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

## Resource Profile: PAS Nutrition Order

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-nutritionorder | Version: 2.2.0-ballot
Standards status: Trial-use | Maturity Level: 3 | Computable Name: PASNutritionOrder
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.62

PAS constraint on Nutrition Order resource for elements relevant to the ordering of nutrition on a prior authorization request

Usages:

- Refer to this Profile: RequestedService
- Examples for this Profile: NutritionOrder/NutritionOrderExample

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder | C | 0..* | NutritionOrder | Diet, formula or nutritional supplement request Constraints: nor-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:coverage | S C | 0..1 | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes identifying the lifecycle stage of the nutrition order.
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a nutrition order. Fixed Value: order
patient | S Σ | 1..1 | Reference(PAS Beneficiary Patient) | The person who requires the diet, formula or nutritional supplement
dateTime | Σ | 1..1 | dateTime | Date and time the nutrition order was requested
oralDiet | S C | 0..1 | BackboneElement | Oral diet components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: X12 278 Nutrition Oral Diet Type (required)
enteralFormula | S C | 0..1 | BackboneElement | Enteral formula components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
baseFormulaType | S Σ | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: X12 278 Nutrition Enteral Formula Type (required)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
NutritionOrder.status | required | RequestStatus `http://hl7.org/fhir/ValueSet/request-status|4.0.1` From the FHIR Standard
NutritionOrder.intent | required | Fixed Value: order `http://hl7.org/fhir/ValueSet/request-intent|4.0.1` From the FHIR Standard
NutritionOrder.oralDiet.type | required | X12278NutritionOralDietType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionOralDietType` From this IG
NutritionOrder.enteralFormula.baseFormulaType | required | X12278NutritionEnteralFormulaType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionEnteralFormulaType` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
crd-ci-q1 | error | NutritionOrder.extension:coverage | Questionnaire is only allowed when doc-needed exists : extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists() |
crd-ci-q2 | error | NutritionOrder.extension:coverage | If covered is set to 'not-covered', then 'pa-needed' must not exist. : extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not() |
crd-ci-q3 | error | NutritionOrder.extension:coverage | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. : extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists() |
crd-ci-q4 | error | NutritionOrder.extension:coverage | If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'withpa'. : extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa') |
crd-ci-q5 | error | NutritionOrder.extension:coverage | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. : extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists() |
crd-ci-q6 | error | NutritionOrder.extension:coverage | If 'info-needed' is Other, then reason must be specified : extension.where(url = 'info-needed' and value = 'Other').exists() implies extension.where(url = 'reason').exists() |
crd-ci-q7 | error | NutritionOrder.extension:coverage | If reason.coding is present and is not from the extensible value set, then reason.text must be present : extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons') |
dom-2 | error | NutritionOrder | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | NutritionOrder | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | NutritionOrder | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
nor-1 | warning | NutritionOrder | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class : oralDiet.exists() or supplement.exists() or enteralFormula.exists() |

