Usage

This profile is used to capture a course of radiotherapy delivered to a patient. An overview of radiotherapy courses, phases, and treatment plans is shown here. A course of therapy systematically addresses a condition or set of related conditions. The course can include multiple sessions, can be divided into multiple phases, and can last for several months. A course of treatment has a distinct beginning and end. While the Radiotherapy Course Summary can be incrementally updated as the treatment progresses, the primary purpose is to summarize the entire course of treatment from beginning to end. The status element indicates whether the treatment is in progress or complete. The relationships between the various radiotherapy profiles are shown here.

Course and Phase definitions follow the recommendations of the American Association of Physicists in Medicine (AAPM) Operational Ontology for Oncology (O3).

Conformance

Procedure resources whose code is SNOMEDCT 1217123003 (Radiotherapy course of treatment (regime/therapy)) MUST conform to this profile. Any resource intended to conform to this profile SHOULD populate meta.profile accordingly.

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Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: us-core-7, termination-reason-code-invariant, termination-reason-invariant, mcode-reason-required, codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred, codexrt-procedure-status
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:terminationReason		0..1	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:modalityAndTechnique	SC	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Constraints: TechniquesForNeutronBeamModality, TechniquesForPhotonBeamModality, TechniquesForElectronBeamModality, TechniquesForCarbonIonBeamModality, TechniquesForProtonBeamModality, TechniquesForInternalRadiotherapyPermanentSeeds, TechniquesForLowDoseRateUsingTempRadSource, TechniquesForPulsedDoseRate, TechniquesForHighDoseRate, TechniquesForHighDoseRateElectronic, TechniquesForRadioPharmaceutical, ModalityTextRequiredForOther, TechniqueTextRequiredForOther
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modality	S	1..1	(Complex)	Radiotherapy Modality Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Modality Value Set (required)
extension:technique	S	0..*	(Complex)	Radiotherapy Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Technique Value Set (required)
extension:radiotherapyEnergyOrIsotope	S	0..*	SimpleQuantity	Radiotherapy Energy or Isotope URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope Binding: Radiotherapy Energy Unit Value Set (required)
extension:radiotherapyTreatmentApplicatorType	S	0..*	CodeableConcept	Radiotherapy Treatment Applicator Type URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type Binding: Brachytherapy Applicator Type Value Set (extensible)
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
extension:actualNumberOfSessions	S	0..1	unsignedInt	Radiotherapy Number of Sessions Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions
extension:doseDeliveredToVolume	S	0..*	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:volume	S	1..1	Extension	Volume in the body where radiation was delivered
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"volume"
extension:totalDoseDelivered	S	0..1	Extension	Total Physical Radiation Dose Delivered
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"totalDoseDelivered"
value[x]		0..1	Quantity	Value of extension Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< | <= | >= | > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: cGy
extension:fractionsDelivered	S	0..1	Extension	Number of Fractions Delivered
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"fractionsDelivered"
extension:pointDose	S	0..1	boolean	Point Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
extension:primaryPlanDose	S	0..1	boolean	Primary Plan Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
extension:radiobiologicMetric	S	0..*	Quantity	Radiotherapy Biologically Effective Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
extension:uniformFractionation	S	1..1	boolean	Uniform Fractionation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-uniform-fractionation
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
extension:respiratoryMotionManagement	S	0..*	CodeableConcept	Respiratory Motion Management URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management Binding: Radiotherapy Respiratory Motion Management Value Set (required)
extension:freeBreathingMotionManagementTechnique	S	0..*	CodeableConcept	Free-Breathing Motion Management Technique URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
extension:intrafractionVerification	S	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
extension:imageGuidedRadiotherapyModality	S	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	2..*	Identifier	External Identifiers for this procedure Slice: Unordered, Open by value:use
identifier:displayName	SΣ	1..1	Identifier	The name that is displayed to the user.
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
identifier:official	SΣ	1..*	Identifier	A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
Slices for basedOn	Σ	0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	(USCDI) A request for this procedure Slice: Unordered, Open by profile:$this.resolve()
basedOn:planned-course	SΣ	0..1	Reference(Radiotherapy Planned Course)	Radiotherapy Planned Course that planned the treatment summarized in this Radiotherapy Course Summary.
basedOn:course-prescription	SΣ	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that prescribed the treatment summarized in this Radiotherapy Course Summary.
status	?!SΣC	1..1	code	(USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
statusReason	SΣ	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reason Value Set (preferred)
category	Σ	1..1	CodeableConcept	Classification of the procedure Binding: Radiotherapy Category Code Max Value Set (required)
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
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
subject	SΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on
performed[x]	SΣC	0..1	Period	(USCDI) When the procedure was performed
start	SΣC	0..1	dateTime	The date and time when the first therapeutic radiation was delivered.
