臺灣健保事前審查實作指引
1.1.0 - ci-build

臺灣健保事前審查實作指引, published by 衛生福利部中央健康保險署. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TWNHIFHIR/pas/ and changes regularly. See the Directory of published versions

## TWPAS ImplementationGuide Resource

Official URL: https://nhicore.nhi.gov.tw/pas/ImplementationGuide/tw.gov.mohw.nhi.pas | Version:1.1.0
NPM package name: tw.gov.mohw.nhi.pas | Computable Name: TWPAS

- XML
- JSON

#### Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (tw.gov.mohw.nhi.pas.r4) and R4B (tw.gov.mohw.nhi.pas.r4b) are available.

#### IG Dependencies

This IG Contains the following dependencies on other IGs.

IG | Package | FHIR | Comment
--- | --- | --- | ---
臺灣健保事前審查實作指引 | tw.gov.mohw.nhi.pas#1.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#7.0.1 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.2.0 | R4 |
臺灣核心實作指引(TW Core IG) | tw.gov.mohw.twcore#0.3.2 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#6.1.0 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.1.0 | R4 |
International Patient Summary Implementation Guide | hl7.fhir.uv.ips#1.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.0.0 | R4 |
fhir.dicom | fhir.dicom#2022.4.20221006 | R4 |
Structured Data Capture | hl7.fhir.uv.sdc#3.0.0 | R4 |
電子病歷交換單張實作指引(EMR-IG) | tw.gov.mohw.emr#0.2.0 | R4 |
Da Vinci Prior Authorization Support (PAS) FHIR IG | hl7.fhir.us.davinci-pas#2.1.0 | R4 |
US Core (Reuse Wrapper) | hl7.fhir.us.core.v311#3.1.1 | R4 |
US Core | hl7.fhir.us.core#3.1.1 | R4 |
US Core (Reuse Wrapper) | hl7.fhir.us.core.v610#6.1.0 | R4 |
US Core Implementation Guide | hl7.fhir.us.core#6.1.0 | R4 |
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#1.0.0 | R4 |
Bulk Data Access IG | hl7.fhir.uv.bulkdata#2.0.0 | R4 |
SMART App Launch | hl7.fhir.uv.smart-app-launch#2.1.0 | R4 |
VSAC | us.nlm.vsac#0.11.0 | R4 |
PHINVads | us.cdc.phinvads#0.12.0 | R4 |
IHE FormatCode Vocabulary | ihe.formatcode.fhir#1.1.0 | R4 |
US Core Implementation Guide | hl7.fhir.us.core#7.0.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.5.0 | R4 |
SMART App Launch | hl7.fhir.uv.smart-app-launch#2.0.0 | R4 |
VSAC | us.nlm.vsac#0.18.0 | R4 |
Da Vinci - Coverage Requirements Discovery | hl7.fhir.us.davinci-crd#2.0.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#5.3.0 | R4 |
Da Vinci Health Record Exchange (HRex) | hl7.fhir.us.davinci-hrex#1.0.0 | R4 |
Security for Scalable Registration, Authentication, and Authorization | hl7.fhir.us.udap-security#0.1.0 | R4 |
Da Vinci Health Record Exchange (HRex) | hl7.fhir.us.davinci-hrex#1.1.0 | R4 |
VSAC | us.nlm.vsac#0.19.0 | R4 |
Subscriptions R5 Backport | hl7.fhir.uv.subscriptions-backport.r4#1.1.0 | R4 |
CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) | hl7.fhir.us.carin-bb#2.0.0 | R4 |
VSAC | us.nlm.vsac#0.7.0 | R4 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#0.9.0 | R4 | for example references

Package hl7.fhir.uv.extensions.r4#5.2.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Mon, Feb 10, 2025 21:45+1100+11:00)

Package hl7.fhir.uv.extensions.r4#5.1.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sat, Apr 27, 2024 18:39+1000+10:00)

Package hl7.fhir.uv.ips#1.1.0 International Patient Summary (IPS) FHIR Implementation Guide (built Tue, Nov 22, 2022 03:24+0000+00:00)

Package hl7.fhir.uv.sdc#3.0.0 The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR. This includes two components: * Support more sophisticated questionnaire/form use-cases such as those needed for research, oncology, pathology and other clinical domains. *Support pre-population and auto-population of EHR data into forms/questionnaires for uses outside direct clinical care (patient safety, adverse event reporting, public health reporting, etc.). (built Tue, Mar 8, 2022 18:32+0000+00:00)

