Da Vinci - Coverage Requirements Discovery
2.0.1 - STU 2
Da Vinci - Coverage Requirements Discovery
2.0.1 - STU 2
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. For a full list of available versions, see the Directory of published versions
| Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/CRDMetricData | Version: 2.0.1 | |||
| Standards status: Informative | Maturity Level: 1 | Computable Name: CRDMetricData | ||
A logical model describing the information that should be captured by CRD implementers about every CRD invocation to support measures evaluating CRD implementation
This model is NOT a FHIR data structure for information exchange. Instead, it is a logical model of the information that SHOULD be collected and maintained for each CRD transaction. While implementers may choose any internal storage format that is appropriate for their system, the information collected should ultimately be mapped to the information model below.
Mapping implementation data to these elements will allow metrics (see the table on the metrics page) to be represented in a way that provides consistent responses to requirements from various interested parties (providers, payers, regulators, quality organizations, certification agencies, states, etc.) by each of the participants in the CRD exchanges.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Base
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  CRDMetricData | 0..* | Base | CRD Metric Data Instances of this logical model are not marked to be the target of a Reference | |
  source | 1..1 | code | provider-src | payer-src Binding: CRD Metric Data Source Value Set (required) | |
| hookInstance | 1..1 | string | Unique hook invocation id | |
| hookType | 1..1 | code | order-select | order-sign + Binding: CDS Hook Types Value Set (extensible) | |
  providerId | 1..1 | Identifier | User invoking hook | |
 system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
 value | 1..1 | string | The value that is unique | |
| groupId | 1..1 | Identifier | Healthcare org of user | |
| system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
| value | 1..1 | string | The value that is unique | |
| payerId | 1..1 | Identifier | Payer receiving hook | |
| system | 1..1 | uri | The namespace for the identifier value | |
| value | 1..1 | string | The value that is unique | |
| requestTime | 1..1 | instant | Time hook initiated | |
| responseTime | 0..1 | instant | Time of hook response | |
| httpResponse | 1..1 | positiveInt | e.g. 200 | |
| issue | 0..* | BackboneElement | OperationOutcome info | |
| code | 1..1 | code | Error code Binding: IssueType (required) | |
| details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
| tokenUse | 0..1 | code | used | not-used | rejected Binding: CRD Metric Token Use (example) | |
| orderDetail | 0..* | CodeableConcept | Service or product code(s) Binding: CRD Order Detail Codes Value Set (extensible) | |
| resources | 0..* | BackboneElement | Resource types accessed | |
| type | 1..1 | code | Kind of resource Binding: ResourceType (required) | |
| profile | 0..1 | canonical(StructureDefinition) | Solicited profile | |
| count | 1..1 | positiveInt | Number retrieved | |
| prefetch | 0..1 | boolean | Retrieved by prefetch? | |
 response | 0..* | BackboneElement | Returned card/system action | |
 type | 0..1 | code | Type of CRD card Binding: CRD Card Types Value Set (required) | |
| focus | 0..* | code | Resource tied to card | |
| engagement | 0..1 | code | ignore | accept | override | |
| coverageInfo | 0..* | BackboneElement | Coverage information | |
| covered | 0..1 | code | covered | not-covered | conditional Binding: CRD Coverage Information Covered Value Set (required) | |
| paNeeded | 0..1 | code | auth-needed | no-auth | satisfied + Binding: CRD Coverage Information Prior Authorization Value Set (required) | |
| docNeeded | 0..1 | code | no-doc | clinical | admin | both + Binding: CRD Coverage Information Additional Documentation Value Set (required) | |
| infoNeeded | 0..1 | code | performer | location | timeframe Binding: CRD Information Needed Value Set (required) | |
| questionnaire | 0..* | BackboneElement | Questionnaire(s) returned | |
| reference | 1..1 | canonical(Questionnaire) | Questionnaire url & version | |
| adaptive | 1..1 | boolean | Is questionnaire adaptive? | |
| response | 1..1 | boolean | Pre-pop response provided? | |
| assertionId | 1..1 | string | Id for coverage assertion | |
| satisfiedId | 0..1 | string | Id if PA is satisfied | |
| businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| CRDMetricData.source | required | MetricDataSource |
