This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.0.1: STU 2.0) based on FHIR (HL7® FHIR® Standard) 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

• Narrative Content
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: Questionnaire Task example - XML Representation

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<Task xmlns="http://hl7.org/fhir">
  <id value="questionnaire-example"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Task</b><a name="questionnaire-example"> </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 &quot;questionnaire-example&quot; </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/STU3/CodeSystem-temp.html">Temporary SDC Codes</a>#complete-questionnaire)</span></p><p><b>for</b>: <a href="Patient-example.html">Patient/example</a> &quot; SHAW&quot;</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/STU3/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/STU3/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>: After-completion action <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-include)</span></p></blockquote></div>
  </text>
  <basedOn>🔗 
    <reference value="MedicationRequest/example"/>
  </basedOn>
  <status value="ready"/>
  <intent value="order"/>
  <code>
    <coding>
      <system value="http://hl7.org/fhir/uv/sdc/CodeSystem/temp"/>
      <code value="complete-questionnaire"/>
    </coding>
  </code>
  <for>🔗 
    <reference value="Patient/example"/>
  </for>
  <encounter>🔗 
    <reference value="Encounter/example"/>
  </encounter>
  <authoredOn value="2018-08-09"/>
  <requester>
    <reference value="http://example.org/fhir/Organization/payer"/>
  </requester>
  <reasonCode>
    <coding>
      <system value="http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp"/>
      <code value="reason-prior-auth"/>
    </coding>
    <text value="Needed for prior authorization"/>
  </reasonCode>
  <input>
    <type>
      <coding>
        <system value="http://hl7.org/fhir/uv/sdc/CodeSystem/temp"/>
        <code value="questionnaire"/>
      </coding>
    </type>
    <valueCanonical value="http://example.org/Questionnaire/XYZ|2"/>
  </input>
  <input>
    <type>
      <coding>
        <system value="http://hl7.org/fhir/uv/sdc/CodeSystem/temp"/>
        <code value="response-endpoint"/>
      </coding>
    </type>
    <valueUrl value="http://example.org/somePayer"/>
  </input>
  <input>
    <type>
      <coding>
        <system value="http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp"/>
        <code value="after-completion-action"/>
      </coding>
    </type>
    <valueCodeableConcept>
      <coding>
        <system value="http://hl7.org/fhir/us/davinci-crd/CodeSystem/temp"/>
        <code value="prior-auth-include"/>
        <display value="Include in prior authorization"/>
      </coding>
    </valueCodeableConcept>
  </input>
</Task>