end	SΣC	0..1	dateTime	An end date is expected if the status is 'stopped' or 'completed'
Slices for performer	SΣ	0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by profile:actor.resolve()
performer:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
performer:organization	SΣ	0..*	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(US Core Organization Profile)	Organization that provided the radiotherapy treatment.
location	SΣ	0..1	Reference(US Core Location Profile)	Location where the radiotherapy treatment was performed.
reasonCode	SΣ	0..*	CodeableConcept	Coded reason procedure performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	The justification that the procedure was performed
bodySite	SΣ	0..*	CodeableConcept	All body structure(s) treated Binding: Radiotherapy Treatment Location Value Set (extensible)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	CodeableConcept	General location qualifier (excluding laterality) for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier		0..1	CodeableConcept	Laterality qualifier for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required)
Slices for focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device Slice: Unordered, Open by profile:manipulated.resolve()
focalDevice:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manipulated		1..1	Reference(Device)	Device that was changed
focalDevice:seedDevice	S	0..*	BackboneElement	Radiotherapy Seed Device used as part of therapy.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manipulated		1..1	Reference(Radiotherapy Seed Device)	Device that was changed
Slices for usedReference	S	0..*	Reference(Device | Medication | Substance)	Items used during procedure Slice: Unordered, Open by profile:$this.resolve()
usedReference:treatmentDevice	S	0..*	Reference(Radiotherapy Treatment Device)	Radiotherapy Treatment Device used as part of therapy.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.extension:modalityAndTechnique.​extension:modality.value[x]	Base	required	Radiotherapy Modality Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.extension:modalityAndTechnique.​extension:technique.​value[x]	Base	required	Radiotherapy Technique Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.identifier:displayName.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Procedure.identifier:official.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	preferred	Treatment Termination Reason Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.category	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
Procedure.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	extensible	Radiotherapy Treatment Location Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0

Constraints

Id	Grade	Path(s)	Description	Expression
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
ModalityTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
TechniqueTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
TechniquesForCarbonIonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Carbon Ion Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
TechniquesForElectronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Electron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
TechniquesForHighDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForHighDoseRateElectronic	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate Electronic	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForInternalRadiotherapyPermanentSeeds	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Internal Radiotherapy - Permanent Seeds	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
TechniquesForLowDoseRateUsingTempRadSource	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Low Dose Rate Using Temp Radiation Source	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
TechniquesForNeutronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Neutron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
TechniquesForPhotonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Photon Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
TechniquesForProtonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Proton Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
TechniquesForPulsedDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Pulsed Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
TechniquesForRadioPharmaceutical	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Radiopharmaceutical	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')
codexrt-free-breathing-technique	error	Procedure	The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-none	error	Procedure	If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-status	error	Procedure	Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed	status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	Procedure	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	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	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()
mcode-reason-required	warning	Procedure	One of reasonCode or reasonReference SHALL be present	reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	Procedure	When status is stopped, only certain statusReason values are allowed	status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	Procedure	Certain statusReason values are allowed only when status is stopped	statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred, codexrt-procedure-status
Slices for extension				Content/Rules for all slices
extension:modalityAndTechnique		0..*	RadiotherapyModalityAndTechnique	Radiotherapy Modality And Technique Extension
Slices for extension				Content/Rules for all slices
extension:radiotherapyEnergyOrIsotope	S	0..*	SimpleQuantity	Radiotherapy Energy or Isotope URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope Binding: Radiotherapy Energy Unit Value Set (required)
extension:radiotherapyTreatmentApplicatorType	S	0..*	CodeableConcept	Radiotherapy Treatment Applicator Type URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type Binding: Brachytherapy Applicator Type Value Set (extensible)
extension:doseDeliveredToVolume		0..*	RadiotherapyDoseDeliveredToVolume	Radiotherapy Dose Delivered To Volume Extension
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:pointDose	S	0..1	boolean	Point Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
extension:primaryPlanDose	S	0..1	boolean	Primary Plan Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
extension:radiobiologicMetric	S	0..*	Quantity	Radiotherapy Biologically Effective Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
extension:uniformFractionation	S	1..1	boolean	Uniform Fractionation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-uniform-fractionation
extension:respiratoryMotionManagement	S	0..*	CodeableConcept	Respiratory Motion Management URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management Binding: Radiotherapy Respiratory Motion Management Value Set (required)
extension:freeBreathingMotionManagementTechnique	S	0..*	CodeableConcept	Free-Breathing Motion Management Technique URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
extension:intrafractionVerification	S	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
extension:imageGuidedRadiotherapyModality	S	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
Slices for identifier	S	2..*	Identifier	External Identifiers for this procedure Slice: Unordered, Open by value:use
identifier:displayName	S	1..1	Identifier	The name that is displayed to the user.
