The PAS DocumentReference resource is an documentReference resource profile that mandates support for additional elements e.g. text/rtf/xml attachment to the document which are required for a prior authorization request. This profile is required as part of the PAS Claim Bundle and is referenced in the PAS Claim resource.

Goal: Get PAS DocumentReference resource by ID for inclusion in the Claim Bundle.

Reference: PAS DocumentReference is referenced in the PAS Claim resource and PAS claim update as part of the required Claim Bundle structure.

Required for Claim Bundle. PAS DocumentReference is derived from PAS Base DocumentReference which is turn is derived from R4 DocumentReference resource

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference		0..*	DocumentReference	A reference to a document
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: US Core DocumentReference Type (required)
Slices for category	SΣ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:uscore	Σ	0..*	CodeableConcept	ADDITIONAL USCDI: Categorization of document Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a starter set of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets.
subject	SΣ	1..1	Reference(Patient)	Who/what is the subject of the document
date	SΣ	0..1	instant	When this document reference was created
author	SΣ	0..*	Reference(Practitioner)	Who and/or what authored the document
content	SΣ	1..*	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	SΣ	1..1	Attachment	Where to access the document
contentType	SΣ	1..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
data	S	1..1	base64Binary	Data inline, base64ed
format	SΣ	0..1	Coding	Format/content rules for the document Binding: HL7 ValueSet of Format Codes for use with Document Sharing (extensible)
context	SΣ	0..1	BackboneElement	Clinical context of document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter	S	0..*	Reference(Encounter)	Context of the document content
period	SΣ	0..1	Period	Time of service that is being documented
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 From the FHIR Standard
DocumentReference.type	required	USCoreDocumentReferenceType http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.category:uscore	required	USCoreDocumentReferenceCategory http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.content.attachment.contentType	required	Mime Types(a valid code from urn:ietf:bcp:13) http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 From the FHIR Standard
DocumentReference.content.format	extensible	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DocumentReference

