Da Vinci Clinical Data Exchange (CDex)
2.1.0-snapshot - CI Build
Da Vinci Clinical Data Exchange (CDex)
2.1.0-snapshot - CI Build
This page is part of the Da Vinci Clinical Documentation Exchange (v2.1.0-snapshot: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
| Page standards status: Informative |
<Task xmlns="http://hl7.org/fhir">
<id value="cdex-task-example23"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Task cdex-task-example23</b></p><a name="cdex-task-example23"> </a><a name="hccdex-task-example23"> </a><a name="cdex-task-example23-en-US"> </a><p><b>identifier</b>: Re-Association Tracking Control Number/trackingid1034</p><p><b>status</b>: Requested</p><p><b>intent</b>: order</p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes attachment-request-questionnaire}">Attachment Request Questionnaire</span></p><p><b>for</b>: <a href="#hccdex-task-example23/patient">Amy Shaw (no stated gender), DoB: 1987-02-20 ( Patient Account Number: PA-123 (use: usual, ))</a></p><p><b>authoredOn</b>: 2022-06-17 16:16:06+0000</p><p><b>lastModified</b>: 2022-06-17 16:16:06+0000</p><p><b>requester</b>: Identifier: <code>http://example.org/cdex/payer/payer-ids</code>/Payer123</p><p><b>owner</b>: <a href="#hccdex-task-example23/practitionerrole">PractitionerRole</a></p><p><b>reasonCode</b>: <span title="Codes:{http://hl7.org/fhir/claim-use preauthorization}">preauthorization</span></p><p><b>reasonReference</b>: Identifier: <code>http://example.org/cdex/payer/claim-ids</code>/Preauth123</p><h3>Restrictions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Period</b></td></tr><tr><td style="display: none">*</td><td>?? --> 2022-06-21</td></tr></table><blockquote><p><b>input</b></p><p><b>PALineNumber</b>: 1</p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes questionnaires-needed}">Questionnaires Needed</span></p><p><b>value</b>: <a href="https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&canonical=http://example.org/base_adaptive_questionnaire">http://example.org/base_adaptive_questionnaire</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp signature-flag}">Signature Flag</span></p><p><b>value</b>: true</p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes payer-url}">Payer URL</span></p><p><b>value</b>: <a href="https://simplifier.net/resolve?scope=hl7.fhir.us.core.3.1.1@3.1.1&canonical=http://example.org/cdex/payer/$submit-attachment">http://example.org/cdex/payer/$submit-attachment</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp purpose-of-use}">Purpose Of Use</span></p><p><b>value</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActReason COVAUTH}">coverage authorization</span></p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Patient #patient</b></p><a name="cdex-task-example23/patient"> </a><a name="hccdex-task-example23/patient"> </a><a name="cdex-task-example23/patient-en-US"> </a><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Amy Shaw (no stated gender), DoB: 1987-02-20 ( Patient Account Number: PA-123 (use: usual, ))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Other Id (see the one above)">Other Id:</td><td colspan="3">Member Number/Member123 (use: usual, )</td></tr></table></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: PractitionerRole #practitionerrole</b></p><a name="cdex-task-example23/practitionerrole"> </a><a name="hccdex-task-example23/practitionerrole"> </a><a name="cdex-task-example23/practitionerrole-en-US"> </a><p><b>practitioner</b>: Identifier: <a href="http://terminology.hl7.org/5.5.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/9941339100</p><p><b>organization</b>: Identifier: <a href="http://terminology.hl7.org/5.5.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/1234567893</p></blockquote></div>
</text>
<contained>
<Patient>
<id value="patient"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MB"/>
<display value="Member Number"/>
</coding>
<text value="Member Number"/>
</type>
<system value="http://example.org/cdex/payer/member-ids"/>
<value value="Member123"/>
</identifier>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType"/>
<code value="pat"/>
<display value="Patient Account Number"/>
</coding>
<text value="Patient Account Number"/>
</type>
<system value="http://example.org/cdex/provider/patient-ids"/>
<value value="PA-123"/>
</identifier>
<name>
<family value="Shaw"/>
<given value="Amy"/>
</name>
<birthDate value="1987-02-20"/>
</Patient>
</contained>
<contained>
<PractitionerRole>
<id value="practitionerrole"/>
<practitioner>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9941339100"/>
</identifier>
</practitioner>
<organization>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1234567893"/>
</identifier>
</organization>
</PractitionerRole>
</contained>
<identifier>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
<code value="tracking-id"/>
<display value="Tracking Id"/>
</coding>
<text value="Re-Association Tracking Control Number"/>
</type>
<system value="http://example.org/payer"/>
<value value="trackingid1034"/>
</identifier>
<status value="requested"/>
<intent value="order"/>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
<code value="attachment-request-questionnaire"/>
</coding>
<text value="Attachment Request Questionnaire"/>
</code>
<for>
<reference value="#patient"/>
</for>
<authoredOn value="2022-06-17T16:16:06Z"/>
<lastModified value="2022-06-17T16:16:06Z"/>
<requester>
<identifier>
<system value="http://example.org/cdex/payer/payer-ids"/>
<value value="Payer123"/>
</identifier>
</requester>
<owner>
<reference value="#practitionerrole"/>
</owner>
<reasonCode>
<coding>
<system value="http://hl7.org/fhir/claim-use"/>
<code value="preauthorization"/>
<display value="Preauthorization"/>
</coding>
<text value="preauthorization"/>
</reasonCode>
<reasonReference>
<identifier>
<system value="http://example.org/cdex/payer/claim-ids"/>
<value value="Preauth123"/>
</identifier>
</reasonReference>
<restriction>
<period>
<end value="2022-06-21"/>
</period>
</restriction>
<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="questionnaires-needed"/>
</coding>
</type>
<valueCanonical value="http://example.org/base_adaptive_questionnaire"/>
</input>
<input>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
<code value="signature-flag"/>
</coding>
</type>
<valueBoolean value="true"/>
</input>
<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/cdex/payer/$submit-attachment"/>
</input>
<input>
<type>
<coding>
<system
value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
<code value="purpose-of-use"/>
</coding>
</type>
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
<code value="COVAUTH"/>
<display value="coverage authorization"/>
</coding>
</valueCodeableConcept>
</input>
</Task>
IG © 2024+ HL7 International / Payer/Provider Information Exchange Work Group. Package hl7.fhir.us.davinci-cdex#2.1.0-snapshot based on FHIR 4.0.1. Generated 2024-09-28
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