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: usual
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique
identifier:official	S	1..*	Identifier	A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: official
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique
Slices for basedOn		0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	(USCDI) A request for this procedure Slice: Unordered, Open by profile:$this.resolve()
basedOn:planned-course	S	0..1	Reference(Radiotherapy Planned Course)	Radiotherapy Planned Course that planned the treatment summarized in this Radiotherapy Course Summary.
basedOn:course-prescription	S	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that prescribed the treatment summarized in this Radiotherapy Course Summary.
category		1..1	CodeableConcept	Classification of the procedure Binding: Radiotherapy Category Code Max Value Set (required)
performed[x]
start	S	0..1	dateTime	The date and time when the first therapeutic radiation was delivered.
end	S	0..1	dateTime	An end date is expected if the status is 'stopped' or 'completed'
Slices for performer	S	0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by profile:actor.resolve()
performer:organization	S	0..*	BackboneElement	The people who performed the procedure
actor		1..1	Reference(US Core Organization Profile)	Organization that provided the radiotherapy treatment.
location	S	0..1	Reference(US Core Location Profile)	Location where the radiotherapy treatment was performed.
Slices for focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device Slice: Unordered, Open by profile:manipulated.resolve()
focalDevice:seedDevice	S	0..*	BackboneElement	Radiotherapy Seed Device used as part of therapy.
manipulated		1..1	Reference(Radiotherapy Seed Device)	Device that was changed
Slices for usedReference	S	0..*	Reference(Device | Medication | Substance)	Items used during procedure Slice: Unordered, Open by profile:$this.resolve()
usedReference:treatmentDevice	S	0..*	Reference(Radiotherapy Treatment Device)	Radiotherapy Treatment Device used as part of therapy.
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Procedure.category	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-technique	error	Procedure	The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-none	error	Procedure	If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-status	error	Procedure	Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed	status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: us-core-7, termination-reason-code-invariant, termination-reason-invariant, mcode-reason-required, codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred, codexrt-procedure-status
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
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:terminationReason		0..1	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:modalityAndTechnique	SC	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Constraints: TechniquesForNeutronBeamModality, TechniquesForPhotonBeamModality, TechniquesForElectronBeamModality, TechniquesForCarbonIonBeamModality, TechniquesForProtonBeamModality, TechniquesForInternalRadiotherapyPermanentSeeds, TechniquesForLowDoseRateUsingTempRadSource, TechniquesForPulsedDoseRate, TechniquesForHighDoseRate, TechniquesForHighDoseRateElectronic, TechniquesForRadioPharmaceutical, ModalityTextRequiredForOther, TechniqueTextRequiredForOther
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modality	S	1..1	(Complex)	Radiotherapy Modality Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Modality Value Set (required)
extension:technique	S	0..*	(Complex)	Radiotherapy Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Technique Value Set (required)
extension:radiotherapyEnergyOrIsotope	S	0..*	SimpleQuantity	Radiotherapy Energy or Isotope URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope Binding: Radiotherapy Energy Unit Value Set (required)
extension:radiotherapyTreatmentApplicatorType	S	0..*	CodeableConcept	Radiotherapy Treatment Applicator Type URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type Binding: Brachytherapy Applicator Type Value Set (extensible)
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
extension:actualNumberOfSessions	S	0..1	unsignedInt	Radiotherapy Number of Sessions Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions
extension:doseDeliveredToVolume	S	0..*	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:volume	S	1..1	Extension	Volume in the body where radiation was delivered
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"volume"
value[x]		0..1	Reference(Radiotherapy Volume Profile)	Value of extension
extension:totalDoseDelivered	S	0..1	Extension	Total Physical Radiation Dose Delivered
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"totalDoseDelivered"
value[x]		0..1	Quantity	Value of extension Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< | <= | >= | > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: cGy
extension:fractionsDelivered	S	0..1	Extension	Number of Fractions Delivered
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"fractionsDelivered"
value[x]		0..1	unsignedInt	Value of extension
extension:pointDose	S	0..1	boolean	Point Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
extension:primaryPlanDose	S	0..1	boolean	Primary Plan Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
extension:radiobiologicMetric	S	0..*	Quantity	Radiotherapy Biologically Effective Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
extension:uniformFractionation	S	1..1	boolean	Uniform Fractionation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-uniform-fractionation
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
extension:respiratoryMotionManagement	S	0..*	CodeableConcept	Respiratory Motion Management URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management Binding: Radiotherapy Respiratory Motion Management Value Set (required)
extension:freeBreathingMotionManagementTechnique	S	0..*	CodeableConcept	Free-Breathing Motion Management Technique URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
extension:intrafractionVerification	S	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
extension:imageGuidedRadiotherapyModality	S	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	2..*	Identifier	External Identifiers for this procedure Slice: Unordered, Open by value:use
identifier:displayName	SΣ	1..1	Identifier	The name that is displayed to the user.
