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-claimResponseReviewer | Version: 2.2.0-ballot
Standards status: Trial-use Active as of 2026-01-30 | Maturity Level: 3 | Computable Name: ClaimResponseReviewer
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.83

The responsible practitioner who reviewed to the request.

Context of Use

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

- Element ID: `ClaimResponse`

Usage info

Usages:

- Use this Extension: PAS Claim Response Base
- Examples for this Extension: Bundle/RejectionResponseBundleExample and ClaimResponse/RejectionResponseExample

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
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:wasHumanReviewedFlag |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "wasHumanReviewedFlag"
value[x] |  | 0..1 | boolean | Value of extension
extension:reviewerNPI |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "reviewerNPI"
value[x] |  | 0..1 | PASIdentifier(2.2.0-ballot) | Value of extension
extension:reviewerSpecialty |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "reviewerSpecialty"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: HealthcareProviderTaxonomy (20240606) (extensible)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:reviewerSpecialty.​value[x] | Base | extensible | Healthcare Provider Taxonomy | 📍20240606 | VSAC v0.21

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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:wasHumanReviewedFlag |  | 1..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 | "wasHumanReviewedFlag"
value[x] |  | 0..1 | boolean | Value of extension
extension:reviewerNPI |  | 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 | "reviewerNPI"
value[x] |  | 0..1 | PASIdentifier(2.2.0-ballot) | Value of extension
extension:reviewerSpecialty |  | 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 | "reviewerSpecialty"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: HealthcareProviderTaxonomy (20240606) (extensible)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer"
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:reviewerSpecialty.​value[x] | Base | extensible | Healthcare Provider Taxonomy | 📍20240606 | VSAC v0.21

#### 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 responsible practitioner who reviewed to the request.

- wasHumanReviewedFlag: boolean: An Extension
- reviewerNPI: Identifier: An Extension
- reviewerSpecialty: CodeableConcept: An Extension

Maturity: 3

Differential ViewDifferential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Extension
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:wasHumanReviewedFlag |  | 1..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "wasHumanReviewedFlag"
value[x] |  | 0..1 | boolean | Value of extension
extension:reviewerNPI |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "reviewerNPI"
value[x] |  | 0..1 | PASIdentifier(2.2.0-ballot) | Value of extension
extension:reviewerSpecialty |  | 0..1 | Extension | Extension
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "reviewerSpecialty"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: HealthcareProviderTaxonomy (20240606) (extensible)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer"
value[x] |  | 0..0 |  | Value of extension
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:reviewerSpecialty.​value[x] | Base | extensible | Healthcare Provider Taxonomy | 📍20240606 | VSAC v0.21

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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:wasHumanReviewedFlag |  | 1..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 | "wasHumanReviewedFlag"
value[x] |  | 0..1 | boolean | Value of extension
extension:reviewerNPI |  | 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 | "reviewerNPI"
value[x] |  | 0..1 | PASIdentifier(2.2.0-ballot) | Value of extension
extension:reviewerSpecialty |  | 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 | "reviewerSpecialty"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: HealthcareProviderTaxonomy (20240606) (extensible)
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer"
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Extension.extension:reviewerSpecialty.​value[x] | Base | extensible | Healthcare Provider Taxonomy | 📍20240606 | VSAC v0.21

#### 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 responsible practitioner who reviewed to the request.

- wasHumanReviewedFlag: boolean: An Extension
- reviewerNPI: Identifier: An Extension
- reviewerSpecialty: CodeableConcept: An Extension

Maturity: 3

Other representations of profile: CSV, Excel, Schematron