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: PASMetricData - Detailed Descriptions

Page standards status: Informative | Maturity Level: 1

Definitions for the PASMetricData logical model.

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

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

0. PASMetricData
Definition | A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation
Short | PAS Metric Data
Control | 0..*
Is Modifier | false
Logical Model | Instances of this logical model are not marked to be the target of a Reference
2. PASMetricData.source
Definition | A code to indicate which type of system collected the metric data.
Short | provider | intermediary | payer
Control | 1..1
Binding | The codes SHALL be taken from Metric Data Source (required to `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` )
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
4. PASMetricData.providerId
Definition | The NPI number of the user who initiated the PAS request.
Short | User invoking hook
Control | 1..1
Type | Identifier
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. PASMetricData.providerId.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
8. PASMetricData.providerId.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.providerId.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. PASMetricData.providerId.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. PASMetricData.providerId.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. PASMetricData.providerId.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Pattern Value | `http://hl7.org/fhir/sid/us-npi`
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. PASMetricData.providerId.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | <br/><b>General</b>:123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. PASMetricData.providerId.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. PASMetricData.providerId.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. PASMetricData.groupId
Definition | The NPI of the hospital/clinic/other organization that initiated the PAS request.
Short | Healthcare org of user
Control | 1..1
Type | Identifier
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. PASMetricData.groupId.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
26. PASMetricData.groupId.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.groupId.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
28. PASMetricData.groupId.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. PASMetricData.groupId.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. PASMetricData.groupId.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Pattern Value | `http://hl7.org/fhir/sid/us-npi`
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. PASMetricData.groupId.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | <br/><b>General</b>:123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. PASMetricData.groupId.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. PASMetricData.groupId.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. PASMetricData.payerId
Definition | The identifier of the payer organization to whom the PAS call was made.
Short | Payer receiving hook
Control | 1..1
Type | Identifier
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. PASMetricData.payerId.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
44. PASMetricData.payerId.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.payerId.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
46. PASMetricData.payerId.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. PASMetricData.payerId.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. PASMetricData.payerId.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 10..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. PASMetricData.payerId.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 10..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | <br/><b>General</b>:123456
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. PASMetricData.payerId.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. PASMetricData.payerId.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. PASMetricData.exchange
Definition | Exchanges between providers, intermediares, and payers to support prior authorization.
Short | Prior Authorization Exchanges
Control | 1..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. PASMetricData.exchange.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
62. PASMetricData.exchange.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.exchange.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
64. PASMetricData.exchange.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())
66. PASMetricData.exchange.type
Definition | A code indicating the type of exchange
Short | initial | subsequent | cancel | update | query | initialDocToPayer
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
68. PASMetricData.exchange.with
Definition | The destination for the exchange
Short | provider | intermediary | payer
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
70. PASMetricData.exchange.method
Definition | Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set.
Short | x12 | restful | ihe | direct | other
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
72. PASMetricData.exchange.requestTime
Definition | For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer.
Short | Time exchange initiated
Control | 1..1
Type | instant
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
74. PASMetricData.exchange.responseTime
Definition | For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer.
Short | Time of exchange response
Control | 0..1
Type | instant
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
76. PASMetricData.exchange.httpResponse
Definition | What HTTP response code was returned for the exchange invocation.
Short | e.g. 200
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
78. PASMetricData.issue
Definition | In the event of an HTTP error, if an OperationOutcome was returned, what were the issues.
Short | OperationOutcome info
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. PASMetricData.issue.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
82. PASMetricData.issue.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.issue.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
84. PASMetricData.issue.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())
86. PASMetricData.issue.code
Definition | The issue.code value from the OperationOutcome for this issue.
Short | Error code
Control | 1..1
Binding | The codes SHALL be taken from IssueType (required to `http://hl7.org/fhir/ValueSet/issue-type` )
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
88. PASMetricData.issue.details
Definition | The issue.details value from the OperationOutcome for this issue.
Short | More detailed error code
Control | 0..1
Binding | For example codes, see OperationOutcomeCodes (example to `http://hl7.org/fhir/ValueSet/operation-outcome` )
Type | CodeableConcept
90. PASMetricData.aaaCodes
Definition | Any AAA codes returned during the exchange.
Short | AAA codes returned
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. PASMetricData.aaaCodes.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
94. PASMetricData.aaaCodes.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.aaaCodes.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
96. PASMetricData.aaaCodes.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())
98. PASMetricData.aaaCodes.loopID
Definition | X12 loop ID.