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	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual
type	Σ	0..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.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	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(Organization)	Organization that issued id (may be just text)
identifier:official	SΣ	1..*	Identifier	A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
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	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
type	Σ	0..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.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	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(Organization)	Organization that issued id (may be just text)
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
Slices for basedOn	Σ	0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	(USCDI) A request for this procedure Slice: Unordered, Open by profile:$this.resolve()
basedOn:planned-course	SΣ	0..1	Reference(Radiotherapy Planned Course)	Radiotherapy Planned Course that planned the treatment summarized in this Radiotherapy Course Summary.
basedOn:course-prescription	SΣ	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that prescribed the treatment summarized in this Radiotherapy Course Summary.
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event
status	?!SΣC	1..1	code	(USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
statusReason	SΣ	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reason Value Set (preferred)
category	Σ	1..1	CodeableConcept	Classification of the procedure Binding: Radiotherapy Category Code Max Value Set (required)
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
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
subject	SΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
performed[x]	SΣC	0..1	Period	(USCDI) When the procedure was performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	The date and time when the first therapeutic radiation was delivered.
end	SΣC	0..1	dateTime	An end date is expected if the status is 'stopped' or 'completed'
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
Slices for performer	SΣ	0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by profile:actor.resolve()
performer:All Slices				Content/Rules for all slices
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:organization	SΣ	0..*	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(US Core Organization Profile)	Organization that provided the radiotherapy treatment.
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	SΣ	0..1	Reference(US Core Location Profile)	Location where the radiotherapy treatment was performed.
reasonCode	SΣ	0..*	CodeableConcept	Coded reason procedure performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	The justification that the procedure was performed
bodySite	SΣ	0..*	CodeableConcept	All body structure(s) treated Binding: Radiotherapy Treatment Location Value Set (extensible)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:locationQualifier		0..*	CodeableConcept	General location qualifier (excluding laterality) for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier		0..1	CodeableConcept	Laterality qualifier for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	A condition that is a result of the procedure
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
Slices for focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device Slice: Unordered, Open by profile:manipulated.resolve()
focalDevice:All Slices				Content/Rules for all slices
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
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
focalDevice:seedDevice	S	0..*	BackboneElement	Radiotherapy Seed Device used as part of therapy.
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
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Radiotherapy Seed Device)	Device that was changed
Slices for usedReference	S	0..*	Reference(Device | Medication | Substance)	Items used during procedure Slice: Unordered, Open by profile:$this.resolve()
usedReference:treatmentDevice	S	0..*	Reference(Radiotherapy Treatment Device)	Radiotherapy Treatment Device used as part of therapy.
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Procedure.extension:modalityAndTechnique.​extension:modality.value[x]	Base	required	Radiotherapy Modality Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.extension:modalityAndTechnique.​extension:technique.​value[x]	Base	required	Radiotherapy Technique Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.identifier:displayName.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Procedure.identifier:displayName.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Procedure.identifier:official.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Procedure.identifier:official.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	preferred	Treatment Termination Reason Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.category	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
Procedure.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
Procedure.performer.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:organization.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	extensible	Radiotherapy Treatment Location Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.outcome	Base	example	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📦4.0.1	FHIR Std.
Procedure.followUp	Base	example	Procedure Follow up Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.focalDevice.​action	Base	preferred	Procedure Device Action Codes	📦4.0.1	FHIR Std.
Procedure.focalDevice:seedDevice.​action	Base	preferred	Procedure Device Action Codes	📦4.0.1	FHIR Std.
