Patient Cost Transparency Implementation Guide
2.0.1 - STU 2

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

## Resource Profile: PCT AEOB Packet Document Reference

Official URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-aeob-documentreference | Version: 2.0.1
Standards status: Trial-use | Maturity Level: 1 | Computable Name: PCTAdvancedEOBDocumentReference
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.42.53

PCT AEOB Packet Document Reference that enables searching and subscriptions for AEOB Packets.

Usages:

- Examples for this Profile: DocumentReference/PCT-AEOB-DocumentReference-1
- CapabilityStatements using this Profile: Patient Cost Transparency Implementation Guide Coordination Requester Capability Statement and Patient Cost Transparency Implementation Guide Payer Capability Statement

You can also check for usages in the FHIR IG Statistics

Changes since version 1.1.0:

- New Content

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | USCoreDocumentReferenceProfile(7.0.0) | A reference to a document
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:requestInitiationTime | S | 1..1 | instant | Estimate Request instant (instance GFE Packet submitted to payer) URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestInitiationTime
extension:gfeServiceLinkingInfo | S | 0..1 | (Complex) | GFE Service Linking Information including planned period of service and a GFE linking identifier URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
extension:procedureOrService | S | 0..* | CodeableConcept | Primary Procedures and/or products involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateProcedureOrService Binding: Claim Medical Product or Service Value Set (required)
extension:condition | S | 0..* | CodeableConcept | Primary diagnoses involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateCondition Binding: PCT ICD-10 Diagnostic Codes (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Other identifiers for the document
status | ?!S Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
docStatus | S Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: USCoreDocumentReferenceType (7.0.0) (required): All LOINC values whose SCALE is "Doc" in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'
Additional Bindings | Purpose
USCoreClinicalNoteType (7.0.0) | Min Binding
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:estimate | S Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 111479-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
Slices for category | S Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:uscore | Σ | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Categorization of document Binding: USCoreDocumentReferenceCategory (7.0.0) (required): The US Core DocumentReferences Type Value Set is a "starter set" of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:estimate | S Σ | 1..1 | CodeableConcept | Estimate category Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: estimate
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S | Practitioner | Group | Device) | Who/what is the subject of the document
date | S Σ C | 0..1 | instant | When this document reference was created Constraints: pct-datetime-to-seconds
author | S Σ | 2..* | Reference(PCT Organization | PCT Practitioner) | All involved authoring parties, including payer all Good Faith Estimate (GFE) providers
Slices for relatesTo | Σ | 0..* | BackboneElement | Relationship to other AEOB packets. Required if this estimate is replacing another. Slice: Unordered, Open by value:code
relatesTo:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
relatesTo:replaces | S Σ | 0..1 | BackboneElement | Relationships to other documents
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. Required Pattern: replaces
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
content | S Σ | 1..1 | BackboneElement | Document referenced
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | S Σ C | 1..1 | Attachment | Where to access the document Constraints: us-core-6
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
data | S C | 0..1 | base64Binary | Data inline, base64ed
url | S Σ C | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
format | S Σ | 0..1 | Coding | Format/content rules for the document Binding: HL7FormatCodes (2.1.0) (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: pct-aeob-packet
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
context | S Σ | 0..1 | BackboneElement | Clinical context of document
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
encounter | S | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Context of the document content
period | S Σ | 0..1 | Period | Time of service that is being documented
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.status | Base | required | DocumentReferenceStatus | 📦4.0.1 | FHIR Std.
DocumentReference.docStatus | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | required | US Core DocumentReference Type | 📍7.0.0 | US Core v7.0
DocumentReference.category | Base | example | Document Class Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.category:uscore | Base | required | US Core DocumentReference Category | 📍7.0.0 | US Core v7.0
DocumentReference.category:estimate | Base | example | Document Class Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo:replaces.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​format | Base | extensible | HL7 ValueSet of Format Codes for use with Document Sharing | 📍2.1.0 | THO v6.5

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
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()`
pct-datetime-to-seconds | error | DocumentReference.date | Datetime must be at least to seconds. | `$this is dateTime implies $this.toString().length() >= 19`
us-core-6 | error | DocumentReference.content.attachment | DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present. | `url.exists() or data.exists()`

This structure is derived from USCoreDocumentReferenceProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | USCoreDocumentReferenceProfile(7.0.0) | A reference to a document
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:requestInitiationTime | S | 1..1 | instant | Estimate Request instant (instance GFE Packet submitted to payer) URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestInitiationTime
extension:gfeServiceLinkingInfo | S | 0..1 | (Complex) | GFE Service Linking Information including planned period of service and a GFE linking identifier URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
extension:procedureOrService | S | 0..* | CodeableConcept | Primary Procedures and/or products involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateProcedureOrService Binding: Claim Medical Product or Service Value Set (required)
extension:condition | S | 0..* | CodeableConcept | Primary diagnoses involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateCondition Binding: PCT ICD-10 Diagnostic Codes (required)
docStatus | S | 1..1 | code | preliminary | final | amended | entered-in-error
type |  |  |  |
Slices for coding |  | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:estimate | S | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 111479-2
Slices for category |  |  |  | Content/Rules for all slices
category:estimate | S | 1..1 | CodeableConcept | Estimate category Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: estimate
date | C | 0..1 | instant | When this document reference was created Constraints: pct-datetime-to-seconds
author |  | 2..* | Reference(PCT Organization | PCT Practitioner) | All involved authoring parties, including payer all Good Faith Estimate (GFE) providers
Slices for relatesTo |  | 0..* | BackboneElement | Relationship to other AEOB packets. Required if this estimate is replacing another. Slice: Unordered, Open by value:code
relatesTo:replaces | S | 0..1 | BackboneElement | Relationships to other documents
code |  | 1..1 | code | replaces | transforms | signs | appends Required Pattern: replaces
content |  | 1..1 | BackboneElement | Document referenced
format |  | 0..1 | Coding | Format/content rules for the document Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: pct-aeob-packet
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
pct-datetime-to-seconds | error | DocumentReference.date | Datetime must be at least to seconds. | `$this is dateTime implies $this.toString().length() >= 19`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | USCoreDocumentReferenceProfile(7.0.0) | A reference to a document
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:requestInitiationTime | S | 1..1 | instant | Estimate Request instant (instance GFE Packet submitted to payer) URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestInitiationTime
extension:gfeServiceLinkingInfo | S | 0..1 | (Complex) | GFE Service Linking Information including planned period of service and a GFE linking identifier URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
extension:procedureOrService | S | 0..* | CodeableConcept | Primary Procedures and/or products involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateProcedureOrService Binding: Claim Medical Product or Service Value Set (required)
extension:condition | S | 0..* | CodeableConcept | Primary diagnoses involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateCondition Binding: PCT ICD-10 Diagnostic Codes (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 0..1 | Identifier | Master Version Specific Identifier
identifier | S Σ | 0..* | Identifier | Other identifiers for the document
status | ?!S Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
docStatus | S Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: USCoreDocumentReferenceType (7.0.0) (required): All LOINC values whose SCALE is "Doc" in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'
Additional Bindings | Purpose
USCoreClinicalNoteType (7.0.0) | Min Binding
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:estimate | S Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 111479-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
Slices for category | S Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:uscore | Σ | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Categorization of document Binding: USCoreDocumentReferenceCategory (7.0.0) (required): The US Core DocumentReferences Type Value Set is a "starter set" of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:estimate | S Σ | 1..1 | CodeableConcept | Estimate category Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: estimate
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S | Practitioner | Group | Device) | Who/what is the subject of the document
date | S Σ C | 0..1 | instant | When this document reference was created Constraints: pct-datetime-to-seconds
author | S Σ | 2..* | Reference(PCT Organization | PCT Practitioner) | All involved authoring parties, including payer all Good Faith Estimate (GFE) providers
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Who/what authenticated the document
custodian |  | 0..1 | Reference(Organization) | Organization which maintains the document
Slices for relatesTo | Σ | 0..* | BackboneElement | Relationship to other AEOB packets. Required if this estimate is replacing another. Slice: Unordered, Open by value:code
relatesTo:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
relatesTo:replaces | S Σ | 0..1 | BackboneElement | Relationships to other documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. Required Pattern: replaces
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
description | Σ | 0..1 | string | Human-readable description
securityLabel | Σ | 0..* | CodeableConcept | Document security-tags Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content | S Σ | 1..1 | BackboneElement | Document referenced
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | S Σ C | 1..1 | Attachment | Where to access the document Constraints: us-core-6
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Example General: en-AU
data | S C | 0..1 | base64Binary | Data inline, base64ed
url | S Σ C | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 0..1 | dateTime | Date attachment was first created
format | S Σ | 0..1 | Coding | Format/content rules for the document Binding: HL7FormatCodes (2.1.0) (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: pct-aeob-packet
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
context | S Σ | 0..1 | BackboneElement | Clinical context of document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
encounter | S | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Context of the document content
event |  | 0..* | CodeableConcept | Main clinical acts documented Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
period | S Σ | 0..1 | Period | Time of service that is being documented
facilityType |  | 0..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting |  | 0..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo |  | 0..1 | Reference(Patient) | Patient demographics from source
related |  | 0..* | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📦4.0.1 | FHIR Std.
DocumentReference.docStatus | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | required | US Core DocumentReference Type | 📍7.0.0 | US Core v7.0
DocumentReference.category | Base | example | Document Class Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.category:uscore | Base | required | US Core DocumentReference Category | 📍7.0.0 | US Core v7.0
DocumentReference.category:estimate | Base | example | Document Class Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo:replaces.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.securityLabel | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
DocumentReference.content.​format | Base | extensible | HL7 ValueSet of Format Codes for use with Document Sharing | 📍2.1.0 | THO v6.5
DocumentReference.context.​event | Base | example | v3 Code System ActCode | 📍3.0.0 | THO v6.5
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
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()`
pct-datetime-to-seconds | error | DocumentReference.date | Datetime must be at least to seconds. | `$this is dateTime implies $this.toString().length() >= 19`
us-core-6 | error | DocumentReference.content.attachment | DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present. | `url.exists() or data.exists()`

This structure is derived from USCoreDocumentReferenceProfile

Summary

Mandatory: 6 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- PCT Organization (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization)
- PCT Practitioner (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestInitiationTime
- http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
- http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateProcedureOrService
- http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateCondition

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DocumentReference.type.coding
- The element 1 is sliced based on the value of DocumentReference.relatesTo

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | USCoreDocumentReferenceProfile(7.0.0) | A reference to a document
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:requestInitiationTime | S | 1..1 | instant | Estimate Request instant (instance GFE Packet submitted to payer) URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestInitiationTime
extension:gfeServiceLinkingInfo | S | 0..1 | (Complex) | GFE Service Linking Information including planned period of service and a GFE linking identifier URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
extension:procedureOrService | S | 0..* | CodeableConcept | Primary Procedures and/or products involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateProcedureOrService Binding: Claim Medical Product or Service Value Set (required)
extension:condition | S | 0..* | CodeableConcept | Primary diagnoses involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateCondition Binding: PCT ICD-10 Diagnostic Codes (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | Other identifiers for the document
status | ?!S Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
docStatus | S Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: USCoreDocumentReferenceType (7.0.0) (required): All LOINC values whose SCALE is "Doc" in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'
Additional Bindings | Purpose
USCoreClinicalNoteType (7.0.0) | Min Binding
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:estimate | S Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 111479-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
Slices for category | S Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:uscore | Σ | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Categorization of document Binding: USCoreDocumentReferenceCategory (7.0.0) (required): The US Core DocumentReferences Type Value Set is a "starter set" of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:estimate | S Σ | 1..1 | CodeableConcept | Estimate category Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: estimate
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S | Practitioner | Group | Device) | Who/what is the subject of the document
date | S Σ C | 0..1 | instant | When this document reference was created Constraints: pct-datetime-to-seconds
author | S Σ | 2..* | Reference(PCT Organization | PCT Practitioner) | All involved authoring parties, including payer all Good Faith Estimate (GFE) providers
Slices for relatesTo | Σ | 0..* | BackboneElement | Relationship to other AEOB packets. Required if this estimate is replacing another. Slice: Unordered, Open by value:code
relatesTo:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
relatesTo:replaces | S Σ | 0..1 | BackboneElement | Relationships to other documents
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. Required Pattern: replaces
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
content | S Σ | 1..1 | BackboneElement | Document referenced
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | S Σ C | 1..1 | Attachment | Where to access the document Constraints: us-core-6
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
data | S C | 0..1 | base64Binary | Data inline, base64ed
url | S Σ C | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
format | S Σ | 0..1 | Coding | Format/content rules for the document Binding: HL7FormatCodes (2.1.0) (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: pct-aeob-packet
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
context | S Σ | 0..1 | BackboneElement | Clinical context of document
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
encounter | S | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Context of the document content
period | S Σ | 0..1 | Period | Time of service that is being documented
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.status | Base | required | DocumentReferenceStatus | 📦4.0.1 | FHIR Std.
DocumentReference.docStatus | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | required | US Core DocumentReference Type | 📍7.0.0 | US Core v7.0
DocumentReference.category | Base | example | Document Class Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.category:uscore | Base | required | US Core DocumentReference Category | 📍7.0.0 | US Core v7.0
DocumentReference.category:estimate | Base | example | Document Class Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo:replaces.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​format | Base | extensible | HL7 ValueSet of Format Codes for use with Document Sharing | 📍2.1.0 | THO v6.5

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
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()`
pct-datetime-to-seconds | error | DocumentReference.date | Datetime must be at least to seconds. | `$this is dateTime implies $this.toString().length() >= 19`
us-core-6 | error | DocumentReference.content.attachment | DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present. | `url.exists() or data.exists()`

Differential View

This structure is derived from USCoreDocumentReferenceProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | USCoreDocumentReferenceProfile(7.0.0) | A reference to a document
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:requestInitiationTime | S | 1..1 | instant | Estimate Request instant (instance GFE Packet submitted to payer) URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestInitiationTime
extension:gfeServiceLinkingInfo | S | 0..1 | (Complex) | GFE Service Linking Information including planned period of service and a GFE linking identifier URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
extension:procedureOrService | S | 0..* | CodeableConcept | Primary Procedures and/or products involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateProcedureOrService Binding: Claim Medical Product or Service Value Set (required)
extension:condition | S | 0..* | CodeableConcept | Primary diagnoses involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateCondition Binding: PCT ICD-10 Diagnostic Codes (required)
docStatus | S | 1..1 | code | preliminary | final | amended | entered-in-error
type |  |  |  |
Slices for coding |  | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:estimate | S | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 111479-2
Slices for category |  |  |  | Content/Rules for all slices
category:estimate | S | 1..1 | CodeableConcept | Estimate category Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: estimate
date | C | 0..1 | instant | When this document reference was created Constraints: pct-datetime-to-seconds
author |  | 2..* | Reference(PCT Organization | PCT Practitioner) | All involved authoring parties, including payer all Good Faith Estimate (GFE) providers
Slices for relatesTo |  | 0..* | BackboneElement | Relationship to other AEOB packets. Required if this estimate is replacing another. Slice: Unordered, Open by value:code
relatesTo:replaces | S | 0..1 | BackboneElement | Relationships to other documents
code |  | 1..1 | code | replaces | transforms | signs | appends Required Pattern: replaces
content |  | 1..1 | BackboneElement | Document referenced
format |  | 0..1 | Coding | Format/content rules for the document Required Pattern: At least the following
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: pct-aeob-packet
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
pct-datetime-to-seconds | error | DocumentReference.date | Datetime must be at least to seconds. | `$this is dateTime implies $this.toString().length() >= 19`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DocumentReference |  | 0..* | USCoreDocumentReferenceProfile(7.0.0) | A reference to a document
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:requestInitiationTime | S | 1..1 | instant | Estimate Request instant (instance GFE Packet submitted to payer) URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestInitiationTime
extension:gfeServiceLinkingInfo | S | 0..1 | (Complex) | GFE Service Linking Information including planned period of service and a GFE linking identifier URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
extension:procedureOrService | S | 0..* | CodeableConcept | Primary Procedures and/or products involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateProcedureOrService Binding: Claim Medical Product or Service Value Set (required)
extension:condition | S | 0..* | CodeableConcept | Primary diagnoses involved in the estimates URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateCondition Binding: PCT ICD-10 Diagnostic Codes (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
masterIdentifier | Σ | 0..1 | Identifier | Master Version Specific Identifier
identifier | S Σ | 0..* | Identifier | Other identifiers for the document
status | ?!S Σ | 1..1 | code | current | superseded | entered-in-error Binding: DocumentReferenceStatus (required)
docStatus | S Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible) Binding: USCoreDocumentReferenceType (7.0.0) (required): All LOINC values whose SCALE is "Doc" in the LOINC database and the HL7 v3 Code System NullFlavor concept 'unknown'
Additional Bindings | Purpose
USCoreClinicalNoteType (7.0.0) | Min Binding
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:$this
coding:estimate | S Σ | 1..1 | Coding | Code defined by a terminology system Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 111479-2
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
Slices for category | S Σ | 1..* | CodeableConcept | Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:uscore | Σ | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Categorization of document Binding: USCoreDocumentReferenceCategory (7.0.0) (required): The US Core DocumentReferences Type Value Set is a "starter set" of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:estimate | S Σ | 1..1 | CodeableConcept | Estimate category Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: estimate
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S | Practitioner | Group | Device) | Who/what is the subject of the document
date | S Σ C | 0..1 | instant | When this document reference was created Constraints: pct-datetime-to-seconds
author | S Σ | 2..* | Reference(PCT Organization | PCT Practitioner) | All involved authoring parties, including payer all Good Faith Estimate (GFE) providers
authenticator |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Who/what authenticated the document
custodian |  | 0..1 | Reference(Organization) | Organization which maintains the document
Slices for relatesTo | Σ | 0..* | BackboneElement | Relationship to other AEOB packets. Required if this estimate is replacing another. Slice: Unordered, Open by value:code
relatesTo:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
relatesTo:replaces | S Σ | 0..1 | BackboneElement | Relationships to other documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents. Required Pattern: replaces
target | Σ | 1..1 | Reference(DocumentReference) | Target of the relationship
description | Σ | 0..1 | string | Human-readable description
securityLabel | Σ | 0..* | CodeableConcept | Document security-tags Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content | S Σ | 1..1 | BackboneElement | Document referenced
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
attachment | S Σ C | 1..1 | Attachment | Where to access the document Constraints: us-core-6
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
contentType | S Σ | 0..1 | code | Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language | Σ | 0..1 | code | Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Example General: en-AU
data | S C | 0..1 | base64Binary | Data inline, base64ed
url | S Σ C | 0..1 | url | Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size | Σ | 0..1 | unsignedInt | Number of bytes of content (if url provided)
hash | Σ | 0..1 | base64Binary | Hash of the data (sha-1, base64ed)
title | Σ | 0..1 | string | Label to display in place of the data Example General: Official Corporate Logo
creation | Σ | 0..1 | dateTime | Date attachment was first created
format | S Σ | 0..1 | Coding | Format/content rules for the document Binding: HL7FormatCodes (2.1.0) (extensible) Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: pct-aeob-packet
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
context | S Σ | 0..1 | BackboneElement | Clinical context of document
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
encounter | S | 0..1 | Reference(US Core Encounter Profile(7.0.0)) | Context of the document content
event |  | 0..* | CodeableConcept | Main clinical acts documented Binding: ActCode (3.0.0) (example): This list of codes represents the main clinical acts being documented.
period | S Σ | 0..1 | Period | Time of service that is being documented
facilityType |  | 0..1 | CodeableConcept | Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting |  | 0..1 | CodeableConcept | Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo |  | 0..1 | Reference(Patient) | Patient demographics from source
related |  | 0..* | Reference(Resource) | Related identifiers or resources
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DocumentReference.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
DocumentReference.status | Base | required | DocumentReferenceStatus | 📦4.0.1 | FHIR Std.
DocumentReference.docStatus | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
DocumentReference.type | Base | required | US Core DocumentReference Type | 📍7.0.0 | US Core v7.0
DocumentReference.category | Base | example | Document Class Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.category:uscore | Base | required | US Core DocumentReference Category | 📍7.0.0 | US Core v7.0
DocumentReference.category:estimate | Base | example | Document Class Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.relatesTo:replaces.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
DocumentReference.securityLabel | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std.
DocumentReference.content.​attachment.contentType | Base | required | MimeType | 📍4.0.1 | FHIR Std.
DocumentReference.content.​attachment.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
DocumentReference.content.​format | Base | extensible | HL7 ValueSet of Format Codes for use with Document Sharing | 📍2.1.0 | THO v6.5
DocumentReference.context.​event | Base | example | v3 Code System ActCode | 📍3.0.0 | THO v6.5
DocumentReference.context.​facilityType | Base | example | Facility Type Code Value Set | 📦4.0.1 | FHIR Std.
DocumentReference.context.​practiceSetting | Base | example | Practice Setting Code Value Set | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DocumentReference | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DocumentReference | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | DocumentReference | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DocumentReference | A resource should have narrative for robust management | `text.`div`.exists()`
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()`
pct-datetime-to-seconds | error | DocumentReference.date | Datetime must be at least to seconds. | `$this is dateTime implies $this.toString().length() >= 19`
us-core-6 | error | DocumentReference.content.attachment | DocumentReference.content.attachment.url or DocumentReference.content.attachment.data or both SHALL be present. | `url.exists() or data.exists()`

This structure is derived from USCoreDocumentReferenceProfile

Summary

Mandatory: 6 elements
Must-Support: 8 elements

Structures

This structure refers to these other structures:

- PCT Organization (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization)
- PCT Practitioner (http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-practitioner)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-pct/StructureDefinition/requestInitiationTime
- http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeServiceLinkingInfo
- http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateProcedureOrService
- http://hl7.org/fhir/us/davinci-pct/StructureDefinition/estimateCondition

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DocumentReference.type.coding
- The element 1 is sliced based on the value of DocumentReference.relatesTo

Maturity: 1

Other representations of profile: CSV, Excel, Schematron