| CRDMetricData.hookType | extensible | CDSHookType |
| CRDMetricData.issue.code | required | IssueType |
| CRDMetricData.issue.details | example | OperationOutcomeCodes |
| CRDMetricData.tokenUse | example | MetricTokenUse |
| CRDMetricData.orderDetail | extensible | MetricOrderDetail |
| CRDMetricData.resources.type | required | ResourceType |
| CRDMetricData.response.type | required | CRDCardType |
| CRDMetricData.response.coverageInfo.covered | required | CRDCoveredInfo |
| CRDMetricData.response.coverageInfo.paNeeded | required | CRDCoveragePaDetail |
| CRDMetricData.response.coverageInfo.docNeeded | required | CRDAdditionalDoc |
| CRDMetricData.response.coverageInfo.infoNeeded | required | CRDInformationNeeded |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CRDMetricData | 0..* | Base | CRD Metric Data Instances of this logical model are not marked to be the target of a Reference | |
| source | 1..1 | code | provider-src | payer-src Binding: CRD Metric Data Source Value Set (required) | |
| hookInstance | 1..1 | string | Unique hook invocation id | |
| hookType | 1..1 | code | order-select | order-sign + Binding: CDS Hook Types Value Set (extensible) | |
| providerId | 1..1 | Identifier | User invoking hook | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| groupId | 1..1 | Identifier | Healthcare org of user | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| payerId | 1..1 | Identifier | Payer receiving hook | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| requestTime | 1..1 | instant | Time hook initiated | |
| responseTime | 0..1 | instant | Time of hook response | |
| httpResponse | 1..1 | positiveInt | e.g. 200 | |
| issue | 0..* | BackboneElement | OperationOutcome info | |
 modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code | 1..1 | code | Error code Binding: IssueType (required) | |
| details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
| tokenUse | 0..1 | code | used | not-used | rejected Binding: CRD Metric Token Use (example) | |
| orderDetail | 0..* | CodeableConcept | Service or product code(s) Binding: CRD Order Detail Codes Value Set (extensible) | |
| resources | 0..* | BackboneElement | Resource types accessed | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | code | Kind of resource Binding: ResourceType (required) | |
| profile | 0..1 | canonical(StructureDefinition) | Solicited profile | |
| count | 1..1 | positiveInt | Number retrieved | |
| prefetch | 0..1 | boolean | Retrieved by prefetch? | |
| response | 0..* | BackboneElement | Returned card/system action | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 0..1 | code | Type of CRD card Binding: CRD Card Types Value Set (required) | |
| focus | 0..* | code | Resource tied to card | |
| engagement | 0..1 | code | ignore | accept | override | |
| coverageInfo | 0..* | BackboneElement | Coverage information | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| covered | 0..1 | code | covered | not-covered | conditional Binding: CRD Coverage Information Covered Value Set (required) | |
| paNeeded | 0..1 | code | auth-needed | no-auth | satisfied + Binding: CRD Coverage Information Prior Authorization Value Set (required) | |
| docNeeded | 0..1 | code | no-doc | clinical | admin | both + Binding: CRD Coverage Information Additional Documentation Value Set (required) | |
| infoNeeded | 0..1 | code | performer | location | timeframe Binding: CRD Information Needed Value Set (required) | |
| questionnaire | 0..* | BackboneElement | Questionnaire(s) returned | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| reference | 1..1 | canonical(Questionnaire) | Questionnaire url & version | |
| adaptive | 1..1 | boolean | Is questionnaire adaptive? | |
| response | 1..1 | boolean | Pre-pop response provided? | |
| assertionId | 1..1 | string | Id for coverage assertion | |
| satisfiedId | 0..1 | string | Id if PA is satisfied | |
| businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| CRDMetricData.source | required | MetricDataSource |
| CRDMetricData.hookType | extensible | CDSHookType |
| CRDMetricData.providerId.use | required | IdentifierUse |
| CRDMetricData.groupId.use | required | IdentifierUse |
| CRDMetricData.payerId.use | required | IdentifierUse |
| CRDMetricData.issue.code | required | IssueType |
| CRDMetricData.issue.details | example | OperationOutcomeCodes |
| CRDMetricData.tokenUse | example | MetricTokenUse |
| CRDMetricData.orderDetail | extensible | MetricOrderDetail |
| CRDMetricData.resources.type | required | ResourceType |