Procedure.usedCode	Base	example	FHIR Device Types	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
ModalityTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
TechniqueTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
TechniquesForCarbonIonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Carbon Ion Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
TechniquesForElectronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Electron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
TechniquesForHighDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForHighDoseRateElectronic	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate Electronic	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForInternalRadiotherapyPermanentSeeds	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Internal Radiotherapy - Permanent Seeds	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
TechniquesForLowDoseRateUsingTempRadSource	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Low Dose Rate Using Temp Radiation Source	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
TechniquesForNeutronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Neutron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
TechniquesForPhotonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Photon Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
TechniquesForProtonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Proton Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
TechniquesForPulsedDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Pulsed Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
TechniquesForRadioPharmaceutical	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Radiopharmaceutical	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')
codexrt-free-breathing-technique	error	Procedure	The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-none	error	Procedure	If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-status	error	Procedure	Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed	status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	Procedure	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	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	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()
mcode-reason-required	warning	Procedure	One of reasonCode or reasonReference SHALL be present	reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	Procedure	When status is stopped, only certain statusReason values are allowed	status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	Procedure	Certain statusReason values are allowed only when status is stopped	statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: us-core-7, termination-reason-code-invariant, termination-reason-invariant, mcode-reason-required, codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred, codexrt-procedure-status
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:terminationReason		0..1	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:modalityAndTechnique	SC	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Constraints: TechniquesForNeutronBeamModality, TechniquesForPhotonBeamModality, TechniquesForElectronBeamModality, TechniquesForCarbonIonBeamModality, TechniquesForProtonBeamModality, TechniquesForInternalRadiotherapyPermanentSeeds, TechniquesForLowDoseRateUsingTempRadSource, TechniquesForPulsedDoseRate, TechniquesForHighDoseRate, TechniquesForHighDoseRateElectronic, TechniquesForRadioPharmaceutical, ModalityTextRequiredForOther, TechniqueTextRequiredForOther
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modality	S	1..1	(Complex)	Radiotherapy Modality Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Modality Value Set (required)
extension:technique	S	0..*	(Complex)	Radiotherapy Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Technique Value Set (required)
extension:radiotherapyEnergyOrIsotope	S	0..*	SimpleQuantity	Radiotherapy Energy or Isotope URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope Binding: Radiotherapy Energy Unit Value Set (required)
extension:radiotherapyTreatmentApplicatorType	S	0..*	CodeableConcept	Radiotherapy Treatment Applicator Type URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type Binding: Brachytherapy Applicator Type Value Set (extensible)
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
extension:actualNumberOfSessions	S	0..1	unsignedInt	Radiotherapy Number of Sessions Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions
extension:doseDeliveredToVolume	S	0..*	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:volume	S	1..1	Extension	Volume in the body where radiation was delivered
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"volume"
extension:totalDoseDelivered	S	0..1	Extension	Total Physical Radiation Dose Delivered
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"totalDoseDelivered"
value[x]		0..1	Quantity	Value of extension Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< | <= | >= | > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: cGy
extension:fractionsDelivered	S	0..1	Extension	Number of Fractions Delivered
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"fractionsDelivered"
extension:pointDose	S	0..1	boolean	Point Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
extension:primaryPlanDose	S	0..1	boolean	Primary Plan Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
extension:radiobiologicMetric	S	0..*	Quantity	Radiotherapy Biologically Effective Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
extension:uniformFractionation	S	1..1	boolean	Uniform Fractionation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-uniform-fractionation
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
extension:respiratoryMotionManagement	S	0..*	CodeableConcept	Respiratory Motion Management URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management Binding: Radiotherapy Respiratory Motion Management Value Set (required)
extension:freeBreathingMotionManagementTechnique	S	0..*	CodeableConcept	Free-Breathing Motion Management Technique URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
extension:intrafractionVerification	S	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
extension:imageGuidedRadiotherapyModality	S	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	2..*	Identifier	External Identifiers for this procedure Slice: Unordered, Open by value:use
identifier:displayName	SΣ	1..1	Identifier	The name that is displayed to the user.
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
identifier:official	SΣ	1..*	Identifier	A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
use	?!Σ	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
Slices for basedOn	Σ	0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	(USCDI) A request for this procedure Slice: Unordered, Open by profile:$this.resolve()
basedOn:planned-course	SΣ	0..1	Reference(Radiotherapy Planned Course)	Radiotherapy Planned Course that planned the treatment summarized in this Radiotherapy Course Summary.
basedOn:course-prescription	SΣ	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that prescribed the treatment summarized in this Radiotherapy Course Summary.
status	?!SΣC	1..1	code	(USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
statusReason	SΣ	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reason Value Set (preferred)
category	Σ	1..1	CodeableConcept	Classification of the procedure Binding: Radiotherapy Category Code Max Value Set (required)
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
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
subject	SΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on
performed[x]	SΣC	0..1	Period	(USCDI) When the procedure was performed
start	SΣC	0..1	dateTime	The date and time when the first therapeutic radiation was delivered.
end	SΣC	0..1	dateTime	An end date is expected if the status is 'stopped' or 'completed'
Slices for performer	SΣ	0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by profile:actor.resolve()
performer:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
performer:organization	SΣ	0..*	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(US Core Organization Profile)	Organization that provided the radiotherapy treatment.
location	SΣ	0..1	Reference(US Core Location Profile)	Location where the radiotherapy treatment was performed.
