StructureDefinition-cdex-task-attachment-request

Sourcehl7.fhir.us.davinci-cdex#current:Da Vinci Clinical Data Exchange (CDex) (v4.0.1)
resourceTypeStructureDefinition
idcdex-task-attachment-request
canonicalhttp://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-task-attachment-request
version2.1.0-preview
statusdraft
publisherHL7 International - Patient Care Work Group
nameCDexTaskAttachmentRequest
titleCDex Task Attachment Request Profile
date2023-05-26T04:44:34+00:00
descriptionPayers use the [Task](http://hl7.org/StructureDefinition/Task) based profile to request additional documentation ("attachments") for claims or prior authorizations. It constrains the Task resource to minimal necessary data elements needed to request attachments and respond in a way that is compatible with existing X12 277 RFAI and 278 response transactions to allow for association and requests for (typically PDF and CCDA) documents using LOINC as the standard. It also supports requests for more detailed missing data using Questionnaire, CQL, and QuestionnaireResponse, as supported by Da Vinci DTR. It constrains the following elements to be *mandatory* (min=1): - A [contained](http://hl7.org/fhir/R4/references.html) Patient Resource defined by the [CDex Patient Demographics Profile](http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-patient-demographics) and communicating additional patient demographic data elements. - A [contained](http://hl7.org/fhir/R4/references.html) PractitionerRole Resource defined by the [CDex PractitionerRole Profile](http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-practitionerrole) to communicate the provider ID as either a unique organization/location identifier (e.g., Type 2 NPI) or unique provider identifier (e.g., Type 1 NPI) or both. - A Task.identifier element representing the payers tracking identifier (referred to as the “re-association tracking control numbers”) - A Task.status with a required binding to HRex [Task Status ValueSet](http://hl7.org/fhir/us/davinci-hrex/STU1/ValueSet-hrex-task-status.html) (this element is a mandatory Task element). For guidance when the provider is not able to complete the Task, refer to the [When The Task Cannot Be Completed section](http://hl7.org/fhir/us/davinci-cdex/STU2/task-based-approach.html#when-the-task-cannot-be-completed). - A Task.intent fixed to "order" (this element is a mandatory Task element) - A Task.code of either "attachment-request-code" or "attachment-request-questionnaire" communicating that the Payer is requesting attachments for a claim or prior authorization using a code or data request questionnaire. - If the code is "attachment-request-code", the provider system returns attachment(s) identified by the LOINC attachment code(s) in the "code" input parameter. - If the code is "attachment-request-questionnaire", the provider system uses [Documentation Templates and Rules (DTR)](http://hl7.org/fhir/us/davinci-dtr/2022May/) to complete the Questionnaire referenced in the "questionnaire" input parameter. - When either code is present, the provider system uses the $submit-attachment operation to return the information to the endpoint provided in "payer-url" input parameter. - A Task.requester.identifier element representing the Payer ID - A Task.owner.reference element fixed to "\#practionerrole" - a reference the contained PractitionerRole Resource that represents the Provider ID. - A Task.for.reference element fixed to "\#patient" - a reference the contained Patient Resource that represents basic Patient demographic data. - A Task.reasonCode to communicate whether the attachments are for a Claim or Prior Authorization - A Task.reasonReference.reference referencing the Claim or Prior Authorization ID (business Identifier) - A "payer-url" Task.input element representing the Payer endpoint URL to communicate to the provider to submit the attachments using the `$submit-attachment` operation It constrains following elements to be [*must support*](attachments-conformance.html#cdex-must-support-definition) (min=0): - A Task.Restriction.period element representing the due date for submitting the attachments - A Task.statusReason.text to communicate the reason for the status (for example, if the Task is rejected or failed) - A "code" Task.input element to communicate to the provider what attachments are needed using LOINC attachment codes.* - A "code" or "questionnaire" Task.input element extension representing a claim or prior authorization line item numbers associated with the attachment or questionnaire. - A "signature" Task.input element representing a flag to indicate whether the requested data requires a signature. For more information about requiring and requesting signatures, refer to the [Signatures section](http://hl7.org/fhir/us/davinci-cdex/STU2/sending-attachments.html#signatures). - A "service-date" Task.input element representing the date of service or starting date of the service for the claim or prior authorization. It SHALL be present if the attachment is for a claim. It defines the following elements to be *optional*: - A "questionnaire" Task.input element to communicate to the provider a URL of a data request [FHIR Questionnaire](http://hl7.org/fhir/questionnaire.html) that conforms to the [DTR SDC Questionnaire Profile](http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-sdc-questionnaire) or the [DTR SDC Questionnaire for Adaptive Form Profile](http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-sdc-questionnaire-adapt).* - A questionnaireDisplay extension to communicate the display name of the Questionnaire - A "POU" Task.input element representing the purpose of use (POU) for the requested data using an extensible [CDex Purpose of Use Value Set](http://hl7.org/fhir/us/davinci-cdex/ValueSet/cdex-POU). For more information about sending purpose POU codes, refer to the [Purpose of Use section](http://hl7.org/fhir/us/davinci-cdex/STU2/sending-attachments.html#signatures). - A "multiple-submits" Task.input element representing a flag to indicate whether the requested data can be sent in multiple submissions - A "data-value" Task.output element referring to FHIR resource(s) representing the result(s) of the data request code. - A "response" Task.output element which is a local reference to the [FHIR QuestionnaireResponse](http://hl7.org/fhir/questionnaireresponse.html) resulting from the data request Questionnaire. The QuestionnaireResponse conforms to the [SDC Questionnaire Response Profile](http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse) or the [SDC Adaptive Questionnaire Response Profile](http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt). \* Either a "code" or a "questionnaire" Task.input element is required