| CRDMetricData.response.type | required | CRDCardType |
| CRDMetricData.response.coverageInfo.covered | required | CRDCoveredInfo |
| CRDMetricData.response.coverageInfo.paNeeded | required | CRDCoveragePaDetail |
| CRDMetricData.response.coverageInfo.docNeeded | required | CRDAdditionalDoc |
| CRDMetricData.response.coverageInfo.infoNeeded | required | CRDInformationNeeded |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CRDMetricData | 0..* | Base | CRD Metric Data Instances of this logical model are not marked to be the target of a Reference | |
| source | 1..1 | code | provider-src | payer-src Binding: CRD Metric Data Source Value Set (required) | |
| hookInstance | 1..1 | string | Unique hook invocation id | |
| hookType | 1..1 | code | order-select | order-sign + Binding: CDS Hook Types Value Set (extensible) | |
| providerId | 1..1 | Identifier | User invoking hook | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
 extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
 assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| groupId | 1..1 | Identifier | Healthcare org of user | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| payerId | 1..1 | Identifier | Payer receiving hook | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| requestTime | 1..1 | instant | Time hook initiated | |
| responseTime | 0..1 | instant | Time of hook response | |
| httpResponse | 1..1 | positiveInt | e.g. 200 | |
| issue | 0..* | BackboneElement | OperationOutcome info | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code | 1..1 | code | Error code Binding: IssueType (required) | |
| details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
| tokenUse | 0..1 | code | used | not-used | rejected Binding: CRD Metric Token Use (example) | |
| orderDetail | 0..* | CodeableConcept | Service or product code(s) Binding: CRD Order Detail Codes Value Set (extensible) | |
| resources | 0..* | BackboneElement | Resource types accessed | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | code | Kind of resource Binding: ResourceType (required) | |
| profile | 0..1 | canonical(StructureDefinition) | Solicited profile | |
| count | 1..1 | positiveInt | Number retrieved | |
| prefetch | 0..1 | boolean | Retrieved by prefetch? | |
| response | 0..* | BackboneElement | Returned card/system action | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 0..1 | code | Type of CRD card Binding: CRD Card Types Value Set (required) | |
| focus | 0..* | code | Resource tied to card | |
| engagement | 0..1 | code | ignore | accept | override | |
| coverageInfo | 0..* | BackboneElement | Coverage information | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| covered | 0..1 | code | covered | not-covered | conditional Binding: CRD Coverage Information Covered Value Set (required) | |
| paNeeded | 0..1 | code | auth-needed | no-auth | satisfied + Binding: CRD Coverage Information Prior Authorization Value Set (required) | |
| docNeeded | 0..1 | code | no-doc | clinical | admin | both + Binding: CRD Coverage Information Additional Documentation Value Set (required) | |
| infoNeeded | 0..1 | code | performer | location | timeframe Binding: CRD Information Needed Value Set (required) | |
| questionnaire | 0..* | BackboneElement | Questionnaire(s) returned | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| reference | 1..1 | canonical(Questionnaire) | Questionnaire url & version | |
| adaptive | 1..1 | boolean | Is questionnaire adaptive? | |
| response | 1..1 | boolean | Pre-pop response provided? | |
| assertionId | 1..1 | string | Id for coverage assertion | |
| satisfiedId | 0..1 | string | Id if PA is satisfied | |
| businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| CRDMetricData.source | required | MetricDataSource |
| CRDMetricData.hookType | extensible | CDSHookType |
| CRDMetricData.providerId.use | required | IdentifierUse |
| CRDMetricData.providerId.type | extensible | Identifier Type Codes |
| CRDMetricData.groupId.use | required | IdentifierUse |
| CRDMetricData.groupId.type | extensible | Identifier Type Codes |
| CRDMetricData.payerId.use | required | IdentifierUse |
| CRDMetricData.payerId.type | extensible | Identifier Type Codes |
| CRDMetricData.issue.code | required | IssueType |
| CRDMetricData.issue.details | example | OperationOutcomeCodes |
| CRDMetricData.tokenUse | example | MetricTokenUse |
| CRDMetricData.orderDetail | extensible | MetricOrderDetail |
| CRDMetricData.resources.type | required | ResourceType |
| CRDMetricData.response.type | required | CRDCardType |
| CRDMetricData.response.coverageInfo.covered | required | CRDCoveredInfo |