Short | see X12 loop IDs
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
100. PASMetricData.aaaCodes.aaaCode
Definition | AAA code returned with response.
Short | approved | modified | denied
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
102. PASMetricData.itemDetail
Definition | Service level detail. One interation of the backbone for each service item in the PA exchange.
Short | Service level item detail
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. PASMetricData.itemDetail.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
106. PASMetricData.itemDetail.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.itemDetail.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
108. PASMetricData.itemDetail.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())
110. PASMetricData.itemDetail.trn
Definition | Service level TRN assigned by the payer if a questionnaire is required.
Short | Service Level TRN
Control | 0..1
Type | integer
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
112. PASMetricData.itemDetail.item
Definition | The specific procedure, item, medication, appointment, nutrition that is the subject of the order.
Short | eg. ICD10, HCPCS, NDC
Control | 1..1
Type | CodeableConcept
114. PASMetricData.itemDetail.assertionId
Definition | The unique ID for the order item returned by CRD in the coverage information.
Short | Unique ID for order item
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
116. PASMetricData.itemDetail.initialSubmissionTime
Definition | Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item.
Short | Date/time of the initial submission of the item
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
118. PASMetricData.itemDetail.finalResponseTime
Definition | Date/time that the final result was returned for the specific service item.
Short | Date/time of final result
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
120. PASMetricData.itemDetail.responsesRequired
Definition | Number of responses (initial and any with result pended) for the service item.
Short | Number of responses
Control | 0..1
Type | integer
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
122. PASMetricData.itemDetail.aaaCodes
Definition | Any AAA codes returned during the exchange.
Short | AAA codes returned
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. PASMetricData.itemDetail.aaaCodes.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
126. PASMetricData.itemDetail.aaaCodes.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.itemDetail.aaaCodes.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
128. PASMetricData.itemDetail.aaaCodes.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())
130. PASMetricData.itemDetail.aaaCodes.loopID
Definition | X12 loop ID.
Short | see X12 loop IDs
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
132. PASMetricData.itemDetail.aaaCodes.aaaCode
Definition | AAA error code returned in the response.
Short | approved | modified | deined
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
134. PASMetricData.itemDetail.locationType
Definition | The site where the service will be performed.
Short | inpatient | outpatient | home
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
136. PASMetricData.itemDetail.result
Definition | Final result of the specific service item.
Short | approved | modified | denied | pended | cancelled
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
138. PASMetricData.itemDetail.denialReason
Definition | A code specifying the reason why the item was denied.
Short | Denial Reason
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
140. PASMetricData.supportingDoc
Definition | The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item.
Short | Documentation submitted as part of PAS Bundle
Control | 0..1
Type | url
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
142. PASMetricData.requestedDoc
Definition | Documentation requested via 278 response.
Short | Documentation requested via 278 response
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
144. PASMetricData.requestedDoc.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
146. PASMetricData.requestedDoc.extension
Definition | 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 | 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())
Slicing | This element introduces a set of slices on `PASMetricData.requestedDoc.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
148. PASMetricData.requestedDoc.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())
150. PASMetricData.requestedDoc.docRequest
Definition | Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element.
Short | Coded requests for additional documentation
Control | 1..*
Type | CodeableConcept
152. PASMetricData.requestedDoc.timeRequested
Definition | Date/Time of initial request for this item (may be part of the initial submission or part an update.
Short | Date/Time of initial request
Control | 1..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
154. PASMetricData.requestedDoc.timeSubmitted
Definition | Date/Time of final result for this item (may be part of the initial submission or part an update.
Short | Date/Time of final result
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
156. PASMetricData.requestedDoc.submissionMethod
Definition | The technical method used to submit the requested additional documentation.
Short | CDex | portal | fax | x12 | other
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
158. PASMetricData.exceptionSubmission
Definition | Indicator that exchange was performed under an exception grant from the National Standard Group.
Short | True if exchange is based on the exception grant
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
160. PASMetricData.businessLine
Definition | A code that indicates which type of insurance the patient is covered by.
Short | E.g. MedicareAdvantage
Control | 0..1
Type | CodeableConcept

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

0. PASMetricData
Definition | A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation
Short | PAS Metric Data
Logical Model | Instances of this logical model are not marked to be the target of a Reference
2. PASMetricData.source
Definition | A code to indicate which type of system collected the metric data.