copyrightUsed by permission of HL7 International all rights reserved Creative Commons License
jurisdictionsus
fhirVersion4.0.1
kindresource
abstractfalse
sdTtypeTask
derivationconstraint
basehttp://hl7.org/fhir/StructureDefinition/Task
Usages
Name Flags Card. Type Description & Constraints doco
. . Task C Task cdex-1: The "service-date" input SHALL be present if the attachment is for a claim.
cdex-4: If code = "attachment-request-code", must have one or more "code" inputs.
cdex-5: If code = "attachment-request-questionnaire", must have one "questionnaire" input.
cdex-6: Must only have "code" inputs or one "questionnaire" input not both.
cdex-10: If code = "attachment-request-questionnaire" and status = "completed", should have one "questionnaire-response" output referencing the QuestionnaireResponse.
tdr-2: Task statusReason SHALL be populated if status is 'rejected' or 'failed'
. . . Slices for contained S 2 .. Slice: Unordered, Open by type:$this
. . . . contained:practitionerrole S 1..1 PractitionerRole Contained PractitionerRole resource
. . . . contained:patient S 1..1 Patient Contained Patient resource
. . . Slices for identifier S 1 .. Slice: Unordered, Open by pattern:$this
. . . . identifier:tracking-id S 1..1 Re-association tracking control number
Required Pattern: At least the following
. . . . . type 1..1 CodeableConcept Description of identifier
Fixed Value: (complex)
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: tracking-id
. . . . . system S
. . . . . value S 1..
. . . status S C Binding: HRex Task Status ValueSet ( required )
. . . statusReason S C
. . . . text S 1..
. . . intent S Fixed Value: order
. . . code S C 1.. attachment-request-code | attachment-request-questionnaire
Binding: CDex Attachment Task Code Value Set ( required )
. . . . coding S 1..
. . . . . system S Fixed Value: http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp
. . . . . code S 1..
. . . for S 1.. Reference (CDex Patient Demographics Profile) { c } Contained Patient.
. . . . reference S 1.. Contained resource reference
Fixed Value: #patient
. . . requester S 1.. Reference (US Core Organization Profile) Payer asking for attachments
. . . . identifier S 1.. Payer ID
. . . owner S 1.. Reference (CDex PractitionerRole Profile) { c } Provider who submitted claim or preauthorization
. . . . reference S 1.. Contained resource reference
Fixed Value: #practitionerrole
. . . reasonCode S 1..
. . . . Slices for coding S C 1 .. Slice: Unordered, Open by value:$this
. . . . . coding:use S 1..* Binding: CDex Claim Use Value Set ( required )
. . . . . . system S
. . . . . . code S 1.. claim | preauthorization
. . . . text S claim | preauthorization
Binding: CDex Claim Use Value Set ( required )
. . . reasonReference S 1..
. . . . identifier S 1.. Claim or Prior Authorization ID
. . . restriction S 0..
. . . . period S 0.. Attachments due date
. . . Slices for input S 2 .. Slice: Unordered, Open by pattern:type
. . . . input:code S C Attachment Codes
Binding: todo ( extensible )
. . . . . extension S 0..
. . . . . . url S "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber"
. . . . . . value[x] S 1.. positiveInt
. . . . . type S Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-hrex/CodeSystem/hrex-temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: data-code
. . . . . value[x] S CodeableConcept LOINC attachment code value
. . . . input:questionnaire C D ..1 Data Request questionnaire
. . . . . extension S 0..
. . . . . . url S "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceLineNumber"
. . . . . . value[x] S 1.. positiveInt
. . . . . type 1..1 CodeableConcept Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/sdc/CodeSystem/temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: questionnaire
. . . . . value[x] 1..1 canonical (http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-sdc-questionnaire | http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/dtr-sdc-questionnaire-adapt) URL
. . . . . . questionnaireDisplay 0..1 string Display name for canonical reference
URL: http://hl7.org/fhir/StructureDefinition/display
. . . . input:payer-url S 1..1 Payer Url
. . . . . type S Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: payer-url
. . . . . value[x] S url Payer url value
. . . . input:service-date S C ..1 Service Date
. . . . . type S Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: service-date
. . . . . value[x] S C date Service Date value
cdex-2: Date must be to day.
. . . . input:signature S ..1 Signature flag
. . . . . type S Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: signature-flag
. . . . . value[x] S boolean Signature flag value
. . . . input:POU ..1 Purpose of use code'
. . . . . type Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: purpose-of-use
. . . . . value[x] CodeableConcept Purpose of use value
Binding: CDex Purpose of Use Value Set ( extensible )
. . . . input:multiple-submits ..1 Multiple submits flag
. . . . . type Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: multiple-submits-flag
. . . . . value[x] boolean Multiple submits flag value
. . . Slices for output Slice: Unordered, Open by pattern:type
. . . . output:data Requested data
. . . . . type Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/us/davinci-hrex/CodeSystem/hrex-temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: data-value
. . . . . value[x] Reference () data reference
. . . . output:response C D ..1
. . . . . type CodeableConcept Required Pattern: At least the following
. . . . . . coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
. . . . . . . system 1..1 uri Identity of the terminology system
Fixed Value: http://hl7.org/fhir/uv/sdc/CodeSystem/temp
. . . . . . . code 1..1 code Symbol in syntax defined by the system
Fixed Value: questionnaire-response
. . . . . value[x] 1..1 Reference (SDC Questionnaire Response | Adaptive Questionnaire Response) Reference to the QuestionnaireResponse

doco Documentation for this format

Produced 08 Sep 2023