Name	Flags	Card.	Type	Description & Constraints
ServiceRequest		0..*	ServiceRequest	A request for a service to be performed
Slices for identifier		1..2	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier		1..1	Identifier	Identifiers assigned to this order
type		1..1	CodeableConcept	Description of identifier 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://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
value		1..1	string	The value that is unique
assigner		0..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier		0..1	Identifier	Identifiers assigned to this order
type		1..1	CodeableConcept	Description of identifier 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://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
value		1..1	string	The value that is unique
assigner		1..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
status		1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent		1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: order
code		1..1	CodeableConcept	Referral or specific type of referral Binding: Bidirectional Services eReferral Type (extensible)
subject		1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
occurrence[x]		1..1	dateTime	When service should occur
requester		1..1	Reference(BSeR Referral Initiator Practitioner Role)	Who/what is requesting service
performer		1..1	Reference(BSeR Referral Recipient Practitioner Role)	Requested performer
reasonCode	S	0..1	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:sliceInsuranceBSeRCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
supportingInfo	S	1..1	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
note		0..*	Annotation	Comments
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
ServiceRequest.code	extensible	Bidirectional Services eReferral Type
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ServiceRequest	A request for a service to be performed
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	1..2	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier	Σ	1..1	Identifier	Identifiers assigned to this order
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. 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://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
value	Σ	1..1	string	The value that is unique Example General: 123456
assigner	Σ	0..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier	Σ	0..1	Identifier	Identifiers assigned to this order
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. 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://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
value	Σ	1..1	string	The value that is unique Example General: 123456
assigner	Σ	1..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!Σ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: order
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	Σ	1..1	CodeableConcept	Referral or specific type of referral Binding: Bidirectional Services eReferral Type (extensible)
subject	Σ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
occurrence[x]	Σ	1..1	dateTime	When service should occur
requester	Σ	1..1	Reference(BSeR Referral Initiator Practitioner Role)	Who/what is requesting service
performer	Σ	1..1	Reference(BSeR Referral Recipient Practitioner Role)	Requested performer
reasonCode	SΣ	0..1	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:sliceInsuranceBSeRCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
supportingInfo	S	1..1	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
note		0..*	Annotation	Comments
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.use	required	IdentifierUse
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.type	extensible	Pattern: PLAC
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.use	required	IdentifierUse
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.type	extensible	Pattern: FILL
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	Pattern: order
ServiceRequest.code	extensible	Bidirectional Services eReferral Type
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ServiceRequest	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	ServiceRequest	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	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ServiceRequest	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()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists()

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ServiceRequest	A request for a service to be performed
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
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	1..2	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier	Σ	1..1	Identifier	Identifiers assigned to this order
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier	Σ	0..1	Identifier	Identifiers assigned to this order
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	1..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!Σ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: order
category	Σ	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	Σ	1..1	CodeableConcept	Referral or specific type of referral Binding: Bidirectional Services eReferral Type (extensible)
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	Σ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	Σ	1..1	dateTime	When service should occur
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	Σ	0..1	dateTime	Date request signed
requester	Σ	1..1	Reference(BSeR Referral Initiator Practitioner Role)	Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	Σ	1..1	Reference(BSeR Referral Recipient Practitioner Role)	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	SΣ	0..1	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:sliceInsuranceBSeRCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
supportingInfo	S	1..1	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.use	required	IdentifierUse
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.type	extensible	Pattern: PLAC
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.use	required	IdentifierUse
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.type	extensible	Pattern: FILL
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	Pattern: order
ServiceRequest.category	example	ServiceRequestCategoryCodes
ServiceRequest.priority	required	RequestPriority
ServiceRequest.code	extensible	Bidirectional Services eReferral Type
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerType	example	ParticipantRoles
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Summary

Mandatory: 12 elements (3 nested mandatory elements)
Must-Support: 4 elements

Structures

This structure refers to these other structures:

• BSeR Organization (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Organization)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• BSeR Referral Initiator Practitioner Role (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralInitiatorPractitionerRole)
• BSeR Referral Recipient Practitioner Role (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRecipientPractitionerRole)
• BSeR Coverage (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage)
• BSeR Referral Request Document Bundle (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRequestDocumentBundle)

Slices

This structure defines the following Slices:

• The element ServiceRequest.identifier is sliced based on the value of value:type
• The element ServiceRequest.insurance is sliced based on the value of profile:resolve()

