Usage

This profile is used to represent a planned course of radiotherapy as elaborated in a radiotherapy treatment planning system. An overview of radiotherapy courses, phases, and treatment plans is shown here. In FHIR, treatment plans and the summaries of treatment plans for a phase or a course are represented as filler orders, and the corresponding prescriptions are represented as original orders. The relationships between the various radiotherapy profiles are shown here.

Conformance

ServiceRequest resource instances whose code is SNOMEDCT 1217123003 (Radiotherapy course of treatment (regime/therapy)) and whose intent is http://hl7.org/fhir/request-intent#filler-order "Filler Order" MUST conform to this profile. Any resource intended to conform to this profile SHOULD populate meta.profile accordingly.

• Key Elements Table
• Differential Table
• Snapshot Table
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Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed Constraints: prr-1, codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred
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: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:imageGuidedRadiotherapyModality	SC	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality Constraints: IGRTEnergyAllowed
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:radiotherapyDosePlannedToVolume	S	0..*	(Complex)	Planned Dose to a Dose Reference URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:volume	S	1..1	Extension	Volume targeted by the planned dose
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"volume"
value[x]		1..1	Reference(Radiotherapy Volume)	Value of extension
extension:totalDose	S	0..1	Extension	Total Planned Radiation Dose
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"totalDose"
value[x]		1..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:fractions	S	0..1	Extension	Number of Planned Fractions
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"fractions"
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
url		1..1	uri	"http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume"
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
extension:intrafractionVerification	SC	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification Constraints: IntrafractionVerificationQualifierAllowed
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)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	2..*	Identifier	Identifiers assigned to this order 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(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills Slice: Unordered, Open by profile:$this.resolve()
basedOn:course-prescription	SΣ	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that this Radiotherapy Planned Course fulfills.
replaces	Σ	0..*	Reference(Radiotherapy Planned Course)	What request replaces
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: filler-order
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	(USCDI) Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:radiotherapy	SΣ	1..1	CodeableConcept	(USCDI) Classification of service Binding: Radiotherapy Category Code Max Value Set (required)
code	SΣ	1..1	CodeableConcept	(USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible) 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		1..1	string	Representation defined by the system Fixed Value: Radiotherapy course of treatment (regime/therapy)
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(US Core Patient Profile)	(USCDI) Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		(USCDI) When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
authoredOn	SΣ	0..1	dateTime	(USCDI) Date request signed
requester	SΣ	0..1	Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core Organization Profile)	(USCDI) Who/what is requesting service
Slices for performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer Slice: Unordered, Open by profile:$this.resolve()
performer:treatmentOrSeedDevice	SΣ	0..*	Reference(Radiotherapy Treatment Device | Radiotherapy Seed Device)	Radiotherapy Treatment Device or Seed Device used as part of therapy.
locationReference	SΣ	0..*	Reference(US Core Location Profile)	Location where the radiotherapy treatment is requested.
reasonCode	SΣ	0..*	CodeableConcept	(USCDI) Explanation/Justification for procedure or service Binding: Cancer Disorder Value Set (extensible)
reasonReference	SΣ	0..*	Reference(Condition)	(USCDI) US Core Profile that supports the requested service
bodySite	SΣ	0..*	CodeableConcept	Body site that is treated with radiotherapy 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)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.extension:modalityAndTechnique.​extension:modality.value[x]	Base	required	Radiotherapy Modality Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.extension:modalityAndTechnique.​extension:technique.​value[x]	Base	required	Radiotherapy Technique Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.identifier:displayName.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
ServiceRequest.identifier:official.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
ServiceRequest.status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
ServiceRequest.intent	Base	required	RequestIntent	📍4.0.1	FHIR Std.
ServiceRequest.category	Base	example	Service Request Category Codes	📦4.0.1	FHIR Std.
