Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0-preview - STU 2 United States of America flag

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.1.0-preview: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.1. For a full list of available versions, see the Directory of published versions

Resource Profile: PAS CommunicationRequest

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest Version: 2.1.0-preview
Standards status: Trial-use Maturity Level: 3 Computable Name: PASCommunicationRequest

PAS constraints on CommunicationRequest resource mandating support for elements relevant to the prior authorization response

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from CommunicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest CommunicationRequest
... identifier S 0..* Identifier Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
... status 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Fixed Value: active
... category S 0..* CodeableConcept Message category
Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

... payload S 0..* BackboneElement Message payload
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... serviceLineNumber S 0..1 positiveInt Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber
..... communicatedDiagnosis S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis
Binding: X12 278 Diagnosis Code Value Set (required)
..... contentModifier S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier
Binding: X12 278 Diagnosis Information Type (required)
.... content[x] S 1..1 string Message part content
... requester S 0..1 Reference(PAS Insurer Organization) Who/what is requesting service
... recipient S 0..* Reference(PAS Practitioner | PAS Organization Base Profile) Message recipient
... sender S 0..1 Reference(PAS Requestor Organization) Message sender

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
CommunicationRequest.categoryrequiredhttps://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
CommunicationRequest.mediumextensiblePASCommunicationRequestMedium
http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest 0..* CommunicationRequest A request for information to be sent to a receiver
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
... category S 0..* CodeableConcept Message category
Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... medium S 0..* CodeableConcept A channel of communication
Binding: PAS Communication Medium Value Set (extensible)
... payload S 0..* BackboneElement Message payload
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... serviceLineNumber S 0..1 positiveInt Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber
..... communicatedDiagnosis S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis
Binding: X12 278 Diagnosis Code Value Set (required)
..... contentModifier S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier
Binding: X12 278 Diagnosis Information Type (required)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... content[x] S 1..1 string Message part content
... requester SΣ 0..1 Reference(PAS Insurer Organization) Who/what is requesting service
... recipient S 0..* Reference(PAS Practitioner | PAS Organization Base Profile) Message recipient
... sender SΣ 0..1 Reference(PAS Requestor Organization) Message sender

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CommunicationRequest.statusrequiredFixed Value: active
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
CommunicationRequest.categoryrequiredhttps://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
CommunicationRequest.mediumextensiblePASCommunicationRequestMedium
http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest 0..* CommunicationRequest A request for information to be sent to a receiver
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
... basedOn Σ 0..* Reference(Resource) Fulfills plan or proposal
... replaces Σ 0..* Reference(CommunicationRequest) Request(s) replaced by this request
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... status ?!Σ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of the communication request.


Fixed Value: active
... statusReason 0..1 CodeableConcept Reason for current status
Binding Description (No ValueSet): (example): Codes identifying the reason for the current state of a request.

... category S 0..* CodeableConcept Message category
Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Codes indicating the relative importance of a communication request.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... medium S 0..* CodeableConcept A channel of communication
Binding: PAS Communication Medium Value Set (extensible)
... subject 0..1 Reference(Patient | Group) Focus of message
... about 0..* Reference(Resource) Resources that pertain to this communication request
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... payload S 0..* BackboneElement Message payload
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... serviceLineNumber S 0..1 positiveInt Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber
..... communicatedDiagnosis S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis
Binding: X12 278 Diagnosis Code Value Set (required)
..... contentModifier S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier
Binding: X12 278 Diagnosis Information Type (required)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... content[x] S 1..1 string Message part content
... occurrence[x] Σ 0..1 When scheduled
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
... authoredOn Σ 0..1 dateTime When request transitioned to being actionable
... requester SΣ 0..1 Reference(PAS Insurer Organization) Who/what is requesting service
... recipient S 0..* Reference(PAS Practitioner | PAS Organization Base Profile) Message recipient
... sender SΣ 0..1 Reference(PAS Requestor Organization) Message sender
... reasonCode Σ 0..* CodeableConcept Why is communication needed?
Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication.


... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why is communication needed?
... note 0..* Annotation Comments made about communication request

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CommunicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
CommunicationRequest.statusrequiredFixed Value: active
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
CommunicationRequest.statusReasonexample
CommunicationRequest.categoryrequiredhttps://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
CommunicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
CommunicationRequest.mediumextensiblePASCommunicationRequestMedium
http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium
from this IG
CommunicationRequest.reasonCodeexampleActReason
http://terminology.hl7.org/ValueSet/v3-ActReason

Differential View

This structure is derived from CommunicationRequest

NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest CommunicationRequest
... identifier S 0..* Identifier Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
... status 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Fixed Value: active
... category S 0..* CodeableConcept Message category
Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.