Short | provider | intermediary | payer
Control | 1..1
Binding | The codes SHALL be taken from Metric Data Source (required to `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` )
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
4. PASMetricData.providerId
Definition | The NPI number of the user who initiated the PAS request.
Short | User invoking hook
Control | 1..1
Type | Identifier
6. PASMetricData.providerId.system
Pattern Value | `http://hl7.org/fhir/sid/us-npi`
8. PASMetricData.providerId.value
Control | 1..?
10. PASMetricData.groupId
Definition | The NPI of the hospital/clinic/other organization that initiated the PAS request.
Short | Healthcare org of user
Control | 1..1
Type | Identifier
12. PASMetricData.groupId.system
Pattern Value | `http://hl7.org/fhir/sid/us-npi`
14. PASMetricData.groupId.value
Control | 1..?
16. PASMetricData.payerId
Definition | The identifier of the payer organization to whom the PAS call was made.
Short | Payer receiving hook
Control | 1..1
Type | Identifier
18. PASMetricData.payerId.system
Control | 1..?
20. PASMetricData.payerId.value
Control | 1..?
22. PASMetricData.exchange
Definition | Exchanges between providers, intermediares, and payers to support prior authorization.
Short | Prior Authorization Exchanges
Control | 1..*
Type | BackboneElement
24. PASMetricData.exchange.type
Definition | A code indicating the type of exchange
Short | initial | subsequent | cancel | update | query | initialDocToPayer
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
26. PASMetricData.exchange.with
Definition | The destination for the exchange
Short | provider | intermediary | payer
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
28. PASMetricData.exchange.method
Definition | Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set.
Short | x12 | restful | ihe | direct | other
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
30. PASMetricData.exchange.requestTime
Definition | For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer.
Short | Time exchange initiated
Control | 1..1
Type | instant
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
32. PASMetricData.exchange.responseTime
Definition | For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer.
Short | Time of exchange response
Control | 0..1
Type | instant
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
34. PASMetricData.exchange.httpResponse
Definition | What HTTP response code was returned for the exchange invocation.
Short | e.g. 200
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
36. PASMetricData.issue
Definition | In the event of an HTTP error, if an OperationOutcome was returned, what were the issues.
Short | OperationOutcome info
Control | 0..*
Type | BackboneElement
38. PASMetricData.issue.code
Definition | The issue.code value from the OperationOutcome for this issue.
Short | Error code
Control | 1..1
Binding | The codes SHALL be taken from IssueType (required to `http://hl7.org/fhir/ValueSet/issue-type` )
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
40. PASMetricData.issue.details
Definition | The issue.details value from the OperationOutcome for this issue.
Short | More detailed error code
Control | 0..1
Binding | For example codes, see OperationOutcomeCodes (example to `http://hl7.org/fhir/ValueSet/operation-outcome` )
Type | CodeableConcept
42. PASMetricData.aaaCodes
Definition | Any AAA codes returned during the exchange.
Short | AAA codes returned
Control | 0..*
Type | BackboneElement
44. PASMetricData.aaaCodes.loopID
Definition | X12 loop ID.
Short | see X12 loop IDs
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
46. PASMetricData.aaaCodes.aaaCode
Definition | AAA code returned with response.
Short | approved | modified | denied
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
48. PASMetricData.itemDetail
Definition | Service level detail. One interation of the backbone for each service item in the PA exchange.
Short | Service level item detail
Control | 0..*
Type | BackboneElement
50. PASMetricData.itemDetail.trn
Definition | Service level TRN assigned by the payer if a questionnaire is required.
Short | Service Level TRN
Control | 0..1
Type | integer
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
52. PASMetricData.itemDetail.item
Definition | The specific procedure, item, medication, appointment, nutrition that is the subject of the order.
Short | eg. ICD10, HCPCS, NDC
Control | 1..1
Type | CodeableConcept
54. PASMetricData.itemDetail.assertionId
Definition | The unique ID for the order item returned by CRD in the coverage information.
Short | Unique ID for order item
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
56. PASMetricData.itemDetail.initialSubmissionTime
Definition | Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item.
Short | Date/time of the initial submission of the item
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
58. PASMetricData.itemDetail.finalResponseTime
Definition | Date/time that the final result was returned for the specific service item.
Short | Date/time of final result
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
60. PASMetricData.itemDetail.responsesRequired
Definition | Number of responses (initial and any with result pended) for the service item.
