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:Claim;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "HomecareAuthorizationUpdateExample"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update";
fhir:index 0;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update> ]
];
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>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.html\">Generated Summary: id: 12345678901; JOE SMITH ; gender: male</a></p><p><b>created</b>: Jul 20, 2019 6:01:00 AM</p><p><b>insurer</b>: <a href=\"Organization-InsurerExample.html\">Generated Summary: id: 789312; active; <span title=\"Codes: {https://codesystem.x12.org/005010/98 PR}\">PR</span>; name: MARYLAND CAPITAL INSURANCE COMPANY</a></p><p><b>provider</b>: <a href=\"Organization-UMOExample.html\">Generated Summary: id: 8189991234; active; <span title=\"Codes: {https://codesystem.x12.org/005010/98 X3}\">X3</span>; name: DR. JOE SMITH CORPORATION</a></p><p><b>priority</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><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.html\">Generated Summary: status: active</a></td></tr></table><blockquote><p><b>item</b></p><p><b>ServiceItemRequestType</b>: <span title=\"Codes: {http://codesystem.x12.org/005010/1525 HS}\">Health Services Review</span></p><p><b>CertificationType</b>: <span title=\"Codes: {http://codesystem.x12.org/005010/1322 I}\">Initial</span></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt G0154}\">G0154</span></p></blockquote><blockquote><p><b>item</b></p><p><b>ServiceItemRequestType</b>: <span title=\"Codes: {http://codesystem.x12.org/005010/1525 HS}\">Health Services Review</span></p><p><b>CertificationType</b>: <span title=\"Codes: {http://codesystem.x12.org/005010/1322 I}\">Initial</span></p><h3>ModifierExtension[http://hl7.org/fhir/us/davinci-pas/StructureDefinition/modifierextension-infoCancelled]s</h3><table class=\"grid\"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>sequence</b>: 2</p><p><b>productOrService</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt B4184}\">B4184</span></p></blockquote><blockquote><p><b>item</b></p><p><b>InfoChanged</b>: added</p><p><b>ServiceItemRequestType</b>: <span title=\"Codes: {http://codesystem.x12.org/005010/1525 HS}\">Health Services Review</span></p><p><b>CertificationType</b>: <span title=\"Codes: {http://codesystem.x12.org/005010/1322 I}\">Initial</span></p><p><b>sequence</b>: 3</p><p><b>productOrService</b>: <span title=\"Codes: {http://www.ama-assn.org/go/cpt B4185}\">B4185</span></p></blockquote></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 "2019-07-20T11:01:00+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.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 "HS" ];
fhir:Coding.display [ fhir:value "Health Services 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:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://www.ama-assn.org/go/cpt" ];
fhir:Coding.code [ fhir:value "G0154" ] ] ]
], [
fhir:index 1;
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 "HS" ];
fhir:Coding.display [ fhir:value "Health Services 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:BackboneElement.modifierExtension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/modifierextension-infoCancelled" ];
fhir:Extension.valueBoolean [ fhir:value "true"^^xsd:boolean ] ];
fhir:Claim.item.sequence [ fhir:value "2"^^xsd:positiveInteger ];
fhir:Claim.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://www.ama-assn.org/go/cpt" ];
fhir:Coding.code [ fhir:value "B4184" ] ] ]
], [
fhir:index 2;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-infoChanged" ];
fhir:Extension.valueCode [ fhir:value "added" ] ], [
fhir:index 1;
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 "HS" ];
fhir:Coding.display [ fhir:value "Health Services Review" ] ] ] ], [
fhir:index 2;
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:Claim.item.sequence [ fhir:value "3"^^xsd:positiveInteger ];
fhir:Claim.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://www.ama-assn.org/go/cpt" ];
fhir:Coding.code [ fhir:value "B4185" ] ] ]
].
# - 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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