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

## Logical Model: PAS Metric Data

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/PASMetricData | Version: 2.2.0-ballot
Standards status: Informative | Maturity Level: 1 | Computable Name: PASMetricData
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.1

A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation

Usages:

- This Logical Model is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
PASMetricData |  | 0..* | Base | PAS Metric Data
source |  | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required)
providerId |  | 1..1 | Identifier | User invoking hook
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
groupId |  | 1..1 | Identifier | Healthcare org of user
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
payerId |  | 1..1 | Identifier | Payer receiving hook
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
exchange |  | 1..* | BackboneElement | Prior Authorization Exchanges
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type |  | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer
with |  | 0..1 | code | provider | intermediary | payer
method |  | 1..1 | code | x12 | restful | ihe | direct | other
requestTime |  | 1..1 | instant | Time exchange initiated
responseTime |  | 0..1 | instant | Time of exchange response
httpResponse |  | 1..1 | code | e.g. 200
issue |  | 0..* | BackboneElement | OperationOutcome info
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | Error code Binding: IssueType (required)
details |  | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example)
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | denied
itemDetail |  | 0..* | BackboneElement | Service level item detail
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
trn |  | 0..1 | integer | Service Level TRN
item |  | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC
assertionId |  | 0..1 | string | Unique ID for order item
initialSubmissionTime |  | 0..1 | dateTime | Date/time of the initial submission of the item
finalResponseTime |  | 0..1 | dateTime | Date/time of final result
responsesRequired |  | 0..1 | integer | Number of responses
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | deined
locationType |  | 0..1 | code | inpatient | outpatient | home
result |  | 0..1 | code | approved | modified | denied | pended | cancelled
denialReason |  | 0..1 | code | Denial Reason
supportingDoc |  | 0..1 | url | Documentation submitted as part of PAS Bundle
requestedDoc |  | 0..* | BackboneElement | Documentation requested via 278 response
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
docRequest |  | 1..* | CodeableConcept | Coded requests for additional documentation
timeRequested |  | 1..1 | dateTime | Date/Time of initial request
timeSubmitted |  | 0..1 | dateTime | Date/Time of final result
submissionMethod |  | 0..1 | code | CDex | portal | fax | x12 | other
exceptionSubmission |  | 0..1 | boolean | True if exchange is based on the exception grant
businessLine |  | 0..1 | CodeableConcept | E.g. MedicareAdvantage
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
PASMetricData.source | required | MetricDataSource `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` From this IG
PASMetricData.providerId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.providerId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.groupId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.groupId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.payerId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.payerId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.issue.code | required | IssueType `http://hl7.org/fhir/ValueSet/issue-type` From the FHIR Standard
PASMetricData.issue.details | example | OperationOutcomeCodes `http://hl7.org/fhir/ValueSet/operation-outcome` From the FHIR Standard

#### 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() |

This structure is derived from Base

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
PASMetricData |  | 0..* | Base | PAS Metric Data
source |  | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required)
providerId |  | 1..1 | Identifier | User invoking hook
system |  | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value |  | 1..1 | string | The value that is unique
groupId |  | 1..1 | Identifier | Healthcare org of user
system |  | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value |  | 1..1 | string | The value that is unique
payerId |  | 1..1 | Identifier | Payer receiving hook
system |  | 1..1 | uri | The namespace for the identifier value
value |  | 1..1 | string | The value that is unique
exchange |  | 1..* | BackboneElement | Prior Authorization Exchanges
type |  | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer
with |  | 0..1 | code | provider | intermediary | payer
method |  | 1..1 | code | x12 | restful | ihe | direct | other
requestTime |  | 1..1 | instant | Time exchange initiated
responseTime |  | 0..1 | instant | Time of exchange response
httpResponse |  | 1..1 | code | e.g. 200
issue |  | 0..* | BackboneElement | OperationOutcome info
code |  | 1..1 | code | Error code Binding: IssueType (required)
details |  | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example)
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | denied
itemDetail |  | 0..* | BackboneElement | Service level item detail
trn |  | 0..1 | integer | Service Level TRN
item |  | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC
assertionId |  | 0..1 | string | Unique ID for order item
initialSubmissionTime |  | 0..1 | dateTime | Date/time of the initial submission of the item
finalResponseTime |  | 0..1 | dateTime | Date/time of final result
responsesRequired |  | 0..1 | integer | Number of responses
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | deined
locationType |  | 0..1 | code | inpatient | outpatient | home
result |  | 0..1 | code | approved | modified | denied | pended | cancelled
denialReason |  | 0..1 | code | Denial Reason
supportingDoc |  | 0..1 | url | Documentation submitted as part of PAS Bundle
requestedDoc |  | 0..* | BackboneElement | Documentation requested via 278 response
docRequest |  | 1..* | CodeableConcept | Coded requests for additional documentation
timeRequested |  | 1..1 | dateTime | Date/Time of initial request
timeSubmitted |  | 0..1 | dateTime | Date/Time of final result
submissionMethod |  | 0..1 | code | CDex | portal | fax | x12 | other
exceptionSubmission |  | 0..1 | boolean | True if exchange is based on the exception grant
businessLine |  | 0..1 | CodeableConcept | E.g. MedicareAdvantage
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
PASMetricData.source | required | MetricDataSource `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` From this IG
PASMetricData.issue.code | required | IssueType `http://hl7.org/fhir/ValueSet/issue-type` From the FHIR Standard
PASMetricData.issue.details | example | OperationOutcomeCodes `http://hl7.org/fhir/ValueSet/operation-outcome` From the FHIR Standard