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest		0..*	ServiceRequest	A request for a service to be performed
Slices for identifier		1..2	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier		1..1	Identifier	Identifiers assigned to this order
type		1..1	CodeableConcept	Description of identifier 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://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
value		1..1	string	The value that is unique
assigner		0..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier		0..1	Identifier	Identifiers assigned to this order
type		1..1	CodeableConcept	Description of identifier 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://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
value		1..1	string	The value that is unique
assigner		1..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
status		1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown
intent		1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: order
code		1..1	CodeableConcept	Referral or specific type of referral Binding: Bidirectional Services eReferral Type (extensible)
subject		1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
occurrence[x]		1..1	dateTime	When service should occur
requester		1..1	Reference(BSeR Referral Initiator Practitioner Role)	Who/what is requesting service
performer		1..1	Reference(BSeR Referral Recipient Practitioner Role)	Requested performer
reasonCode	S	0..1	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:sliceInsuranceBSeRCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
supportingInfo	S	1..1	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
note		0..*	Annotation	Comments
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet
ServiceRequest.code	extensible	Bidirectional Services eReferral Type
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ServiceRequest	A request for a service to be performed
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	1..2	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier	Σ	1..1	Identifier	Identifiers assigned to this order
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. 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://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
value	Σ	1..1	string	The value that is unique Example General: 123456
assigner	Σ	0..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier	Σ	0..1	Identifier	Identifiers assigned to this order
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. 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://terminology.hl7.org/CodeSystem/v2-0203
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
value	Σ	1..1	string	The value that is unique Example General: 123456
assigner	Σ	1..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!Σ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: order
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	Σ	1..1	CodeableConcept	Referral or specific type of referral Binding: Bidirectional Services eReferral Type (extensible)
subject	Σ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
occurrence[x]	Σ	1..1	dateTime	When service should occur
requester	Σ	1..1	Reference(BSeR Referral Initiator Practitioner Role)	Who/what is requesting service
performer	Σ	1..1	Reference(BSeR Referral Recipient Practitioner Role)	Requested performer
reasonCode	SΣ	0..1	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:sliceInsuranceBSeRCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
supportingInfo	S	1..1	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
note		0..*	Annotation	Comments
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.use	required	IdentifierUse
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.type	extensible	Pattern: PLAC
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.use	required	IdentifierUse
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.type	extensible	Pattern: FILL
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	Pattern: order
ServiceRequest.code	extensible	Bidirectional Services eReferral Type
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	ServiceRequest	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	ServiceRequest	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	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	ServiceRequest	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()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present : orderDetail.empty() or code.exists()

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	ServiceRequest	A request for a service to be performed
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
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	1..2	Identifier	Identifiers assigned to this order Slice: Unordered, Open by value:type
identifier:referralInitiatorServiceRequestIdentifier	Σ	1..1	Identifier	Identifiers assigned to this order
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PLAC
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
identifier:referralRecipientServiceRequestIdentifier	Σ	0..1	Identifier	Identifiers assigned to this order
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: FILL
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	1..1	Reference(BSeR Organization)	Organization that issued id (may be just text)
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!Σ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!Σ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: order
category	Σ	0..*	CodeableConcept	Classification of service Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	Σ	1..1	CodeableConcept	Referral or specific type of referral Binding: Bidirectional Services eReferral Type (extensible)
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	Σ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	Σ	1..1	dateTime	When service should occur
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	Σ	0..1	dateTime	Date request signed
requester	Σ	1..1	Reference(BSeR Referral Initiator Practitioner Role)	Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	Σ	1..1	Reference(BSeR Referral Recipient Practitioner Role)	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	SΣ	0..1	CodeableConcept	Reason for referral Binding: Bidirectional Services eReferral Reason (extensible)
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
Slices for insurance	S	0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage Slice: Unordered, Open by profile:resolve()
insurance:sliceInsuranceBSeRCoverage	S	0..*	Reference(BSeR Coverage)	Associated insurance coverage
supportingInfo	S	1..1	Reference(BSeR Referral Request Document Bundle)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.use	required	IdentifierUse
ServiceRequest.identifier:referralInitiatorServiceRequestIdentifier.type	extensible	Pattern: PLAC
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.use	required	IdentifierUse
ServiceRequest.identifier:referralRecipientServiceRequestIdentifier.type	extensible	Pattern: FILL
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	Pattern: order
ServiceRequest.category	example	ServiceRequestCategoryCodes
ServiceRequest.priority	required	RequestPriority
ServiceRequest.code	extensible	Bidirectional Services eReferral Type
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerType	example	ParticipantRoles
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	extensible	Bidirectional Services eReferral Reason
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Summary

Mandatory: 12 elements (3 nested mandatory elements)
Must-Support: 4 elements

Structures

This structure refers to these other structures:

• BSeR Organization (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Organization)
• US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
• BSeR Referral Initiator Practitioner Role (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralInitiatorPractitionerRole)
• BSeR Referral Recipient Practitioner Role (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRecipientPractitionerRole)
• BSeR Coverage (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-Coverage)
• BSeR Referral Request Document Bundle (http://hl7.org/fhir/us/bser/StructureDefinition/BSeR-ReferralRequestDocumentBundle)

Slices

This structure defines the following Slices:

• The element ServiceRequest.identifier is sliced based on the value of value:type
• The element ServiceRequest.insurance is sliced based on the value of profile:resolve()