ext-R5-ClaimResponse.ite.reviewOutcome
type: StructureDefinition
node role: treeRoot
id:
  v: ext-R5-ClaimResponse.ite.reviewOutcome
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition ext-R5-ClaimResponse.ite.reviewOutcome Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> Extension 0..1 Extension R5: Adjudication results (new) #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:decision 0..1 Extension R5: Result of the adjudication (new) #xD; url 1..1 uri "decision" #xD; value[x] 0..1 CodeableConcept Result of the adjudication Binding: R5ClaimDecisionForR3 (0.1.0) (example) #xD; extension:reason 0..* Extension R5: Reason for result of the adjudication (new) #xD; url 1..1 uri "reason" #xD; value[x] 0..1 CodeableConcept Reason for result of the adjudication Binding: R5ClaimDecisionReasonForR3 (0.1.0) (example) #xD; extension:preAuthRef 0..1 Extension R5: Preauthorization reference (new) #xD; url 1..1 uri "preAuthRef" #xD; value[x] 0..1 string Preauthorization reference #xD; extension:preAuthPeriod 0..1 Extension R5: Preauthorization reference effective period (new) #xD; url 1..1 uri "preAuthPeriod" #xD; value[x] 0..1 Period Preauthorization reference effective period #xD; url 1..1 uri "http://hl7.org/fhir/5.0/StructureDefinition/extension-ClaimResponse.item.reviewOutcome" #xD; value[x] 0..0 Value of extension #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
extension:
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    l: structuredefinition-wg
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extension:
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        l: hl7.fhir.uv.xver-r5.r3
extension:
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    l: structuredefinition-standards-status
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    v: trial-use
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        l: structuredefinition-conformance-derivedFrom
      value: Uri
        v: http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r3
        l: hl7.fhir.uv.xver-r5.r3
url:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-ClaimResponse.item.reviewOutcome
  l: extension-ClaimResponse.item.reviewOutcome
version:
  v: 0.1.0
name:
  v: ExtensionClaimResponse_Item_ReviewOutcome
title:
  v: R5: Adjudication results (new)
status:
  v: active
experimental:
  v: false
date:
  v: 2026-03-17T21:02:03.8104715+00:00
publisher:
  v: FHIR Infrastructure
contact:
  name:
    v: FHIR Infrastructure
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/fiwg
description:
  v: R5: `ClaimResponse.item.reviewOutcome` (new:BackboneElement)
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
      l: m49.htm
    code:
      v: 001
    display:
      v: World
purpose:
  v: This extension is part of the cross-version definitions generated to enable use of the element `ClaimResponse.item.reviewOutcome` as defined in FHIR R5 in FHIR STU3. The source element is defined as: `ClaimResponse.item.reviewOutcome` 0..1 `BackboneElement` Across FHIR versions, the element set has been mapped as: * R5: `ClaimResponse.item.reviewOutcome` 0..1 `BackboneElement` Following are the generation technical comments: Element `ClaimResponse.item.reviewOutcome` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
fhir version:
  v: 3.0.2
mapping:
  identity:
    v: rim
  uri:
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    l: v3
  name:
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kind:
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abstract:
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context type:
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context:
  v: ClaimResponse.item
type:
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base definition:
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derivation:
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snapshot:
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    path:
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    short:
      v: R5: Adjudication results (new)
    definition:
      v: R5: `ClaimResponse.item.reviewOutcome` (new:BackboneElement)
    comment:
      v: Element `ClaimResponse.item.reviewOutcome` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
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      severity:
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        v: hasValue() | (children().count() > id.count())
      xpath:
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code:
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  l: string

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map:
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path:
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slicing:
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definition:
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id:
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path:
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slice name:
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short:
  v: R5: Result of the adjudication (new)
definition:
  v: R5: `ClaimResponse.item.reviewOutcome.decision` (new:CodeableConcept)
comment:
  v: Element `ClaimResponse.item.reviewOutcome.decision` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.decision` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.decision` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The element is used to indicate the current state of the adjudication overall for the claim resource, for example: the request has been held (pended) for adjudication processing, for manual review or other reasons; that it has been processed and will be paid, or the outstanding paid, as submitted (approved); that no amount will be paid (denied); or that some amount between zero and the submitted amount will be paid (partial).
requirements:
  v: To advise the requestor of the result of the adjudication process. Element `ClaimResponse.item.reviewOutcome.decision` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.decision` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.decision` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
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id:
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representation:
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short:
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definition:
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id:
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    v: Extensions are always sliced by (at least) url
  rules:
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short:
  v: Additional Content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. In order 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.
comment:
  v: 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.
alias:
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alias:
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id:
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path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
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fixed: Uri
  v: decision
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mapping:
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    v: N/A