This structure is derived from NutritionOrder

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder |  | 0..* | NutritionOrder | Diet, formula or nutritional supplement request
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:coverage | S | 0..1 | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
intent | S | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Fixed Value: order
patient | S | 1..1 | Reference(PAS Beneficiary Patient) | The person who requires the diet, formula or nutritional supplement
oralDiet | S | 0..1 | BackboneElement | Oral diet components
type | S | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: X12 278 Nutrition Oral Diet Type (required)
enteralFormula | S | 0..1 | BackboneElement | Enteral formula components
baseFormulaType | S | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: X12 278 Nutrition Enteral Formula Type (required)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
NutritionOrder.oralDiet.type | required | X12278NutritionOralDietType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionOralDietType` From this IG
NutritionOrder.enteralFormula.baseFormulaType | required | X12278NutritionEnteralFormulaType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionEnteralFormulaType` From this IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder | C | 0..* | NutritionOrder | Diet, formula or nutritional supplement request Constraints: nor-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:coverage | S C | 0..1 | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Identifiers assigned to this order
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
instantiates |  | 0..* | uri | Instantiates protocol or definition
status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes identifying the lifecycle stage of the nutrition order.
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a nutrition order. Fixed Value: order
patient | S Σ | 1..1 | Reference(PAS Beneficiary Patient) | The person who requires the diet, formula or nutritional supplement
encounter |  | 0..1 | Reference(Encounter) | The encounter associated with this nutrition order
dateTime | Σ | 1..1 | dateTime | Date and time the nutrition order was requested
orderer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | Who ordered the diet, formula or nutritional supplement
allergyIntolerance |  | 0..* | Reference(AllergyIntolerance) | List of the patient's food and nutrition-related allergies and intolerances
foodPreferenceModifier |  | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
excludeFoodModifier |  | 0..* | CodeableConcept | Order-specific modifier about the type of food that should not be given Binding: FoodTypeCodes (example): Codes used to indicate the type of food that should NOT be given to the patient.
oralDiet | S C | 0..1 | BackboneElement | Oral diet components
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: X12 278 Nutrition Oral Diet Type (required)
schedule |  | 0..* | Timing | Scheduled frequency of diet
nutrient |  | 0..* | BackboneElement | Required nutrient modifications
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
modifier |  | 0..1 | CodeableConcept | Type of nutrient that is being modified Binding: NutrientModifierCodes (example): Codes for types of nutrients that are being modified such as carbohydrate or sodium.
amount |  | 0..1 | SimpleQuantity | Quantity of the specified nutrient
texture |  | 0..* | BackboneElement | Required texture modifications
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
modifier |  | 0..1 | CodeableConcept | Code to indicate how to alter the texture of the foods, e.g. pureed Binding: TextureModifierCodes (example): Codes for food consistency types or texture modifications to apply to foods.
foodType |  | 0..1 | CodeableConcept | Concepts that are used to identify an entity that is ingested for nutritional purposes Binding: TextureModifiedFoodTypeCodes (example): Codes for types of foods that are texture-modified.
fluidConsistencyType |  | 0..* | CodeableConcept | The required consistency of fluids and liquids provided to the patient Binding: FluidConsistencyTypeCodes (example): Codes used to represent the consistency of fluids and liquids provided to the patient.
instruction | Σ | 0..1 | string | Instructions or additional information about the oral diet
supplement | C | 0..* | BackboneElement | Supplement components
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 0..1 | CodeableConcept | Type of supplement product requested Binding: SupplementTypeCodes (example): Codes for nutritional supplements to be provided to the patient.
productName |  | 0..1 | string | Product or brand name of the nutritional supplement
schedule |  | 0..* | Timing | Scheduled frequency of supplement
quantity |  | 0..1 | SimpleQuantity | Amount of the nutritional supplement
instruction | Σ | 0..1 | string | Instructions or additional information about the oral supplement
enteralFormula | S C | 0..1 | BackboneElement | Enteral formula components
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
baseFormulaType | S Σ | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: X12 278 Nutrition Enteral Formula Type (required)