reasonCode	SΣ	0..*	CodeableConcept	Coded reason procedure performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	The justification that the procedure was performed
bodySite	SΣ	0..*	CodeableConcept	All body structure(s) treated Binding: Radiotherapy Treatment Location Value Set (extensible)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	CodeableConcept	General location qualifier (excluding laterality) for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier		0..1	CodeableConcept	Laterality qualifier for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required)
Slices for focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device Slice: Unordered, Open by profile:manipulated.resolve()
focalDevice:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manipulated		1..1	Reference(Device)	Device that was changed
focalDevice:seedDevice	S	0..*	BackboneElement	Radiotherapy Seed Device used as part of therapy.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manipulated		1..1	Reference(Radiotherapy Seed Device)	Device that was changed
Slices for usedReference	S	0..*	Reference(Device | Medication | Substance)	Items used during procedure Slice: Unordered, Open by profile:$this.resolve()
usedReference:treatmentDevice	S	0..*	Reference(Radiotherapy Treatment Device)	Radiotherapy Treatment Device used as part of therapy.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.extension:modalityAndTechnique.​extension:modality.value[x]	Base	required	Radiotherapy Modality Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.extension:modalityAndTechnique.​extension:technique.​value[x]	Base	required	Radiotherapy Technique Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.identifier:displayName.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Procedure.identifier:official.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	preferred	Treatment Termination Reason Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.category	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
Procedure.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	extensible	Radiotherapy Treatment Location Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0

Constraints

Id	Grade	Path(s)	Description	Expression
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
ModalityTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
TechniqueTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
TechniquesForCarbonIonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Carbon Ion Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
TechniquesForElectronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Electron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
TechniquesForHighDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForHighDoseRateElectronic	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate Electronic	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForInternalRadiotherapyPermanentSeeds	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Internal Radiotherapy - Permanent Seeds	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
TechniquesForLowDoseRateUsingTempRadSource	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Low Dose Rate Using Temp Radiation Source	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
TechniquesForNeutronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Neutron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
TechniquesForPhotonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Photon Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
TechniquesForProtonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Proton Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
TechniquesForPulsedDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Pulsed Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
TechniquesForRadioPharmaceutical	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Radiopharmaceutical	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')
codexrt-free-breathing-technique	error	Procedure	The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-none	error	Procedure	If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-status	error	Procedure	Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed	status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	Procedure	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	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	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()
mcode-reason-required	warning	Procedure	One of reasonCode or reasonReference SHALL be present	reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	Procedure	When status is stopped, only certain statusReason values are allowed	status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	Procedure	Certain statusReason values are allowed only when status is stopped	statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred, codexrt-procedure-status
Slices for extension				Content/Rules for all slices
extension:modalityAndTechnique		0..*	RadiotherapyModalityAndTechnique	Radiotherapy Modality And Technique Extension
Slices for extension				Content/Rules for all slices
extension:radiotherapyEnergyOrIsotope	S	0..*	SimpleQuantity	Radiotherapy Energy or Isotope URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope Binding: Radiotherapy Energy Unit Value Set (required)
extension:radiotherapyTreatmentApplicatorType	S	0..*	CodeableConcept	Radiotherapy Treatment Applicator Type URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type Binding: Brachytherapy Applicator Type Value Set (extensible)
extension:doseDeliveredToVolume		0..*	RadiotherapyDoseDeliveredToVolume	Radiotherapy Dose Delivered To Volume Extension
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:pointDose	S	0..1	boolean	Point Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
extension:primaryPlanDose	S	0..1	boolean	Primary Plan Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
extension:radiobiologicMetric	S	0..*	Quantity	Radiotherapy Biologically Effective Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
extension:uniformFractionation	S	1..1	boolean	Uniform Fractionation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-uniform-fractionation
extension:respiratoryMotionManagement	S	0..*	CodeableConcept	Respiratory Motion Management URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management Binding: Radiotherapy Respiratory Motion Management Value Set (required)
extension:freeBreathingMotionManagementTechnique	S	0..*	CodeableConcept	Free-Breathing Motion Management Technique URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
extension:intrafractionVerification	S	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
extension:imageGuidedRadiotherapyModality	S	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
Slices for identifier	S	2..*	Identifier	External Identifiers for this procedure Slice: Unordered, Open by value:use
identifier:displayName	S	1..1	Identifier	The name that is displayed to the user.
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: usual
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique
identifier:official	S	1..*	Identifier	A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
use		1..1	code	usual | official | temp | secondary | old (If known) Required Pattern: official
system	S	1..1	uri	The namespace for the identifier value
value	S	1..1	string	The value that is unique
Slices for basedOn		0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	(USCDI) A request for this procedure Slice: Unordered, Open by profile:$this.resolve()
basedOn:planned-course	S	0..1	Reference(Radiotherapy Planned Course)	Radiotherapy Planned Course that planned the treatment summarized in this Radiotherapy Course Summary.
basedOn:course-prescription	S	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that prescribed the treatment summarized in this Radiotherapy Course Summary.
category		1..1	CodeableConcept	Classification of the procedure Binding: Radiotherapy Category Code Max Value Set (required)
performed[x]
start	S	0..1	dateTime	The date and time when the first therapeutic radiation was delivered.
end	S	0..1	dateTime	An end date is expected if the status is 'stopped' or 'completed'
Slices for performer	S	0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by profile:actor.resolve()
performer:organization	S	0..*	BackboneElement	The people who performed the procedure
actor		1..1	Reference(US Core Organization Profile)	Organization that provided the radiotherapy treatment.
location	S	0..1	Reference(US Core Location Profile)	Location where the radiotherapy treatment was performed.
