![.](tbl_spacer.png) 0 Table of Contents |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 1 Prior Authorization Implementation Guide Home Page |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 2 Use Cases and Overview |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 3 Request for Additional Information |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 4 Technical Background |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 5 HIPAA Regulations |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 6 Formal Specification |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 7 Privacy & Security |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 8 PAS ePA Coordinator Information |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 9 PAS Metrics |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 10 Downloads |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 11 Credits |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 12 Artifacts Overview |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 13 Change Log |
![.](tbl_spacer.png) ![.](tbl_vjoin.png) 14 Conformance |
![.](tbl_spacer.png) ![.](tbl_vjoin_end-open.png) 15 Artifacts Summary |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.1 EHR PAS Capabilities |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.2 Intermediary PAS Capabilities |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.3 Search for a Prior Authorization Response by example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.4 Submit a Prior Authorization Request for adjudication |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.5 PAS Metric Data |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.6 PAS Claim Base |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.7 PAS Claim Response Base |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.8 PAS Organization Base Profile |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.9 PAS Beneficiary Patient |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.10 PAS Claim |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.11 PAS Claim Inquiry |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.12 PAS Claim Inquiry Response |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.13 PAS Claim Response |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.14 PAS Claim Update |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.15 PAS CommunicationRequest |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.16 PAS Coverage |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.17 PAS Device Request |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.18 PAS Encounter |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.19 PAS Inquiry Request Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.20 PAS Inquiry Response Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.21 PAS Insurer Organization |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.22 PAS Location Profile |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.23 PAS Medication Request |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.24 PAS Nutrition Order |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.25 PAS Practitioner |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.26 PAS PractitionerRole |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.27 PAS Request Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.28 PAS Requestor Organization |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.29 PAS Response Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.30 PAS Service Request |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.31 PAS Subscriber Patient |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.32 PAS Subscription |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.33 PAS Task |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.34 PAS Identifier |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.35 PAS Quantity |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.36 PAS Timing |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.37 AdministrationReferenceNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.38 AuthorizationNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.39 AuthorizedProviderType |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.40 CalendarPattern |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.41 CareTeamClaimScope |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.42 CertificationEffectiveDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.43 CertificationExpirationDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.44 CertificationIssueDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.45 CertificationType |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.46 CommunicatedDiagnosis |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.47 ConditionCode |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.48 ContentModifier |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.49 DeliveryPattern |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.50 DiagnosisRecordedDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.51 EPSDTIndicator |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.52 ErrorElement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.53 ErrorFollowupAction |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.54 ErrorPath |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.55 HomeHealthCareInformation |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.56 IdentifierJurisdiction |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.57 IdentifierSubDepartment |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.58 InfoCancelledFlag |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.59 InfoChanged |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.60 ItemAuthorizedDetail |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.61 ItemAuthorizedProvider |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.62 ItemPreAuthIssueDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.63 ItemPreAuthPeriod |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.64 ItemRequestedServiceDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.65 ItemTraceNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.66 LevelOfServiceCode |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.67 MilitaryStatus |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.68 NursingHomeLevelOfCare |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.69 NursingHomeResidentialStatus |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.70 PALineNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.71 PatientStatus |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.72 ProductOrServiceCodeEnd |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.73 RequestedService |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.74 RevenueCode |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.75 RevenueUnitRateLimit |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.76 ReviewAction |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.77 ReviewActionCode |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.78 ServiceItemRequestType |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.79 ServiceLineNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.80 AHA NUBC Revenue Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.81 Metric Data Source |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.82 PAS Communication Medium Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.83 PAS Information Change Mode Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.84 PAS LOINC Attachment Codes Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.85 PAS PWK01 Attachment Report Type Code Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.86 PAS Supporting Info Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.87 PAS Task Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.88 X12 278 CRC Condition Category |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.89 X12 278 CRC Condition Code |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.90 X12 278 Diagnosis Code Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.91 X12 278 Diagnosis Information Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.92 X12 278 Diagnosis Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.93 X12 278 Follow Up Action Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.94 X12 278 Health Care Service Location Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.95 X12 278 Nutrition Enteral Formula Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.96 X12 278 Nutrition Oral Diet Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.97 X12 278 Reject Reason Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.98 X12 278 Requested Service Modifier Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.99 X12 278 Requested Service Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.100 X12 278 Review Decision Reason Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.101 PAS Temporary Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.102 Additional Information Task Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.103 Authorization Response with Practitioner Requestor and Additional Content Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.104 Authorization Response with Practitioner Requestor Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.105 Communication Request Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.106 Device Request Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.107 Encounter Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.108 Error Response Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.109 Error Response Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.110 Homecare Authorization Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.111 Homecare Authorization Differential Update Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.112 Homecare Authorization Differential Update Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.113 Homecare Authorization Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.114 Homecare Authorization Update Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.115 Homecare Authorization Update Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.116 Medical Services Authorization Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.117 Medical Services Authorization Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.118 Medication Request Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.119 Nutrition Order Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.120 PAS Claim Inquiry Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.121 PAS Claim Inquiry ResponseExample |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.122 PAS Inquiry Request Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.123 PAS Inquiry Response Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.124 PAS Subscription example for a specific provider |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.125 PAS Subscription Notification example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.126 PAS Subscription Notification Parameters |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.127 Pending Authorization Response with Practitioner Requestor Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.128 Referral Authorization Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.129 Referral Authorization Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.130 Referral Authorization Response Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.131 Referral Pending Authorization Response Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.132 Rejection Response Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.133 Rejection Response Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.134 Submit Claim Beneficiary Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.135 Submit Claim Insurance Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.136 Submit Claim Insurer Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.137 Submit Claim Referral Location Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.138 Submit Claim Referral Practitioner Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.139 Submit Claim Referral Practitioner Role Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.140 Submit Claim Referral Request Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.141 Submit Claim Requestor Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.142 Submit Claim Subscriber Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.143 Submit Claim Surgical Location Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.144 Submit Claim Surgical Practitioner Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.145 Submit Claim Surgical Practitioner Role Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.146 Surgical Admission Request Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 15.147 Surgical Request Authorization Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin_end.png) 15.148 PAS Subscription Topic |