baseFormulaProductName |  | 0..1 | string | Product or brand name of the enteral or infant formula
additiveType |  | 0..1 | CodeableConcept | Type of modular component to add to the feeding Binding: EnteralFormulaAdditiveTypeCode (example): Codes for the type of modular component such as protein, carbohydrate or fiber to be provided in addition to or mixed with the base formula.
additiveProductName |  | 0..1 | string | Product or brand name of the modular additive
caloricDensity |  | 0..1 | SimpleQuantity | Amount of energy per specified volume that is required
routeofAdministration |  | 0..1 | CodeableConcept | How the formula should enter the patient's gastrointestinal tract Binding: EnteralRouteCodes (extensible): Codes specifying the route of administration of enteral formula.
administration |  | 0..* | BackboneElement | Formula feeding instruction as structured data
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
schedule |  | 0..1 | Timing | Scheduled frequency of enteral feeding
quantity |  | 0..1 | SimpleQuantity | The volume of formula to provide
rate[x] |  | 0..1 |  | Speed with which the formula is provided per period of time
rateQuantity |  |  | Quantity(SimpleQuantity) |
rateRatio |  |  | Ratio |
maxVolumeToDeliver |  | 0..1 | SimpleQuantity | Upper limit on formula volume per unit of time
administrationInstruction | Σ | 0..1 | string | Formula feeding instructions expressed as text
note |  | 0..* | Annotation | Comments
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
NutritionOrder.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
NutritionOrder.status | required | RequestStatus `http://hl7.org/fhir/ValueSet/request-status|4.0.1` From the FHIR Standard
NutritionOrder.intent | required | Fixed Value: order `http://hl7.org/fhir/ValueSet/request-intent|4.0.1` From the FHIR Standard
NutritionOrder.foodPreferenceModifier | example | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` From the FHIR Standard
NutritionOrder.excludeFoodModifier | example | FoodTypeCodes `http://hl7.org/fhir/ValueSet/food-type` From the FHIR Standard
NutritionOrder.oralDiet.type | required | X12278NutritionOralDietType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionOralDietType` From this IG
NutritionOrder.oralDiet.nutrient.modifier | example | NutrientModifierCodes `http://hl7.org/fhir/ValueSet/nutrient-code` From the FHIR Standard
NutritionOrder.oralDiet.texture.modifier | example | TextureModifierCodes `http://hl7.org/fhir/ValueSet/texture-code` From the FHIR Standard
NutritionOrder.oralDiet.texture.foodType | example | TextureModifiedFoodTypeCodes `http://hl7.org/fhir/ValueSet/modified-foodtype` From the FHIR Standard
NutritionOrder.oralDiet.fluidConsistencyType | example | FluidConsistencyTypeCodes `http://hl7.org/fhir/ValueSet/consistency-type` From the FHIR Standard
NutritionOrder.supplement.type | example | SupplementTypeCodes `http://hl7.org/fhir/ValueSet/supplement-type` From the FHIR Standard
NutritionOrder.enteralFormula.baseFormulaType | required | X12278NutritionEnteralFormulaType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionEnteralFormulaType` From this IG
NutritionOrder.enteralFormula.additiveType | example | EnteralFormulaAdditiveTypeCode `http://hl7.org/fhir/ValueSet/entformula-additive` From the FHIR Standard
NutritionOrder.enteralFormula.routeofAdministration | extensible | EnteralRouteCodes `http://hl7.org/fhir/ValueSet/enteral-route` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
crd-ci-q1 | error | NutritionOrder.extension:coverage | Questionnaire is only allowed when doc-needed exists : extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists() |
crd-ci-q2 | error | NutritionOrder.extension:coverage | If covered is set to 'not-covered', then 'pa-needed' must not exist. : extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not() |
crd-ci-q3 | error | NutritionOrder.extension:coverage | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. : extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists() |
crd-ci-q4 | error | NutritionOrder.extension:coverage | If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'withpa'. : extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa') |
crd-ci-q5 | error | NutritionOrder.extension:coverage | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. : extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists() |
crd-ci-q6 | error | NutritionOrder.extension:coverage | If 'info-needed' is Other, then reason must be specified : extension.where(url = 'info-needed' and value = 'Other').exists() implies extension.where(url = 'reason').exists() |
crd-ci-q7 | error | NutritionOrder.extension:coverage | If reason.coding is present and is not from the extensible value set, then reason.text must be present : extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons') |
dom-2 | error | NutritionOrder | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | NutritionOrder | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | NutritionOrder | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
nor-1 | warning | NutritionOrder | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class : oralDiet.exists() or supplement.exists() or enteralFormula.exists() |

