Da Vinci Prior Authorization Support (PAS) FHIR IG
1.2.0-ballot - STU 1.2
US
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 
| Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest | Version: 1.2.0-ballot | |||
| Active as of 2022-02-17 | Computable Name: PASCommunicationRequest | |||
PAS constraints on CommunicationRequest resource mandating support for elements relevant to the prior authorization response
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from CommunicationRequest
Summary
Must-Support: 11 elements
Fixed Value: 1 element
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
This structure is derived from CommunicationRequest
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  CommunicationRequest | 0..* | CommunicationRequest | A request for information to be sent to a receiver | |
  identifier | S | 0..* | Identifier | Unique identifier |
| 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. |
| medium | S | 0..* | CodeableConcept | A channel of communication Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/02/00/756 (required): 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. |
 payload | S | 0..* | BackboneElement | Message payload |
  Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
 extension-serviceLineNumber | S | 0..1 | positiveInt | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber |
| extension-communicatedDiagnosis | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis Binding: X12 278 Diagnosis Code Value Set (required) |
| extension-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 |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CommunicationRequest | 0..* | CommunicationRequest | A request for information to be sent to a receiver | |
| id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language. | |
| 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 |
| 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: (unbound) (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: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/02/00/756 (required): 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. |
| 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 | |
| extension-serviceLineNumber | S | 0..1 | positiveInt | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber |
| extension-communicatedDiagnosis | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis Binding: X12 278 Diagnosis Code Value Set (required) |
| extension-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 | |
| Documentation for this format | ||||
This structure is derived from CommunicationRequest
Summary
Must-Support: 11 elements
Fixed Value: 1 element
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Differential View
This structure is derived from CommunicationRequest
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CommunicationRequest | 0..* | CommunicationRequest | A request for information to be sent to a receiver | |
| identifier | S | 0..* | Identifier | Unique identifier |
| 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. |
| medium | S | 0..* | CodeableConcept | A channel of communication Binding: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/02/00/756 (required): 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. |
| payload | S | 0..* | BackboneElement | Message payload |
| Slices for extension | 0..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension-serviceLineNumber | S | 0..1 | positiveInt | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber |
| extension-communicatedDiagnosis | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis Binding: X12 278 Diagnosis Code Value Set (required) |
| extension-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 |
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| CommunicationRequest | 0..* | CommunicationRequest | A request for information to be sent to a receiver | |
| id | Σ | 0..1 | string | 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) Max Binding: AllLanguages: A human language. | |
| 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 |
| 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: (unbound) (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: https://valueset.x12.org/x217/005010/response/2000D/PWK/1/02/00/756 (required): 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. |
| 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 | |
| extension-serviceLineNumber | S | 0..1 | positiveInt | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber |
| extension-communicatedDiagnosis | S | 0..* | CodeableConcept | Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis Binding: X12 278 Diagnosis Code Value Set (required) |
| extension-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 | |
| Documentation for this format | ||||
Other representations of profile: CSV, Excel, Schematron
| Path | Conformance | ValueSet / Code |
| CommunicationRequest.language | preferred | CommonLanguages Max Binding: AllLanguages |
| CommunicationRequest.status | required | Fixed Value: active |
| CommunicationRequest.statusReason | example | |
| CommunicationRequest.category | required | https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 |
| CommunicationRequest.priority | required | RequestPriority |
| CommunicationRequest.medium | required | https://valueset.x12.org/x217/005010/response/2000D/PWK/1/02/00/756 |
| CommunicationRequest.reasonCode | example | ActReason |
IG © 2020+ HL7 International - Financial Management Work Group. Package hl7.fhir.us.davinci-pas#1.2.0-ballot based on FHIR 4.0.1. Generated 2022-02-17
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