This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.1.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Page standards status: Trial-use | Maturity Level: 3 |
Definitions for the profile-communicationrequest resource profile.
Guidance on how to interpret the contents of this table can be found here
0. CommunicationRequest | |
2. CommunicationRequest.identifier | |
Short | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number). |
Note | This is a business identifier, not a resource identifier (see discussion) |
Must Support | true |
4. CommunicationRequest.status | |
Fixed Value | active |
6. CommunicationRequest.category | |
Binding | The codes SHALL be taken from https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required to 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. |
Must Support | true |
8. CommunicationRequest.medium | |
Binding | Unless not suitable, these codes SHALL be taken from PAS Communication Medium Value Set (extensible to http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium ) |
Must Support | true |
10. CommunicationRequest.payload | |
Must Support | true |
12. CommunicationRequest.payload.extension | |
Slicing | This element introduces a set of slices on CommunicationRequest.payload.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
14. CommunicationRequest.payload.extension:serviceLineNumber | |
Slice Name | serviceLineNumber |
Control | 0..1 |
Type | Extension(ServiceLineNumber) (Extension Type: positiveInt) |
Must Support | true |
16. CommunicationRequest.payload.extension:communicatedDiagnosis | |
Slice Name | communicatedDiagnosis |
Control | 0..* |
Type | Extension(CommunicatedDiagnosis) (Extension Type: CodeableConcept) |
Must Support | true |
18. CommunicationRequest.payload.extension:contentModifier | |
Slice Name | contentModifier |
Control | 0..* |
Type | Extension(ContentModifier) (Extension Type: CodeableConcept) |
Must Support | true |
20. CommunicationRequest.payload.content[x] | |
Type | string, Reference(Resource), Attachment |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
22. CommunicationRequest.requester | |
Type | Reference(PAS Insurer Organization) |
Must Support | true |
24. CommunicationRequest.recipient | |
Type | Reference(PAS Practitioner, PAS Organization Base Profile) |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
26. CommunicationRequest.sender | |
Type | Reference(PAS Requestor Organization) |
Must Support | true |
Guidance on how to interpret the contents of this table can be found here
0. 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. |
Short | A request for information to be sent to a receiver |
Control | 0..* |
Is Modifier | false |
Summary | false |
Invariants | 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.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. |
Short | A set of rules under which this content was created |
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. |
Control | 0..1 |
Type | uri |
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
4. 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). |
Short | Extensions that cannot be ignored |
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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
Summary | false |
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 Names | extensions, user content |
Invariants | 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()) |
6. 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. |
Short | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number).Unique identifier |
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. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..* |
Type | Identifier |
Is Modifier | false |
Must Support | true |
Summary | true |
Requirements | Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers. |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
8. CommunicationRequest.status | |
Definition | The status of the proposal or order. |
Short | draft | active | on-hold | revoked | completed | entered-in-error | unknown |
Control | 1..1 |
Binding | The codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1 (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1 )The status of the communication request. |
Type | code |
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Fixed Value | active |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
10. CommunicationRequest.category | |
Definition | The type of message to be sent such as alert, notification, reminder, instruction, etc. |
Short | Message category |
Comments | There may be multiple axes of categorization and one communication request may serve multiple purposes. |
Control | 0..* |
Binding | The codes SHALL be taken from For example codes, see https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755http://hl7.org/fhir/ValueSet/communication-category (required to 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. Codes for general categories of communications such as alerts, instruction, etc. |
Type | CodeableConcept |
Is Modifier | false |
Must Support | true |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
12. CommunicationRequest.doNotPerform | |
Definition | If true indicates that the CommunicationRequest is asking for the specified action to not occur. |
Short | True if request is prohibiting action |
Comments | The attributes provided with the request qualify what is not to be done. |
Control | 0..1 |
Type | boolean |
Is Modifier | true because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Alternate Names | prohibited |
Meaning if Missing | If do not perform is not specified, the request is a positive request e.g. "do perform" |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
14. CommunicationRequest.medium | |
Definition | A channel that was used for this communication (e.g. email, fax). |
Short | A channel of communication |
Control | 0..* |
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see PAS Communication Medium Value Sethttp://terminology.hl7.org/ValueSet/v3-ParticipationMode (extensible to http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium ) |