Package tw.gov.mohw.twcore#0.3.2 臺灣核心實作指引(TW Core IG) (built Thu, Dec 12, 2024 12:41+0800+08:00)

Package tw.gov.mohw.emr#0.2.0 電子病歷交換單張實作指引 EMR IG (built Mon, Jan 20, 2025 16:33+0800+08:00)

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Package hl7.fhir.uv.bulkdata#2.0.0 FHIR based approach for exporting large data sets from a FHIR server to a client application (built Fri, Nov 26, 2021 05:56+1100+11:00)

Package ihe.formatcode.fhir#1.1.0 Implementation Guide for IHE defined FormatCode vocabulary. (built Thu, Feb 24, 2022 16:55-0600-06:00)

Package hl7.fhir.us.core#6.1.0 The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and ONC U.S. Core Data for Interoperability (USCDI) v1 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm. These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes. (built Fri, Jun 30, 2023 14:02+0000+00:00)

Package hl7.fhir.us.core#7.0.0 The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and ONC U.S. Core Data for Interoperability (USCDI) v1 provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. This guide was used as the basis for further testing and guidance by the Argonaut Project Team to provide additional content and guidance specific to Data Query Access for purpose of ONC Certification testing. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm. These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes. (built Wed, May 8, 2024 15:33+0000+00:00)

Package hl7.fhir.us.udap-security#0.1.0 This implementation guide describes how to extend OAuth 2.0 to support secure and scalable workflows for business-to-business (B2B) apps that implement the client credentials flow or authorization code flow. (built Fri, Aug 6, 2021 15:57+0000+00:00)

Package hl7.fhir.us.davinci-hrex#1.0.0 The Da Vinci Payer Health Record exchange (HRex) Framework/library specifies the FHIR elements used in multiple Da Vinci implementation guides. This includes FHIR profiles, functions, operations, and constraints on other specifications such as CDS-Hooks and other aspects of Da Vinci Use Cases that are common across more than a single use case. Da Vinci HRex Implementation Guide (IG) will make use of US Core profiles that are based on the FHIR R4 specification wherever practical. The HRex IG will use the HL7 FHIR Release 4/US Core STU3 specification as its base but will provide additional guidance and documentation to support implementations that follow the HL7 FHIR STU3/US Core STU2 and HL7 FHIR DSTU2/Argonaut specifications. The HRex profiles documented in this IG will be used to exchange data between providers systems (e.g. EHRs) and other providers, payers, and third-party applications where appropriate. In addition, exchanges from payer systems to providers, other payers, and third-party applications are supported by the HRex profiles and operations. HRex may define new extensions, profiles, value sets, constraints/extension to other specification (e.g. specific CDS-Hooks) that are specific Da Vinci requirements. Where appropriate these Da Vinci specific artifacts will be promoted for incorporation into the future versions of existing standards (e.g. R4 US Core profiles) and deprecated in this guide on publication in the updated standard. (built Wed, Mar 23, 2022 18:55+0000+00:00)

Package hl7.fhir.us.davinci-crd#2.0.0 Guidelines for conveying coverage requirements to clinicians when planning treatment (built Fri, Oct 20, 2023 14:17+0000+00:00)

Package hl7.fhir.us.davinci-hrex#1.1.0 The Da Vinci Payer Health Record exchange (HRex) Framework/library specifies the FHIR elements used in multiple Da Vinci implementation guides. This includes FHIR profiles, functions, operations, and constraints on other specifications such as CDS-Hooks and other aspects of Da Vinci Use Cases that are common across more than a single use case.\n\nDa Vinci HRex Implementation Guide (IG) will make use of US Core profiles that are based on the FHIR R4 specification wherever practical. The HRex IG will use the HL7 FHIR Release 4/US Core STU3 specification as its base but will provide additional guidance and documentation to support implementations that follow the HL7 FHIR STU3/US Core STU2 and HL7 FHIR DSTU2/Argonaut specifications.\n\nThe HRex profiles documented in this IG will be used to exchange data between providers systems (e.g. EHRs) and other providers, payers, and third-party applications where appropriate. In addition, exchanges from payer systems to providers, other payers, and third-party applications are supported by the HRex profiles and operations.\n\nHRex may define new extensions, profiles, value sets, constraints/extension to other specification (e.g. specific CDS-Hooks) that are specific Da Vinci requirements. Where appropriate these Da Vinci specific artifacts will be promoted for incorporation into the future versions of existing standards (e.g. R4 US Core profiles) and deprecated in this guide on publication in the updated standard. (built Tue, Dec 10, 2024 16:43+0000+00:00)