id:
  v: Extension.extension:decision.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Result of the adjudication
definition:
  v: The result of the claim, predetermination, or preauthorization adjudication.
comment:
  v: The element is used to indicate the current state of the adjudication overall for the claim resource, for example: the request has been held (pended) for adjudication processing, for manual review or other reasons; that it has been processed and will be paid, or the outstanding paid, as submitted (approved); that no amount will be paid (denied); or that some amount between zero and the submitted amount will be paid (partial).
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type:
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binding:
  strength:
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  value set: Uri
    v: http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-for-R3|0.1.0
    l: http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-for-R3
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:reason
path:
  v: Extension.extension
slice name:
  v: reason
short:
  v: R5: Reason for result of the adjudication (new)
definition:
  v: R5: `ClaimResponse.item.reviewOutcome.reason` (new:CodeableConcept)
comment:
  v: Element `ClaimResponse.item.reviewOutcome.reason` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.reason` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.reason` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
requirements:
  v: To advise the requestor of the contributors to the result of the adjudication process. Element `ClaimResponse.item.reviewOutcome.reason` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.reason` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.reason` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
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short:
  v: xml:id (or equivalent in JSON)
definition:
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definition:
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comment:
  v: 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.
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alias:
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id:
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path:
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representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
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fixed: Uri
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id:
  v: Extension.extension:reason.value[x]
path:
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short:
  v: Reason for result of the adjudication
definition:
  v: The reasons for the result of the claim, predetermination, or preauthorization adjudication.
min:
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base:
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type:
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binding:
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  value set: Uri
    v: http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-reason-for-R3|0.1.0
    l: http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-reason-for-R3
mapping:
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    v: rim
  map:
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id:
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path:
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slice name:
  v: preAuthRef
short:
  v: R5: Preauthorization reference (new)
definition:
  v: R5: `ClaimResponse.item.reviewOutcome.preAuthRef` (new:string)
comment:
  v: Element `ClaimResponse.item.reviewOutcome.preAuthRef` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.preAuthRef` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.preAuthRef` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This value is only present on preauthorization adjudications.
requirements:
  v: On subsequent claims, the insurer may require the provider to quote this value. Element `ClaimResponse.item.reviewOutcome.preAuthRef` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.preAuthRef` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.preAuthRef` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
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type:
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id:
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path:
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representation:
  v: xmlAttr
short:
  v: xml:id (or equivalent in JSON)
definition:
  v: unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
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base:
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type:
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mapping:
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id:
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path:
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slicing:
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  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional Content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. In order 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
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base:
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type:
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    l: Extension
mapping:
  identity:
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id:
  v: Extension.extension:preAuthRef.url
path:
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representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
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base:
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  min:
    v: 1
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type:
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    v: uri
    l: uri
fixed: Uri
  v: preAuthRef
  l: preAuthRef
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:preAuthRef.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Preauthorization reference
definition:
  v: Reference from the Insurer which is used in later communications which refers to this adjudication.
comment:
  v: This value is only present on preauthorization adjudications.
min:
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base:
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type:
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mapping:
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  map:
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id:
  v: Extension.extension:preAuthPeriod
path:
  v: Extension.extension
slice name:
  v: preAuthPeriod
short:
  v: R5: Preauthorization reference effective period (new)
definition:
  v: R5: `ClaimResponse.item.reviewOutcome.preAuthPeriod` (new:Period)
comment:
  v: Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
requirements:
  v: To convey to the provider when the authorized products and services must be supplied for the authorized adjudication to apply. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
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id:
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path:
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representation:
  v: xmlAttr
short:
  v: xml:id (or equivalent in JSON)
definition:
  v: unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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type:
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    l: string
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:preAuthPeriod.extension
path:
  v: Extension.extension.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  description:
    v: Extensions are always sliced by (at least) url
  rules:
    v: open
short:
  v: Additional Content defined by implementations
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element. In order 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: Extension.extension:preAuthPeriod.url
path:
  v: Extension.extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
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type:
  code:
    v: uri
    l: uri
fixed: Uri
  v: preAuthPeriod
  l: preAuthPeriod
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.extension:preAuthPeriod.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Preauthorization reference effective period
definition:
  v: The time frame during which this authorization is effective.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
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type:
  code:
    v: Period
    l: Period
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.url
path:
  v: Extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
fixed: Uri
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-ClaimResponse.item.reviewOutcome
  l: extension-ClaimResponse.item.reviewOutcome
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.value[x]
path:
  v: Extension.value[x]
short:
  v: Value of extension
definition:
  v: Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
min:
  v: 0
max:
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base:
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    v: Extension.value[x]
  min:
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type:
  code:
    v: base64Binary
    l: base64Binary
type:
  code:
    v: boolean
    l: boolean
type:
  code:
    v: code
    l: code
type:
  code:
    v: date
    l: date
type:
  code:
    v: dateTime
    l: dateTime
type:
  code:
    v: decimal
    l: decimal
type:
  code:
    v: id
    l: id
type:
  code:
    v: instant
    l: instant
type:
  code:
    v: integer
    l: integer
type:
  code:
    v: markdown
    l: markdown
type:
  code:
    v: oid
    l: oid
type:
  code:
    v: positiveInt
    l: positiveInt
type:
  code:
    v: string
    l: string
type:
  code:
    v: time
    l: time
type:
  code:
    v: unsignedInt
    l: unsignedInt
type:
  code:
    v: uri
    l: uri
type:
  code:
    v: Address
    l: Address
type:
  code:
    v: Age
    l: Age
type:
  code:
    v: Annotation
    l: Annotation
type:
  code:
    v: Attachment
    l: Attachment
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
type:
  code:
    v: Coding
    l: Coding
type:
  code:
    v: ContactPoint
    l: ContactPoint
type:
  code:
    v: Count
    l: Count
type:
  code:
    v: Distance
    l: Distance
type:
  code:
    v: Duration
    l: Duration
type:
  code:
    v: HumanName
    l: HumanName
type:
  code:
    v: Identifier
    l: Identifier
type:
  code:
    v: Money
    l: Money
type:
  code:
    v: Period
    l: Period
type:
  code:
    v: Quantity
    l: Quantity
type:
  code:
    v: Range
    l: Range
type:
  code:
    v: Ratio
    l: Ratio
type:
  code:
    v: Reference
    l: Reference
type:
  code:
    v: SampledData
    l: SampledData
type:
  code:
    v: Signature
    l: Signature
type:
  code:
    v: Timing
    l: Timing
type:
  code:
    v: Meta
    l: Meta
mapping:
  identity:
    v: rim
  map:
    v: N/A