| CRDMetricData.response.coverageInfo.paNeeded | required | CRDCoveragePaDetail |
| CRDMetricData.response.coverageInfo.docNeeded | required | CRDAdditionalDoc |
| CRDMetricData.response.coverageInfo.infoNeeded | required | CRDInformationNeeded |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Differential View
This structure is derived from Base
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CRDMetricData | 0..* | Base | CRD Metric Data Instances of this logical model are not marked to be the target of a Reference | |
| source | 1..1 | code | provider-src | payer-src Binding: CRD Metric Data Source Value Set (required) | |
| hookInstance | 1..1 | string | Unique hook invocation id | |
| hookType | 1..1 | code | order-select | order-sign + Binding: CDS Hook Types Value Set (extensible) | |
| providerId | 1..1 | Identifier | User invoking hook | |
| system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
| value | 1..1 | string | The value that is unique | |
| groupId | 1..1 | Identifier | Healthcare org of user | |
| system | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi | |
| value | 1..1 | string | The value that is unique | |
| payerId | 1..1 | Identifier | Payer receiving hook | |
| system | 1..1 | uri | The namespace for the identifier value | |
| value | 1..1 | string | The value that is unique | |
| requestTime | 1..1 | instant | Time hook initiated | |
| responseTime | 0..1 | instant | Time of hook response | |
| httpResponse | 1..1 | positiveInt | e.g. 200 | |
| issue | 0..* | BackboneElement | OperationOutcome info | |
| code | 1..1 | code | Error code Binding: IssueType (required) | |
| details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
| tokenUse | 0..1 | code | used | not-used | rejected Binding: CRD Metric Token Use (example) | |
| orderDetail | 0..* | CodeableConcept | Service or product code(s) Binding: CRD Order Detail Codes Value Set (extensible) | |
| resources | 0..* | BackboneElement | Resource types accessed | |
| type | 1..1 | code | Kind of resource Binding: ResourceType (required) | |
| profile | 0..1 | canonical(StructureDefinition) | Solicited profile | |
| count | 1..1 | positiveInt | Number retrieved | |
| prefetch | 0..1 | boolean | Retrieved by prefetch? | |
| response | 0..* | BackboneElement | Returned card/system action | |
| type | 0..1 | code | Type of CRD card Binding: CRD Card Types Value Set (required) | |
| focus | 0..* | code | Resource tied to card | |
| engagement | 0..1 | code | ignore | accept | override | |
| coverageInfo | 0..* | BackboneElement | Coverage information | |
| covered | 0..1 | code | covered | not-covered | conditional Binding: CRD Coverage Information Covered Value Set (required) | |
| paNeeded | 0..1 | code | auth-needed | no-auth | satisfied + Binding: CRD Coverage Information Prior Authorization Value Set (required) | |
| docNeeded | 0..1 | code | no-doc | clinical | admin | both + Binding: CRD Coverage Information Additional Documentation Value Set (required) | |
| infoNeeded | 0..1 | code | performer | location | timeframe Binding: CRD Information Needed Value Set (required) | |
| questionnaire | 0..* | BackboneElement | Questionnaire(s) returned | |
| reference | 1..1 | canonical(Questionnaire) | Questionnaire url & version | |
| adaptive | 1..1 | boolean | Is questionnaire adaptive? | |
| response | 1..1 | boolean | Pre-pop response provided? | |
| assertionId | 1..1 | string | Id for coverage assertion | |
| satisfiedId | 0..1 | string | Id if PA is satisfied | |
| businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| CRDMetricData.source | required | MetricDataSource |
| CRDMetricData.hookType | extensible | CDSHookType |
| CRDMetricData.issue.code | required | IssueType |
| CRDMetricData.issue.details | example | OperationOutcomeCodes |
| CRDMetricData.tokenUse | example | MetricTokenUse |
| CRDMetricData.orderDetail | extensible | MetricOrderDetail |
| CRDMetricData.resources.type | required | ResourceType |
| CRDMetricData.response.type | required | CRDCardType |
| CRDMetricData.response.coverageInfo.covered | required | CRDCoveredInfo |
| CRDMetricData.response.coverageInfo.paNeeded | required | CRDCoveragePaDetail |
| CRDMetricData.response.coverageInfo.docNeeded | required | CRDAdditionalDoc |
| CRDMetricData.response.coverageInfo.infoNeeded | required | CRDInformationNeeded |
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CRDMetricData | 0..* | Base | CRD Metric Data Instances of this logical model are not marked to be the target of a Reference | |