Type | CodeableConcept |
Is Modifier | false |
Must Support | true |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
16. CommunicationRequest.payload | |
Definition | Text, attachment(s), or resource(s) to be communicated to the recipient. |
Short | Message payload |
Control | 0..* |
Type | BackboneElement |
Is Modifier | false |
Must Support | true |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
18. CommunicationRequest.payload.extension | |
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. 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. |
Short | ExtensionAdditional content defined by implementations |
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. |
Control | 0..* |
Type | Extension |
Is Modifier | false |
Summary | false |
Alternate Names | extensions, user content |
Invariants | 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()) |
Slicing | This element introduces a set of slices on CommunicationRequest.payload.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
20. CommunicationRequest.payload.extension:serviceLineNumber | |
Slice Name | serviceLineNumber |
Definition | A number that links the content being requested with the claim item number. |
Short | Extension |
Control | 0..1 This element is affected by the following invariants: ele-1 |
Type | Extension(ServiceLineNumber) (Extension Type: positiveInt) |
Is Modifier | false |
Must Support | true |
Invariants | 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() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
22. CommunicationRequest.payload.extension:communicatedDiagnosis | |
Slice Name | communicatedDiagnosis |
Definition | A code representing the diagnosis that is the subject of the communication |
Short | Extension |
Control | 0..* This element is affected by the following invariants: ele-1 |
Type | Extension(CommunicatedDiagnosis) (Extension Type: CodeableConcept) |
Is Modifier | false |
Must Support | true |
Invariants | 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() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
24. CommunicationRequest.payload.extension:contentModifier | |
Slice Name | contentModifier |
Definition | A code representing a modifier of the content being requested |
Short | Extension |
Control | 0..* This element is affected by the following invariants: ele-1 |
Type | Extension(ContentModifier) (Extension Type: CodeableConcept) |
Is Modifier | false |
Must Support | true |
Invariants | 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() )ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
26. 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). |
Short | Extensions that cannot be ignored even if unrecognized |
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. |
Control | 0..* |
Type | Extension |
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
Summary | true |
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 Names | extensions, user content, modifiers |
Invariants | 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.content[x] | |
Definition | The communicated content (or for multi-part communications, one portion of the communication). |
Short | Message part content |
Control | 1..1 |
Type | string, Reference(Resource), Attachment |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Must Support | true |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
30. CommunicationRequest.requester | |
Definition | The device, individual, or organization who initiated the request and has responsibility for its activation. |
Short | Who/what is requesting service |
Control | 0..1 |
Type | Reference(PAS Insurer Organization, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device) |
Is Modifier | false |
Must Support | true |
Summary | true |
Alternate Names | author |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
32. 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. |
Short | Message recipient |
Control | 0..* |
Type | Reference(PAS Practitioner, PAS Organization Base Profile, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, Group, CareTeam, HealthcareService) |
Is Modifier | false |
Must Support | true |
Must Support Types | No must-support rules about the choice of types/profiles |
Summary | false |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
34. CommunicationRequest.sender | |
Definition | The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication. |
Short | Message sender |
Control | 0..1 |
Type | Reference(PAS Requestor Organization, Device, Organization, Patient, Practitioner, PractitionerRole, RelatedPerson, HealthcareService) |
Is Modifier | false |
Must Support | true |
Summary | true |
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be found here
0. 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. | ||||
Short | A request for information to be sent to a receiver | ||||
Control | 0..* | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | 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. | ||||
Short | Logical id of this artifact | ||||
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. | ||||
Control | 0..1 | ||||
Type | id | ||||
Is Modifier | false | ||||
Summary | true | ||||
4. 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. | ||||
Short | Metadata about the resource | ||||
Control | 0..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
6. 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. | ||||
Short | A set of rules under which this content was created | ||||
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. | ||||
Control | 0..1 | ||||
Type | uri | ||||
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
8. CommunicationRequest.language | |||||
Definition | The base language in which the resource is written. | ||||
Short | Language of the resource content | ||||
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). | ||||
Control | 0..1 | ||||
Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages )A human language.
| ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
10. 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. | ||||
Short | Text summary of the resource, for human interpretation | ||||
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. | ||||
Control | 0..1 | ||||
Type | Narrative | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | narrative, html, xhtml, display | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
12. 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. | ||||
Short | Contained, inline 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. | ||||
Control | 0..* | ||||
Type | Resource | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||
14. 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. | ||||
Short | Additional content defined by implementations | ||||
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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | extensions, user content | ||||
Invariants | 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() ) | ||||
16. 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). | ||||
Short | Extensions that cannot be ignored | ||||
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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
Summary | false | ||||
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 Names | extensions, user content | ||||
Invariants | 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() ) | ||||
18. 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. | ||||
Short | Unique Identifier used in linking the Communication Request to the response (X12's Attachment Control Number). | ||||
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. | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..* | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | true | ||||
Requirements | Allows identification of the communication request as it is known by various participating systems and in a way that remains consistent across servers. | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
20. CommunicationRequest.basedOn | |||||
Definition | A plan or proposal that is fulfilled in whole or in part by this request. | ||||
Short | Fulfills plan or proposal | ||||
Control | 0..* | ||||
Type | Reference(Resource) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon. | ||||
Alternate Names | fulfills | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
22. CommunicationRequest.replaces | |||||
Definition | Completed or terminated request(s) whose function is taken by this new request. | ||||
Short | Request(s) replaced by this request | ||||
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. | ||||
Control | 0..* | ||||
Type | Reference(CommunicationRequest) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests. | ||||
Alternate Names | supersedes, prior | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
24. 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. | ||||
Short | Composite request this is part of | ||||
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. | ||||
Control | 0..1 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Alternate Names | grouperId | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
26. CommunicationRequest.status | |||||
Definition | The status of the proposal or order. | ||||
Short | draft | active | on-hold | revoked | completed | entered-in-error | unknown | ||||
Control | 1..1 | ||||
Binding | The codes SHALL be taken from RequestStatus (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1 )The status of the communication request. | ||||
Type | code | ||||
Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Fixed Value | active | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
28. CommunicationRequest.statusReason | |||||
Definition | Captures the reason for the current state of the CommunicationRequest. | ||||
Short | Reason for current status | ||||
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]. | ||||
Control | 0..1 | ||||
Binding | Codes identifying the reason for the current state of a request. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | Suspended Reason, Cancelled Reason | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
30. CommunicationRequest.category | |||||
Definition | The type of message to be sent such as alert, notification, reminder, instruction, etc. | ||||
Short | Message category | ||||
Comments | There may be multiple axes of categorization and one communication request may serve multiple purposes. | ||||
Control | 0..* | ||||
Binding | The codes SHALL be taken from https://valueset.x12.org/x217/005010/response/2000D/PWK/1/01/00/755 (required to 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. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
32. CommunicationRequest.priority | |||||
Definition | Characterizes how quickly the proposed act must be initiated. Includes concepts such as stat, urgent, routine. | ||||
Short | routine | urgent | asap | stat | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from RequestPriority (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1 )Codes indicating the relative importance of a communication request. | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Meaning if Missing | If missing, this task should be performed with normal priority | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
34. CommunicationRequest.doNotPerform | |||||
Definition | If true indicates that the CommunicationRequest is asking for the specified action to not occur. | ||||
Short | True if request is prohibiting action | ||||
Comments | The attributes provided with the request qualify what is not to be done. | ||||
Control | 0..1 | ||||
Type | boolean | ||||
Is Modifier | true because If true this element negates the specified action. For Example, instead of a request for a communication, it is a request for the communication to not occur. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Alternate Names | prohibited | ||||
Meaning if Missing | If do not perform is not specified, the request is a positive request e.g. "do perform" | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
36. CommunicationRequest.medium | |||||
Definition | A channel that was used for this communication (e.g. email, fax). | ||||
Short | A channel of communication | ||||
Control | 0..* | ||||
Binding | Unless not suitable, these codes SHALL be taken from PAS Communication Medium Value Set (extensible to http://hl7.org/fhir/us/davinci-pas/ValueSet/PASCommunicationRequestMedium ) | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
38. CommunicationRequest.subject | |||||
Definition | The patient or group that is the focus of this communication request. | ||||
Short | Focus of message | ||||
Control | 0..1 | ||||
Type | Reference(Patient, Group) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | patient | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
40. CommunicationRequest.about | |||||
Definition | Other resources that pertain to this communication request and to which this communication request should be associated. | ||||