element:
  id:
    v: Extension
  path:
    v: Extension
  short:
    v: R5: Adjudication results (new)
  definition:
    v: R5: `ClaimResponse.item.reviewOutcome` (new:BackboneElement)
  comment:
    v: Element `ClaimResponse.item.reviewOutcome` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
  min:
    v: 0
  max:
    v: 1
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      v: Extension
    min:
      v: 0
    max:
      v: *
  is modifier:
    v: false
element:
  id:
    v: Extension.extension
  path:
    v: Extension.extension
  slicing:
    discriminator:
      type:
        v: value
      path:
        v: url
    ordered:
      v: false
    rules:
      v: open
  min:
    v: 0
  max:
    v: *
  base:
    path:
      v: Extension.extension
    min:
      v: 0
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element:
  id:
    v: Extension.extension:decision
  path:
    v: Extension.extension
  slice name:
    v: decision
  short:
    v: R5: Result of the adjudication (new)
  definition:
    v: R5: `ClaimResponse.item.reviewOutcome.decision` (new:CodeableConcept)
  comment:
    v: Element `ClaimResponse.item.reviewOutcome.decision` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.decision` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.decision` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The element is used to indicate the current state of the adjudication overall for the claim resource, for example: the request has been held (pended) for adjudication processing, for manual review or other reasons; that it has been processed and will be paid, or the outstanding paid, as submitted (approved); that no amount will be paid (denied); or that some amount between zero and the submitted amount will be paid (partial).
  requirements:
    v: To advise the requestor of the result of the adjudication process. Element `ClaimResponse.item.reviewOutcome.decision` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.decision` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.decision` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
  min:
    v: 0
  max:
    v: 1
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      v: Extension.extension
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      v: 0
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      v: *
element:
  id:
    v: Extension.extension:decision.url
  path:
    v: Extension.extension.url
  min:
    v: 1
  max:
    v: 1
  base:
    path:
      v: Extension.url
    min:
      v: 1
    max:
      v: 1
  fixed: Uri
    v: decision
    l: decision
element:
  id:
    v: Extension.extension:decision.value[x]
  path:
    v: Extension.extension.value[x]
  short:
    v: Result of the adjudication
  definition:
    v: The result of the claim, predetermination, or preauthorization adjudication.
  comment:
    v: The element is used to indicate the current state of the adjudication overall for the claim resource, for example: the request has been held (pended) for adjudication processing, for manual review or other reasons; that it has been processed and will be paid, or the outstanding paid, as submitted (approved); that no amount will be paid (denied); or that some amount between zero and the submitted amount will be paid (partial).
  min:
    v: 0
  max:
    v: 1
  base:
    path:
      v: Extension.value[x]
    min:
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  type:
    code:
      v: CodeableConcept
      l: CodeableConcept
  binding:
    strength:
      v: example
    value set: Uri
      v: http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-for-R3|0.1.0
      l: http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-for-R3
element:
  id:
    v: Extension.extension:reason
  path:
    v: Extension.extension
  slice name:
    v: reason
  short:
    v: R5: Reason for result of the adjudication (new)
  definition:
    v: R5: `ClaimResponse.item.reviewOutcome.reason` (new:CodeableConcept)
  comment:
    v: Element `ClaimResponse.item.reviewOutcome.reason` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.reason` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.reason` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
  requirements:
    v: To advise the requestor of the contributors to the result of the adjudication process. Element `ClaimResponse.item.reviewOutcome.reason` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.reason` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.reason` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
  min:
    v: 0
  max:
    v: *
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      v: Extension.extension
    min:
      v: 0
    max:
      v: *
element:
  id:
    v: Extension.extension:reason.url
  path:
    v: Extension.extension.url
  min:
    v: 1
  max:
    v: 1
  base:
    path:
      v: Extension.url
    min:
      v: 1
    max:
      v: 1
  fixed: Uri
    v: reason
    l: reason
element:
  id:
    v: Extension.extension:reason.value[x]
  path:
    v: Extension.extension.value[x]
  short:
    v: Reason for result of the adjudication
  definition:
    v: The reasons for the result of the claim, predetermination, or preauthorization adjudication.
  min:
    v: 0
  max:
    v: 1
  base:
    path:
      v: Extension.value[x]
    min:
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    max:
      v: 1
  type:
    code:
      v: CodeableConcept
      l: CodeableConcept
  binding:
    strength:
      v: example
    value set: Uri
      v: http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-reason-for-R3|0.1.0
      l: http://hl7.org/fhir/uv/xver/ValueSet/R5-claim-decision-reason-for-R3

