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 Claim Update - Mappings

Page standards status: Trial-use | Maturity Level: 3

Mappings for the profile-claim-update resource profile.

#### Mappings to Structures in this Implementation Guide

No Mappings Found

#### Mappings to other Structures

No Mappings Found

#### Other Mappings

Name | Workflow Pattern | FiveWs Pattern Mapping | RIM Mapping
--- | --- | --- | ---
Claim | Request |  | Entity. Role or Act
id |  |  |
meta |  |  |
implicitRules |  |  |
language |  |  |
text |  |  | Act.text?
contained |  |  | N/A
Slices for extension |  |  |
extension:levelOfServiceType |  |  |
extension:conditionCode |  |  |
extension:homeHealthCareInformation |  |  |
extension:authorizationNumber |  |  |
extension:administrationReferenceNumber |  |  |
extension:encounter |  |  | N/A
id |  |  | n/a
extension |  |  |
url |  |  | N/A
value[x] |  |  | N/A
extension:certificationType |  |  |
modifierExtension |  |  | N/A
identifier | Request.identifier | FiveWs.identifier |
id |  |  | n/a
Slices for extension |  |  | n/a
extension:subDepartment |  |  |
extension:jurisdiction |  |  |
use |  |  | Role.code or implied by context
type |  |  | Role.code or implied by context
system |  |  | II.root or Role.id.root
value |  |  | II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
period |  |  | Role.effectiveTime or implied by context
assigner |  |  | II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
status | Request.status | FiveWs.status |
type |  | FiveWs.class |
subType |  | FiveWs.class |
use |  | FiveWs.class |
patient | Request.subject | FiveWs.subject |
billablePeriod |  | FiveWs.done[x] |
created | Request.authoredOn | FiveWs.recorded |
enterer |  | FiveWs.author |
insurer | Request.performer |  |
provider | Request.requester | FiveWs.source |
priority | Request.priority |  |
fundsReserve |  |  |
related |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
claim | Request.replaces |  |
relationship |  |  |
reference |  |  |
prescription |  |  |
originalPrescription |  |  |
payee |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
type |  |  |
party |  |  |
referral |  | FiveWs.cause |
facility |  | FiveWs.where[x] |
Slices for careTeam |  |  |
careTeam:All Slices |  |  |
id |  |  | n/a
Slices for extension |  |  |
extension:careTeamClaimScope |  |  |
modifierExtension |  |  | N/A
sequence |  |  |
provider |  | FiveWs.actor |
responsible |  |  |
role |  |  |
qualification |  |  |
careTeam:OverallClaimMember |  |  |
id |  |  | n/a
Slices for extension |  |  |
extension:careTeamClaimScope |  |  |
id |  |  | n/a
extension |  |  |
url |  |  | N/A
value[x] |  |  | N/A
modifierExtension |  |  | N/A
sequence |  |  |
provider |  | FiveWs.actor |
responsible |  |  |
role |  |  |
qualification |  |  |
careTeam:ItemClaimMember |  |  |
id |  |  | n/a
Slices for extension |  |  |
extension:careTeamClaimScope |  |  |
id |  |  | n/a
extension |  |  |
url |  |  | N/A
value[x] |  |  | N/A
modifierExtension |  |  | N/A
sequence |  |  |
provider |  | FiveWs.actor |
responsible |  |  |
role |  |  |
qualification |  |  |
Slices for supportingInfo | Request.supportingInfo |  |
supportingInfo:All Slices |  |  |
id |  |  | n/a
Slices for extension |  |  |
extension:infoChanged |  |  |
Slices for modifierExtension |  |  |
modifierExtension:infoCancelledFlag |  |  |
sequence |  |  |
category |  |  |
code |  |  |
timing[x] |  |  |
value[x] |  |  |
reason |  |  |
supportingInfo:PatientEvent | Request.supportingInfo |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
category |  |  |
code |  |  |
Slices for timing[x] |  |  |
timing[x]:timingDate |  |  |