... payload S 0..* BackboneElement Message payload
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... serviceLineNumber S 0..1 positiveInt Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber
..... communicatedDiagnosis S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis
Binding: X12 278 Diagnosis Code Value Set (required)
..... contentModifier S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier
Binding: X12 278 Diagnosis Information Type (required)
.... content[x] S 1..1 string Message part content
... requester S 0..1 Reference(PAS Insurer Organization) Who/what is requesting service
... recipient S 0..* Reference(PAS Practitioner | PAS Organization Base Profile) Message recipient
... sender S 0..1 Reference(PAS Requestor Organization) Message sender

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
CommunicationRequest.categoryrequiredhttps://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
CommunicationRequest.mediumextensiblePASCommunicationRequestMedium
http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest 0..* CommunicationRequest A request for information to be sent to a receiver
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
... category S 0..* CodeableConcept Message category
Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... medium S 0..* CodeableConcept A channel of communication
Binding: PAS Communication Medium Value Set (extensible)
... payload S 0..* BackboneElement Message payload
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... serviceLineNumber S 0..1 positiveInt Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber
..... communicatedDiagnosis S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis
Binding: X12 278 Diagnosis Code Value Set (required)
..... contentModifier S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier
Binding: X12 278 Diagnosis Information Type (required)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... content[x] S 1..1 string Message part content
... requester SΣ 0..1 Reference(PAS Insurer Organization) Who/what is requesting service
... recipient S 0..* Reference(PAS Practitioner | PAS Organization Base Profile) Message recipient
... sender SΣ 0..1 Reference(PAS Requestor Organization) Message sender

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CommunicationRequest.statusrequiredFixed Value: active
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
CommunicationRequest.categoryrequiredhttps://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
CommunicationRequest.mediumextensiblePASCommunicationRequestMedium
http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium
from this IG

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. CommunicationRequest 0..* CommunicationRequest A request for information to be sent to a receiver
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier SΣ 0..* Identifier Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).
... basedOn Σ 0..* Reference(Resource) Fulfills plan or proposal
... replaces Σ 0..* Reference(CommunicationRequest) Request(s) replaced by this request
... groupIdentifier Σ 0..1 Identifier Composite request this is part of
... status ?!Σ 1..1 code draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of the communication request.


Fixed Value: active
... statusReason 0..1 CodeableConcept Reason for current status
Binding Description (No ValueSet): (example): Codes identifying the reason for the current state of a request.

... category S 0..* CodeableConcept Message category
Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required): Codes indicating the title or contents of a document, report or supporting item. These codes are listed within an X12 implementation guide (TR3) and maintained by X12. All X12 work products are copyrighted. See their website for licensing terms and conditions.


... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Codes indicating the relative importance of a communication request.

... doNotPerform ?!Σ 0..1 boolean True if request is prohibiting action
... medium S 0..* CodeableConcept A channel of communication
Binding: PAS Communication Medium Value Set (extensible)
... subject 0..1 Reference(Patient | Group) Focus of message
... about 0..* Reference(Resource) Resources that pertain to this communication request
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... payload S 0..* BackboneElement Message payload
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... serviceLineNumber S 0..1 positiveInt Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber
..... communicatedDiagnosis S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis
Binding: X12 278 Diagnosis Code Value Set (required)
..... contentModifier S 0..* CodeableConcept Extension
URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-contentModifier
Binding: X12 278 Diagnosis Information Type (required)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... content[x] S 1..1 string Message part content
... occurrence[x] Σ 0..1 When scheduled
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
... authoredOn Σ 0..1 dateTime When request transitioned to being actionable
... requester SΣ 0..1 Reference(PAS Insurer Organization) Who/what is requesting service
... recipient S 0..* Reference(PAS Practitioner | PAS Organization Base Profile) Message recipient
... sender SΣ 0..1 Reference(PAS Requestor Organization) Message sender
... reasonCode Σ 0..* CodeableConcept Why is communication needed?
Binding: v3 Code System ActReason (example): Codes for describing reasons for the occurrence of a communication.


... reasonReference Σ 0..* Reference(Condition | Observation | DiagnosticReport | DocumentReference) Why is communication needed?
... note 0..* Annotation Comments made about communication request

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
CommunicationRequest.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
CommunicationRequest.statusrequiredFixed Value: active
http://hl7.org/fhir/ValueSet/request-status|4.0.1
from the FHIR Standard
CommunicationRequest.statusReasonexample
CommunicationRequest.categoryrequiredhttps://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755
CommunicationRequest.priorityrequiredRequestPriority
http://hl7.org/fhir/ValueSet/request-priority|4.0.1
from the FHIR Standard
CommunicationRequest.mediumextensiblePASCommunicationRequestMedium
http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium
from this IG
CommunicationRequest.reasonCodeexampleActReason
http://terminology.hl7.org/ValueSet/v3-ActReason

 

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