This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v1.1.0-ballot: STU 1.1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions
{
"resourceType" : "Task",
"id" : "questionnaire-example",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></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 \"questionnaire-example\" </p></div><p><b>basedOn</b>: <a href=\"MedicationRequest-example.html\">MedicationRequest/example</a></p><p><b>status</b>: ready</p><p><b>intent</b>: order</p><p><b>code</b>: Complete Questionnaire <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/uv/sdc/3.0.0-preview/CodeSystem-temp.html\">Temporary SDC Codes</a>#complete-questionnaire)</span></p><p><b>for</b>: <a href=\"Patient-example.html\">Patient/example</a> \" SHAW\"</p><p><b>encounter</b>: <a href=\"Encounter-example.html\">Encounter/example</a></p><p><b>authoredOn</b>: 2018-08-09</p><p><b>requester</b>: <a href=\"http://example.org/fhir/Organization/payer\">http://example.org/fhir/Organization/payer</a></p><p><b>reasonCode</b>: Needed for prior authorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-temp.html\">CRD Temporary Codes</a>#reason-prior-auth)</span></p><blockquote><p><b>input</b></p><p><b>type</b>: Questionnaire <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/uv/sdc/3.0.0-preview/CodeSystem-temp.html\">Temporary SDC Codes</a>#questionnaire)</span></p><p><b>value</b>: <a href=\"http://example.org/Questionnaire/XYZ\">http://example.org/Questionnaire/XYZ|2</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: Response Endpoint <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/uv/sdc/3.0.0-preview/CodeSystem-temp.html\">Temporary SDC Codes</a>#response-endpoint)</span></p><p><b>value</b>: <a href=\"http://example.org/somePayer\">http://example.org/somePayer</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: A task input indicating an action that should be taken after a QuestionnaireResponse has been completed on a specified Questionnaire. (Multiple completion actions can be specified.) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-temp.html\">CRD Temporary Codes</a>#after-completion-action)</span></p><p><b>value</b>: Include in prior authorization <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-temp.html\">CRD Temporary Codes</a>#prior-auth)</span></p></blockquote></div>"
},
"basedOn" : [
{
"reference" : "MedicationRequest/example"
}
],
"status" : "ready",
"intent" : "order",
"code" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
"code" : "complete-questionnaire"
}
]
},
"for" : {
"reference" : "Patient/example"
},
"encounter" : {
"reference" : "Encounter/example"
},
"authoredOn" : "2018-08-09",
"requester" : {
"reference" : "http://example.org/fhir/Organization/payer"
},
"reasonCode" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
"code" : "reason-prior-auth"
}
],
"text" : "Needed for prior authorization"
},
"input" : [
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
"code" : "questionnaire"
}
]
},
"valueCanonical" : "http://example.org/Questionnaire/XYZ|2"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/uv/sdc/CodeSystem/temp",
"code" : "response-endpoint"
}
]
},
"valueUrl" : "http://example.org/somePayer"
},
{
"type" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
"code" : "after-completion-action"
}
]
},
"valueCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp",
"code" : "prior-auth",
"display" : "Include in prior authorization"
}
]
}
}
]
}