This structure is derived from NutritionOrder

Summary

Must-Support: 7 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- PAS Beneficiary Patient (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information

Maturity: 3

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder | C | 0..* | NutritionOrder | Diet, formula or nutritional supplement request Constraints: nor-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:coverage | S C | 0..1 | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes identifying the lifecycle stage of the nutrition order.
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a nutrition order. Fixed Value: order
patient | S Σ | 1..1 | Reference(PAS Beneficiary Patient) | The person who requires the diet, formula or nutritional supplement
dateTime | Σ | 1..1 | dateTime | Date and time the nutrition order was requested
oralDiet | S C | 0..1 | BackboneElement | Oral diet components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: X12 278 Nutrition Oral Diet Type (required)
enteralFormula | S C | 0..1 | BackboneElement | Enteral formula components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
baseFormulaType | S Σ | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: X12 278 Nutrition Enteral Formula Type (required)
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
NutritionOrder.status | required | RequestStatus `http://hl7.org/fhir/ValueSet/request-status|4.0.1` From the FHIR Standard
NutritionOrder.intent | required | Fixed Value: order `http://hl7.org/fhir/ValueSet/request-intent|4.0.1` From the FHIR Standard
NutritionOrder.oralDiet.type | required | X12278NutritionOralDietType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionOralDietType` From this IG
NutritionOrder.enteralFormula.baseFormulaType | required | X12278NutritionEnteralFormulaType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionEnteralFormulaType` From this IG

#### Constraints

Id | Grade | Path(s) | Details | Requirements
crd-ci-q1 | error | NutritionOrder.extension:coverage | Questionnaire is only allowed when doc-needed exists : extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists() |
crd-ci-q2 | error | NutritionOrder.extension:coverage | If covered is set to 'not-covered', then 'pa-needed' must not exist. : extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not() |
crd-ci-q3 | error | NutritionOrder.extension:coverage | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. : extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists() |
crd-ci-q4 | error | NutritionOrder.extension:coverage | If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'withpa'. : extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa') |
crd-ci-q5 | error | NutritionOrder.extension:coverage | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. : extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists() |
crd-ci-q6 | error | NutritionOrder.extension:coverage | If 'info-needed' is Other, then reason must be specified : extension.where(url = 'info-needed' and value = 'Other').exists() implies extension.where(url = 'reason').exists() |
crd-ci-q7 | error | NutritionOrder.extension:coverage | If reason.coding is present and is not from the extensible value set, then reason.text must be present : extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons') |
dom-2 | error | NutritionOrder | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | NutritionOrder | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | NutritionOrder | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
nor-1 | warning | NutritionOrder | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class : oralDiet.exists() or supplement.exists() or enteralFormula.exists() |

