Care Request Item Input

The details of a care service request, including name, modifiers, and the effective date. One or more care service requests can be associated with a care request.

Root XML tag 

<careRequestItem>

JSON example 

1{
2	"name": "95810",
3	"codeType": "CPT",
4	"sourceSystem": "source_system_name",
5	"codeDescription": "Dysuria",
6	"sourceSystemIdentifier": "0015cmi",
7	"quantity": "15"
8	}

Properties 

NameTypeDescriptionRequiredAvailable Version
approvedLength​OfStayIntegerThe number of days requested for the admission. Maps to: CareRequestItem.ApprovedLengthOfStayNo52.0
approvedLevel​OfCareIntegerSpecifies the approved level of care for the patient. Maps to: CareRequestItem.ApprovedLevelOfCareNo52.0
approvedQuantityIntegerThe approved quantity of the care item. Maps to: CareRequestItem.ApprovedQuantityNo46.0
approvedService​EndDateStringThe end date of the approved service that the patient received. Maps to: CareRequestItem.ApprovedServiceEndDateNo52.0
approvedService​StartDateStringThe start date of the approved service that the patient received. Maps to: CareRequestItem.ApprovedServiceStartDateNo52.0
AssertionIdentifierStringThe unique identifier of the coverage assertion. This is unavailable for PATCH requests.No63.0
authApproval​IdentifierStringThe unique identifier assigned to the item on approval of the prior authorization request. Maps to: CareRequestItem.AuthApprovalIdentifierNo57.0
authorization​RefIdentifierStringThe unique identifier of the prior authorization request associated with this requested item. Maps to: CareRequestItem.AuthorizationRefIdentifierNo57.0
careRequest​ReviewersCare Request Reviewer InputThe care request item associated with the care request reviewer. Maps to: CareRequestItem.CareRequestReviewersNo52.0
clinical​DeterminationStringThe clinical determination of the care request. Maps to: CareRequestItem.ClinicalDetermintationNo52.0
clinical​DeterminationNotesStringThe notes related to the clinical determination. Maps to: CareRequestItem.ClinicalDetermintationNotesNo52.0
clinical​DeterminationReasonStringThe reason for the clinical determination. Maps to: CareRequestItem.ClinicalDetermintationReasonNo52.0
clinicalService​RequestIdStringThe clinical service request associated with the care request item. Maps to: CareRequestItem.ClinicalServiceRequestNo57.0
codeStringID of the service code. Maps to: CareRequestItem.NameNo46.0
codeDescriptionStringDescription of the denied service code. Maps to: CareRequestItem.CodeDescriptionNo46.0
codeTypeStringCode type for the service. Maps to: CareRequestItem.CodeTypeNo46.0
codeTypeIdStringID of the code type for the service. Maps to: CareRequestItem.CodeTypeIdentifierNo46.0
cumulativeLength​OfStayIntegerThe number of days a patient is admitted. Maps to: CareRequestItem.CumulativeLengthOfStayNo52.0
currentLevel​OfCareStringSpecifies the level of care the patient is receiving. Maps to: CareRequestItem.CurrentLevelOfCareNo52.0
decisionDateStringThe date and time when the last decision was made for this care request item. Maps to: CareRequestItem.DecisionDateNo52.0
deniedLevel​OfCareStringThe level of care denied for the patient. Maps to: CareRequestItem.DeniedLevelOfCareNo52.0
deniedQuantityIntegerThe quantity of the denied service. Maps to: CareRequestItem.DeniedQuantityNo46.0
effectiveDateStringEffective date for the diagnosis Maps to: CareRequestItem.EffectiveDateNo46.0
endDateStringTermination date for the service. Maps to: CareRequestItem.EndDateNo46.0
freeFormProcedure​DescriptionStringFree-form description of the procedure. Maps to: CareRequestItem.FreeFormProcedureDescriptionNo46.0
healthcare​ProcedureCodeStringHealthcare Procedure Code.No46.0
idStringID of the CareRequestItem.Required for PATCH.46.0
modifiedCare​EndDateStringModified Care End DateNo46.0
modifiedCodeStringModified CodeNo46.0
modifiedCode​DescriptionStringDescription of the modified service code. Maps to: CareRequestItem.ModifiedCodeDescriptionNo46.0
modifiedCode​TypeStringCode type for the modified service. Maps to: CareRequestItem.ModifiedCodeTypeNo46.0
modifiedCode​TypeIdStringID of the code type for the modified service. Maps to: CareRequestItem.ModifiedCodeTypeIdentifierNo46.0
modified​EffectiveDateStringEffective date for the modified service. Maps to: CareRequestItem.ModifiedEffectiveDateNo46.0
modifiedLevel​OfCareStringSpecifies the modified level of care for the patient. Maps to: CareRequestItem.ModifiedLevelOfCareNo52.0
