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

## : Additional Information Task Example

Page standards status: Informative

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    <Task xmlns="http://hl7.org/fhir">
      <id value="AdditionalInformationTaskExample"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task"/>
      </meta>
      <language value="en"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><p class="res-header-id"><b>Generated Narrative: Task AdditionalInformationTaskExample</b></p><a name="AdditionalInformationTaskExample"> </a><a name="hcAdditionalInformationTaskExample"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: en</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-profile-task.html">PAS Task</a></p></div><p><b>identifier</b>: <code>http://example.org/ITEM_TRACE_NUMBER</code>/1122334</p><p><b>status</b>: Requested</p><p><b>intent</b>: order</p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes attachment-request-code}">Attach Request Code</span></p><p><b>for</b>: <a href="Patient-BeneficiaryExample.html">JESSE SMITH  Female, DoB: 1947-01-18 ( Member Number)</a></p><p><b>requester</b>: Identifier: <a href="http://terminology.hl7.org/6.2.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/789312</p><p><b>owner</b>: Identifier: <a href="http://terminology.hl7.org/6.2.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/789312</p><p><b>reasonCode</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes priorAuthorization}">Prior Authorization Information Request</span></p><p><b>reasonReference</b>: <a href="Claim-MedicalServicesAuthorizationExample.html">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</a></p><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes payer-url}">Payer URL</span></p><p><b>value</b>: <a href="https://simplifier.net/resolve?scope=hl7.fhir.us.carin-bb@2.1.0&amp;canonical=http://example.org/payerURL">http://example.org/payerURL</a></p></blockquote><blockquote><p><b>input</b></p><p><b>ServiceLineNumber</b>: 1</p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes attachments-needed}">Attachments Needed</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org 28570-0}">Procedure note</span></p></blockquote></div>
      </text>
      <identifier>
        <system value="http://example.org/ITEM_TRACE_NUMBER"/>
        <value value="1122334"/>
      </identifier>
      <status value="requested"/>
      <intent value="order"/>
      <code>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
          <code value="attachment-request-code"/>
        </coding>
      </code>
      <for>🔗
        <reference value="Patient/BeneficiaryExample"/>
      </for>
      <requester>
        <identifier>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="789312"/>
        </identifier>
      </requester>
      <owner>
        <identifier>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="789312"/>
        </identifier>
      </owner>
      <reasonCode>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
          <code value="priorAuthorization"/>
        </coding>
      </reasonCode>
      <reasonReference>🔗
        <reference value="Claim/MedicalServicesAuthorizationExample"/>
      </reasonReference>
      <input>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
            <code value="payer-url"/>
          </coding>
        </type>
        <valueUrl value="http://example.org/payerURL"/>
      </input>
      <input>
        <extension
                   url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber">
          <valuePositiveInt value="1"/>
        </extension>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
            <code value="attachments-needed"/>
          </coding>
        </type>
        <valueCodeableConcept>
          <coding>
            <system value="http://loinc.org"/>
            <code value="28570-0"/>
          </coding>
        </valueCodeableConcept>
      </input>
    </Task>