This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.0.1: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Additional Information Task Example - XML Representation

Raw xml | Download

<Task xmlns="http://hl7.org/fhir">
  <id value="AdditionalInformationTaskExample"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Task</b><a name="AdditionalInformationTaskExample"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Task &quot;AdditionalInformationTaskExample&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-profile-task.html">PAS Task</a></p></div><p><b>identifier</b>: id: 1122334</p><p><b>status</b>: requested</p><p><b>intent</b>: order</p><p><b>code</b>: Attach Request Code <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-PASTempCodes.html">PAS Temporary Codes</a>#attachment-request-code)</span></p><p><b>for</b>: <a href="Patient-BeneficiaryExample.html">Patient/BeneficiaryExample</a> &quot; SMITH&quot;</p><p><b>requester</b>: <span>id: <a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">#</a>789312</span></p><p><b>owner</b>: <span>id: <a href="http://terminology.hl7.org/5.0.0/NamingSystem-npi.html">#</a>789312</span></p><p><b>reasonCode</b>: Prior Authorization Information Request <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-PASTempCodes.html">PAS Temporary Codes</a>#priorAuthorization)</span></p><p><b>reasonReference</b>: <a href="Claim-MedicalServicesAuthorizationExample.html">Claim/MedicalServicesAuthorizationExample</a></p><blockquote><p><b>input</b></p><p><b>type</b>: Payer URL <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-PASTempCodes.html">PAS Temporary Codes</a>#payer-url)</span></p><p><b>value</b>: <a href="http://example.org/payerURL">http://example.org/payerURL</a></p></blockquote><blockquote><p><b>input</b></p><p><b>PALineNumber</b>: 1</p><p><b>type</b>: Attachments Needed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-PASTempCodes.html">PAS Temporary Codes</a>#attachments-needed)</span></p><p><b>value</b>: 26443-2 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#26443-2)</span></p></blockquote></div>
  </text>
  <identifier>
    <system value="http://example.org/ITEM_TRACE_NUMBER"/>
    <value value="1122334"/>
  </identifier>
  <status value="requested"/>
  <intent value="order"/>
  <code>
    <coding>
      <system
              value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
      <code value="attachment-request-code"/>
    </coding>
  </code>
  <for>🔗 
    <reference value="Patient/BeneficiaryExample"/>
  </for>
  <requester>
    <identifier>
      <system value="http://hl7.org/fhir/sid/us-npi"/>
      <value value="789312"/>
    </identifier>
  </requester>
  <owner>
    <identifier>
      <system value="http://hl7.org/fhir/sid/us-npi"/>
      <value value="789312"/>
    </identifier>
  </owner>
  <reasonCode>
    <coding>
      <system
              value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
      <code value="priorAuthorization"/>
    </coding>
  </reasonCode>
  <reasonReference>🔗 
    <reference value="Claim/MedicalServicesAuthorizationExample"/>
  </reasonReference>
  <input>
    <type>
      <coding>
        <system
                value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
        <code value="payer-url"/>
      </coding>
    </type>
    <valueUrl value="http://example.org/payerURL"/>
  </input>
  <input>
    <extension
               url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber">
      <valueInteger value="1"/>
    </extension>
    <type>
      <coding>
        <system
                value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
        <code value="attachments-needed"/>
      </coding>
    </type>
    <valueCodeableConcept>
      <coding>
        <system value="http://loinc.org"/>
        <code value="26443-2"/>
      </coding>
    </valueCodeableConcept>
  </input>
</Task>