Differential View

This structure is derived from NutritionOrder

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder |  | 0..* | NutritionOrder | Diet, formula or nutritional supplement request
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:coverage | S | 0..1 | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
intent | S | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Fixed Value: order
patient | S | 1..1 | Reference(PAS Beneficiary Patient) | The person who requires the diet, formula or nutritional supplement
oralDiet | S | 0..1 | BackboneElement | Oral diet components
type | S | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: X12 278 Nutrition Oral Diet Type (required)
enteralFormula | S | 0..1 | BackboneElement | Enteral formula components
baseFormulaType | S | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: X12 278 Nutrition Enteral Formula Type (required)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
NutritionOrder.oralDiet.type | required | X12278NutritionOralDietType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionOralDietType` From this IG
NutritionOrder.enteralFormula.baseFormulaType | required | X12278NutritionEnteralFormulaType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionEnteralFormulaType` From this IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder | C | 0..* | NutritionOrder | Diet, formula or nutritional supplement request Constraints: nor-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:coverage | S C | 0..1 | (Complex) | CoverageInfo URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Identifiers assigned to this order
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
instantiates |  | 0..* | uri | Instantiates protocol or definition
status | ?!Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes identifying the lifecycle stage of the nutrition order.
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a nutrition order. Fixed Value: order
patient | S Σ | 1..1 | Reference(PAS Beneficiary Patient) | The person who requires the diet, formula or nutritional supplement
encounter |  | 0..1 | Reference(Encounter) | The encounter associated with this nutrition order
dateTime | Σ | 1..1 | dateTime | Date and time the nutrition order was requested
orderer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | Who ordered the diet, formula or nutritional supplement
allergyIntolerance |  | 0..* | Reference(AllergyIntolerance) | List of the patient's food and nutrition-related allergies and intolerances
foodPreferenceModifier |  | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
excludeFoodModifier |  | 0..* | CodeableConcept | Order-specific modifier about the type of food that should not be given Binding: FoodTypeCodes (example): Codes used to indicate the type of food that should NOT be given to the patient.
oralDiet | S C | 0..1 | BackboneElement | Oral diet components
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: X12 278 Nutrition Oral Diet Type (required)
schedule |  | 0..* | Timing | Scheduled frequency of diet
nutrient |  | 0..* | BackboneElement | Required nutrient modifications
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
modifier |  | 0..1 | CodeableConcept | Type of nutrient that is being modified Binding: NutrientModifierCodes (example): Codes for types of nutrients that are being modified such as carbohydrate or sodium.
amount |  | 0..1 | SimpleQuantity | Quantity of the specified nutrient
texture |  | 0..* | BackboneElement | Required texture modifications
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
modifier |  | 0..1 | CodeableConcept | Code to indicate how to alter the texture of the foods, e.g. pureed Binding: TextureModifierCodes (example): Codes for food consistency types or texture modifications to apply to foods.
foodType |  | 0..1 | CodeableConcept | Concepts that are used to identify an entity that is ingested for nutritional purposes Binding: TextureModifiedFoodTypeCodes (example): Codes for types of foods that are texture-modified.
fluidConsistencyType |  | 0..* | CodeableConcept | The required consistency of fluids and liquids provided to the patient Binding: FluidConsistencyTypeCodes (example): Codes used to represent the consistency of fluids and liquids provided to the patient.
instruction | Σ | 0..1 | string | Instructions or additional information about the oral diet
supplement | C | 0..* | BackboneElement | Supplement components
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | Σ | 0..1 | CodeableConcept | Type of supplement product requested Binding: SupplementTypeCodes (example): Codes for nutritional supplements to be provided to the patient.
productName |  | 0..1 | string | Product or brand name of the nutritional supplement
schedule |  | 0..* | Timing | Scheduled frequency of supplement
quantity |  | 0..1 | SimpleQuantity | Amount of the nutritional supplement
instruction | Σ | 0..1 | string | Instructions or additional information about the oral supplement
enteralFormula | S C | 0..1 | BackboneElement | Enteral formula components
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
baseFormulaType | S Σ | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: X12 278 Nutrition Enteral Formula Type (required)
baseFormulaProductName |  | 0..1 | string | Product or brand name of the enteral or infant formula
additiveType |  | 0..1 | CodeableConcept | Type of modular component to add to the feeding Binding: EnteralFormulaAdditiveTypeCode (example): Codes for the type of modular component such as protein, carbohydrate or fiber to be provided in addition to or mixed with the base formula.
