PASClaim

PAS Claim

activeDa Vinci PAS2.2.1resource22 key elements

PAS constraints on Claim resource mandating support for elements relevant to the prior authorization request

Metadata

hl7.org/fhir
Canonical URL
http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim
ID
profile-claim
Type
Base Definition
profile-claim-base|2.2.1
Derivation
constraint
Mandatory and Must-Support Elements

Elements with cardinality > 0 or marked as Must Support (S)

PathCard.TypeFlagsDescription
:encounter0..1
Extension
S
Information about a hospital claim being requested.
identifier1..2
1+
:AdditionalInformation0..*
S
Send additional paperwork or supporting information for the request. This can be most commonly a DocumentReference profile although any type of information is allowed.
supportingInfo.extension
1+
:documentInformation1..1
Extension
S1+
supportingInfo.value[x]
Reference
S1+
:MessageText0..*
S
Send text messages to the UMO.
supportingInfo.value[x]
string
S1+
:recordedDate0..1
Extension
S
The date that a diagnosis was recorded. (HIxx-4)
item
1+
item.extension
1+
:requestType
1+
:certificationType
1+
:epsdtIndicator0..1
Extension
S
An indicator of whether early and periodic screen for diagnosis and treatment of children is involved.
:nursingHomeResidentialStatus0..1
Extension
S
A code specifying the status of a nursing home resident at the time of service. (SV209)
item.extension.value[x]
S
:nursingHomeLevelOfCare0..1
Extension
S
A code specifying the level of care provided by a nursing home facility. (SV120, SV210)
:revenueUnitRateLimit0..1
Extension
S
The limit on the rate per unit of revenue for hospital accomodation. (SV206)
:requestedService0..1
Extension
S
The details of the service being requested.
item.category
1+
Since PAS requests only have item-level information, a category is required for conformance with the X12 278 request.
item.location[x]
1+
item.unitPrice
S