ItemAuthorizedDetail - Da Vinci Prior Authorization Support (PAS) FHIR IG v2.2.0-ballot

Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot United States of America flag

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.2.0-ballot: STU 2 Ballot) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 2.1.0. For a full list of available versions, see the Directory of published versions

Extension: ItemAuthorizedDetail

Official URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail		Version: 2.2.0-ballot
Standards status: Trial-use	Maturity Level: 3	Computable Name: ItemAuthorizedDetail
Other Identifiers: OID:2.16.840.1.113883.4.642.40.24.42.19

The details of what has been authorized for this item.

Context of Use

This extension may be used on the following element(s)

Element ID: ExplanationOfBenefit
Element ID: ExplanationOfBenefit.item
Element ID: ClaimResponse.item

Usage info

Usages:

Use this Extension: PAS Claim Response Base
Examples for this Extension: Bundle/PASSubscriptionNotification, Bundle/ReferralAuthorizationResponseBundleExample, ClaimResponse/PractitionerRequestorAdditionalContentResponseExample and ClaimResponse/PractitionerRequestorResponseExample

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

Differential Table
Snapshot Table
Statistics/References
All

This structure is derived from Extension

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Extension	0..*	Extension	Extension
Slices for extension			Content/Rules for all slices
extension:productOrServiceCode	0..1	Extension	Extension
extension	0..0
url	1..1	uri	"productOrServiceCode"
value[x]	0..1	CodeableConcept	Value of extension Binding: X12 278 Requested Service Type (required)
extension:productOrServiceCodeEnd	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd Binding: X12 278 Requested Service Type (required)
extension:modifier	0..*	Extension	Extension
extension	0..0
url	1..1	uri	"modifier"
value[x]	0..1	CodeableConcept	Value of extension Binding: X12 278 Requested Service Modifier Type (required)
extension:unitPrice	0..1	Extension	Extension
extension	0..0
url	1..1	uri	"unitPrice"
value[x]	0..1	Money	Value of extension
extension:quantity	0..1	Extension	Extension
extension	0..0
url	1..1	uri	"quantity"
value[x]	0..1	PASQuantity	Value of extension
extension:epsdtIndicator	0..1	boolean	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator
extension:nursingHomeLevelOfCare	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare Binding: https://valueset.x12.org/x217/005010/request/2000F/SV1/1/20/00/1337 (required): Codes specifying the level of care provided by a nursing home facility. 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.
extension:revenue	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode Binding: AHA NUBC Revenue Value Set (required)
extension:revenueUnitRateLimit	0..1	decimal	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit
extension:authorizedService	0..1	Reference(PAS Medication Request \| PAS Service Request \| PAS Device Request \| PAS Nutrition Order)	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService
url	1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail"
value[x]	0..0
Documentation for this format

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Extension	0..*	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
Slices for extension	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:productOrServiceCode	0..1	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"productOrServiceCode"
value[x]	0..1	CodeableConcept	Value of extension Binding: X12 278 Requested Service Type (required)
extension:productOrServiceCodeEnd	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd Binding: X12 278 Requested Service Type (required)
extension:modifier	0..*	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"modifier"
value[x]	0..1	CodeableConcept	Value of extension Binding: X12 278 Requested Service Modifier Type (required)
extension:unitPrice	0..1	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"unitPrice"
value[x]	0..1	Money	Value of extension
extension:quantity	0..1	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"quantity"
value[x]	0..1	PASQuantity	Value of extension
extension:epsdtIndicator	0..1	boolean	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator
extension:nursingHomeLevelOfCare	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare Binding: https://valueset.x12.org/x217/005010/request/2000F/SV1/1/20/00/1337 (required): Codes specifying the level of care provided by a nursing home facility. 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.
extension:revenue	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode Binding: AHA NUBC Revenue Value Set (required)
extension:revenueUnitRateLimit	0..1	decimal	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit
extension:authorizedService	0..1	Reference(PAS Medication Request \| PAS Service Request \| PAS Device Request \| PAS Nutrition Order)	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService
url	1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: The details of what has been authorized for this item.

