Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot

Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

## Extension:

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider | Version: 2.2.0-ballot
Standards status: Trial-use Active as of 2026-01-30 | Maturity Level: 3 | Computable Name: ItemAuthorizedProvider
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.20

The specific provider who has been authorized to provide this item.

Context of Use

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

- Element ID: `ExplanationOfBenefit`
- Element ID: `ExplanationOfBenefit.item`
- Element ID: `ClaimResponse.item`

Usage info

Usages:

- Use this Extension: PAS Claim Response Base and PAS Claim Response Base
- Examples for this Extension: Bundle/PASSubscriptionNotification, Bundle/ReferralAuthorizationResponseBundleExample, ClaimResponse/PractitionerRequestorAdditionalContentResponseExample and ClaimResponse/PractitionerRequestorResponseExample

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:provider |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "provider"
value[x] |  | 0..1 | Reference(PAS Practitioner(2.2.0-ballot) | PAS Organization Base Profile(2.2.0-ballot)) | Value of extension
extension:providerType |  | 0..1 | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType Binding: https://valueset.x12.org/x217/005010/response/2010EA/NM1/1/01/00/98 (required): Code identifying an organization entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.
extension:role |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "role"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ClaimCareTeamRoleCodes (required)
extension:qualification |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "qualification"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ExampleProviderQualificationCodes (required)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:role.​value[x] | Base | required | Claim Care Team Role Codes | 📦4.0.1 | FHIR Std.
Extension.extension:qualification.​value[x] | Base | required | Example Provider Qualification Codes | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:provider |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "provider"
value[x] |  | 0..1 | Reference(PAS Practitioner(2.2.0-ballot) | PAS Organization Base Profile(2.2.0-ballot)) | Value of extension
extension:providerType |  | 0..1 | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType Binding: https://valueset.x12.org/x217/005010/response/2010EA/NM1/1/01/00/98 (required): Code identifying an organization entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.
extension:role |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "role"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ClaimCareTeamRoleCodes (required)
extension:qualification |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "qualification"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ExampleProviderQualificationCodes (required)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider"
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:role.​value[x] | Base | required | Claim Care Team Role Codes | 📦4.0.1 | FHIR Std.
Extension.extension:qualification.​value[x] | Base | required | Example Provider Qualification Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Summary

Complex Extension: The specific provider who has been authorized to provide this item.

- provider: Reference: An Extension
- role: CodeableConcept: An Extension
- qualification: CodeableConcept: An Extension

Maturity: 3

Differential ViewDifferential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:provider |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "provider"
value[x] |  | 0..1 | Reference(PAS Practitioner(2.2.0-ballot) | PAS Organization Base Profile(2.2.0-ballot)) | Value of extension
extension:providerType |  | 0..1 | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType Binding: https://valueset.x12.org/x217/005010/response/2010EA/NM1/1/01/00/98 (required): Code identifying an organization entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.
extension:role |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "role"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ClaimCareTeamRoleCodes (required)
extension:qualification |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "qualification"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ExampleProviderQualificationCodes (required)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:role.​value[x] | Base | required | Claim Care Team Role Codes | 📦4.0.1 | FHIR Std.
Extension.extension:qualification.​value[x] | Base | required | Example Provider Qualification Codes | 📦4.0.1 | FHIR Std.

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:provider |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "provider"
value[x] |  | 0..1 | Reference(PAS Practitioner(2.2.0-ballot) | PAS Organization Base Profile(2.2.0-ballot)) | Value of extension
extension:providerType |  | 0..1 | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType Binding: https://valueset.x12.org/x217/005010/response/2010EA/NM1/1/01/00/98 (required): Code identifying an organization entity, a physical location, property or an individual. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.
extension:role |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "role"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ClaimCareTeamRoleCodes (required)
extension:qualification |  | 0..1 | Extension | Extension
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "qualification"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ExampleProviderQualificationCodes (required)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedProvider"
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:role.​value[x] | Base | required | Claim Care Team Role Codes | 📦4.0.1 | FHIR Std.
Extension.extension:qualification.​value[x] | Base | required | Example Provider Qualification Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`

Summary

Complex Extension: The specific provider who has been authorized to provide this item.

- provider: Reference: An Extension
- role: CodeableConcept: An Extension
- qualification: CodeableConcept: An Extension

Maturity: 3

Other representations of profile: CSV, Excel, Schematron