ServiceRequest.category:us-core	Base	required	US Core ServiceRequest Category Codes	📦6.1.0	US Core v6.1
ServiceRequest.category:radiotherapy	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
ServiceRequest.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
ServiceRequest.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.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	ServiceRequest	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
IGRTEnergyAllowed	error	ServiceRequest.extension:imageGuidedRadiotherapyModality	Energy is only allowed for X-Ray, Fluorograph, or CT Modalities.	extension.where(url = 'energy').exists() implies (extension.where(url = 'modality').exists() and extension.where(url = 'modality').value.exists() and extension.where(url = 'modality').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006' or code = '44491008' or code = '77477000' or code = '717193008') ) )
IntrafractionVerificationQualifierAllowed	error	ServiceRequest.extension:intrafractionVerification	Qualifier is only allowed for X-Ray procedure.	extension.where(url = 'qualifier').exists() implies (extension.where(url = 'procedure').exists() and extension.where(url = 'procedure').value.exists() and extension.where(url = 'procedure').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006') ) )
ModalityTextRequiredForOther	error	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest	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	ServiceRequest	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
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ServiceRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ServiceRequest	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present	orderDetail.empty() or code.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed Constraints: codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modalityAndTechnique	S	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
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:imageGuidedRadiotherapyModality	S	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
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:radiotherapyDosePlannedToVolume	S	0..*	(Complex)	Planned Dose to a Dose Reference URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
Slices for extension				Content/Rules for all slices
extension:fractionDose		0..0		Not used in this profile. See Planned Phase for detailed fractionation.
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:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
extension:intrafractionVerification	S	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
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)
Slices for identifier	S	2..*	Identifier	Identifiers assigned to this order 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(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills Slice: Unordered, Open by profile:$this.resolve()
basedOn:course-prescription	S	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that this Radiotherapy Planned Course fulfills.
replaces		0..*	Reference(Radiotherapy Planned Course)	What request replaces
intent		1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: filler-order
Slices for category		1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this
category:radiotherapy		1..1	CodeableConcept	(USCDI) Classification of service Binding: Radiotherapy Category Code Max Value Set (required)
doNotPerform		0..0		True if service/procedure should not be performed
code		1..1	CodeableConcept	(USCDI) What is being requested/ordered Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy course of treatment (regime/therapy)
quantity[x]		0..0		Service amount
asNeeded[x]		0..0		Preconditions for service
requester		0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)	(USCDI) Who/what is requesting service
Slices for performer	S	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer Slice: Unordered, Open by profile:$this.resolve()
performer:treatmentOrSeedDevice	S	0..*	Reference(Radiotherapy Treatment Device | Radiotherapy Seed Device)	Radiotherapy Treatment Device or Seed Device used as part of therapy.
locationReference	S	0..*	Reference(US Core Location Profile)	Location where the radiotherapy treatment is requested.
reasonCode	S	0..*	CodeableConcept	(USCDI) Explanation/Justification for procedure or service Binding: Cancer Disorder Value Set (extensible)
reasonReference	S	0..*	Reference(Condition)	(USCDI) US Core Profile that supports the requested service
specimen		0..0		Procedure Samples
bodySite	S	0..*	CodeableConcept	Body site that is treated with radiotherapy 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)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.category:radiotherapy	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
ServiceRequest.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.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	ServiceRequest	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	ServiceRequest	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	ServiceRequest	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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed Constraints: prr-1, codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred
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: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:imageGuidedRadiotherapyModality	SC	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality Constraints: IGRTEnergyAllowed
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:radiotherapyDosePlannedToVolume	S	0..*	(Complex)	Planned Dose to a Dose Reference URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:volume	S	1..1	Extension	Volume targeted by the planned dose
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]		1..1	Reference(Radiotherapy Volume)	Value of extension
extension:totalDose	S	0..1	Extension	Total Planned Radiation Dose
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"totalDose"
value[x]		1..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:fractions	S	0..1	Extension	Number of Planned Fractions
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"fractions"
value[x]		0..1	positiveInt	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
url		1..1	uri	"http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume"
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
extension:intrafractionVerification	SC	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification Constraints: IntrafractionVerificationQualifierAllowed
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)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	2..*	Identifier	Identifiers assigned to this order 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(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
Slices for basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills Slice: Unordered, Open by profile:$this.resolve()
basedOn:course-prescription	SΣ	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that this Radiotherapy Planned Course fulfills.