productOrServiceCode: CodeableConcept: An Extension
modifier: CodeableConcept: An Extension
unitPrice: Money: An Extension
quantity: Quantity: An Extension

Maturity: 3

Differential View

This structure is derived from Extension

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Extension	0..*	Extension	Extension
Slices for extension			Content/Rules for all slices
extension:productOrServiceCode	0..1	Extension	Extension
extension	0..0
url	1..1	uri	"productOrServiceCode"
value[x]	0..1	CodeableConcept	Value of extension Binding: X12 278 Requested Service Type (required)
extension:productOrServiceCodeEnd	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd Binding: X12 278 Requested Service Type (required)
extension:modifier	0..*	Extension	Extension
extension	0..0
url	1..1	uri	"modifier"
value[x]	0..1	CodeableConcept	Value of extension Binding: X12 278 Requested Service Modifier Type (required)
extension:unitPrice	0..1	Extension	Extension
extension	0..0
url	1..1	uri	"unitPrice"
value[x]	0..1	Money	Value of extension
extension:quantity	0..1	Extension	Extension
extension	0..0
url	1..1	uri	"quantity"
value[x]	0..1	PASQuantity	Value of extension
extension:epsdtIndicator	0..1	boolean	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator
extension:nursingHomeLevelOfCare	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare Binding: https://valueset.x12.org/x217/005010/request/2000F/SV1/1/20/00/1337 (required): Codes specifying the level of care provided by a nursing home facility. 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.
extension:revenue	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode Binding: AHA NUBC Revenue Value Set (required)
extension:revenueUnitRateLimit	0..1	decimal	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit
extension:authorizedService	0..1	Reference(PAS Medication Request \| PAS Service Request \| PAS Device Request \| PAS Nutrition Order)	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService
url	1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail"
value[x]	0..0
Documentation for this format

Snapshot View

Name	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Extension	0..*	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
Slices for extension	0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:productOrServiceCode	0..1	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"productOrServiceCode"
value[x]	0..1	CodeableConcept	Value of extension Binding: X12 278 Requested Service Type (required)
extension:productOrServiceCodeEnd	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-productOrServiceCodeEnd Binding: X12 278 Requested Service Type (required)
extension:modifier	0..*	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"modifier"
value[x]	0..1	CodeableConcept	Value of extension Binding: X12 278 Requested Service Modifier Type (required)
extension:unitPrice	0..1	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"unitPrice"
value[x]	0..1	Money	Value of extension
extension:quantity	0..1	Extension	Extension
id	0..1	string	Unique id for inter-element referencing
extension	0..0
url	1..1	uri	"quantity"
value[x]	0..1	PASQuantity	Value of extension
extension:epsdtIndicator	0..1	boolean	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator
extension:nursingHomeLevelOfCare	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare Binding: https://valueset.x12.org/x217/005010/request/2000F/SV1/1/20/00/1337 (required): Codes specifying the level of care provided by a nursing home facility. 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.
extension:revenue	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode Binding: AHA NUBC Revenue Value Set (required)
extension:revenueUnitRateLimit	0..1	decimal	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueUnitRateLimit
extension:authorizedService	0..1	Reference(PAS Medication Request \| PAS Service Request \| PAS Device Request \| PAS Nutrition Order)	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService
url	1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemAuthorizedDetail"
Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: The details of what has been authorized for this item.

productOrServiceCode: CodeableConcept: An Extension
modifier: CodeableConcept: An Extension
unitPrice: Money: An Extension
quantity: Quantity: An Extension

Maturity: 3

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

Path	Conformance	ValueSet	URI
Extension.extension:productOrServiceCode.value[x]	required	X12278RequestedServiceType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceType` From this IG
Extension.extension:modifier.value[x]	required	X12278RequestedServiceModifierType `http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278RequestedServiceModifierType` From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

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IG © 2020+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pas#2.2.0-ballot based on FHIR 4.0.1. Generated 2025-07-30
Links: Table of Contents | QA Report | Version History | | Propose a change