Da Vinci Prior Authorization Support (PAS) FHIR IG
1.2.0-ballot - STU 1.2 US

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.2.0-ballot: STU 1.2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions

Resource Profile: PASCommunicationRequest - Detailed Descriptions

Active as of 2022-02-17

Definitions for the profile-communicationrequest resource profile.

1. CommunicationRequest
Definition

A request to convey information; e.g. the CDS system proposes that an alert be sent to a responsible provider, the CDS system proposes that the public health agency be notified about a reportable condition.

Control0..*
InvariantsDefined on this element
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. CommunicationRequest.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typestring
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

3. CommunicationRequest.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Control0..1
TypeMeta
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. CommunicationRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. CommunicationRequest.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
Max Binding: AllLanguages A human language.

Typecode
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. CommunicationRequest.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. CommunicationRequest.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

8. CommunicationRequest.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
9. CommunicationRequest.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. CommunicationRequest.identifier
Definition

Business identifiers assigned to this communication request by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Must Supporttrue
Requirements

Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers.

Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. CommunicationRequest.basedOn
Definition

A plan or proposal that is fulfilled in whole or in part by this request.

Control0..*
TypeReference(Resource)
Requirements

Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.

Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. CommunicationRequest.replaces
Definition

Completed or terminated request(s) whose function is taken by this new request.

Control0..*
TypeReference(CommunicationRequest)
Requirements

Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests.

Alternate Namessupersedes, prior
Comments

The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. CommunicationRequest.groupIdentifier
Definition

A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form.

Control0..1
TypeIdentifier
Alternate NamesgrouperId
Comments

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. CommunicationRequest.status
Definition

The status of the proposal or order.

Control1..1
BindingThe codes SHALL be taken from RequestStatus The status of the communication request.

Typecode
Is Modifiertrue
Fixed Valueactive
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. CommunicationRequest.statusReason
Definition

Captures the reason for the current state of the CommunicationRequest.

Control0..1
Binding

Codes identifying the reason for the current state of a request.

TypeCodeableConcept
Alternate NamesSuspended Reason, Cancelled Reason
Comments

This is generally only used for "exception" statuses such as "suspended" or "cancelled". The reason why the CommunicationRequest was created at all is captured in reasonCode, not here. [distinct reason codes for different statuses can be enforced using invariants if they are universal bindings].

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. CommunicationRequest.category
Definition

The type of message to be sent such as alert, notification, reminder, instruction, etc.

Control0..*
BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 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.

TypeCodeableConcept
Must Supporttrue
Comments

There may be multiple axes of categorization and one communication request may serve multiple purposes.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. CommunicationRequest.priority
Definition

Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine.

Control0..1
BindingThe codes SHALL be taken from RequestPriority Codes indicating the relative importance of a communication request.

Typecode
Meaning if MissingIf missing, this task should be performed with normal priority
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. CommunicationRequest.doNotPerform
Definition

If true indicates that the CommunicationRequest is asking for the specified action to not occur.

Control0..1
Typeboolean
Is Modifiertrue
Alternate Namesprohibited
Comments

The attributes provided with the request qualify what is not to be done.

Meaning if MissingIf do not perform is not specified, the request is a positive request e.g. "do perform"
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. CommunicationRequest.medium
Definition

A channel that was used for this communication (e.g. email, fax).

Control0..*
BindingThe codes SHALL be taken from https://valueset.x12.org/x217/005010/response/2000D/PWK/1/02/00/756 Codes defining timing, transmission method or format by which reports are to be sent. 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.

TypeCodeableConcept
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. CommunicationRequest.subject
Definition

The patient or group that is the focus of this communication request.

Control0..1
TypeReference(Patient | Group)
Alternate Namespatient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. CommunicationRequest.about
Definition

Other resources that pertain to this communication request and to which this communication request should be associated.

Control0..*
TypeReference(Resource)
Comments

Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. CommunicationRequest.encounter
Definition

The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated.

Control0..1
TypeReference(Encounter)
Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. CommunicationRequest.payload
Definition

Text, attachment(s), or resource(s) to be communicated to the recipient.

Control0..*
TypeBackboneElement
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. CommunicationRequest.payload.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
25. CommunicationRequest.payload.extension
Definition

An Extension

Control0..*
TypeExtension
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on CommunicationRequest.payload.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
26. CommunicationRequest.payload.extension:serviceLineNumber
SliceNameserviceLineNumber
Definition

A number that links the content being requested with the claim item number.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(ServiceLineNumber) (Extension Type: positiveInt)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
27. CommunicationRequest.payload.extension:communicatedDiagnosis
SliceNamecommunicatedDiagnosis
Definition

A code representing the diagnosis that is the subject of the communication

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(CommunicatedDiagnosis) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
28. CommunicationRequest.payload.extension:contentModifier
SliceNamecontentModifier
Definition

A code representing a modifier of the content being requested

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ContentModifier) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
29. CommunicationRequest.payload.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
30. CommunicationRequest.payload.content[x]
Definition

The communicated content (or for multi-part communications, one portion of the communication).

Control1..1
Typestring
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. CommunicationRequest.occurrence[x]
Definition

The time when this communication is to occur.

Control0..1
TypeChoice of: dateTime, Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Alternate Namestiming
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. CommunicationRequest.authoredOn
Definition

For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation.

Control0..1
TypedateTime
Alternate NamescreatedOn
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. CommunicationRequest.requester
Definition

The device, individual, or organization who initiated the request and has responsibility for its activation.

Control0..1
TypeReference(PASInsurer)
Must Supporttrue
Alternate Namesauthor
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. CommunicationRequest.recipient
Definition

The entity (e.g. person, organization, clinical information system, device, group, or care team) which is the intended target of the communication.

Control0..*
TypeReference(PASPractitioner | PASOrganization)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. CommunicationRequest.sender
Definition

The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication.

Control0..1
TypeReference(PASRequestor)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. CommunicationRequest.reasonCode
Definition

Describes why the request is being made in coded or textual form.

Control0..*
BindingFor example codes, see v3 Code System ActReason Codes for describing reasons for the occurrence of a communication.

TypeCodeableConcept
Comments

Textual reasons can be captured using reasonCode.text.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. CommunicationRequest.reasonReference
Definition

Indicates another resource whose existence justifies this request.

Control0..*
TypeReference(Condition | Observation | DiagnosticReport | DocumentReference)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. CommunicationRequest.note
Definition

Comments made about the request by the requester, sender, recipient, subject or other participants.

Control0..*
TypeAnnotation
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))