| source | 1..1 | code | provider-src | payer-src Binding: CRD Metric Data Source Value Set (required) | |
| hookInstance | 1..1 | string | Unique hook invocation id | |
| hookType | 1..1 | code | order-select | order-sign + Binding: CDS Hook Types Value Set (extensible) | |
| providerId | 1..1 | Identifier | User invoking hook | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| groupId | 1..1 | Identifier | Healthcare org of user | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| payerId | 1..1 | Identifier | Payer receiving hook | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| requestTime | 1..1 | instant | Time hook initiated | |
| responseTime | 0..1 | instant | Time of hook response | |
| httpResponse | 1..1 | positiveInt | e.g. 200 | |
| issue | 0..* | BackboneElement | OperationOutcome info | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code | 1..1 | code | Error code Binding: IssueType (required) | |
| details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
| tokenUse | 0..1 | code | used | not-used | rejected Binding: CRD Metric Token Use (example) | |
| orderDetail | 0..* | CodeableConcept | Service or product code(s) Binding: CRD Order Detail Codes Value Set (extensible) | |
| resources | 0..* | BackboneElement | Resource types accessed | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | code | Kind of resource Binding: ResourceType (required) | |
| profile | 0..1 | canonical(StructureDefinition) | Solicited profile | |
| count | 1..1 | positiveInt | Number retrieved | |
| prefetch | 0..1 | boolean | Retrieved by prefetch? | |
| response | 0..* | BackboneElement | Returned card/system action | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 0..1 | code | Type of CRD card Binding: CRD Card Types Value Set (required) | |
| focus | 0..* | code | Resource tied to card | |
| engagement | 0..1 | code | ignore | accept | override | |
| coverageInfo | 0..* | BackboneElement | Coverage information | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| covered | 0..1 | code | covered | not-covered | conditional Binding: CRD Coverage Information Covered Value Set (required) | |
| paNeeded | 0..1 | code | auth-needed | no-auth | satisfied + Binding: CRD Coverage Information Prior Authorization Value Set (required) | |
| docNeeded | 0..1 | code | no-doc | clinical | admin | both + Binding: CRD Coverage Information Additional Documentation Value Set (required) | |
| infoNeeded | 0..1 | code | performer | location | timeframe Binding: CRD Information Needed Value Set (required) | |
| questionnaire | 0..* | BackboneElement | Questionnaire(s) returned | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| reference | 1..1 | canonical(Questionnaire) | Questionnaire url & version | |
| adaptive | 1..1 | boolean | Is questionnaire adaptive? | |
| response | 1..1 | boolean | Pre-pop response provided? | |
| assertionId | 1..1 | string | Id for coverage assertion | |
| satisfiedId | 0..1 | string | Id if PA is satisfied | |
| businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| CRDMetricData.source | required | MetricDataSource |
| CRDMetricData.hookType | extensible | CDSHookType |
| CRDMetricData.providerId.use | required | IdentifierUse |
| CRDMetricData.groupId.use | required | IdentifierUse |
| CRDMetricData.payerId.use | required | IdentifierUse |
| CRDMetricData.issue.code | required | IssueType |
| CRDMetricData.issue.details | example | OperationOutcomeCodes |
| CRDMetricData.tokenUse | example | MetricTokenUse |
| CRDMetricData.orderDetail | extensible | MetricOrderDetail |
| CRDMetricData.resources.type | required | ResourceType |
| CRDMetricData.response.type | required | CRDCardType |
| CRDMetricData.response.coverageInfo.covered | required | CRDCoveredInfo |
| CRDMetricData.response.coverageInfo.paNeeded | required | CRDCoveragePaDetail |
| CRDMetricData.response.coverageInfo.docNeeded | required | CRDAdditionalDoc |
| CRDMetricData.response.coverageInfo.infoNeeded | required | CRDInformationNeeded |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CRDMetricData | 0..* | Base | CRD Metric Data Instances of this logical model are not marked to be the target of a Reference | |
| source | 1..1 | code | provider-src | payer-src Binding: CRD Metric Data Source Value Set (required) | |
| hookInstance | 1..1 | string | Unique hook invocation id | |
| hookType | 1..1 | code | order-select | order-sign + Binding: CDS Hook Types Value Set (extensible) | |
