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

## : Error Response Example

Page standards status: Informative

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    <ClaimResponse xmlns="http://hl7.org/fhir">
      <id value="ErrorResponseExample"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse"/>
      </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: ClaimResponse ErrorResponseExample</b></p><a name="ErrorResponseExample"> </a><a name="hcErrorResponseExample"> </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-claimresponse.html">PAS Claim Response</a></p></div><p><b>identifier</b>: <code>http://example.org/PATIENT_EVENT_TRACE_NUMBER</code>/111099</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}">Professional</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href="Patient-SubscriberExample.html">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p><p><b>created</b>: 2005-05-02 11:02:00+0500</p><p><b>insurer</b>: <a href="Organization-InsurerExample.html">Organization MARYLAND CAPITAL INSURANCE COMPANY</a></p><p><b>requestor</b>: <a href="Organization-UMOExample.html">Organization DR. JOE SMITH CORPORATION</a></p><p><b>request</b>: <a href="Claim-ReferralAuthorizationExample.html">Claim: extension = Urgent; identifier = urn:trnorg:9012345678#111099; status = active; type = Professional; use = preauthorization; created = 2005-05-02 11:01:00+0500; priority = Normal</a></p><p><b>outcome</b>: Error</p><blockquote><p><b>error</b></p><p><b>code</b>: <span title="Codes:{https://codesystem.x12.org/005010/901 04}">04</span></p></blockquote><blockquote><p><b>error</b></p><blockquote><p><b>ErrorElement</b></p><ul><li>error: 2010A-NM103</li></ul></blockquote><p><b>ErrorPath</b>: Bundle.entry[1].Organization.name</p><p><b>ErrorFollowupAction</b>: <span title="Codes:{https://codesystem.x12.org/005010/889 C}">C</span></p><p><b>code</b>: <span title="Codes:{https://codesystem.x12.org/005010/901 T4}">T4</span></p></blockquote></div>
      </text>
      <identifier>
        <system value="http://example.org/PATIENT_EVENT_TRACE_NUMBER"/>
        <value value="111099"/>
        <assigner>
          <identifier>
            <system value="http://example.org/USER_ASSIGNED"/>
            <value value="9012345678"/>
          </identifier>
        </assigner>
      </identifier>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
          <code value="professional"/>
        </coding>
      </type>
      <use value="preauthorization"/>
      <patient>🔗
        <reference value="Patient/SubscriberExample"/>
      </patient>
      <created value="2005-05-02T11:02:00+05:00"/>
      <insurer>🔗
        <reference value="Organization/InsurerExample"/>
      </insurer>
      <requestor>🔗
        <reference value="Organization/UMOExample"/>
      </requestor>
      <request>🔗
        <reference value="Claim/ReferralAuthorizationExample"/>
      </request>
      <outcome value="error"/>
      <error>
        <code>
          <coding>
            <system value="https://codesystem.x12.org/005010/901"/>
            <code value="04"/>
          </coding>
        </code>
      </error>
      <error>
        <extension
                   url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement">
          <extension url="error">
            <valueString value="2010A-NM103"/>
          </extension>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorPath">
          <valueString value="Bundle.entry[1].Organization.name"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorFollowupAction">
          <valueCodeableConcept>
            <coding>
              <system value="https://codesystem.x12.org/005010/889"/>
              <code value="C"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="https://codesystem.x12.org/005010/901"/>
            <code value="T4"/>
          </coding>
        </code>
      </error>
    </ClaimResponse>