Short | Number of responses
Control | 0..1
Type | integer
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
62. PASMetricData.itemDetail.aaaCodes
Definition | Any AAA codes returned during the exchange.
Short | AAA codes returned
Control | 0..*
Type | BackboneElement
64. PASMetricData.itemDetail.aaaCodes.loopID
Definition | X12 loop ID.
Short | see X12 loop IDs
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
66. PASMetricData.itemDetail.aaaCodes.aaaCode
Definition | AAA error code returned in the response.
Short | approved | modified | deined
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
68. PASMetricData.itemDetail.locationType
Definition | The site where the service will be performed.
Short | inpatient | outpatient | home
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
70. PASMetricData.itemDetail.result
Definition | Final result of the specific service item.
Short | approved | modified | denied | pended | cancelled
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
72. PASMetricData.itemDetail.denialReason
Definition | A code specifying the reason why the item was denied.
Short | Denial Reason
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
74. PASMetricData.supportingDoc
Definition | The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item.
Short | Documentation submitted as part of PAS Bundle
Control | 0..1
Type | url
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
76. PASMetricData.requestedDoc
Definition | Documentation requested via 278 response.
Short | Documentation requested via 278 response
Control | 0..*
Type | BackboneElement
78. PASMetricData.requestedDoc.docRequest
Definition | Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element.
Short | Coded requests for additional documentation
Control | 1..*
Type | CodeableConcept
80. PASMetricData.requestedDoc.timeRequested
Definition | Date/Time of initial request for this item (may be part of the initial submission or part an update.
Short | Date/Time of initial request
Control | 1..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
82. PASMetricData.requestedDoc.timeSubmitted
Definition | Date/Time of final result for this item (may be part of the initial submission or part an update.
Short | Date/Time of final result
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
84. PASMetricData.requestedDoc.submissionMethod
Definition | The technical method used to submit the requested additional documentation.
Short | CDex | portal | fax | x12 | other
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
86. PASMetricData.exceptionSubmission
Definition | Indicator that exchange was performed under an exception grant from the National Standard Group.
Short | True if exchange is based on the exception grant
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
88. PASMetricData.businessLine
Definition | A code that indicates which type of insurance the patient is covered by.
Short | E.g. MedicareAdvantage
Control | 0..1
Type | CodeableConcept

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

0. PASMetricData
Definition | A logical model describing the information that should be captured by PAS implementers about every PAS invocation to support measures evaluating PAS implementation
Short | PAS Metric Data
Control | 0..*
Is Modifier | false
Logical Model | Instances of this logical model are not marked to be the target of a Reference
2. PASMetricData.source
Definition | A code to indicate which type of system collected the metric data.
Short | provider | intermediary | payer
Control | 1..1
Binding | The codes SHALL be taken from Metric Data Source (required to `http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource` )
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
4. PASMetricData.providerId
Definition | The NPI number of the user who initiated the PAS request.
Short | User invoking hook
Control | 1..1
Type | Identifier
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. PASMetricData.providerId.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
8. PASMetricData.providerId.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.providerId.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
10. PASMetricData.providerId.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. PASMetricData.providerId.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
14. PASMetricData.providerId.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Pattern Value | `http://hl7.org/fhir/sid/us-npi`
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
16. PASMetricData.providerId.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | <br/><b>General</b>:123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
18. PASMetricData.providerId.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
20. PASMetricData.providerId.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
22. PASMetricData.groupId
Definition | The NPI of the hospital/clinic/other organization that initiated the PAS request.
Short | Healthcare org of user
Control | 1..1
Type | Identifier
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. PASMetricData.groupId.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
26. PASMetricData.groupId.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.groupId.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
28. PASMetricData.groupId.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. PASMetricData.groupId.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
32. PASMetricData.groupId.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 0..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Pattern Value | `http://hl7.org/fhir/sid/us-npi`
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. PASMetricData.groupId.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | <br/><b>General</b>:123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
36. PASMetricData.groupId.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
38. PASMetricData.groupId.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. PASMetricData.payerId
Definition | The identifier of the payer organization to whom the PAS call was made.
Short | Payer receiving hook
Control | 1..1
Type | Identifier
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. PASMetricData.payerId.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
44. PASMetricData.payerId.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.payerId.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
46. PASMetricData.payerId.use
Definition | The purpose of this identifier.
