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

## : Additional Information Task Example - JSON Representation

Page standards status: Informative

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    {
      "resourceType" : "Task",
      "id" : "AdditionalInformationTaskExample",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Task AdditionalInformationTaskExample</b></p><a name=\"AdditionalInformationTaskExample\"> </a><a name=\"hcAdditionalInformationTaskExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-task.html\">PAS Task</a></p></div><p><b>identifier</b>: <code>http://example.org/ITEM_TRACE_NUMBER</code>/1122334</p><p><b>status</b>: Requested</p><p><b>intent</b>: order</p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes attachment-request-code}\">Attach Request Code</span></p><p><b>for</b>: <a href=\"Patient-BeneficiaryExample.html\">JESSE SMITH  Female, DoB: 1947-01-18 ( Member Number)</a></p><p><b>requester</b>: Identifier: <a href=\"http://terminology.hl7.org/6.2.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/789312</p><p><b>owner</b>: Identifier: <a href=\"http://terminology.hl7.org/6.2.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/789312</p><p><b>reasonCode</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes priorAuthorization}\">Prior Authorization Information Request</span></p><p><b>reasonReference</b>: <a href=\"Claim-MedicalServicesAuthorizationExample.html\">Claim: identifier = http://example.org/PATIENT_EVENT_TRACE_NUMBER#111099; status = active; type = Professional; use = preauthorization; created = 2005-05-02 11:01:00+0500; priority = Normal</a></p><blockquote><p><b>input</b></p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes payer-url}\">Payer URL</span></p><p><b>value</b>: <a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.carin-bb@2.1.0&amp;canonical=http://example.org/payerURL\">http://example.org/payerURL</a></p></blockquote><blockquote><p><b>input</b></p><p><b>ServiceLineNumber</b>: 1</p><p><b>type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes attachments-needed}\">Attachments Needed</span></p><p><b>value</b>: <span title=\"Codes:{http://loinc.org 28570-0}\">Procedure note</span></p></blockquote></div>"
      },
      "identifier" : [
        {
          "system" : "http://example.org/ITEM_TRACE_NUMBER",
          "value" : "1122334"
        }
      ],
      "status" : "requested",
      "intent" : "order",
      "code" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
            "code" : "attachment-request-code"
          }
        ]
      },
      "for" : {
        🔗 "reference" : "Patient/BeneficiaryExample"
      },
      "requester" : {
        "identifier" : {
          "system" : "http://hl7.org/fhir/sid/us-npi",
          "value" : "789312"
        }
      },
      "owner" : {
        "identifier" : {
          "system" : "http://hl7.org/fhir/sid/us-npi",
          "value" : "789312"
        }
      },
      "reasonCode" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
            "code" : "priorAuthorization"
          }
        ]
      },
      "reasonReference" : {
        🔗 "reference" : "Claim/MedicalServicesAuthorizationExample"
      },
      "input" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                "code" : "payer-url"
              }
            ]
          },
          "valueUrl" : "http://example.org/payerURL"
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber",
              "valuePositiveInt" : 1
            }
          ],
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
                "code" : "attachments-needed"
              }
            ]
          },
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://loinc.org",
                "code" : "28570-0"
              }
            ]
          }
        }
      ]
    }