Da Vinci Prior Authorization Support (PAS) FHIR IG
1.0.0 - STU 1
Da Vinci Prior Authorization Support (PAS) FHIR IG
1.0.0 - STU 1
This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions 
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Bundle;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "ReferralAuthorizationBundleExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle> ]
];
fhir:Bundle.identifier [
fhir:Identifier.system [ fhir:value "http://example.org/SUBMITTER_TRANSACTION_IDENTIFIER" ];
fhir:Identifier.value [ fhir:value "A12345" ]
];
fhir:Bundle.type [ fhir:value "collection"];
fhir:Bundle.timestamp [ fhir:value "2005-05-02T11:01:00+05:00"^^xsd:dateTime];
fhir:Bundle.entry [
fhir:index 0;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Claim/ReferralAuthorizationExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/Claim/ReferralAuthorizationExample>
], [
fhir:index 1;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Organization/UMOExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/Organization/UMOExample>
], [
fhir:index 2;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Organization/InsurerExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/Organization/InsurerExample>
], [
fhir:index 3;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Coverage/InsuranceExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/Coverage/InsuranceExample>
], [
fhir:index 4;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Patient/SubscriberExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/Patient/SubscriberExample>
], [
fhir:index 5;
fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/ServiceRequest/ReferralRequestExample" ];
fhir:Bundle.entry.resource <http://example.org/fhir/ServiceRequest/ReferralRequestExample>
].
<http://example.org/fhir/Claim/ReferralAuthorizationExample> a fhir:Claim;
fhir:Resource.id [ fhir:value "ReferralAuthorizationExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 111099</p><p><b>status</b>: active</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_SubscriberExample\">See above (Patient/SubscriberExample)</a></p><p><b>created</b>: May 2, 2005 6:01:00 AM</p><p><b>insurer</b>: <a href=\"#Organization_InsurerExample\">See above (Organization/InsurerExample)</a></p><p><b>provider</b>: <a href=\"#Organization_UMOExample\">See above (Organization/UMOExample)</a></p><p><b>priority</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>CareTeams</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td>*</td><td>1</td><td><a href=\"Practitioner-ReferralPractitionerExample.html\">Generated Summary: id: 987654321; SUSAN WATSON ; Phone: 4029993456</a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td>*</td><td>1</td><td><span title=\"Codes: {http://hl7.org/fhir/sid/icd-10-cm G89.4}\">Chronic pain syndrome</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\"#Coverage_InsuranceExample\">See above (Coverage/InsuranceExample)</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td>-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>DiagnosisSequence</b></td><td><b>ProductOrService</b></td><td><b>Location[x]</b></td></tr><tr><td>*</td><td>, , </td><td>1</td><td>1</td><td>1</td><td><span title=\"Codes: {http://codesystem.x12.org/005010/1365 3}\">Consultation</span></td><td><span title=\"Codes: {https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set 11}\">11</span></td></tr></table></div>"
];
fhir:Claim.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://example.org/PATIENT_EVENT_TRACE_NUMBER" ];
fhir:Identifier.value [ fhir:value "111099" ];
fhir:Identifier.assigner [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://example.org/USER_ASSIGNED" ];
fhir:Identifier.value [ fhir:value "9012345678" ] ] ]
];
fhir:Claim.status [ fhir:value "active"];
fhir:Claim.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
fhir:Coding.code [ fhir:value "professional" ] ]
];
fhir:Claim.use [ fhir:value "preauthorization"];
fhir:Claim.patient [
fhir:Reference.reference [ fhir:value "Patient/SubscriberExample" ]
];
fhir:Claim.created [ fhir:value "2005-05-02T11:01:00+05:00"^^xsd:dateTime];
fhir:Claim.insurer [
fhir:Reference.reference [ fhir:value "Organization/InsurerExample" ]
];
fhir:Claim.provider [
fhir:Reference.reference [ fhir:value "Organization/UMOExample" ]
];
fhir:Claim.priority [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ];
fhir:Coding.code [ fhir:value "normal" ] ]
];
fhir:Claim.careTeam [
fhir:index 0;
fhir:Claim.careTeam.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.careTeam.provider [
fhir:Reference.reference [ fhir:value "Practitioner/ReferralPractitionerExample" ] ]
];
fhir:Claim.diagnosis [
fhir:index 0;
fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.diagnosis.diagnosisCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/sid/icd-10-cm" ];
fhir:Coding.code [ fhir:value "G89.4" ] ] ]
];
fhir:Claim.insurance [
fhir:index 0;
fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ];
fhir:Claim.insurance.coverage [
fhir:Reference.reference [ fhir:value "Coverage/InsuranceExample" ] ]
];
fhir:Claim.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://codesystem.x12.org/005010/1525" ];
fhir:Coding.code [ fhir:value "SC" ];
fhir:Coding.display [ fhir:value "Specialty Care Review" ] ] ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://codesystem.x12.org/005010/1322" ];
fhir:Coding.code [ fhir:value "I" ];
fhir:Coding.display [ fhir:value "Initial" ] ] ] ], [
fhir:index 2;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService" ];
fhir:Extension.valueReference [
fhir:Reference.reference [ fhir:value "ServiceRequest/ReferralRequestExample" ] ] ];
fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.item.careTeamSequence [
fhir:value "1"^^xsd:positiveInteger;
fhir:index 0 ];
fhir:Claim.item.diagnosisSequence [
fhir:value "1"^^xsd:positiveInteger;
fhir:index 0 ];
fhir:Claim.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://codesystem.x12.org/005010/1365" ];
fhir:Coding.code [ fhir:value "3" ];
fhir:Coding.display [ fhir:value "Consultation" ] ] ];
fhir:Claim.item.locationCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set" ];
fhir:Coding.code [ fhir:value "11" ] ] ]
].