Short | usual | official | temp | secondary | old (If known)
Comments | Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.
Control | 0..1
Binding | The codes SHALL be taken from IdentifierUse (required to `http://hl7.org/fhir/ValueSet/identifier-use|4.0.1` ) Identifies the purpose for this identifier, if known .
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
48. PASMetricData.payerId.type
Definition | A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.
Short | Description of identifier
Comments | This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to `http://hl7.org/fhir/ValueSet/identifier-type` ) A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Allows users to make use of identifiers when the identifier system is not known.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. PASMetricData.payerId.system
Definition | Establishes the namespace for the value - that is, a URL that describes a set values that are unique.
Short | The namespace for the identifier value
Comments | Identifier.system is always case sensitive.
Control | 1..1
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.
Example | <br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. PASMetricData.payerId.value
Definition | The portion of the identifier typically relevant to the user and which is unique within the context of the system.
Short | The value that is unique
Comments | If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.
Control | 1..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Example | <br/><b>General</b>:123456
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. PASMetricData.payerId.period
Definition | Time period during which identifier is/was valid for use.
Short | Time period when id is/was valid for use
Control | 0..1
Type | Period
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. PASMetricData.payerId.assigner
Definition | Organization that issued/manages the identifier.
Short | Organization that issued id (may be just text)
Comments | The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.
Control | 0..1
Type | Reference(Organization)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. PASMetricData.exchange
Definition | Exchanges between providers, intermediares, and payers to support prior authorization.
Short | Prior Authorization Exchanges
Control | 1..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. PASMetricData.exchange.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
62. PASMetricData.exchange.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.exchange.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
64. PASMetricData.exchange.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()`)
66. PASMetricData.exchange.type
Definition | A code indicating the type of exchange
Short | initial | subsequent | cancel | update | query | initialDocToPayer
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
68. PASMetricData.exchange.with
Definition | The destination for the exchange
Short | provider | intermediary | payer
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
70. PASMetricData.exchange.method
Definition | Exchange standard used for this specific exchange. Note: RESTful is the default for any Provider to Intermediary exchange, X12 is the defalt for any exchange between the intermediary and the payer for the X12 278, the exchange of the PAS bundle between the intermediary and the payer may be any of the methods included in the value set.
Short | x12 | restful | ihe | direct | other
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
72. PASMetricData.exchange.requestTime
Definition | For providers, the request was made. For payers, the time the request was received. For intermediaries time the request was received from the provider or time the request was sent to the payer.
Short | Time exchange initiated
Control | 1..1
Type | instant
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
74. PASMetricData.exchange.responseTime
Definition | For providers, the response was received. For payers, the time the response was sent. For intermediaries time the response was sent to the provider or time the response was received from the payer.
Short | Time of exchange response
Control | 0..1
Type | instant
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
76. PASMetricData.exchange.httpResponse
Definition | What HTTP response code was returned for the exchange invocation.
Short | e.g. 200
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
78. PASMetricData.issue
Definition | In the event of an HTTP error, if an OperationOutcome was returned, what were the issues.
Short | OperationOutcome info
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. PASMetricData.issue.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
82. PASMetricData.issue.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.issue.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
84. PASMetricData.issue.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()`)
86. PASMetricData.issue.code
Definition | The issue.code value from the OperationOutcome for this issue.
Short | Error code
Control | 1..1
Binding | The codes SHALL be taken from IssueType (required to `http://hl7.org/fhir/ValueSet/issue-type` )
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
88. PASMetricData.issue.details
Definition | The issue.details value from the OperationOutcome for this issue.
Short | More detailed error code
Control | 0..1
Binding | For example codes, see OperationOutcomeCodes (example to `http://hl7.org/fhir/ValueSet/operation-outcome` )
Type | CodeableConcept
90. PASMetricData.aaaCodes
Definition | Any AAA codes returned during the exchange.
Short | AAA codes returned
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
92. PASMetricData.aaaCodes.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
94. PASMetricData.aaaCodes.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.aaaCodes.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
96. PASMetricData.aaaCodes.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()`)
98. PASMetricData.aaaCodes.loopID
Definition | X12 loop ID.
Short | see X12 loop IDs
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
100. PASMetricData.aaaCodes.aaaCode
Definition | AAA code returned with response.
Short | approved | modified | denied
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
102. PASMetricData.itemDetail
Definition | Service level detail. One interation of the backbone for each service item in the PA exchange.