Package hl7.fhir.uv.subscriptions-backport.r4#1.1.0 The Subscription R5 Backport Implementation Guide enables servers running versions of FHIR earlier than R5 to implement a subset of R5 Subscriptions in a standardized way. (built Wed, Jan 11, 2023 15:34+1100+11:00)

Package hl7.fhir.us.carin-bb#2.0.0 CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) (built Mon, Nov 28, 2022 15:15+0000+00:00)

Package hl7.fhir.us.davinci-pas#2.1.0 Guidelines for conveying coverage requirements to clinicians when planning treatment. (built Fri, Dec 20, 2024 21:03+0000+00:00)

Package hl7.fhir.uv.tools.r4#0.9.0 This IG defines the extensions that the tools use internally. Some of these extensions are content that are being evaluated for elevation into the main spec, and others are tooling concerns (built Tue, Dec 16, 2025 23:18+1100+11:00)

#### Global Profiles

There are no Global profiles defined

#### Copyrights

This publication includes IP covered under the following statements.

- The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
  Show Usage
  - Unified Code for Units of Measure (UCUM): Bundle/bun-1, Bundle/bun-3... Show 16 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example, Claim/cla-1, Claim/cla-3, Claim/cla-imm, ClaimImmTWPAS, ClaimTWPAS, MedicationRequest/medReq-apply, MedicationRequest/medReq-apply-2, MedicationRequest/medReq-treat, MedicationRequestApplyTWPAS, MedicationRequestTreatTWPAS, Observation/obs-lab-min, Substance/sub-min and SubstanceTWPAS
- These codes are excerpted from Digital Imaging and Communications in Medicine (DICOM) Standard, Part 16: Content Mapping Resource, Copyright Â© 2011 by the National Electrical Manufacturers Association.
  Show Usage
  - DICOM Controlled Terminology Definitions: AcquisitionModality, Bundle/bun-1... Show 6 more, Bundle/bun-3, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example, ImagingStudy/imaStu-min and ImagingStudyTWPAS
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  - LOINC: Bundle/bun-1, Bundle/bun-3... Show 34 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example, Composition/opd, CompositionOpdTWPAS, Condition/con-comorbidity, Condition/con-diagnosis, ConditionTWPAS, DNAChangeType, DiagnosticReport/diaRep-ima-loinc, DiagnosticReport/diaRep-min, DiagnosticReport/inline-2-diaRep-ima-loinc, DiagnosticReport/inline-diaRep-ima-loinc, DiagnosticReportImageTWPAS, DiagnosticReportTWPAS, GeneTestCode, ImagingReport, Observation/obs-blood-group, Observation/obs-diagnostic-min, Observation/obs-lab-cbc, Observation/obs-lab-min, Observation/obs-objective, Observation/obs-pat-nyha, Observation/obs-subjective, ObservationDiagnosticTWPAS, ObservationLaboratoryResultTWPAS, ObservationObjectiveTWPAS, ObservationPatientAssessmentTWPAS, ObservationSubjectiveTWPAS, PatAst, ReportType, Specimen/spe-min, SpecimenTWPAS and SpecimenType
- This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
  Show Usage
  - SNOMED Clinical Terms&reg; (SNOMED CT&reg;): Bundle/bun-1, Bundle/bun-3... Show 27 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example, CancerStage, Encounter/enc-opd, EncounterOpdTWPAS, EncounterTWPAS, ImagingStudy/imaStu-min, ImagingStudyTWPAS, Media/med-min, MediaTWPAS, MedicationRequest/medReq-apply, MedicationRequest/medReq-apply-2, MedicationRequest/medReq-treat, MedicationRequestApplyTWPAS, MedicationRequestTreatTWPAS, Observation/obs-blood-group, Observation/obs-cancer-cns, Observation/obs-cancer-figo, Observation/obs-cancer-tnm, Observation/obs-pat-ctcae, ObservationBloodGroupTWPAS, ObservationCancerStageTWPAS, ObservationPatientAssessmentTWPAS, PatAst, SNOMEDCTBodySite and TWPCSMedicationPathSCT
