Da Vinci Clinical Data Exchange (CDex)
2.0.0 - STU2
Da Vinci Clinical Data Exchange (CDex)
2.0.0 - STU2
This page is part of the Da Vinci Clinical Documentation Exchange (v2.0.0: STU2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
| Page standards status: Informative |
{
"resourceType" : "Task",
"id" : "cdex-task-example24",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-task-attachment-request"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Task</b><a name=\"cdex-task-example24\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Task "cdex-task-example24" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-cdex-task-attachment-request.html\">CDex Task Attachment Request Profile</a></p></div><p><b>identifier</b>: Re-Association Tracking Control Number:\u00a0trackingid1012</p><p><b>status</b>: completed</p><p><b>intent</b>: order</p><p><b>code</b>: Attachment Request Questionnaire <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#attachment-request-questionnaire)</span></p><p><b>for</b>: <a name=\"patient\"> </a></p><blockquote><p/><p><a name=\"patient\"> </a></p><p><b>identifier</b>: Member Number:\u00a0Member123\u00a0(use:\u00a0USUAL), Patient Account Number:\u00a0PA-123\u00a0(use:\u00a0USUAL)</p><p><b>name</b>: Amy Shaw </p><p><b>birthDate</b>: 1987-02-20</p></blockquote><p><b>authoredOn</b>: 2022-06-17 16:16:06+0000</p><p><b>lastModified</b>: 2022-06-17 16:17:06+0000</p><p><b>requester</b>: <span/></p><p><b>owner</b>: <a name=\"practitionerrole\"> </a></p><blockquote><p/><p><a name=\"practitionerrole\"> </a></p><p><b>practitioner</b>: <span/></p><p><b>organization</b>: <span/></p></blockquote><p><b>reasonCode</b>: preauthorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/R4/codesystem-claim-use.html\">Use</a>#preauthorization "Preauthorization")</span></p><p><b>reasonReference</b>: <span/></p><h3>Restrictions</h3><table class=\"grid\"><tr><td>-</td><td><b>Period</b></td></tr><tr><td>*</td><td>?? --> 2022-06-21</td></tr></table><blockquote><p><b>input</b></p><p><b>ServiceLineNumber</b>: 1</p><p><b>type</b>: Questionnaire <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/uv/sdc/STU3/CodeSystem-temp.html\">Temporary SDC Codes</a>#questionnaire)</span></p><p><b>value</b>: <a href=\"Questionnaire-cdex-questionnaire-example1.html\">Home Oxygen Therapy Questionnaire</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Payer URL <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#payer-url)</span></p><p><b>value</b>: <a href=\"http://example.org/cdex/payer/$submit-attachment\">http://example.org/cdex/payer/$submit-attachment</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Purpose Of Use <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-cdex-temp.html\">CDex Temporary Code System</a>#purpose-of-use)</span></p><p><b>value</b>: coverage authorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ActReason.html\">ActReason</a>#COVAUTH)</span></p></blockquote><h3>Outputs</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Questionnaire Response <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/uv/sdc/STU3/CodeSystem-temp.html\">Temporary SDC Codes</a>#questionnaire-response)</span></td><td><a href=\"QuestionnaireResponse-cdex-questionnaireresponse-example1.html\">QuestionnaireResponse/cdex-questionnaireresponse-example1</a></td></tr></table><hr/><blockquote><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\"><b>Amy Shaw </b> (no stated gender), DoB: 1987-02-20 ( Member Number:\u00a0Member123\u00a0(use:\u00a0USUAL))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Other Ids (see the one above)\">Other Id:</td><td colspan=\"3\">Patient Account Number:\u00a0PA-123\u00a0(use:\u00a0USUAL)</td></tr></table></blockquote><hr/><blockquote><p><b>Generated Narrative: PractitionerRole #practitionerrole</b><a name=\"practitionerrole\"> </a></p><p><b>practitioner</b>: <span/></p><p><b>organization</b>: <span/></p></blockquote></div>"
},
"contained" : [
{
"resourceType" : "Patient",
"id" : "patient",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-patient-demographics"
]
},
"identifier" : [
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-hrex/CodeSystem/hrex-temp",
"code" : "UMB",
"display" : "Member Number"
}
],
"text" : "Member Number"
},
"system" : "http://example.org/cdex/payer/member-ids",
"value" : "Member123"
},
{
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType",
"code" : "pat",
"display" : "Patient Account Number"
}
],
"text" : "Patient Account Number"
},
"system" : "http://example.org/cdex/provider/patient-ids",
"value" : "PA-123"
}
],
"name" : [
{
"family" : "Shaw",
"given" : [
"Amy"
]
}
],
"birthDate" : "1987-02-20"
},
{
"resourceType" : "PractitionerRole",
"id" : "practitionerrole",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-practitionerrole"
]
},
"practitioner" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
}
},
"organization" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1234567893"
}
}
}
],
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "tracking-id",
"display" : "Tracking Id"
}
],
"text" : "Re-Association Tracking Control Number"
},
"system" : "http://example.org/payer",
"value" : "trackingid1012"
}
],
"status" : "completed",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "attachment-request-questionnaire"
}
],
"text" : "Attachment Request Questionnaire"
},
"for" : {
"reference" : "#patient"
},
"authoredOn" : "2022-06-17T16:16:06Z",
"lastModified" : "2022-06-17T16:17:06Z",
"requester" : {
"identifier" : {
"system" : "http://example.org/cdex/payer/payer-ids",
"value" : "Payer123"
}
},
"owner" : {
"reference" : "#practitionerrole"
},
"reasonCode" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/claim-use",
"code" : "preauthorization",
"display" : "Preauthorization"
}
],
"text" : "preauthorization"
},
"reasonReference" : {
"identifier" : {
"system" : "http://example.org/cdex/payer/claim-ids",
"value" : "Preauth123"
}
},
"restriction" : {
"period" : {
"end" : "2022-06-21"
}
},
"input" : [
{
"extension" : [
{
"url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber",
"valuePositiveInt" : 1
}
],
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
"code" : "questionnaire"
}
]
},
"valueCanonical" : "http://example.org/cdex-questionnaire-example1"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "payer-url"
}
]
},
"valueUrl" : "http://example.org/cdex/payer/$submit-attachment"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
"code" : "purpose-of-use"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
"code" : "COVAUTH",
"display" : "coverage authorization"
}
]
}
}
],
"output" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
"code" : "questionnaire-response"
}
]
},
"valueReference" : {
"reference" : "QuestionnaireResponse/cdex-questionnaireresponse-example1"
}
}
]
}
IG © 2023+ HL7 International - Patient Care Work Group. Package hl7.fhir.us.davinci-cdex#2.0.0 based on FHIR 4.0.1. Generated 2023-03-22
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