timing[x]:timingPeriod |  |  |
id |  |  | n/a
extension |  |  | n/a
start |  |  | ./low
end |  |  | ./high
value[x] |  |  |
reason |  |  |
supportingInfo:AdmissionDates | Request.supportingInfo |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
category |  |  |
code |  |  |
Slices for timing[x] |  |  |
timing[x]:timingDate |  |  |
timing[x]:timingPeriod |  |  |
id |  |  | n/a
extension |  |  | n/a
start |  |  | ./low
end |  |  | ./high
value[x] |  |  |
reason |  |  |
supportingInfo:DischargeDates | Request.supportingInfo |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
category |  |  |
code |  |  |
timing[x] |  |  |
value[x] |  |  |
reason |  |  |
supportingInfo:AdditionalInformation | Request.supportingInfo |  |
id |  |  | n/a
Slices for extension |  |  |
extension:documentInformation |  |  |
modifierExtension |  |  | N/A
sequence |  |  |
category |  |  |
code |  |  |
timing[x] |  |  |
value[x] |  |  |
reason |  |  |
supportingInfo:MessageText | Request.supportingInfo |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
category |  |  |
code |  |  |
timing[x] |  |  |
value[x] |  |  |
reason |  |  |
diagnosis | Request.reasonReference |  |
id |  |  | n/a
Slices for extension |  |  |
extension:recordedDate |  |  |
modifierExtension |  |  | N/A
sequence |  |  |
diagnosis[x] |  |  |
type |  |  |
onAdmission |  |  |
packageCode |  |  |
procedure |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
type |  |  |
date |  |  |
procedure[x] |  |  |
udi |  |  |
insurance |  |  | Coverage
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
focal |  |  |
identifier | Request.identifier | FiveWs.identifier |
coverage |  |  |
businessArrangement |  |  |
preAuthRef |  |  |
claimResponse |  |  |
accident |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
date |  |  |
type |  |  |
location[x] |  |  |
item |  |  |
id |  |  | n/a
Slices for extension |  |  |
extension:itemTraceNumber |  |  |
extension:authorizationNumber |  |  |
extension:administrationReferenceNumber |  |  |
extension:requestType |  |  |
extension:certificationType |  |  |
extension:productOrServiceCodeEnd |  |  |
extension:epsdtIndicator |  |  |
extension:nursingHomeResidentialStatus |  |  |
id |  |  | n/a
extension |  |  |
url |  |  | N/A
value[x] |  |  | N/A
extension:nursingHomeLevelOfCare |  |  |
extension:revenueUnitRateLimit |  |  |
extension:requestedService |  |  |
extension:infoChanged |  |  |
Slices for modifierExtension |  |  |
modifierExtension:infoCancelledFlag |  |  |
sequence |  |  |
careTeamSequence |  |  |
diagnosisSequence |  |  |
procedureSequence |  |  |
informationSequence |  |  |
revenue |  |  |
category |  |  |
productOrService |  |  |
modifier |  |  |
programCode |  |  |
Slices for serviced[x] |  | FiveWs.done[x] |
serviced[x]:servicedDate |  | FiveWs.done[x] |
serviced[x]:servicedPeriod |  | FiveWs.done[x] |
id |  |  | n/a
extension |  |  | n/a
start |  |  | ./low
end |  |  | ./high
location[x] |  | FiveWs.where[x] |
quantity |  |  |
unitPrice |  |  |
factor |  |  |
net |  |  |
udi |  |  |
bodySite |  |  |
subSite |  |  |
encounter | Request.context |  |
detail |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
revenue |  |  |
category |  |  |
productOrService |  |  |
modifier |  |  |
programCode |  |  |
quantity |  |  |
unitPrice |  |  |
factor |  |  |
net |  |  |
udi |  |  |
subDetail |  |  |
id |  |  | n/a
extension |  |  | n/a
modifierExtension |  |  | N/A
sequence |  |  |
revenue |  |  |
category |  |  |
productOrService |  |  |
modifier |  |  |
programCode |  |  |
quantity |  |  |
unitPrice |  |  |
factor |  |  |
net |  |  |
udi |  |  |
total |  |  |
Documentation for this format