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference		0..*	DocumentReference	A reference to a document
identifier	S	0..*	Identifier	Other identifiers for the document
status	S	1..1	code	current | superseded | entered-in-error
type	S	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: US Core DocumentReference Type (required)
Slices for category	S	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this
category:uscore		0..*	CodeableConcept	ADDITIONAL USCDI: Categorization of document Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a starter set of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets.
subject	S	1..1	Reference(Patient)	Who/what is the subject of the document
date	S	0..1	instant	When this document reference was created
author	S	0..*	Reference(Practitioner)	Who and/or what authored the document
content	S	1..*	BackboneElement	Document referenced
attachment	S	1..1	Attachment	Where to access the document
contentType	S	1..1	code	Mime type of the content, with charset etc.
data	S	1..1	base64Binary	Data inline, base64ed
url		0..0
format	S	0..1	Coding	Format/content rules for the document Binding: HL7 ValueSet of Format Codes for use with Document Sharing (extensible)
context	S	0..1	BackboneElement	Clinical context of document
encounter	S	0..*	Reference(Encounter)	Context of the document content
period	S	0..1	Period	Time of service that is being documented
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.type	required	USCoreDocumentReferenceType http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.category:uscore	required	USCoreDocumentReferenceCategory http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.content.format	extensible	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference		0..*	DocumentReference	A reference to a document
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	Σ	0..1	Identifier	Master Version Specific Identifier
identifier	SΣ	0..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
docStatus	Σ	0..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: US Core DocumentReference Type (required)
Slices for category	SΣ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:uscore	Σ	0..*	CodeableConcept	ADDITIONAL USCDI: Categorization of document Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a starter set of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets.
subject	SΣ	1..1	Reference(Patient)	Who/what is the subject of the document
date	SΣ	0..1	instant	When this document reference was created
author	SΣ	0..*	Reference(Practitioner)	Who and/or what authored the document
authenticator		0..1	Reference(Practitioner | PractitionerRole | Organization)	Who/what authenticated the document
custodian		0..1	Reference(Organization)	Organization which maintains the document
relatesTo	Σ	0..*	BackboneElement	Relationships to other documents
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
code	Σ	1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	Σ	0..1	string	Human-readable description
securityLabel	Σ	0..*	CodeableConcept	Document security-tags Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content	SΣ	1..*	BackboneElement	Document referenced
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
attachment	SΣ	1..1	Attachment	Where to access the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	1..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	1..1	base64Binary	Data inline, base64ed
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	Σ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	Σ	0..1	dateTime	Date attachment was first created
format	SΣ	0..1	Coding	Format/content rules for the document Binding: HL7 ValueSet of Format Codes for use with Document Sharing (extensible)
context	SΣ	0..1	BackboneElement	Clinical context of document
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
encounter	S	0..*	Reference(Encounter)	Context of the document content
event		0..*	CodeableConcept	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	SΣ	0..1	Period	Time of service that is being documented
facilityType		0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting		0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo		0..1	Reference(Patient)	Patient demographics from source
related		0..*	Reference(Resource)	Related identifiers or resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 From the FHIR Standard
DocumentReference.docStatus	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
DocumentReference.type	required	USCoreDocumentReferenceType http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.category:uscore	required	USCoreDocumentReferenceCategory http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 From the FHIR Standard
DocumentReference.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
DocumentReference.content.attachment.contentType	required	Mime Types(a valid code from urn:ietf:bcp:13) http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 From the FHIR Standard
DocumentReference.content.attachment.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.content.format	extensible	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.context.event	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityType	example	FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodes From the FHIR Standard
DocumentReference.context.practiceSetting	example	PracticeSettingCodeValueSet http://hl7.org/fhir/ValueSet/c80-practice-codes From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference		0..*	DocumentReference	A reference to a document
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: US Core DocumentReference Type (required)
Slices for category	SΣ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:uscore	Σ	0..*	CodeableConcept	ADDITIONAL USCDI: Categorization of document Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a starter set of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets.
subject	SΣ	1..1	Reference(Patient)	Who/what is the subject of the document
date	SΣ	0..1	instant	When this document reference was created
author	SΣ	0..*	Reference(Practitioner)	Who and/or what authored the document
content	SΣ	1..*	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	SΣ	1..1	Attachment	Where to access the document
contentType	SΣ	1..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
data	S	1..1	base64Binary	Data inline, base64ed
format	SΣ	0..1	Coding	Format/content rules for the document Binding: HL7 ValueSet of Format Codes for use with Document Sharing (extensible)
context	SΣ	0..1	BackboneElement	Clinical context of document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
encounter	S	0..*	Reference(Encounter)	Context of the document content
period	SΣ	0..1	Period	Time of service that is being documented
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 From the FHIR Standard
DocumentReference.type	required	USCoreDocumentReferenceType http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.category:uscore	required	USCoreDocumentReferenceCategory http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.content.attachment.contentType	required	Mime Types(a valid code from urn:ietf:bcp:13) http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 From the FHIR Standard
DocumentReference.content.format	extensible	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from DocumentReference