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
PASMetricData |  | 0..* | Base | PAS Metric Data
source |  | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required)
providerId |  | 1..1 | Identifier | User invoking hook
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
groupId |  | 1..1 | Identifier | Healthcare org of user
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
payerId |  | 1..1 | Identifier | Payer receiving hook
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
exchange |  | 1..* | BackboneElement | Prior Authorization Exchanges
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type |  | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer
with |  | 0..1 | code | provider | intermediary | payer
method |  | 1..1 | code | x12 | restful | ihe | direct | other
requestTime |  | 1..1 | instant | Time exchange initiated
responseTime |  | 0..1 | instant | Time of exchange response
httpResponse |  | 1..1 | code | e.g. 200
issue |  | 0..* | BackboneElement | OperationOutcome info
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | Error code Binding: IssueType (required)
details |  | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example)
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | denied
itemDetail |  | 0..* | BackboneElement | Service level item detail
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
trn |  | 0..1 | integer | Service Level TRN
item |  | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC
assertionId |  | 0..1 | string | Unique ID for order item
initialSubmissionTime |  | 0..1 | dateTime | Date/time of the initial submission of the item
finalResponseTime |  | 0..1 | dateTime | Date/time of final result
responsesRequired |  | 0..1 | integer | Number of responses
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | deined
locationType |  | 0..1 | code | inpatient | outpatient | home
result |  | 0..1 | code | approved | modified | denied | pended | cancelled
denialReason |  | 0..1 | code | Denial Reason
supportingDoc |  | 0..1 | url | Documentation submitted as part of PAS Bundle
requestedDoc |  | 0..* | BackboneElement | Documentation requested via 278 response
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
docRequest |  | 1..* | CodeableConcept | Coded requests for additional documentation
timeRequested |  | 1..1 | dateTime | Date/Time of initial request
timeSubmitted |  | 0..1 | dateTime | Date/Time of final result
submissionMethod |  | 0..1 | code | CDex | portal | fax | x12 | other
exceptionSubmission |  | 0..1 | boolean | True if exchange is based on the exception grant
businessLine |  | 0..1 | CodeableConcept | E.g. MedicareAdvantage
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
PASMetricData.source | required | MetricDataSource `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` From this IG
PASMetricData.providerId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.providerId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.groupId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.groupId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.payerId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.payerId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.issue.code | required | IssueType `http://hl7.org/fhir/ValueSet/issue-type` From the FHIR Standard
PASMetricData.issue.details | example | OperationOutcomeCodes `http://hl7.org/fhir/ValueSet/operation-outcome` From the FHIR Standard

#### 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() |

This structure is derived from Base

Summary

Mandatory: 4 elements(17 nested mandatory elements)

