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

## Extension: ConditionCode

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-conditionCode | Version: 2.2.0-ballot
Standards status: Trial-use | Maturity Level: 3 | Computable Name: ConditionCode
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.8

Information to supply various patient conditions.

Context of Use

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

- Element ID: `Claim`

Usage info

Usages:

- Use this Extension: PAS Claim Base
- Examples for this Extension: Bundle/SurgicalRequestBundleExample and Claim/SurgicalAuthorizationRequestExample

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

- 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 | Extension
extension |  | 3..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:category |  | 1..1 | Extension | Condition Code Category (CRC01)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 278 CRC Condition Category (required)
extension:indicator |  | 1..1 | Extension | Certification Condition Indicator (CRC02)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "indicator"
value[x] |  | 0..1 | boolean | Value of extension
extension:code |  | 1..* | Extension | Condition Code (CRC03)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "code"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 278 CRC Condition Code (required)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-conditionCode"
value[x] |  | 0..0 |  |
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:category |  | 1..1 | Extension | Condition Code Category (CRC01)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 278 CRC Condition Category (required)
extension:indicator |  | 1..1 | Extension | Certification Condition Indicator (CRC02)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "indicator"
value[x] |  | 0..1 | boolean | Value of extension
extension:code |  | 1..* | Extension | Condition Code (CRC03)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "code"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 278 CRC Condition Code (required)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-conditionCode"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Information to supply various patient conditions.

- category: CodeableConcept: An Extension
- indicator: boolean: An Extension
- code: CodeableConcept: An Extension

Maturity: 3

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Extension
extension |  | 3..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:category |  | 1..1 | Extension | Condition Code Category (CRC01)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 278 CRC Condition Category (required)
extension:indicator |  | 1..1 | Extension | Certification Condition Indicator (CRC02)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "indicator"
value[x] |  | 0..1 | boolean | Value of extension
extension:code |  | 1..* | Extension | Condition Code (CRC03)
extension |  | 0..0 |  |
url |  | 1..1 | uri | "code"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 278 CRC Condition Code (required)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-conditionCode"
value[x] |  | 0..0 |  |
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 3..* | Extension | Extension Slice: Unordered, Open by value:url
extension:category |  | 1..1 | Extension | Condition Code Category (CRC01)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 278 CRC Condition Category (required)
extension:indicator |  | 1..1 | Extension | Certification Condition Indicator (CRC02)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "indicator"
value[x] |  | 0..1 | boolean | Value of extension
extension:code |  | 1..* | Extension | Condition Code (CRC03)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "code"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 278 CRC Condition Code (required)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-conditionCode"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Information to supply various patient conditions.

- category: CodeableConcept: An Extension
- indicator: boolean: An Extension
- code: CodeableConcept: An Extension

Maturity: 3

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Extension.extension:category.value[x] | required | X12278ConditionCategory(a valid code from `https://codesystem.x12.org/005010/1136`) `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278ConditionCategory` From this IG
Extension.extension:code.value[x] | required | X12278ConditionCode(a valid code from `https://codesystem.x12.org/005010/1321`) `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278ConditionCode` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |