PCT GFE ServiceRequest - Patient Cost Transparency Implementation Guide v2.0.2

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 2.0.2 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 GFE ServiceRequest

Official URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-servicerequest	Version: 2.0.2	Highlight text changes?
Standards status: Trial-use	Maturity Level: 2	Computable Name: PCTServiceRequest
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.42.23

The PCT ServiceRequest including details about a service for which a GFE is being requested.

Usages:

Use this Profile: PCT GFE Information Bundle and PCT GFE Missing Bundle
Examples for this Profile: ServiceRequest/PCT-ServiceRequest-1

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 Differentials, Snapshots, and other representations.

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
ServiceRequest	C	0..*	USCoreServiceRequestProfile(7.0.0)	A request for a service to be performed Constraints: prr-1
ServiceRequest.implicitRules	This element is a modifier element. This element is included in summaries.	0..1	uri	A set of rules under which this content was created
ServiceRequest.modifierExtension	This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
ServiceRequest.status	This element is a modifier element. This element must be supported. This element is included in summaries.	1..1	code	draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown Binding: RequestStatus (required): The status of a service order. Required Pattern: active (extensions allowed)
ServiceRequest.intent	This element is a modifier element. This element must be supported. This element is included in summaries.	1..1	code	proposal \| plan \| directive \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Binding: RequestIntent (required): The kind of service request. Required Pattern: proposal (extensions allowed)
ServiceRequest.Slices for category	This element must be supported. This element is included in summaries.	0..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
ServiceRequest.Slices for category.category:us-core	This element must be supported. This element is included in summaries.	0..*	CodeableConcept	Classification of service Binding: USCoreServiceRequestCategoryCodes (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
ServiceRequest.code	This element must be supported. This element is included in summaries.	1..1	CodeableConcept	What is being requested/ordered Binding: Claim Medical Product or Service Value Set (extensible)
ServiceRequest.quantity[x]	This element must be supported. This element is included in summaries.	0..1		Service amount
ServiceRequest.quantity[x].quantityQuantity			Quantity
ServiceRequest.quantity[x].quantityRatio			Ratio
ServiceRequest.quantity[x].quantityRange			Range
ServiceRequest.subject	This element must be supported. This element is included in summaries.	1..1	Reference(US Core Patient Profile(7.0.0))	Individual or Entity the service is ordered for
ServiceRequest.encounter	This element must be supported. This element is included in summaries.	0..1	Reference(US Core Encounter Profile(7.0.0))	Encounter in which the request was created
ServiceRequest.occurrence[x]	This element must be supported. This element is included in summaries.	0..1		When service should occur
ServiceRequest.occurrence[x].occurrencePeriod			Period This type must be supported.
ServiceRequest.occurrence[x].occurrenceDateTime			dateTime
ServiceRequest.occurrence[x].occurrenceTiming			Timing
ServiceRequest.authoredOn	This element must be supported. This element is included in summaries.	0..1	dateTime	Date request signed
ServiceRequest.requester	This element must be supported. This element is included in summaries.	0..1	Reference(US Core Practitioner Profile(7.0.0) This type must be supported. \| US Core Organization Profile(7.0.0) \| US Core Patient Profile(7.0.0) \| PractitionerRole \| US Core RelatedPerson Profile(7.0.0) \| Device)	Who/what is requesting service
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
ServiceRequest.intent	Base	required	RequestIntent	📍4.0.1	FHIR Std.
ServiceRequest.category	Base	example	Service Request Category Codes	📦4.0.1	FHIR Std.
ServiceRequest.category:us-core	Base	required	US Core ServiceRequest Category Codes	📍7.0.0	US Core v7.0
ServiceRequest.code	Base	extensible	Claim Medical Product or Service Value Set	📦2.0.2	This IG

Constraints

Grade

Path(s)

Description

Expression

This structure is derived from USCoreServiceRequestProfile

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
ServiceRequest			USCoreServiceRequestProfile(7.0.0)
ServiceRequest.status		1..1	code	draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown Required Pattern: active (extensions allowed)
ServiceRequest.intent		1..1	code	proposal \| plan \| directive \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Required Pattern: proposal (extensions allowed)
ServiceRequest.doNotPerform		0..0		True if service/procedure should not be performed
ServiceRequest.code		1..1	CodeableConcept	What is being requested/ordered Binding: Claim Medical Product or Service Value Set (extensible)
ServiceRequest.quantity[x]	This element must be supported.	0..1	Quantity, Ratio, Range	Service amount
ServiceRequest.subject		1..1	Reference(US Core Patient Profile(7.0.0))	Individual or Entity the service is ordered for
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.code	Base	extensible	Claim Medical Product or Service Value Set	📦2.0.2	This IG

Description & Constraints Filter:

ServiceRequest

0..*

USCoreServiceRequestProfile(7.0.0)

A request for a service to be performed
Constraints: prr-1

0..1

Logical id of this artifact

Meta

Metadata about the resource

implicitRules

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

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

0..*

Extension

Extensions that cannot be ignored

identifier

0..*

Identifier

Identifiers assigned to this order

instantiatesCanonical

0..*

canonical(ActivityDefinition | PlanDefinition)

Instantiates FHIR protocol or definition

instantiatesUri

0..*

uri

Instantiates external protocol or definition

basedOn

0..*

Reference(CarePlan | ServiceRequest | MedicationRequest)

What request fulfills

replaces

0..*

Reference(ServiceRequest)

What request replaces

requisition

0..1

Identifier

Composite Request ID

status

1..1

code

intent

1..1

code

Slices for category

0..*

CodeableConcept

Classification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them

category:us-core

0..*

CodeableConcept

Classification of service
Binding: USCoreServiceRequestCategoryCodes (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

priority

0..1

code

routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.

code

1..1

CodeableConcept

What is being requested/ordered
Binding: Claim Medical Product or Service Value Set (extensible)

orderDetail

0..*

CodeableConcept

Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.

quantity[x]

0..1

Service amount

quantityQuantity

quantityRatio

quantityRange

1..1

Reference(US Core Patient Profile(7.0.0))

Individual or Entity the service is ordered for

encounter

0..1

Reference(US Core Encounter Profile(7.0.0))

Encounter in which the request was created

occurrence[x]

0..1

When service should occur

occurrencePeriod

occurrenceDateTime

occurrenceTiming

0..1

Preconditions for service
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

asNeededBoolean

boolean

asNeededCodeableConcept

0..1

Date request signed

0..1

Who/what is requesting service

performerType

0..1

CodeableConcept

Performer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

performer

0..*

Requested performer

locationCode

0..*

CodeableConcept

Requested location
Binding: ServiceDeliveryLocationRoleType (3.0.0) (example): A location type where services are delivered.

0..*

Requested location

0..*

𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Explanation/Justification for procedure or service
Binding: USCoreConditionCodes (7.0.0) (extensible)

reasonReference

0..*

Reference(Condition | Observation | DiagnosticReport | DocumentReference)

𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Profile that supports the requested service

insurance

0..*

Reference(Coverage | ClaimResponse)

Associated insurance coverage

supportingInfo

0..*

Reference(Resource)

Additional clinical information

0..*

Procedure Samples

0..*

Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

note

0..*

Annotation

Comments

patientInstruction

0..1

string

Patient or consumer-oriented instructions

relevantHistory

0..*

Reference(Provenance)

Request provenance

Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
ServiceRequest.status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
ServiceRequest.intent	Base	required	RequestIntent	📍4.0.1	FHIR Std.
ServiceRequest.category	Base	example	Service Request Category Codes	📦4.0.1	FHIR Std.
ServiceRequest.category:us-core	Base	required	US Core ServiceRequest Category Codes	📍7.0.0	US Core v7.0
ServiceRequest.priority	Base	required	Request priority	📍4.0.1	FHIR Std.
ServiceRequest.code	Base	extensible	Claim Medical Product or Service Value Set	📦2.0.2	This IG
ServiceRequest.orderDetail	Base	example	Service Request Order Details Codes	📦4.0.1	FHIR Std.
ServiceRequest.asNeeded[x]	Base	example	SNOMED CT Medication As Needed Reason Codes	📦4.0.1	FHIR Std.
ServiceRequest.performerType	Base	example	Participant Roles	📦4.0.1	FHIR Std.
ServiceRequest.locationCode	Base	example	ServiceDeliveryLocationRoleType	📍3.0.0	THO v7.1
ServiceRequest.reasonCode	Base	extensible	US Core Condition Codes	📍7.0.0	US Core v7.0
ServiceRequest.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.

Constraints

Grade

Path(s)

Description

Expression

This structure is derived from USCoreServiceRequestProfile

Summary

Must-Support: 1 element
Prohibited: 1 element

Structures

This structure refers to these other structures:

US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0)