additiveProductName |  | 0..1 | string | Product or brand name of the modular additive
caloricDensity |  | 0..1 | SimpleQuantity | Amount of energy per specified volume that is required
routeofAdministration |  | 0..1 | CodeableConcept | How the formula should enter the patient's gastrointestinal tract Binding: EnteralRouteCodes (extensible): Codes specifying the route of administration of enteral formula.
administration |  | 0..* | BackboneElement | Formula feeding instruction as structured data
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
schedule |  | 0..1 | Timing | Scheduled frequency of enteral feeding
quantity |  | 0..1 | SimpleQuantity | The volume of formula to provide
rate[x] |  | 0..1 |  | Speed with which the formula is provided per period of time
rateQuantity |  |  | Quantity(SimpleQuantity) |
rateRatio |  |  | Ratio |
maxVolumeToDeliver |  | 0..1 | SimpleQuantity | Upper limit on formula volume per unit of time
administrationInstruction | Σ | 0..1 | string | Formula feeding instructions expressed as text
note |  | 0..* | Annotation | Comments
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
NutritionOrder.language | preferred | CommonLanguages `http://hl7.org/fhir/ValueSet/languages` From the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
NutritionOrder.status | required | RequestStatus `http://hl7.org/fhir/ValueSet/request-status|4.0.1` From the FHIR Standard
NutritionOrder.intent | required | Fixed Value: order `http://hl7.org/fhir/ValueSet/request-intent|4.0.1` From the FHIR Standard
NutritionOrder.foodPreferenceModifier | example | Diet `http://hl7.org/fhir/ValueSet/encounter-diet` From the FHIR Standard
NutritionOrder.excludeFoodModifier | example | FoodTypeCodes `http://hl7.org/fhir/ValueSet/food-type` From the FHIR Standard
NutritionOrder.oralDiet.type | required | X12278NutritionOralDietType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionOralDietType` From this IG
NutritionOrder.oralDiet.nutrient.modifier | example | NutrientModifierCodes `http://hl7.org/fhir/ValueSet/nutrient-code` From the FHIR Standard
NutritionOrder.oralDiet.texture.modifier | example | TextureModifierCodes `http://hl7.org/fhir/ValueSet/texture-code` From the FHIR Standard
NutritionOrder.oralDiet.texture.foodType | example | TextureModifiedFoodTypeCodes `http://hl7.org/fhir/ValueSet/modified-foodtype` From the FHIR Standard
NutritionOrder.oralDiet.fluidConsistencyType | example | FluidConsistencyTypeCodes `http://hl7.org/fhir/ValueSet/consistency-type` From the FHIR Standard
NutritionOrder.supplement.type | example | SupplementTypeCodes `http://hl7.org/fhir/ValueSet/supplement-type` From the FHIR Standard
NutritionOrder.enteralFormula.baseFormulaType | required | X12278NutritionEnteralFormulaType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278NutritionEnteralFormulaType` From this IG
NutritionOrder.enteralFormula.additiveType | example | EnteralFormulaAdditiveTypeCode `http://hl7.org/fhir/ValueSet/entformula-additive` From the FHIR Standard
NutritionOrder.enteralFormula.routeofAdministration | extensible | EnteralRouteCodes `http://hl7.org/fhir/ValueSet/enteral-route` From the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
crd-ci-q1 | error | NutritionOrder.extension:coverage | Questionnaire is only allowed when doc-needed exists : extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists() |
crd-ci-q2 | error | NutritionOrder.extension:coverage | If covered is set to 'not-covered', then 'pa-needed' must not exist. : extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not() |
crd-ci-q3 | error | NutritionOrder.extension:coverage | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. : extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists() |
crd-ci-q4 | error | NutritionOrder.extension:coverage | If 'pa-needed' is 'satisfied', then 'Doc-purpose' can't be 'withpa'. : extension.where(url = 'pa-needed' and value = 'satisfied') and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa') |
crd-ci-q5 | error | NutritionOrder.extension:coverage | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. : extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists() |
crd-ci-q6 | error | NutritionOrder.extension:coverage | If 'info-needed' is Other, then reason must be specified : extension.where(url = 'info-needed' and value = 'Other').exists() implies extension.where(url = 'reason').exists() |
crd-ci-q7 | error | NutritionOrder.extension:coverage | If reason.coding is present and is not from the extensible value set, then reason.text must be present : extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons') |
dom-2 | error | NutritionOrder | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | NutritionOrder | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty() |
dom-4 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() |
dom-5 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | NutritionOrder | A resource should have narrative for robust management : text.`div`.exists() |
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
nor-1 | warning | NutritionOrder | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class : oralDiet.exists() or supplement.exists() or enteralFormula.exists() |

This structure is derived from NutritionOrder

Summary

Must-Support: 7 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- PAS Beneficiary Patient (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information

Maturity: 3

Other representations of profile: CSV, Excel, Schematron