Details
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Change Request
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Resolution: Not Persuasive
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Medium
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US Da Vinci PAS (FHIR)
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1.2.0-ballot [deprecated]
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Financial Mgmt
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Formal Specification
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Bob Dieterle / Jeff Brown : 9-0-1
Description
as/2022May/StructureDefinition-profile-claim-definitions.html#Claim.procedure.procedure[x] has 2 possible data types, CodableConcept and Resource(Procedure). The Procedure Resource at http://hl7.org/fhir/R4/procedure.html doesn’t seem to allow for procedure modifier codes. These are used today in some Prior Authorization workflows, including common cases such as knee/hip replacements where left/right indicators are required.
Also, most PA workflows authorize based on CPT/HCPCS codes, and it’s unclear if the Procedure resource permits codesets other than SNOMED.
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