Maturity: 2

Key Elements View

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
ServiceRequest	C	0..*	USCoreServiceRequestProfile(7.0.0)	A request for a service to be performed Constraints: prr-1
ServiceRequest.implicitRules	This element is a modifier element. This element is included in summaries.	0..1	uri	A set of rules under which this content was created
ServiceRequest.modifierExtension	This element is a modifier element.	0..*	Extension	Extensions that cannot be ignored
ServiceRequest.status	This element is a modifier element. This element must be supported. This element is included in summaries.	1..1	code	draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown Binding: RequestStatus (required): The status of a service order. Required Pattern: active (extensions allowed)
ServiceRequest.intent	This element is a modifier element. This element must be supported. This element is included in summaries.	1..1	code	proposal \| plan \| directive \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Binding: RequestIntent (required): The kind of service request. Required Pattern: proposal (extensions allowed)
ServiceRequest.Slices for category	This element must be supported. This element is included in summaries.	0..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service. Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
ServiceRequest.Slices for category.category:us-core	This element must be supported. This element is included in summaries.	0..*	CodeableConcept	Classification of service Binding: USCoreServiceRequestCategoryCodes (7.0.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
ServiceRequest.code	This element must be supported. This element is included in summaries.	1..1	CodeableConcept	What is being requested/ordered Binding: Claim Medical Product or Service Value Set (extensible)
ServiceRequest.quantity[x]	This element must be supported. This element is included in summaries.	0..1		Service amount
ServiceRequest.quantity[x].quantityQuantity			Quantity
ServiceRequest.quantity[x].quantityRatio			Ratio
ServiceRequest.quantity[x].quantityRange			Range
ServiceRequest.subject	This element must be supported. This element is included in summaries.	1..1	Reference(US Core Patient Profile(7.0.0))	Individual or Entity the service is ordered for
ServiceRequest.encounter	This element must be supported. This element is included in summaries.	0..1	Reference(US Core Encounter Profile(7.0.0))	Encounter in which the request was created
ServiceRequest.occurrence[x]	This element must be supported. This element is included in summaries.	0..1		When service should occur
ServiceRequest.occurrence[x].occurrencePeriod			Period This type must be supported.
ServiceRequest.occurrence[x].occurrenceDateTime			dateTime
ServiceRequest.occurrence[x].occurrenceTiming			Timing
ServiceRequest.authoredOn	This element must be supported. This element is included in summaries.	0..1	dateTime	Date request signed
ServiceRequest.requester	This element must be supported. This element is included in summaries.	0..1	Reference(US Core Practitioner Profile(7.0.0) This type must be supported. \| US Core Organization Profile(7.0.0) \| US Core Patient Profile(7.0.0) \| PractitionerRole \| US Core RelatedPerson Profile(7.0.0) \| Device)	Who/what is requesting service
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
ServiceRequest.intent	Base	required	RequestIntent	📍4.0.1	FHIR Std.
ServiceRequest.category	Base	example	Service Request Category Codes	📦4.0.1	FHIR Std.
ServiceRequest.category:us-core	Base	required	US Core ServiceRequest Category Codes	📍7.0.0	US Core v7.0
ServiceRequest.code	Base	extensible	Claim Medical Product or Service Value Set	📦2.0.2	This IG

Constraints

Grade

Path(s)

Description

Expression

Differential View

This structure is derived from USCoreServiceRequestProfile

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
ServiceRequest			USCoreServiceRequestProfile(7.0.0)
ServiceRequest.status		1..1	code	draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown Required Pattern: active (extensions allowed)
ServiceRequest.intent		1..1	code	proposal \| plan \| directive \| order \| original-order \| reflex-order \| filler-order \| instance-order \| option Required Pattern: proposal (extensions allowed)
ServiceRequest.doNotPerform		0..0		True if service/procedure should not be performed
ServiceRequest.code		1..1	CodeableConcept	What is being requested/ordered Binding: Claim Medical Product or Service Value Set (extensible)
ServiceRequest.quantity[x]	This element must be supported.	0..1	Quantity, Ratio, Range	Service amount
ServiceRequest.subject		1..1	Reference(US Core Patient Profile(7.0.0))	Individual or Entity the service is ordered for
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.code	Base	extensible	Claim Medical Product or Service Value Set	📦2.0.2	This IG

Snapshot ViewView

Description & Constraints Filter:

ServiceRequest

0..*

USCoreServiceRequestProfile(7.0.0)

A request for a service to be performed
Constraints: prr-1

0..1

Logical id of this artifact

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
ServiceRequest.status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
ServiceRequest.intent	Base	required	RequestIntent	📍4.0.1	FHIR Std.
ServiceRequest.category	Base	example	Service Request Category Codes	📦4.0.1	FHIR Std.
ServiceRequest.category:us-core	Base	required	US Core ServiceRequest Category Codes	📍7.0.0	US Core v7.0
ServiceRequest.priority	Base	required	Request priority	📍4.0.1	FHIR Std.
ServiceRequest.code	Base	extensible	Claim Medical Product or Service Value Set	📦2.0.2	This IG
ServiceRequest.orderDetail	Base	example	Service Request Order Details Codes	📦4.0.1	FHIR Std.
ServiceRequest.asNeeded[x]	Base	example	SNOMED CT Medication As Needed Reason Codes	📦4.0.1	FHIR Std.
ServiceRequest.performerType	Base	example	Participant Roles	📦4.0.1	FHIR Std.
ServiceRequest.locationCode	Base	example	ServiceDeliveryLocationRoleType	📍3.0.0	THO v7.1
ServiceRequest.reasonCode	Base	extensible	US Core Condition Codes	📍7.0.0	US Core v7.0
ServiceRequest.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.