# Additional Information Task Example - Da Vinci Prior Authorization Support (PAS) FHIR IG v2.2.0-ballot

## Example Task: Additional Information Task Example

Language: en

Profile: [PAS Task](StructureDefinition-profile-task.md)

**identifier**: `http://example.org/ITEM_TRACE_NUMBER`/1122334

**status**: Requested

**intent**: order

**code**: Attach Request Code

**for**: [JESSE SMITH Female, DoB: 1947-01-18 ( Member Number)](Patient-BeneficiaryExample.md)

**requester**: Identifier: [United States National Provider Identifier](http://terminology.hl7.org/6.2.0/NamingSystem-npi.html)/789312

**owner**: Identifier: [United States National Provider Identifier](http://terminology.hl7.org/6.2.0/NamingSystem-npi.html)/789312

**reasonCode**: Prior Authorization Information Request

**reasonReference**: [Claim: identifier = http://example.org/PATIENT_EVENT_TRACE_NUMBER#111099; status = active; type = Professional; use = preauthorization; created = 2005-05-02 11:01:00+0500; priority = Normal](Claim-MedicalServicesAuthorizationExample.md)

> **input****type**: Payer URL**value**: [http://example.org/payerURL](https://simplifier.net/resolve?scope=hl7.fhir.us.carin-bb@2.1.0&canonical=http://example.org/payerURL)

> **input****ServiceLineNumber**: 1**type**: Attachments Needed**value**: Procedure note



## Resource Content

```json
{
  "resourceType" : "Task",
  "id" : "AdditionalInformationTaskExample",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task"
    ]
  },
  "language" : "en",
  "identifier" : [
    {
      "system" : "http://example.org/ITEM_TRACE_NUMBER",
      "value" : "1122334"
    }
  ],
  "status" : "requested",
  "intent" : "order",
  "code" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
        "code" : "attachment-request-code"
      }
    ]
  },
  "for" : {
    "reference" : "Patient/BeneficiaryExample"
  },
  "requester" : {
    "identifier" : {
      "system" : "http://hl7.org/fhir/sid/us-npi",
      "value" : "789312"
    }
  },
  "owner" : {
    "identifier" : {
      "system" : "http://hl7.org/fhir/sid/us-npi",
      "value" : "789312"
    }
  },
  "reasonCode" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
        "code" : "priorAuthorization"
      }
    ]
  },
  "reasonReference" : {
    "reference" : "Claim/MedicalServicesAuthorizationExample"
  },
  "input" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
            "code" : "payer-url"
          }
        ]
      },
      "valueUrl" : "http://example.org/payerURL"
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber",
          "valuePositiveInt" : 1
        }
      ],
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
            "code" : "attachments-needed"
          }
        ]
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "28570-0"
          }
        ]
      }
    }
  ]
}

```