id:
  v: Extension.extension:preAuthRef
path:
  v: Extension.extension
slice name:
  v: preAuthRef
short:
  v: R5: Preauthorization reference (new)
definition:
  v: R5: `ClaimResponse.item.reviewOutcome.preAuthRef` (new:string)
comment:
  v: Element `ClaimResponse.item.reviewOutcome.preAuthRef` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.preAuthRef` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.preAuthRef` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). This value is only present on preauthorization adjudications.
requirements:
  v: On subsequent claims, the insurer may require the provider to quote this value. Element `ClaimResponse.item.reviewOutcome.preAuthRef` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.preAuthRef` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.preAuthRef` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.extension
  min:
    v: 0
  max:
    v: *

id:
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path:
  v: Extension.extension.url
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
fixed: Uri
  v: preAuthRef
  l: preAuthRef

id:
  v: Extension.extension:preAuthRef.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Preauthorization reference
definition:
  v: Reference from the Insurer which is used in later communications which refers to this adjudication.
comment:
  v: This value is only present on preauthorization adjudications.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
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type:
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    l: string

id:
  v: Extension.extension:preAuthPeriod
path:
  v: Extension.extension
slice name:
  v: preAuthPeriod
short:
  v: R5: Preauthorization reference effective period (new)
definition:
  v: R5: `ClaimResponse.item.reviewOutcome.preAuthPeriod` (new:Period)
comment:
  v: Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
requirements:
  v: To convey to the provider when the authorized products and services must be supplied for the authorized adjudication to apply. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` is part of an existing definition because parent element `ClaimResponse.item.reviewOutcome` requires a cross-version extension. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` has a context of ClaimResponse.item based on following the parent source element upwards and mapping to `ClaimResponse`. Element `ClaimResponse.item.reviewOutcome.preAuthPeriod` has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element).
min:
  v: 0
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  v: 1
base:
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    v: 0
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    v: *

id:
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path:
  v: Extension.extension.url
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
fixed: Uri
  v: preAuthPeriod
  l: preAuthPeriod

id:
  v: Extension.extension:preAuthPeriod.value[x]
path:
  v: Extension.extension.value[x]
short:
  v: Preauthorization reference effective period
definition:
  v: The time frame during which this authorization is effective.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
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    v: 1
type:
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    l: Period

id:
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path:
  v: Extension.url
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  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
fixed: Uri
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-ClaimResponse.item.reviewOutcome
  l: extension-ClaimResponse.item.reviewOutcome

id:
  v: Extension.value[x]
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  v: Extension.value[x]
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