![.](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_end-open.png) 14 Artifacts Summary |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.1 EHR PAS Capabilities |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.2 Intermediary PAS Capabilities |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.3 Submit a Claim resource for adjudication |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.4 Submit a Claim resource for inquiry |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.5 PAS Metric Data |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.6 PAS Claim Base |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.7 PAS Claim Response Base |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.8 PAS Organization Base Profile |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.9 PAS Beneficiary Patient |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.10 PAS Claim |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.11 PAS Claim Inquiry |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.12 PAS Claim Inquiry Response |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.13 PAS Claim Response |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.14 PAS Claim Update |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.15 PAS CommunicationRequest |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.16 PAS Coverage |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.17 PAS Device Request |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.18 PAS Encounter |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.19 PAS Inquiry Request Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.20 PAS Inquiry Response Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.21 PAS Insurer Organization |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.22 PAS Location Profile |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.23 PAS Medication Request |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.24 PAS Nutrition Order |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.25 PAS Practitioner |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.26 PAS PractitionerRole |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.27 PAS Request Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.28 PAS Requestor Organization |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.29 PAS Response Bundle |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.30 PAS Service Request |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.31 PAS Subscriber Patient |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.32 PAS Task |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.33 PAS Identifier |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.34 PAS Timing |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.35 AdministrationReferenceNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.36 AuthorizationNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.37 CalendarPattern |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.38 CareTeamClaimScope |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.39 CertificationEffectiveDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.40 CertificationExpirationDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.41 CertificationIssueDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.42 CertificationType |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.43 CommunicatedDiagnosis |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.44 ConditionCode |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.45 ContentModifier |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.46 DeliveryPattern |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.47 DiagnosisRecordedDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.48 EPSDTIndicator |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.49 ErrorElement |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.50 ErrorFollowupAction |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.51 ErrorPath |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.52 HomeHealthCareInformation |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.53 IdentifierJurisdiction |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.54 IdentifierSubDepartment |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.55 InfoCancelledFlag |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.56 InfoChanged |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.57 ItemAuthorizedDetail |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.58 ItemAuthorizedProvider |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.59 ItemPreAuthIssueDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.60 ItemPreAuthPeriod |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.61 ItemRequestedServiceDate |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.62 ItemTraceNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.63 LevelOfServiceCode |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.64 MilitaryStatus |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.65 NursingHomeLevelOfCare |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.66 NursingHomeResidentialStatus |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.67 PALineNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.68 PatientStatus |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.69 ProductOrServiceCodeEnd |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.70 RequestedService |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.71 RevenueUnitRateLimit |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.72 ReviewAction |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.73 ReviewActionCode |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.74 ServiceItemRequestType |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.75 ServiceLineNumber |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.76 AHA NUBC Revenue Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.77 Attachment Request Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.78 Metric Data Source |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.79 PAS Communication Medium Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.80 PAS Information Change Mode Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.81 PAS Supporting Info Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.82 PAS Task Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.83 X12 278 CRC Condition Category |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.84 X12 278 CRC Condition Code |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.85 X12 278 Diagnosis Code Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.86 X12 278 Diagnosis Information Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.87 X12 278 Diagnosis Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.88 X12 278 Follow Up Action Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.89 X12 278 Health Care Service Location Type Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.90 X12 278 Nutrition Enteral Formula Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.91 X12 278 Nutrition Oral Diet Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.92 X12 278 Reject Reason Value Set |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.93 X12 278 Requested Service Modifier Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.94 X12 278 Requested Service Type |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.95 X12 278 Review Decision Reason Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.96 PAS Temporary Codes |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.97 Additional Information Task Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.98 Authorization Response with Practitioner Requestor Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.99 Communication Request Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.100 Device Request Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.101 Encounter Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.102 Error Response Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.103 Error Response Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.104 Homecare Authorization Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.105 Homecare Authorization Differential Update Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.106 Homecare Authorization Differential Update Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.107 Homecare Authorization Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.108 Homecare Authorization Update Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.109 Homecare Authorization Update Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.110 Medical Services Authorization Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.111 Medical Services Authorization Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.112 Medication Request Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.113 Nutrition Order Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.114 PAS Claim Inquiry Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.115 PAS Claim Inquiry ResponseExample |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.116 PAS Inquiry Request Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.117 PAS Inquiry Response Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.118 Referral Authorization Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.119 Referral Authorization Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.120 Referral Authorization Response Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.121 Referral Authorization Response Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.122 Submit Claim Beneficiary Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.123 Submit Claim Insurance Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.124 Submit Claim Insurer Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.125 Submit Claim Referral Location Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.126 Submit Claim Referral Practitioner Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.127 Submit Claim Referral Practitioner Role Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.128 Submit Claim Referral Request Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.129 Submit Claim Requestor Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.130 Submit Claim Subscriber Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.131 Submit Claim Surgical Location Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.132 Submit Claim Surgical Practitioner Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.133 Submit Claim Surgical Practitioner Role Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.134 Surgical Admission Request Bundle Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin.png) 14.135 Surgical Request Authorization Example |
![.](tbl_spacer.png) ![.](tbl_blank.png) ![.](tbl_vjoin_end.png) 14.136 PAS Subscription |