Short | Resources that pertain to this communication request | ||||
Comments | Don't use CommunicationRequest.about element when a more specific element exists, such as basedOn, reasonReference, or replaces. | ||||
Control | 0..* | ||||
Type | Reference(Resource) | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
42. CommunicationRequest.encounter | |||||
Definition | The Encounter during which this CommunicationRequest was created or to which the creation of this record is tightly associated. | ||||
Short | Encounter created as part of | ||||
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. | ||||
Control | 0..1 | ||||
Type | Reference(Encounter) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
44. CommunicationRequest.payload | |||||
Definition | Text, attachment(s), or resource(s) to be communicated to the recipient. | ||||
Short | Message payload | ||||
Control | 0..* | ||||
Type | BackboneElement | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
46. 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. | ||||
Short | Unique id for inter-element referencing | ||||
Control | 0..1 | ||||
Type | string | ||||
Is Modifier | false | ||||
XML Format | In the XML format, this property is represented as an attribute. | ||||
Summary | false | ||||
48. CommunicationRequest.payload.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | 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() ) | ||||
Slicing | This element introduces a set of slices on CommunicationRequest.payload.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
50. CommunicationRequest.payload.extension:serviceLineNumber | |||||
Slice Name | serviceLineNumber | ||||
Definition | A number that links the content being requested with the claim item number. | ||||
Short | Extension | ||||
Control | 0..1 This element is affected by the following invariants: ele-1 | ||||
Type | Extension(ServiceLineNumber) (Extension Type: positiveInt) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | 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() ) | ||||
52. CommunicationRequest.payload.extension:communicatedDiagnosis | |||||
Slice Name | communicatedDiagnosis | ||||
Definition | A code representing the diagnosis that is the subject of the communication | ||||
Short | Extension | ||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||
Type | Extension(CommunicatedDiagnosis) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | 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() ) | ||||
54. CommunicationRequest.payload.extension:contentModifier | |||||
Slice Name | contentModifier | ||||
Definition | A code representing a modifier of the content being requested | ||||
Short | Extension | ||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||
Type | Extension(ContentModifier) (Extension Type: CodeableConcept) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Invariants | 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() ) | ||||
56. 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). | ||||
Short | Extensions that cannot be ignored even if unrecognized | ||||
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. | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
Summary | true | ||||
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 Names | extensions, user content, modifiers | ||||
Invariants | 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() ) | ||||
58. CommunicationRequest.payload.content[x] | |||||
Definition | The communicated content (or for multi-part communications, one portion of the communication). | ||||
Short | Message part content | ||||
Control | 1..1 | ||||
Type | string | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Must Support | true | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
60. CommunicationRequest.occurrence[x] | |||||
Definition | The time when this communication is to occur. | ||||
Short | When scheduled | ||||
Control | 0..1 | ||||
Type | Choice of: dateTime, Period | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Alternate Names | timing | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
62. CommunicationRequest.authoredOn | |||||
Definition | For draft requests, indicates the date of initial creation. For requests with other statuses, indicates the date of activation. | ||||
Short | When request transitioned to being actionable | ||||
Control | 0..1 | ||||
Type | dateTime | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Alternate Names | createdOn | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
64. CommunicationRequest.requester | |||||
Definition | The device, individual, or organization who initiated the request and has responsibility for its activation. | ||||
Short | Who/what is requesting service | ||||
Control | 0..1 | ||||
Type | Reference(PAS Insurer Organization) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | true | ||||
Alternate Names | author | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
66. 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. | ||||
Short | Message recipient | ||||
Control | 0..* | ||||
Type | Reference(PAS Practitioner, PAS Organization Base Profile) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Must Support Types | No must-support rules about the choice of types/profiles | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
68. CommunicationRequest.sender | |||||
Definition | The entity (e.g. person, organization, clinical information system, or device) which is to be the source of the communication. | ||||
Short | Message sender | ||||
Control | 0..1 | ||||
Type | Reference(PAS Requestor Organization) | ||||
Is Modifier | false | ||||
Must Support | true | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
70. CommunicationRequest.reasonCode | |||||
Definition | Describes why the request is being made in coded or textual form. | ||||
Short | Why is communication needed? | ||||
Comments | Textual reasons can be captured using reasonCode.text. | ||||
Control | 0..* | ||||
Binding | For example codes, see v3 Code System ActReason (example to http://terminology.hl7.org/ValueSet/v3-ActReason )Codes for describing reasons for the occurrence of a communication. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
72. CommunicationRequest.reasonReference | |||||
Definition | Indicates another resource whose existence justifies this request. | ||||
Short | Why is communication needed? | ||||
Control | 0..* | ||||
Type | Reference(Condition, Observation, DiagnosticReport, DocumentReference) | ||||
Is Modifier | false | ||||
Summary | true | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) | ||||
74. CommunicationRequest.note | |||||
Definition | Comments made about the request by the requester, sender, recipient, subject or other participants. | ||||
Short | Comments made about communication request | ||||
Control | 0..* | ||||
Type | Annotation | ||||
Is Modifier | false | ||||
Summary | false | ||||
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()) ) |