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
PASMetricData |  | 0..* | Base | PAS Metric Data
source |  | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required)
providerId |  | 1..1 | Identifier | User invoking hook
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
groupId |  | 1..1 | Identifier | Healthcare org of user
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
payerId |  | 1..1 | Identifier | Payer receiving hook
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
exchange |  | 1..* | BackboneElement | Prior Authorization Exchanges
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type |  | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer
with |  | 0..1 | code | provider | intermediary | payer
method |  | 1..1 | code | x12 | restful | ihe | direct | other
requestTime |  | 1..1 | instant | Time exchange initiated
responseTime |  | 0..1 | instant | Time of exchange response
httpResponse |  | 1..1 | code | e.g. 200
issue |  | 0..* | BackboneElement | OperationOutcome info
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | Error code Binding: IssueType (required)
details |  | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example)
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | denied
itemDetail |  | 0..* | BackboneElement | Service level item detail
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
trn |  | 0..1 | integer | Service Level TRN
item |  | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC
assertionId |  | 0..1 | string | Unique ID for order item
initialSubmissionTime |  | 0..1 | dateTime | Date/time of the initial submission of the item
finalResponseTime |  | 0..1 | dateTime | Date/time of final result
responsesRequired |  | 0..1 | integer | Number of responses
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | deined
locationType |  | 0..1 | code | inpatient | outpatient | home
result |  | 0..1 | code | approved | modified | denied | pended | cancelled
denialReason |  | 0..1 | code | Denial Reason
supportingDoc |  | 0..1 | url | Documentation submitted as part of PAS Bundle
requestedDoc |  | 0..* | BackboneElement | Documentation requested via 278 response
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
docRequest |  | 1..* | CodeableConcept | Coded requests for additional documentation
timeRequested |  | 1..1 | dateTime | Date/Time of initial request
timeSubmitted |  | 0..1 | dateTime | Date/Time of final result
submissionMethod |  | 0..1 | code | CDex | portal | fax | x12 | other
exceptionSubmission |  | 0..1 | boolean | True if exchange is based on the exception grant
businessLine |  | 0..1 | CodeableConcept | E.g. MedicareAdvantage
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
PASMetricData.source | required | MetricDataSource `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` From this IG
PASMetricData.providerId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.providerId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.groupId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.groupId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.payerId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.payerId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.issue.code | required | IssueType `http://hl7.org/fhir/ValueSet/issue-type` From the FHIR Standard
PASMetricData.issue.details | example | OperationOutcomeCodes `http://hl7.org/fhir/ValueSet/operation-outcome` From the FHIR Standard

#### 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() |

Differential View

This structure is derived from Base

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
PASMetricData |  | 0..* | Base | PAS Metric Data
source |  | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required)
providerId |  | 1..1 | Identifier | User invoking hook
system |  | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value |  | 1..1 | string | The value that is unique
groupId |  | 1..1 | Identifier | Healthcare org of user
system |  | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value |  | 1..1 | string | The value that is unique
payerId |  | 1..1 | Identifier | Payer receiving hook
system |  | 1..1 | uri | The namespace for the identifier value
value |  | 1..1 | string | The value that is unique
exchange |  | 1..* | BackboneElement | Prior Authorization Exchanges
type |  | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer
with |  | 0..1 | code | provider | intermediary | payer
method |  | 1..1 | code | x12 | restful | ihe | direct | other
requestTime |  | 1..1 | instant | Time exchange initiated
responseTime |  | 0..1 | instant | Time of exchange response
httpResponse |  | 1..1 | code | e.g. 200
issue |  | 0..* | BackboneElement | OperationOutcome info
code |  | 1..1 | code | Error code Binding: IssueType (required)
details |  | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example)
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | denied
itemDetail |  | 0..* | BackboneElement | Service level item detail
trn |  | 0..1 | integer | Service Level TRN
item |  | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC
assertionId |  | 0..1 | string | Unique ID for order item
initialSubmissionTime |  | 0..1 | dateTime | Date/time of the initial submission of the item
finalResponseTime |  | 0..1 | dateTime | Date/time of final result
responsesRequired |  | 0..1 | integer | Number of responses
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | deined
locationType |  | 0..1 | code | inpatient | outpatient | home
result |  | 0..1 | code | approved | modified | denied | pended | cancelled
denialReason |  | 0..1 | code | Denial Reason
supportingDoc |  | 0..1 | url | Documentation submitted as part of PAS Bundle
requestedDoc |  | 0..* | BackboneElement | Documentation requested via 278 response
docRequest |  | 1..* | CodeableConcept | Coded requests for additional documentation
timeRequested |  | 1..1 | dateTime | Date/Time of initial request
timeSubmitted |  | 0..1 | dateTime | Date/Time of final result
submissionMethod |  | 0..1 | code | CDex | portal | fax | x12 | other
exceptionSubmission |  | 0..1 | boolean | True if exchange is based on the exception grant
businessLine |  | 0..1 | CodeableConcept | E.g. MedicareAdvantage
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
PASMetricData.source | required | MetricDataSource `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` From this IG
PASMetricData.issue.code | required | IssueType `http://hl7.org/fhir/ValueSet/issue-type` From the FHIR Standard
PASMetricData.issue.details | example | OperationOutcomeCodes `http://hl7.org/fhir/ValueSet/operation-outcome` From the FHIR Standard

