | false
Summary | false
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`)
2. CommunicationRequest.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. CommunicationRequest.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. CommunicationRequest.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. CommunicationRequest.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. CommunicationRequest.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. CommunicationRequest.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. CommunicationRequest.extension
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
16. CommunicationRequest.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. CommunicationRequest.identifier
Definition | Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.
Short | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
Comments | This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Must Support | true
Summary | true
Requirements | Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. CommunicationRequest.basedOn
Definition | A plan or proposal that is fulfilled in whole or in part by this request.
Short | Fulfills plan or proposal
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | true
Requirements | Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.
Alternate Names | fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. CommunicationRequest.replaces
Definition | Completed or terminated request(s) whose function is taken by this new request.
Short | Request(s) replaced by this request
Comments | The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.
Control | 0..*
Type | Reference(CommunicationRequest)
Is Modifier | false
Summary | true
Requirements | Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.
Alternate Names | supersedes, prior
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. CommunicationRequest.groupIdentifier
Definition | A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.
Short | Composite request this is part of
Comments | Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
Control | 0..1
Type | Identifier
Is Modifier | false
Summary | true
Alternate Names | grouperId
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. CommunicationRequest.status
Definition | The status of the proposal or order.
Short | draft | active | on-hold | revoked | completed | entered-in-error | unknown
Control | 1..1
Binding | The codes SHALL be taken from RequestStatus (required to `http://hl7.org/fhir/ValueSet/request-status|4.0.1` ) The status of the communication request.
Type | code
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Fixed Value | `active`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. CommunicationRequest.statusReason
Definition | Captures the reason for the current state of the CommunicationRequest.
Short | Reason for current status
Comments | This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].
Control | 0..1
Binding | Codes identifying the reason for the current state of a request.
Type | CodeableConcept
Is Modifier | false
Summary | false
Alternate Names | Suspended Reason, Cancelled Reason
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. CommunicationRequest.category
Definition | The type of message to be sent such as alert, notification, reminder, instruction, etc.
Short | Message category
Comments | There may be multiple axes of categorization and one communication request may serve multiple purposes.
Control | 0..*
Binding | The codes SHALL be taken from https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required to `https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755` ) Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. CommunicationRequest.priority
Definition | Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.
Short | routine | urgent | asap | stat
Control | 0..1
Binding | The codes SHALL be taken from RequestPriority (required to `http://hl7.org/fhir/ValueSet/request-priority|4.0.1` ) Codes indicating the relative importance of a communication request.
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Meaning if Missing | If missing, this task should be performed with normal priority
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. CommunicationRequest.doNotPerform
Definition | If true indicates that the CommunicationRequest is asking for the specified action to not occur.
Short | True if request is prohibiting action
Comments | The attributes provided with the request qualify what is not to be done.
Control | 0..1
Type | boolean
Is Modifier | true because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | prohibited
Meaning if Missing | If do not perform is not specified, the request is a positive request e.g. "do perform"
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. CommunicationRequest.medium
Definition | A channel that was used for this communication (e.g. email, fax).
Short | A channel of communication
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from PAS Communication Medium Value Set (extensible to `http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium` )
Type | CodeableConcept
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. CommunicationRequest.subject
Definition | The patient or group that is the focus of this communication request.
Short | Focus of message
Control | 0..1
Type | Reference(Patient, Group)
Is Modifier | false
Summary | false
Alternate Names | patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. CommunicationRequest.about
Definition | Other resources that pertain to this communication request and to which this communication request should be associated.
Short | Resources that pertain to this communication request
Comments | Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. CommunicationRequest.encounter
Definition | The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.
Short | Encounter created as part of
Comments | This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. CommunicationRequest.payload
Definition | Text, attachment(s), or resource(s) to be communicated to the recipient.
Short | Message payload
Control | 0..*
Type | BackboneElement
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
46. CommunicationRequest.payload.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
48. CommunicationRequest.payload.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `CommunicationRequest.payload.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
50. CommunicationRequest.payload.extension:serviceLineNumber
Slice Name | serviceLineNumber
Definition | A number that links the content being requested with the claim item number.
Short | Extension
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(ServiceLineNumber) (Extension Type: positiveInt)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
52. CommunicationRequest.payload.extension:communicatedDiagnosis
Slice Name | communicatedDiagnosis
Definition | A code representing the diagnosis that is the subject of the communication
Short | Extension
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(CommunicatedDiagnosis) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
54. CommunicationRequest.payload.extension:contentModifier
Slice Name | contentModifier
Definition | A code representing a modifier of the content being requested
Short | Extension
Control | 0..* This element is affected by the following invariants: ele-1
Type | Extension(ContentModifier) (Extension Type: CodeableConcept)
Is Modifier | false
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
56. CommunicationRequest.payload.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
58. CommunicationRequest.payload.content[x]
Definition | The communicated content (or for multi-part communications, one portion of the communication).
Short | Message part content
Control | 1..1
Binding | The codes SHALL be taken from LOINC valid-hl7-attachment-requests (required to `http://loinc.org/vs/valid-hl7-attachment-requests` )
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Must Support | true
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. CommunicationRequest.occurrence[x]
Definition | The time when this communication is to occur.
Short | When scheduled
Control | 0..1
Type | Choice of: dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | timing
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. CommunicationRequest.authoredOn
Definition | For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.
Short | When request transitioned to being actionable
Control | 0..1
Type | dateTime
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Alternate Names | createdOn
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. CommunicationRequest.requester
Definition | The device, individual, or organization who initiated the request and has responsibility for its activation.
Short | Who/what is requesting service
Control | 0..1
Type | Reference(PAS Insurer Organization)
Is Modifier | false
Must Support | true
Summary | true
Alternate Names | author
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. CommunicationRequest.recipient
Definition | The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.
Short | Message recipient
Control | 0..*
Type | Reference(PAS Practitioner, PAS Organization Base Profile)
Is Modifier | false
Must Support | true
Must Support Types | No must-support rules about the choice of types/profiles
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
68. CommunicationRequest.sender
Definition | The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.
Short | Message sender
Control | 0..1
Type | Reference(PAS Requestor Organization)
Is Modifier | false
Must Support | true
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. CommunicationRequest.reasonCode
Definition | Describes why the request is being made in coded or textual form.
Short | Why is communication needed?
Comments | Textual reasons can be captured using reasonCode.text.
Control | 0..*
Binding | For example codes, see ActReason (3.0.0) (example to `http://terminology.hl7.org/ValueSet/v3-ActReason|3.0.0` ) Codes for describing reasons for the occurrence of a communication.
Type | CodeableConcept
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. CommunicationRequest.reasonReference
Definition | Indicates another resource whose existence justifies this request.
Short | Why is communication needed?
Control | 0..*
Type | Reference(Condition, Observation, DiagnosticReport, DocumentReference)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. CommunicationRequest.note
Definition | Comments made about the request by the requester, sender, recipient, subject or other participants.
Short | Comments made about communication request
Control | 0..*
Type | Annotation
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)