Slices for focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device Slice: Unordered, Open by profile:manipulated.resolve()
focalDevice:seedDevice	S	0..*	BackboneElement	Radiotherapy Seed Device used as part of therapy.
manipulated		1..1	Reference(Radiotherapy Seed Device)	Device that was changed
Slices for usedReference	S	0..*	Reference(Device | Medication | Substance)	Items used during procedure Slice: Unordered, Open by profile:$this.resolve()
usedReference:treatmentDevice	S	0..*	Reference(Radiotherapy Treatment Device)	Radiotherapy Treatment Device used as part of therapy.
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Procedure.category	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-technique	error	Procedure	The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-none	error	Procedure	If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-status	error	Procedure	Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed	status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: us-core-7, termination-reason-code-invariant, termination-reason-invariant, mcode-reason-required, codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred, codexrt-procedure-status
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
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
extension:terminationReason		0..1	CodeableConcept	Treatment Termination Reason Extension (deprecated) URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:modalityAndTechnique	SC	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Constraints: TechniquesForNeutronBeamModality, TechniquesForPhotonBeamModality, TechniquesForElectronBeamModality, TechniquesForCarbonIonBeamModality, TechniquesForProtonBeamModality, TechniquesForInternalRadiotherapyPermanentSeeds, TechniquesForLowDoseRateUsingTempRadSource, TechniquesForPulsedDoseRate, TechniquesForHighDoseRate, TechniquesForHighDoseRateElectronic, TechniquesForRadioPharmaceutical, ModalityTextRequiredForOther, TechniqueTextRequiredForOther
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modality	S	1..1	(Complex)	Radiotherapy Modality Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Modality Value Set (required)
extension:technique	S	0..*	(Complex)	Radiotherapy Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
value[x]		1..1	CodeableConcept	Value of extension Binding: Radiotherapy Technique Value Set (required)
extension:radiotherapyEnergyOrIsotope	S	0..*	SimpleQuantity	Radiotherapy Energy or Isotope URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope Binding: Radiotherapy Energy Unit Value Set (required)
extension:radiotherapyTreatmentApplicatorType	S	0..*	CodeableConcept	Radiotherapy Treatment Applicator Type URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type Binding: Brachytherapy Applicator Type Value Set (extensible)
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
extension:actualNumberOfSessions	S	0..1	unsignedInt	Radiotherapy Number of Sessions Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions
extension:doseDeliveredToVolume	S	0..*	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:volume	S	1..1	Extension	Volume in the body where radiation was delivered
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"volume"
value[x]		0..1	Reference(Radiotherapy Volume Profile)	Value of extension
extension:totalDoseDelivered	S	0..1	Extension	Total Physical Radiation Dose Delivered
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"totalDoseDelivered"
value[x]		0..1	Quantity	Value of extension Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< | <= | >= | > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: cGy
extension:fractionsDelivered	S	0..1	Extension	Number of Fractions Delivered
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"fractionsDelivered"
value[x]		0..1	unsignedInt	Value of extension
extension:pointDose	S	0..1	boolean	Point Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
extension:primaryPlanDose	S	0..1	boolean	Primary Plan Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
extension:radiobiologicMetric	S	0..*	Quantity	Radiotherapy Biologically Effective Dose URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
extension:uniformFractionation	S	1..1	boolean	Uniform Fractionation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-uniform-fractionation
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
extension:respiratoryMotionManagement	S	0..*	CodeableConcept	Respiratory Motion Management URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management Binding: Radiotherapy Respiratory Motion Management Value Set (required)
extension:freeBreathingMotionManagementTechnique	S	0..*	CodeableConcept	Free-Breathing Motion Management Technique URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
extension:intrafractionVerification	S	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
extension:imageGuidedRadiotherapyModality	S	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	2..*	Identifier	External Identifiers for this procedure Slice: Unordered, Open by value:use
identifier:displayName	SΣ	1..1	Identifier	The name that is displayed to the user.
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	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: usual
type	Σ	0..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.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	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(Organization)	Organization that issued id (may be just text)
identifier:official	SΣ	1..*	Identifier	A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
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	1..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Required Pattern: official
type	Σ	0..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.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	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(Organization)	Organization that issued id (may be just text)
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
Slices for basedOn	Σ	0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	(USCDI) A request for this procedure Slice: Unordered, Open by profile:$this.resolve()
basedOn:planned-course	SΣ	0..1	Reference(Radiotherapy Planned Course)	Radiotherapy Planned Course that planned the treatment summarized in this Radiotherapy Course Summary.
basedOn:course-prescription	SΣ	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that prescribed the treatment summarized in this Radiotherapy Course Summary.