Short | Service level item detail
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. PASMetricData.itemDetail.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
106. PASMetricData.itemDetail.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.itemDetail.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
108. PASMetricData.itemDetail.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()`)
110. PASMetricData.itemDetail.trn
Definition | Service level TRN assigned by the payer if a questionnaire is required.
Short | Service Level TRN
Control | 0..1
Type | integer
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
112. PASMetricData.itemDetail.item
Definition | The specific procedure, item, medication, appointment, nutrition that is the subject of the order.
Short | eg. ICD10, HCPCS, NDC
Control | 1..1
Type | CodeableConcept
114. PASMetricData.itemDetail.assertionId
Definition | The unique ID for the order item returned by CRD in the coverage information.
Short | Unique ID for order item
Control | 0..1
Type | string
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
116. PASMetricData.itemDetail.initialSubmissionTime
Definition | Date/time of the initial submission of the servcie item. This may be the time of the initial PA request or the time of an updated that added the service item.
Short | Date/time of the initial submission of the item
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
118. PASMetricData.itemDetail.finalResponseTime
Definition | Date/time that the final result was returned for the specific service item.
Short | Date/time of final result
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
120. PASMetricData.itemDetail.responsesRequired
Definition | Number of responses (initial and any with result pended) for the service item.
Short | Number of responses
Control | 0..1
Type | integer
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
122. PASMetricData.itemDetail.aaaCodes
Definition | Any AAA codes returned during the exchange.
Short | AAA codes returned
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. PASMetricData.itemDetail.aaaCodes.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
126. PASMetricData.itemDetail.aaaCodes.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.itemDetail.aaaCodes.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
128. PASMetricData.itemDetail.aaaCodes.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()`)
130. PASMetricData.itemDetail.aaaCodes.loopID
Definition | X12 loop ID.
Short | see X12 loop IDs
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
132. PASMetricData.itemDetail.aaaCodes.aaaCode
Definition | AAA error code returned in the response.
Short | approved | modified | deined
Control | 1..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
134. PASMetricData.itemDetail.locationType
Definition | The site where the service will be performed.
Short | inpatient | outpatient | home
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
136. PASMetricData.itemDetail.result
Definition | Final result of the specific service item.
Short | approved | modified | denied | pended | cancelled
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
138. PASMetricData.itemDetail.denialReason
Definition | A code specifying the reason why the item was denied.
Short | Denial Reason
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
140. PASMetricData.supportingDoc
Definition | The URL of the questionnaire that was the basis for the questionnaireResponse submitted as part of the PAS bundle for the specific service item.
Short | Documentation submitted as part of PAS Bundle
Control | 0..1
Type | url
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
142. PASMetricData.requestedDoc
Definition | Documentation requested via 278 response.
Short | Documentation requested via 278 response
Control | 0..*
Type | BackboneElement
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
144. PASMetricData.requestedDoc.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
146. PASMetricData.requestedDoc.extension
Definition | 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 | 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()`)
Slicing | This element introduces a set of slices on `PASMetricData.requestedDoc.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
148. PASMetricData.requestedDoc.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()`)
150. PASMetricData.requestedDoc.docRequest
Definition | Coded requests for documentation in the 278 response. May be LOINC codes as determined by HIPAA tab or X12 codes from the PWK01 element.
Short | Coded requests for additional documentation
Control | 1..*
Type | CodeableConcept
152. PASMetricData.requestedDoc.timeRequested
Definition | Date/Time of initial request for this item (may be part of the initial submission or part an update.
Short | Date/Time of initial request
Control | 1..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
154. PASMetricData.requestedDoc.timeSubmitted
Definition | Date/Time of final result for this item (may be part of the initial submission or part an update.
Short | Date/Time of final result
Control | 0..1
Type | dateTime
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
156. PASMetricData.requestedDoc.submissionMethod
Definition | The technical method used to submit the requested additional documentation.
Short | CDex | portal | fax | x12 | other
Control | 0..1
Type | code
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
158. PASMetricData.exceptionSubmission
Definition | Indicator that exchange was performed under an exception grant from the National Standard Group.
Short | True if exchange is based on the exception grant
Control | 0..1
Type | boolean
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
160. PASMetricData.businessLine
Definition | A code that indicates which type of insurance the patient is covered by.
Short | E.g. MedicareAdvantage
Control | 0..1
Type | CodeableConcept