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: DocumentInformation

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation | Version: 2.2.0-ballot
Standards status: Trial-use | Maturity Level: 3 | Computable Name: DocumentInformation
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.80

Information about the document being included such as the type, transmission method, and identifier.

Context of Use

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

- Element ID: `Claim.supportingInfo`

Usage info

Usages:

- Use this Extension: PAS Claim Update and PAS Claim
- Examples for this Extension: Bundle/ErrorResponseBundleExample, Bundle/PASClaimInquiryResponseBundleExample, Bundle/ReferralAuthorizationBundleExample, Bundle/RejectionResponseBundleExample and Claim/ReferralAuthorizationExample

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 |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:reportTypeCode |  | 1..1 | Extension | The type of additional information being provided
extension |  | 0..0 |  |
url |  | 1..1 | uri | "reportTypeCode"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: PAS PWK01 Attachment Report Type Code Value Set (required)
extension:transmissionMethod |  | 0..1 | Extension | How the additional information is being provided
extension |  | 0..0 |  |
url |  | 1..1 | uri | "transmissionMethod"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 (required)
extension:controlNumber |  | 0..1 | Extension | A control number that identifies the document
extension |  | 0..0 |  |
url |  | 1..1 | uri | "controlNumber"
value[x] |  | 0..1 | string | Value of extension
extension:description |  | 0..1 | Extension | Special information about the additional information provided
extension |  | 0..0 |  |
url |  | 1..1 | uri | "description"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:reportTypeCode |  | 1..1 | Extension | The type of additional information being provided
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "reportTypeCode"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: PAS PWK01 Attachment Report Type Code Value Set (required)
extension:transmissionMethod |  | 0..1 | Extension | How the additional information is being provided
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "transmissionMethod"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 (required)
extension:controlNumber |  | 0..1 | Extension | A control number that identifies the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "controlNumber"
value[x] |  | 0..1 | string | Value of extension
extension:description |  | 0..1 | Extension | Special information about the additional information provided
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "description"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Information about the document being included such as the type, transmission method, and identifier.

- reportTypeCode: CodeableConcept: An Extension
- transmissionMethod: CodeableConcept: An Extension
- controlNumber: string: An Extension
- description: string: 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 |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:reportTypeCode |  | 1..1 | Extension | The type of additional information being provided
extension |  | 0..0 |  |
url |  | 1..1 | uri | "reportTypeCode"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: PAS PWK01 Attachment Report Type Code Value Set (required)
extension:transmissionMethod |  | 0..1 | Extension | How the additional information is being provided
extension |  | 0..0 |  |
url |  | 1..1 | uri | "transmissionMethod"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 (required)
extension:controlNumber |  | 0..1 | Extension | A control number that identifies the document
extension |  | 0..0 |  |
url |  | 1..1 | uri | "controlNumber"
value[x] |  | 0..1 | string | Value of extension
extension:description |  | 0..1 | Extension | Special information about the additional information provided
extension |  | 0..0 |  |
url |  | 1..1 | uri | "description"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:reportTypeCode |  | 1..1 | Extension | The type of additional information being provided
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "reportTypeCode"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: PAS PWK01 Attachment Report Type Code Value Set (required)
extension:transmissionMethod |  | 0..1 | Extension | How the additional information is being provided
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "transmissionMethod"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 (required)
extension:controlNumber |  | 0..1 | Extension | A control number that identifies the document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "controlNumber"
value[x] |  | 0..1 | string | Value of extension
extension:description |  | 0..1 | Extension | Special information about the additional information provided
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "description"
value[x] |  | 0..1 | string | Value of extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Information about the document being included such as the type, transmission method, and identifier.

- reportTypeCode: CodeableConcept: An Extension
- transmissionMethod: CodeableConcept: An Extension
- controlNumber: string: An Extension
- description: string: An Extension

Maturity: 3

Other representations of profile: CSV, Excel, Schematron

#### Terminology Bindings

Path | Conformance | ValueSet | URI
Extension.extension:reportTypeCode.value[x] | required | PASPWK01AttachmentReportTypeCodeValueSet(a valid code from `https://codesystem.x12.org/005010/755`) `http://hl7.org/fhir/us/davinci-pas/ValueSet/pas-pwk01-attachment-report-type-code` From this IG
Extension.extension:transmissionMethod.value[x] | required | https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756 `https://valueset.x12.org/x217/005010/request/2000E/PWK/1/02/00/756`

#### 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() |