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference		0..*	DocumentReference	A reference to a document
identifier	S	0..*	Identifier	Other identifiers for the document
status	S	1..1	code	current | superseded | entered-in-error
type	S	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: US Core DocumentReference Type (required)
Slices for category	S	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this
category:uscore		0..*	CodeableConcept	ADDITIONAL USCDI: Categorization of document Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a starter set of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets.
subject	S	1..1	Reference(Patient)	Who/what is the subject of the document
date	S	0..1	instant	When this document reference was created
author	S	0..*	Reference(Practitioner)	Who and/or what authored the document
content	S	1..*	BackboneElement	Document referenced
attachment	S	1..1	Attachment	Where to access the document
contentType	S	1..1	code	Mime type of the content, with charset etc.
data	S	1..1	base64Binary	Data inline, base64ed
url		0..0
format	S	0..1	Coding	Format/content rules for the document Binding: HL7 ValueSet of Format Codes for use with Document Sharing (extensible)
context	S	0..1	BackboneElement	Clinical context of document
encounter	S	0..*	Reference(Encounter)	Context of the document content
period	S	0..1	Period	Time of service that is being documented
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.type	required	USCoreDocumentReferenceType http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.category:uscore	required	USCoreDocumentReferenceCategory http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.content.format	extensible	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference		0..*	DocumentReference	A reference to a document
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
masterIdentifier	Σ	0..1	Identifier	Master Version Specific Identifier
identifier	SΣ	0..*	Identifier	Other identifiers for the document
status	?!SΣ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
docStatus	Σ	0..1	code	preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): Status of the underlying document.
type	SΣ	1..1	CodeableConcept	Kind of document (LOINC if possible) Binding: US Core DocumentReference Type (required)
Slices for category	SΣ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by pattern:$this Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
category:uscore	Σ	0..*	CodeableConcept	ADDITIONAL USCDI: Categorization of document Binding: US Core DocumentReference Category (required): The US Core DocumentReferences Type Value Set is a starter set of categories supported for fetching and storing clinical notes. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets.
subject	SΣ	1..1	Reference(Patient)	Who/what is the subject of the document
date	SΣ	0..1	instant	When this document reference was created
author	SΣ	0..*	Reference(Practitioner)	Who and/or what authored the document
authenticator		0..1	Reference(Practitioner | PractitionerRole | Organization)	Who/what authenticated the document
custodian		0..1	Reference(Organization)	Organization which maintains the document
relatesTo	Σ	0..*	BackboneElement	Relationships to other documents
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
code	Σ	1..1	code	replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	Σ	0..1	string	Human-readable description
securityLabel	Σ	0..*	CodeableConcept	Document security-tags Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
content	SΣ	1..*	BackboneElement	Document referenced
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
attachment	SΣ	1..1	Attachment	Where to access the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	SΣ	1..1	code	Mime type of the content, with charset etc. Binding: Mime Types (required): The mime type of an attachment. Any valid mime type is allowed. Example General: text/plain; charset=UTF-8, image/png
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding Example General: en-AU
data	S	1..1	base64Binary	Data inline, base64ed
size	Σ	0..1	unsignedInt	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	Σ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	Σ	0..1	dateTime	Date attachment was first created
format	SΣ	0..1	Coding	Format/content rules for the document Binding: HL7 ValueSet of Format Codes for use with Document Sharing (extensible)
context	SΣ	0..1	BackboneElement	Clinical context of document
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
encounter	S	0..*	Reference(Encounter)	Context of the document content
event		0..*	CodeableConcept	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period	SΣ	0..1	Period	Time of service that is being documented
facilityType		0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting		0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: PracticeSettingCodeValueSet (example): Additional details about where the content was created (e.g. clinical specialty).
sourcePatientInfo		0..1	Reference(Patient)	Patient demographics from source
related		0..*	Reference(Resource)	Related identifiers or resources
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
DocumentReference.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|4.0.1 From the FHIR Standard
DocumentReference.docStatus	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|4.0.1 From the FHIR Standard
DocumentReference.type	required	USCoreDocumentReferenceType http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-type
DocumentReference.category	example	DocumentClassValueSet http://hl7.org/fhir/ValueSet/document-classcodes From the FHIR Standard
DocumentReference.category:uscore	required	USCoreDocumentReferenceCategory http://hl7.org/fhir/us/core/ValueSet/us-core-documentreference-category
DocumentReference.relatesTo.code	required	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1 From the FHIR Standard
DocumentReference.securityLabel	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
DocumentReference.content.attachment.contentType	required	Mime Types(a valid code from urn:ietf:bcp:13) http://hl7.org/fhir/ValueSet/mimetypes|4.0.1 From the FHIR Standard
DocumentReference.content.attachment.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
DocumentReference.content.format	extensible	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.context.event	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.context.facilityType	example	FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodes From the FHIR Standard
DocumentReference.context.practiceSetting	example	PracticeSettingCodeValueSet http://hl7.org/fhir/ValueSet/c80-practice-codes From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from DocumentReference

Summary

Mandatory: 5 elements
Must-Support: 15 elements
Prohibited: 1 element

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DocumentReference.category

Supported Interactions

The Interactions supported by this resource are listed below.

• Read