<http://example.org/fhir/Organization/UMOExample> a fhir:Organization;
fhir:Resource.id [ fhir:value "UMOExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 8189991234</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {https://codesystem.x12.org/005010/98 X3}\">X3</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>"
];
fhir:Organization.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ];
fhir:Identifier.value [ fhir:value "8189991234" ]
];
fhir:Organization.active [ fhir:value "true"^^xsd:boolean];
fhir:Organization.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/98" ];
fhir:Coding.code [ fhir:value "X3" ] ]
];
fhir:Organization.name [ fhir:value "DR. JOE SMITH CORPORATION"];
fhir:Organization.address [
fhir:index 0;
fhir:Address.line [
fhir:value "111 1ST STREET";
fhir:index 0 ];
fhir:Address.city [ fhir:value "SAN DIEGO" ];
fhir:Address.state [ fhir:value "CA" ];
fhir:Address.postalCode [ fhir:value "92101" ];
fhir:Address.country [ fhir:value "US" ]
].
<http://example.org/fhir/Organization/InsurerExample> a fhir:Organization;
fhir:Resource.id [ fhir:value "InsurerExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 789312</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {https://codesystem.x12.org/005010/98 PR}\">PR</span></p><p><b>name</b>: MARYLAND CAPITAL INSURANCE COMPANY</p></div>"
];
fhir:Organization.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ];
fhir:Identifier.value [ fhir:value "789312" ]
];
fhir:Organization.active [ fhir:value "true"^^xsd:boolean];
fhir:Organization.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/98" ];
fhir:Coding.code [ fhir:value "PR" ] ]
];
fhir:Organization.name [ fhir:value "MARYLAND CAPITAL INSURANCE COMPANY"].
<http://example.org/fhir/Coverage/InsuranceExample> a fhir:Coverage;
fhir:Resource.id [ fhir:value "InsuranceExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>beneficiary</b>: <a href=\"#Patient_SubscriberExample\">See above (Patient/SubscriberExample)</a></p><p><b>payor</b>: <a href=\"#Organization_InsurerExample\">See above (Organization/InsurerExample)</a></p></div>"
];
fhir:Coverage.status [ fhir:value "active"];
fhir:Coverage.beneficiary [
fhir:Reference.reference [ fhir:value "Patient/SubscriberExample" ]
];
fhir:Coverage.payor [
fhir:index 0;
fhir:Reference.reference [ fhir:value "Organization/InsurerExample" ]
].
<http://example.org/fhir/Patient/SubscriberExample> a fhir:Patient;
fhir:Resource.id [ fhir:value "SubscriberExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "extensions" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>MilitaryStatus</b>: <span title=\"Codes: {https://codesystem.x12.org/005010/584 RU}\">RU</span></p><p><b>identifier</b>: id: 12345678901</p><p><b>name</b>: JOE SMITH </p><p><b>gender</b>: male</p></div>"
];
fhir:DomainResource.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://codesystem.x12.org/005010/584" ];
fhir:Coding.code [ fhir:value "RU" ] ] ]
];
fhir:Patient.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://example.org/MIN" ];
fhir:Identifier.value [ fhir:value "12345678901" ]
];
fhir:Patient.name [
fhir:index 0;
fhir:HumanName.family [ fhir:value "SMITH" ];
fhir:HumanName.given [
fhir:value "JOE";
fhir:index 0 ]
];
fhir:Patient.gender [ fhir:value "male"].
<http://example.org/fhir/ServiceRequest/ReferralRequestExample> a fhir:ServiceRequest;
fhir:Resource.id [ fhir:value "ReferralRequestExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>code</b>: <span title=\"Codes: {http://codesystem.x12.org/005010/1365 3}\">Consultation</span></p><p><b>quantity</b>: 1 {visit}</p><p><b>subject</b>: <a href=\"#Patient_SubscriberExample\">See above (Patient/SubscriberExample)</a></p></div>"
];
fhir:ServiceRequest.status [ fhir:value "active"];
fhir:ServiceRequest.intent [ fhir:value "order"];
fhir:ServiceRequest.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://codesystem.x12.org/005010/1365" ];
fhir:Coding.code [ fhir:value "3" ];
fhir:Coding.display [ fhir:value "Consultation" ] ]
];
fhir:ServiceRequest.quantityQuantity [
fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "{visit}" ]
];
fhir:ServiceRequest.subject [
fhir:Reference.reference [ fhir:value "Patient/SubscriberExample" ]
].
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
IG © 2020+ HL7 International - Financial Management Work Group. Package hl7.fhir.us.davinci-pas#1.0.0 based on FHIR 4.0.1. Generated 2020-12-20
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