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
  Show Usage
  - Adjudication Value Codes: Bundle/bun-response, Bundle/bun-self, Bundle/bun-uuid-example, ClaimResponse/claim-response-example and ClaimResponse/self-assessment-example
  - AllergyIntolerance Clinical Status Codes: AllergyIntolerance/all-min and Bundle/bun-imm
  - Claim Type Codes: Bundle/bun-1, Bundle/bun-3... Show 13 more, Bundle/bun-imm, Bundle/bun-response, Bundle/bun-self, Bundle/bun-uuid-example, Claim/cla-1, Claim/cla-3, Claim/cla-imm, ClaimImmTWPAS, ClaimResponse/claim-response-example, ClaimResponse/self-assessment-example, ClaimResponseSelfAssessmentTWPAS, ClaimResponseTWPAS and ClaimTWPAS
  - Condition Clinical Status Codes: Bundle/bun-imm, Condition/con-comorbidity, Condition/con-diagnosis and ConditionTWPAS
  - MedicationRequest Status Reason Codes: Bundle/bun-1, Bundle/bun-3... Show 4 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example and MedicationRequest/medReq-treat
  - Observation Category Codes: Bundle/bun-imm, Observation/obs-objective, Observation/obs-subjective, ObservationObjectiveTWPAS and ObservationSubjectiveTWPAS
  - Operation Outcome Codes: OperationOutcome/error-example
  - Organization type: Bundle/bun-1, Bundle/bun-3... Show 5 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example, 臺北市立聯合醫院 and 衛生福利部中央健康保險署
  - identifierType: Bundle/bun-1, Bundle/bun-3... Show 8 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example, ClaimResponseRequestor, Patient/pat-min, Patient/pat-resident, Practitioner/pra-min and 臺北市立聯合醫院
  - ActCode: Bundle/bun-1, Bundle/bun-3... Show 7 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example, Encounter/enc-min, Encounter/enc-opd, EncounterOpdTWPAS and EncounterTWPAS
  - GTSAbbreviation: Bundle/bun-1, Bundle/bun-imm... Show 6 more, Bundle/bun-self, Bundle/bun-uuid-example, MedicationRequest/medReq-apply, MedicationRequestApplyTWPAS, MedicationRequestTreatTWPAS and NHIMedicationFrequencyHL7
  - ObservationInterpretation: Bundle/bun-1, Bundle/bun-3... Show 5 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example, Observation/obs-diagnostic-min and Observation/obs-lab-min
  - Orderable Drug Form: Bundle/bun-1, Bundle/bun-3... Show 4 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example and MedicationRequest/medReq-apply-2
- World Health Organization (WHO)
  Show Usage
  - 臺灣健保署2014年中文版ICD-10-CM: ClaimImmTWPAS and ClaimTWPAS
  - 臺灣健保署2014年中文版ICD-10-PCS: ClaimImmTWPAS, ClaimTWPAS... Show 5 more, DiagnosticReportImageTWPAS, ICD10PCSImage, ICD10PCSRadiotherapy, ProcedureTWPAS and SubstanceTWPAS
- 衛生福利部中央健康保險署
  Show Usage
  - 臺灣健保署就醫科別: Bundle/bun-1, Bundle/bun-3... Show 4 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example and Encounter/enc-min
  - 臺灣健保署醫療服務給付項目: ClaimImmTWPAS, ClaimTWPAS and NHIMedicalServicePayment
  - 臺灣健保署給藥途徑: MedicationRequestApplyTWPAS, MedicationRequestTreatTWPAS and TWPCSMedicationPathSCT
- 衛生福利部資訊處
  Show Usage
  - 臺灣衛福部資訊處照護計畫類別: Bundle/bun-imm, CarePlan/careplan-min and CarePlanTWPAS
  - 臺灣衛福部資訊處識別碼類型: Bundle/bun-1, Bundle/bun-3... Show 4 more, Bundle/bun-imm, Bundle/bun-self, Bundle/bun-uuid-example and 衛生福利部中央健康保險署
- 衛生福利部食品藥物管理署
  Show Usage
  - 臺灣食藥署醫療器材許可證: MedicationRequestTreatTWPAS and NHIMedicationFDA
  - 臺灣食藥署藥品許可證: MedicationRequestTreatTWPAS and NHIMedicationFDA