modifiedModifierStringModifier for modified service code. Maps to: CareRequestItem.ModifiedModifierNo46.0
modifiedModifier​DescriptionStringModifier description for modified service code. Maps to: CareRequestItem.ModifiedModifierDescriptionNo46.0
modifiedProcedure​CodeSetStringThe code set for the modified service, drug, or device associated with the care request item. Maps to: CareRequestItem.ModifiedProcedureCodeSetNo52.0
modifiedQuantityIntegerThe modified quantity of requested care. Maps to: CareRequestItem.ModifiedQuantityNo46.0
modifier1StringFirst modifier for the service code. Maps to: CareRequestItem.ModifierNo46.0
modifier1​DescriptionStringDescription for the first modifier for the service code. Maps to: CareRequestItem.ModifierDescriptionNo46.0
modifier2StringSecond modifier for service code. Maps to: CareRequestItem.Modifier2No46.0
modifier2​DescriptionStringDescription of the second modifier for the service code. Maps to: CareRequestItem.Modifier2DescriptionNo46.0
modifier3StringThird modifier for service code. Maps to: CareRequestItem.Modifier3No46.0
modifier3​DescriptionStringDescription of the third modifier for the service code. Maps to: CareRequestItem.Modifier3DescriptionNo46.0
modifier4StringFourth modifier for service code. Maps to: CareRequestItem.Modifier4No46.0
modifier4​DescriptionStringDescription of the fourth modifier for the service code. Maps to: CareRequestItem.Modifier4DescriptionNo46.0
modifierCodeSetStringThe modifier code set for the service code associated with the care request item. Maps to CareRequestItem.ModifierCodeSetNo52.0
nameStringName of the care request item. Maps to CareRequestItem.NameNo46.0
priorityStringThe priority representing the urgency of the item’s authorization request. Maps to CareRequestItem.PriorityNo57.0
procedureCodeSetStringThe code set for the service, drug, or device associated with the care request item. Maps to CareRequestItem.ProcedureCodeSetNo52.0
quantityIntegerThe quantity of the item that is requested. Maps to: CareRequestItem.QuantityNo46.0
quantityTypeStringQuantity type for the request such as days, units, or visits. Maps to: CareRequestItem.QualityTypeNo46.0
reasonCodeStringThe reason justifying the care request of the item. Maps to: CareRequestItem.ReasonCodeNo57.0
requestTypeStringThe type of item request. Maps to: CareRequestItem.RequestTypeNo57.0
requestedLength​OfStayIntegerThe number of days requested for the admission. Maps to: CareRequestItem.RequestedLengthOfStayNo52.0
requestedLevel​OfCareStringSpecifies the requested level of care for the patient. Maps to: CareRequestItem.RequestedLevelOfCareNo52.0
requestedService​EndDateStringThe end date of the requested service. Maps to: CareRequestItem.RequestedServiceEndDateNo52.0
requestedService​StartDateStringThe start date of the requested service. Maps to: CareRequestItem.RequestedServiceStartDateNo52.0
responseDateTimeStringThe date and time when the response was sent for the drug request.No63.0
serviceCategoryStringName of the service type such as medical care, diagnostic radiology, pharmacy, or diagnostic laboratory. Maps to: CareRequestItem.ServiceCategoryNo46.0
serviceCategory​CodeStringAlphanumeric code that uniquely identifies a service type. Maps to: CareRequestItem.ServiceCategoryCodeNo46.0
servicingFacilityServicing Facility InputThe facility where a patient receives service of the requested item. Maps to: CareRequestItem.ServicingFacilityNo57.0
servicingProviderServicing Practitioner InputThe healthcare provider who provides the service of the requested item. Maps to: CareRequestItem.ServicingProviderNo57.0
sourceSystemStringSystem from which the request was sourced. Maps to: CareRequestItem.SourceSystemNo46.0
sourceSystem​IdentifierStringID of the system from which the request was sourced. Maps to: CareRequestItem.SourceSystemIdentifierNo46.0
sourceSystem​ModifiedStringTimestamp of the most recent update from the source system. Maps to: CareRequestItem.SourceSystemModifiedNo46.0
statusStringThe authorization status of this service. Maps to: CareRequestItem.StatusNo46.0
statusReasonStringReason for the authorization status of this service. Maps to: CareRequestItem.StatusReasonNo46.0
submittedDateTimeStringThe date and time when the drug request was submitted. This is unavailable for PATCH requests.Yes63.0
transactionNumberIntegerThe transaction number assigned to the drug request. This is unavailable for PATCH requests.No63.0