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event
status	?!SΣC	1..1	code	(USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
statusReason	SΣ	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reason Value Set (preferred)
category	Σ	1..1	CodeableConcept	Classification of the procedure Binding: Radiotherapy Category Code Max Value Set (required)
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
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
subject	SΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
performed[x]	SΣC	0..1	Period	(USCDI) When the procedure was performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	The date and time when the first therapeutic radiation was delivered.
end	SΣC	0..1	dateTime	An end date is expected if the status is 'stopped' or 'completed'
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
Slices for performer	SΣ	0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by profile:actor.resolve()
performer:All Slices				Content/Rules for all slices
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:organization	SΣ	0..*	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(US Core Organization Profile)	Organization that provided the radiotherapy treatment.
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	SΣ	0..1	Reference(US Core Location Profile)	Location where the radiotherapy treatment was performed.
reasonCode	SΣ	0..*	CodeableConcept	Coded reason procedure performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	The justification that the procedure was performed
bodySite	SΣ	0..*	CodeableConcept	All body structure(s) treated Binding: Radiotherapy Treatment Location Value Set (extensible)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:locationQualifier		0..*	CodeableConcept	General location qualifier (excluding laterality) for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier		0..1	CodeableConcept	Laterality qualifier for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	A condition that is a result of the procedure
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Additional information about the procedure
Slices for focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device Slice: Unordered, Open by profile:manipulated.resolve()
focalDevice:All Slices				Content/Rules for all slices
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
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
focalDevice:seedDevice	S	0..*	BackboneElement	Radiotherapy Seed Device used as part of therapy.
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
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Radiotherapy Seed Device)	Device that was changed
Slices for usedReference	S	0..*	Reference(Device | Medication | Substance)	Items used during procedure Slice: Unordered, Open by profile:$this.resolve()
usedReference:treatmentDevice	S	0..*	Reference(Radiotherapy Treatment Device)	Radiotherapy Treatment Device used as part of therapy.
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Procedure.extension:modalityAndTechnique.​extension:modality.value[x]	Base	required	Radiotherapy Modality Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.extension:modalityAndTechnique.​extension:technique.​value[x]	Base	required	Radiotherapy Technique Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.identifier:displayName.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Procedure.identifier:displayName.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Procedure.identifier:official.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Procedure.identifier:official.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	preferred	Treatment Termination Reason Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.category	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
Procedure.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
Procedure.performer.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:organization.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	extensible	Radiotherapy Treatment Location Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.outcome	Base	example	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📦4.0.1	FHIR Std.
Procedure.followUp	Base	example	Procedure Follow up Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.focalDevice.​action	Base	preferred	Procedure Device Action Codes	📦4.0.1	FHIR Std.
Procedure.focalDevice:seedDevice.​action	Base	preferred	Procedure Device Action Codes	📦4.0.1	FHIR Std.
Procedure.usedCode	Base	example	FHIR Device Types	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
ModalityTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
TechniqueTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
TechniquesForCarbonIonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Carbon Ion Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
TechniquesForElectronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Electron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
TechniquesForHighDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForHighDoseRateElectronic	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate Electronic	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForInternalRadiotherapyPermanentSeeds	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Internal Radiotherapy - Permanent Seeds	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
TechniquesForLowDoseRateUsingTempRadSource	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Low Dose Rate Using Temp Radiation Source	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
TechniquesForNeutronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Neutron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
TechniquesForPhotonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Photon Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
TechniquesForProtonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Proton Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
TechniquesForPulsedDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Pulsed Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
TechniquesForRadioPharmaceutical	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Radiopharmaceutical	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')
codexrt-free-breathing-technique	error	Procedure	The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-none	error	Procedure	If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"	extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-status	error	Procedure	Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed	status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	Procedure	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	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	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()
mcode-reason-required	warning	Procedure	One of reasonCode or reasonReference SHALL be present	reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	Procedure	When status is stopped, only certain statusReason values are allowed	status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	Procedure	Certain statusReason values are allowed only when status is stopped	statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

Summary

Mandatory: 9 elements(1 nested mandatory element)
Must-Support: 28 elements

Structures

This structure refers to these other structures:

• Radiotherapy Planned Course (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-planned-course)
• Radiotherapy Course Prescription (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-prescription)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• US Core Location Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-location)
• Radiotherapy Seed Device (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-seed-device)
• Radiotherapy Treatment Device (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-device)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-uniform-fractionation
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Procedure.identifier
• The element 1 is sliced based on the value of Procedure.basedOn
• The element 1 is sliced based on the value of Procedure.performer
• The element 1 is sliced based on the value of Procedure.focalDevice
• The element 1 is sliced based on the value of Procedure.usedReference