Error: The extension is not allowed to be used at this point

[jinlou98]

The validation errors indicate that the given extensions can only be a part of Claim.Item or ClaimResponse directly, but the same implementation guide also lists them as part of ClaimResponse.item and ClaimResponse.item.extension in the resource profiles.

Below is our sample ClaimResponse.item extension:

ClaimResponse.item[0].extension:
[
   {
         "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-administrationReferenceNumber",
         "valueString": "EXAMPLE_NUMBER"
    },
    {
        "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-epsdtIndicator",
        "valueBoolean": false
    },
    {
        "url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-nursingHomeLevelOfCare",
        "valueCodeableConcept": {
             "coding": [
                 {
                     "code": "EXAMPLE_CODE",
                     "system": "https://codesystem.x12.org/005010/1337"
                 }
              ]
         }
     }
]

Below are the structure definitions showing them as part of ClaimResponse.item.extension:
http://hl7.org/fhir/us/davinci-pas/STU2/StructureDefinition-profile-claimresponse-base-definitions.html#diff_ClaimResponse.item.extension:administrationReferenceNumber
http://hl7.org/fhir/us/davinci-pas/STU2/StructureDefinition-profile-claim-definitions.html#diff_Claim.item.extension:epsdtIndicator
http://hl7.org/fhir/us/davinci-pas/STU2/StructureDefinition-profile-claim-definitions.html#diff_Claim.item.extension:nursingHomeLevelOfCare

I am wondering if you know this is a PAS Test Suite issue or IG issue, thank you!

[karlnaden]

I think this is an IG issue:

• The PAS Claim Response Base profile indicates that the administrationReferenceNumber extension appears under item
• The AdministrationReferenceNumber extension indicates that it appears at the ClaimResponse level (Element ID ClaimResponse)

Compare this to the Claim resource where

• The PAS Claim Base profile indicates that the administrationReferenceNumber extension appears under item
• The AdministrationReferenceNumber extension also indicates that it appears under item within Claim instances (Element ID Claim.item)

I think that each of the extensions you reference should look more like the RequestedService extension which indicates usage in context Element ID ClaimResponse.item.

It looks like the current build version is the same, so it doesn't appear to have been addressed yet. If you raise it with the PAS IG authors and get confirmation that these are spurious errors, we may be able to filter them out of the Inferno output even before the new version is published.

[jinlou98]

Hi Karl, thank you for taking a look! Your theory makes sense to me. I posted in the Zulips FHIR PAS group, and I will update here once I hear back from the IG authors.

[jinlou98]

Hi Karl, I heard back from Jean Duteau that anywhere the extensions are used will be the proper context. Based on the ClaimReponse spec, the extensions appear to be under ClaimResponse.item. Some of the extensions have incorrect contexts and will be updated in the next STU update.

Link to PAS Zulips post: https://chat.fhir.org/#narrow/stream/208874-Da-Vinci-PAS/topic/Extension.20under.20ClaimResponse.20or.20ClaimResponse.2Eitem

[karlnaden]

Thanks for chasing down that answer Jin.

In terms of updating the PAS test kit, our current thinking is that we’re not ready at this stage to start adding exceptions to issues in the IG like we do in some of our other more mature test kits. Our proposal would be to add a list of known issues in the test kit and link to tickets like this one and include a note on specific tests that are impacted. So the errors would still be there, but users would be alerted to their spurious nature. As the test kit matures and clear fixes are published in subsequent versions of the IG, we can promote those to actual exceptions.

It would look something like this:

Linking to: #11

Linking to: https://github.com/inferno-framework/davinci-pas-test-kit/labels/source%20ig%20issue

Let us know what you think of that plan and thanks again for the feedback and for tracking down an answer from the IG authors.

[jinlou98]

Karl, this plan sounds good to me! Thank you.