@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail> a fhir:ValueSet ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "coveragePaDetail"] ; # 
  fhir:language [ fhir:v "en"] ; # 
  fhir:text [
     fhir:status [ fhir:v "extensions" ] ;
     fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet coveragePaDetail</b></p><a name=\"coveragePaDetail\"> </a><a name=\"hccoveragePaDetail\"> </a><ul><li>Include these codes as defined in <a href=\"CodeSystem-coverage-information-codes.html\"><code>http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes</code></a><span title=\"Version is not explicitly stated, which means it is fixed to the version provided in this specification\"> version ?2.2.1</span><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-no-auth\">no-auth</a></td><td style=\"color: #cccccc\">No Prior Authorization</td><td>The ordered service does not require prior authorization</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-auth-needed\">auth-needed</a></td><td style=\"color: #cccccc\">Prior Authorization Needed</td><td>The ordered service will require prior authorization</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-satisfied\">satisfied</a></td><td style=\"color: #cccccc\">Authorization Satisfied</td><td>While prior authorization would typically be needed, the conditions evaluated by prior authorization have already been evaluated and therefore prior authorization can be bypassed</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-performpa\">performpa</a></td><td style=\"color: #cccccc\">Performer Prior Authorization</td><td>Prior authorization is needed for the service, however such prior authoriation must be initiated by the performing (rather than ordering) provider.</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-conditional\">conditional</a></td><td style=\"color: #cccccc\">Conditional</td><td>There is the potential for information requirements from a participant type not listed.  However, a decision on whether there in fact are additional information requirements cannot be made without more information (more detailed code, service rendering information, etc.)</td></tr><tr><td><a href=\"CodeSystem-coverage-information-codes.html#coverage-information-codes-indeterminate\">indeterminate</a></td><td style=\"color: #cccccc\">Indeterminate</td><td>Indicates that, due to technical issues on the part of the client and/or server, consent restrictions by the patient, or similar atypical limitations or constraints, the payer is unable to evaluate coverage requirements</td></tr></table></li></ul></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:extension ( [
     fhir:url [
       fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ;
       fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm>
     ] ;
     fhir:value [
       a fhir:Integer ;
       fhir:v 1
     ]
  ] [
     fhir:url [
       fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ;
       fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-wg>
     ] ;
     fhir:value [
       a fhir:Code ;
       fhir:v "fm"
     ]
  ] [
     fhir:url [
       fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ;
       fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status>
     ] ;
     fhir:value [
       a fhir:Code ;
       fhir:v "trial-use" ;
       fhir:extension ( [
         fhir:url [
           fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom>
         ] ;
         fhir:value [
           a fhir:Canonical ;
           fhir:v "http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd>
         ]
       ] )
     ]
  ] ) ; # 
  fhir:url [
     fhir:v "http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail"^^xsd:anyURI ;
     fhir:l <http://hl7.org/fhir/us/davinci-crd/ValueSet/coveragePaDetail>
  ] ; # 
  fhir:identifier ( [
     fhir:system [
       fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ;
       fhir:l <urn:ietf:rfc:3986>
     ] ;
     fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.40.18.48.14" ]
  ] ) ; # 
  fhir:version [ fhir:v "2.2.1"] ; # 
  fhir:name [ fhir:v "CRDCoveragePaDetail"] ; # 
  fhir:title [ fhir:v "CRD Coverage Information Prior Authorization Value Set"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v false] ; # 
  fhir:date [ fhir:v "2026-03-27T11:32:28+11:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; # 
  fhir:contact ( [
     fhir:telecom ( [
       fhir:system [ fhir:v "url" ] ;
       fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ]
     ] )
  ] ) ; # 
  fhir:description [ fhir:v "Codes defining whether prior auth will be needed for coverage to be provided"] ; # 
  fhir:jurisdiction ( [
     fhir:coding ( [
       fhir:system [
         fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ;
         fhir:l <urn:iso:std:iso:3166>
       ] ;
       fhir:code [ fhir:v "US" ]
     ] )
  ] ) ; # 
  fhir:compose [
     fhir:include ( [
       fhir:system [
         fhir:v "http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes"^^xsd:anyURI ;
         fhir:l <http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes>
       ] ;
       fhir:concept ( [
         fhir:code [ fhir:v "no-auth" ]
       ] [
         fhir:code [ fhir:v "auth-needed" ]
       ] [
         fhir:code [ fhir:v "satisfied" ]
       ] [
         fhir:code [ fhir:v "performpa" ]
       ] [
         fhir:code [ fhir:v "conditional" ]
       ] [
         fhir:code [ fhir:v "indeterminate" ]
       ] )
     ] )
  ] . # 

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