| providerId | 1..1 | Identifier | User invoking hook | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| groupId | 1..1 | Identifier | Healthcare org of user | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 0..1 | uri | The namespace for the identifier value Required Pattern: http://hl7.org/fhir/sid/us-npi |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| payerId | 1..1 | Identifier | Payer receiving hook | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . |
| type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 1..1 | uri | The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient |
| value | Σ | 1..1 | string | The value that is unique Example General: 123456 |
| period | Σ | 0..1 | Period | Time period when id is/was valid for use |
| assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text) |
| requestTime | 1..1 | instant | Time hook initiated | |
| responseTime | 0..1 | instant | Time of hook response | |
| httpResponse | 1..1 | positiveInt | e.g. 200 | |
| issue | 0..* | BackboneElement | OperationOutcome info | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code | 1..1 | code | Error code Binding: IssueType (required) | |
| details | 0..1 | CodeableConcept | More detailed error code Binding: OperationOutcomeCodes (example) | |
| tokenUse | 0..1 | code | used | not-used | rejected Binding: CRD Metric Token Use (example) | |
| orderDetail | 0..* | CodeableConcept | Service or product code(s) Binding: CRD Order Detail Codes Value Set (extensible) | |
| resources | 0..* | BackboneElement | Resource types accessed | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | code | Kind of resource Binding: ResourceType (required) | |
| profile | 0..1 | canonical(StructureDefinition) | Solicited profile | |
| count | 1..1 | positiveInt | Number retrieved | |
| prefetch | 0..1 | boolean | Retrieved by prefetch? | |
| response | 0..* | BackboneElement | Returned card/system action | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 0..1 | code | Type of CRD card Binding: CRD Card Types Value Set (required) | |
| focus | 0..* | code | Resource tied to card | |
| engagement | 0..1 | code | ignore | accept | override | |
| coverageInfo | 0..* | BackboneElement | Coverage information | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| covered | 0..1 | code | covered | not-covered | conditional Binding: CRD Coverage Information Covered Value Set (required) | |
| paNeeded | 0..1 | code | auth-needed | no-auth | satisfied + Binding: CRD Coverage Information Prior Authorization Value Set (required) | |
| docNeeded | 0..1 | code | no-doc | clinical | admin | both + Binding: CRD Coverage Information Additional Documentation Value Set (required) | |
| infoNeeded | 0..1 | code | performer | location | timeframe Binding: CRD Information Needed Value Set (required) | |
| questionnaire | 0..* | BackboneElement | Questionnaire(s) returned | |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| reference | 1..1 | canonical(Questionnaire) | Questionnaire url & version | |
| adaptive | 1..1 | boolean | Is questionnaire adaptive? | |
| response | 1..1 | boolean | Pre-pop response provided? | |
| assertionId | 1..1 | string | Id for coverage assertion | |
| satisfiedId | 0..1 | string | Id if PA is satisfied | |
| businessLine | 0..1 | CodeableConcept | E.g. MedicareAdvantage | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| CRDMetricData.source | required | MetricDataSource |
| CRDMetricData.hookType | extensible | CDSHookType |
| CRDMetricData.providerId.use | required | IdentifierUse |
| CRDMetricData.providerId.type | extensible | Identifier Type Codes |
| CRDMetricData.groupId.use | required | IdentifierUse |
| CRDMetricData.groupId.type | extensible | Identifier Type Codes |
| CRDMetricData.payerId.use | required | IdentifierUse |
| CRDMetricData.payerId.type | extensible | Identifier Type Codes |
| CRDMetricData.issue.code | required | IssueType |
| CRDMetricData.issue.details | example | OperationOutcomeCodes |
| CRDMetricData.tokenUse | example | MetricTokenUse |
| CRDMetricData.orderDetail | extensible | MetricOrderDetail |
| CRDMetricData.resources.type | required | ResourceType |
| CRDMetricData.response.type | required | CRDCardType |
| CRDMetricData.response.coverageInfo.covered | required | CRDCoveredInfo |
| CRDMetricData.response.coverageInfo.paNeeded | required | CRDCoveragePaDetail |
| CRDMetricData.response.coverageInfo.docNeeded | required | CRDAdditionalDoc |
| CRDMetricData.response.coverageInfo.infoNeeded | required | CRDInformationNeeded |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
IG © 2019+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-crd#2.0.1 based on FHIR 4.0.1. Generated 2024-01-08
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