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
PASMetricData |  | 0..* | Base | PAS Metric Data
source |  | 1..1 | code | provider | intermediary | payer Binding: Metric Data Source (required)
providerId |  | 1..1 | Identifier | User invoking hook
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
groupId |  | 1..1 | Identifier | Healthcare org of user
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
payerId |  | 1..1 | Identifier | Payer receiving hook
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
exchange |  | 1..* | BackboneElement | Prior Authorization Exchanges
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type |  | 1..1 | code | initial | subsequent | cancel | update | query | initialDocToPayer
with |  | 0..1 | code | provider | intermediary | payer
method |  | 1..1 | code | x12 | restful | ihe | direct | other
requestTime |  | 1..1 | instant | Time exchange initiated
responseTime |  | 0..1 | instant | Time of exchange response
httpResponse |  | 1..1 | code | e.g. 200
issue |  | 0..* | BackboneElement | OperationOutcome info
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | Error code Binding: IssueType (required)
details |  | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example)
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | denied
itemDetail |  | 0..* | BackboneElement | Service level item detail
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
trn |  | 0..1 | integer | Service Level TRN
item |  | 1..1 | CodeableConcept | eg. ICD10, HCPCS, NDC
assertionId |  | 0..1 | string | Unique ID for order item
initialSubmissionTime |  | 0..1 | dateTime | Date/time of the initial submission of the item
finalResponseTime |  | 0..1 | dateTime | Date/time of final result
responsesRequired |  | 0..1 | integer | Number of responses
aaaCodes |  | 0..* | BackboneElement | AAA codes returned
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
loopID |  | 1..1 | code | see X12 loop IDs
aaaCode |  | 1..1 | code | approved | modified | deined
locationType |  | 0..1 | code | inpatient | outpatient | home
result |  | 0..1 | code | approved | modified | denied | pended | cancelled
denialReason |  | 0..1 | code | Denial Reason
supportingDoc |  | 0..1 | url | Documentation submitted as part of PAS Bundle
requestedDoc |  | 0..* | BackboneElement | Documentation requested via 278 response
@id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
docRequest |  | 1..* | CodeableConcept | Coded requests for additional documentation
timeRequested |  | 1..1 | dateTime | Date/Time of initial request
timeSubmitted |  | 0..1 | dateTime | Date/Time of final result
submissionMethod |  | 0..1 | code | CDex | portal | fax | x12 | other
exceptionSubmission |  | 0..1 | boolean | True if exchange is based on the exception grant
businessLine |  | 0..1 | CodeableConcept | E.g. MedicareAdvantage
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
PASMetricData.source | required | MetricDataSource `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` From this IG
PASMetricData.providerId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.providerId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.groupId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.groupId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.payerId.use | required | IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` From the FHIR Standard
PASMetricData.payerId.type | extensible | Identifier Type Codes `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
PASMetricData.issue.code | required | IssueType `http://hl7.org/fhir/ValueSet/issue-type` From the FHIR Standard
PASMetricData.issue.details | example | OperationOutcomeCodes `http://hl7.org/fhir/ValueSet/operation-outcome` From the FHIR Standard

#### 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() |

This structure is derived from Base

Summary

Mandatory: 4 elements(17 nested mandatory elements)

Maturity: 1

Other representations of profile: CSV, Excel