This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.0.1: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

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Resource Profile: PAS Encounter

PAS constraints on the Encounter resource mandating support for elements relevant to details of a requested institutional stay on the prior authorization request

Usage:

• Refer to this Resource Profile: PAS Claim
• Examples for this Resource Profile: Encounter/SurgicalEncounterExample

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints
Encounter			USCoreEncounterProfile
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
patientStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/03/00/1352 (required): Codes indicating patient status as of the 'statement covers through date'. 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.
nursingHomeResidentialStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus
value[x]		0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345 (required): Codes specifying the status of a nursing home resident at the time of service. 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.
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Fixed Value: planned
type		1..*	CodeableConcept	Specific type of encounter Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315 (required): Codes indicating the priority of this admission. 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.
subject		1..1	Reference(PAS Beneficiary Patient)	The patient or group present at the encounter
hospitalization
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314 (required): Codes indicating the source of this admission. 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.
location
location		1..1	Reference(US Core Location Profile)	Location the encounter takes place
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Encounter.extension:nursingHomeResidentialStatus.value[x]	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345
Encounter.type	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315
Encounter.hospitalization.admitSource	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
patientStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/03/00/1352 (required): Codes indicating patient status as of the 'statement covers through date'. 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.
nursingHomeResidentialStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus"
value[x]		0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345 (required): Codes specifying the status of a nursing home resident at the time of service. 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.
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Fixed Value: planned
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315 (required): Codes indicating the priority of this admission. 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.
subject	SΣ	1..1	Reference(PAS Beneficiary Patient)	The patient or group present at the encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
period	S	0..1	Period	The start and end time of the encounter
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314 (required): Codes indicating the source of this admission. 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.
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	0..*	BackboneElement	List of locations where the patient has been
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(US Core Location Profile)	Location the encounter takes place
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.extension:nursingHomeResidentialStatus.value[x]	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345
Encounter.identifier.use	required	IdentifierUse
Encounter.status	required	Fixed Value: planned
Encounter.class	extensible	ActEncounterCode
Encounter.type	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315
Encounter.participant.type	extensible	ParticipantType
Encounter.reasonCode	preferred	EncounterReasonCodes
Encounter.hospitalization.admitSource	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
patientStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/03/00/1352 (required): Codes indicating patient status as of the 'statement covers through date'. 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.
nursingHomeResidentialStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus"
value[x]		0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345 (required): Codes specifying the status of a nursing home resident at the time of service. 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.
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Fixed Value: planned
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315 (required): Codes indicating the priority of this admission. 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.
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(PAS Beneficiary Patient)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(Condition | Procedure | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314 (required): Codes indicating the source of this admission. 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.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	0..*	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(US Core Location Profile)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Encounter.extension:nursingHomeResidentialStatus.value[x]	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345
Encounter.identifier.use	required	IdentifierUse
Encounter.identifier.type	extensible	Identifier Type Codes
Encounter.status	required	Fixed Value: planned
Encounter.statusHistory.status	required	EncounterStatus
Encounter.class	extensible	ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode
Encounter.type	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315
Encounter.serviceType	example	ServiceType
Encounter.priority	example	ActPriority
Encounter.participant.type	extensible	ParticipantType
Encounter.reasonCode	preferred	EncounterReasonCodes
Encounter.diagnosis.use	preferred	DiagnosisRole
Encounter.hospitalization.admitSource	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator
Encounter.hospitalization.dietPreference	example	Diet
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition
Encounter.location.status	required	EncounterLocationStatus
Encounter.location.physicalType	example	LocationType

This structure is derived from USCoreEncounterProfile

Summary

Must-Support: 3 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

• PAS Beneficiary Patient (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary)
• US Core Location Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-location)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus
• http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus

Maturity: 3

Differential View

This structure is derived from USCoreEncounterProfile

Name	Flags	Card.	Type	Description & Constraints
Encounter			USCoreEncounterProfile
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
patientStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/03/00/1352 (required): Codes indicating patient status as of the 'statement covers through date'. 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.
nursingHomeResidentialStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus
value[x]		0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345 (required): Codes specifying the status of a nursing home resident at the time of service. 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.
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Fixed Value: planned
type		1..*	CodeableConcept	Specific type of encounter Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315 (required): Codes indicating the priority of this admission. 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.
subject		1..1	Reference(PAS Beneficiary Patient)	The patient or group present at the encounter
hospitalization
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314 (required): Codes indicating the source of this admission. 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.
location
location		1..1	Reference(US Core Location Profile)	Location the encounter takes place
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
Encounter.extension:nursingHomeResidentialStatus.value[x]	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345
Encounter.type	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315
Encounter.hospitalization.admitSource	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
patientStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/03/00/1352 (required): Codes indicating patient status as of the 'statement covers through date'. 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.
nursingHomeResidentialStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus"
value[x]		0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345 (required): Codes specifying the status of a nursing home resident at the time of service. 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.
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Fixed Value: planned
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315 (required): Codes indicating the priority of this admission. 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.
subject	SΣ	1..1	Reference(PAS Beneficiary Patient)	The patient or group present at the encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
period	S	0..1	Period	The start and end time of the encounter
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314 (required): Codes indicating the source of this admission. 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.
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	0..*	BackboneElement	List of locations where the patient has been
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(US Core Location Profile)	Location the encounter takes place
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.extension:nursingHomeResidentialStatus.value[x]	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345
Encounter.identifier.use	required	IdentifierUse
Encounter.status	required	Fixed Value: planned
Encounter.class	extensible	ActEncounterCode
Encounter.type	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315
Encounter.participant.type	extensible	ParticipantType
Encounter.reasonCode	preferred	EncounterReasonCodes
Encounter.hospitalization.admitSource	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USCoreEncounterProfile	An interaction during which services are provided to the patient
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
patientStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/03/00/1352 (required): Codes indicating patient status as of the 'statement covers through date'. 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.
nursingHomeResidentialStatus	S	0..1	CodeableConcept	Extension URL: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus"
value[x]		0..1	CodeableConcept	Value of extension Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345 (required): Codes specifying the status of a nursing home resident at the time of service. 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.
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter. Fixed Value: planned
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315 (required): Codes indicating the priority of this admission. 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.
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(PAS Beneficiary Patient)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	0..1	Period	The start and end time of the encounter
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	Σ	0..*	Reference(Condition | Procedure | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	Σ	0..*	BackboneElement	The list of diagnosis relevant to this encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	Σ	1..1	Reference(Condition | Procedure)	The diagnosis or procedure relevant to the encounter
use		0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource	S	0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314 (required): Codes indicating the source of this admission. 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.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	0..*	BackboneElement	List of locations where the patient has been
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(US Core Location Profile)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider		0..1	Reference(Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Encounter.extension:nursingHomeResidentialStatus.value[x]	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/04/00/1345
Encounter.identifier.use	required	IdentifierUse
Encounter.identifier.type	extensible	Identifier Type Codes
Encounter.status	required	Fixed Value: planned
Encounter.statusHistory.status	required	EncounterStatus
Encounter.class	extensible	ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode
Encounter.type	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/01/00/1315
Encounter.serviceType	example	ServiceType
Encounter.priority	example	ActPriority
Encounter.participant.type	extensible	ParticipantType
Encounter.reasonCode	preferred	EncounterReasonCodes
Encounter.diagnosis.use	preferred	DiagnosisRole
Encounter.hospitalization.admitSource	required	https://valueset.x12.org/x217/005010/request/2000E/CL1/1/02/00/1314
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator
Encounter.hospitalization.dietPreference	example	Diet
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition
Encounter.location.status	required	EncounterLocationStatus
Encounter.location.physicalType	example	LocationType

This structure is derived from USCoreEncounterProfile

Summary

Must-Support: 3 elements
Fixed Value: 1 element

Structures

This structure refers to these other structures:

• PAS Beneficiary Patient (http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary)
• US Core Location Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-location)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-patientStatus
• http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeResidentialStatus

Maturity: 3

Other representations of profile: CSV, Excel, Schematron