replaces	Σ	0..*	Reference(Radiotherapy Planned Course)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: filler-order
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	(USCDI) Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:radiotherapy	SΣ	1..1	CodeableConcept	(USCDI) Classification of service Binding: Radiotherapy Category Code Max Value Set (required)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
code	SΣ	1..1	CodeableConcept	(USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible) 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		1..1	string	Representation defined by the system Fixed Value: Radiotherapy course of treatment (regime/therapy)
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	SΣ	0..1		(USCDI) When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
authoredOn	SΣ	0..1	dateTime	(USCDI) Date request signed
requester	SΣ	0..1	Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core Organization Profile)	(USCDI) Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
Slices for performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer Slice: Unordered, Open by profile:$this.resolve()
performer:treatmentOrSeedDevice	SΣ	0..*	Reference(Radiotherapy Treatment Device | Radiotherapy Seed Device)	Radiotherapy Treatment Device or Seed Device used as part of therapy.
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	SΣ	0..*	Reference(US Core Location Profile)	Location where the radiotherapy treatment is requested.
reasonCode	SΣ	0..*	CodeableConcept	(USCDI) Explanation/Justification for procedure or service Binding: Cancer Disorder Value Set (extensible)
reasonReference	SΣ	0..*	Reference(Condition)	(USCDI) US Core Profile that supports the requested service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
bodySite	SΣ	0..*	CodeableConcept	Body site that is treated with radiotherapy 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
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
ServiceRequest.extension:modalityAndTechnique.​extension:modality.value[x]	Base	required	Radiotherapy Modality Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.extension:modalityAndTechnique.​extension:technique.​value[x]	Base	required	Radiotherapy Technique Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.identifier:displayName.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
ServiceRequest.identifier:displayName.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
ServiceRequest.identifier:official.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
ServiceRequest.identifier:official.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
ServiceRequest.status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
ServiceRequest.intent	Base	required	RequestIntent	📍4.0.1	FHIR Std.
ServiceRequest.category	Base	example	Service Request Category Codes	📦4.0.1	FHIR Std.
ServiceRequest.category:us-core	Base	required	US Core ServiceRequest Category Codes	📦6.1.0	US Core v6.1
ServiceRequest.category:radiotherapy	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
ServiceRequest.priority	Base	required	Request priority	📍4.0.1	FHIR Std.
ServiceRequest.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
ServiceRequest.orderDetail	Base	example	Service Request Order Details Codes	📦4.0.1	FHIR Std.
ServiceRequest.performerType	Base	example	Participant Roles	📦4.0.1	FHIR Std.
ServiceRequest.locationCode	Base	example	ServiceDeliveryLocationRoleType	📦3.0.0	THO v7.0
ServiceRequest.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.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	ServiceRequest	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
IGRTEnergyAllowed	error	ServiceRequest.extension:imageGuidedRadiotherapyModality	Energy is only allowed for X-Ray, Fluorograph, or CT Modalities.	extension.where(url = 'energy').exists() implies (extension.where(url = 'modality').exists() and extension.where(url = 'modality').value.exists() and extension.where(url = 'modality').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006' or code = '44491008' or code = '77477000' or code = '717193008') ) )
IntrafractionVerificationQualifierAllowed	error	ServiceRequest.extension:intrafractionVerification	Qualifier is only allowed for X-Ray procedure.	extension.where(url = 'qualifier').exists() implies (extension.where(url = 'procedure').exists() and extension.where(url = 'procedure').value.exists() and extension.where(url = 'procedure').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006') ) )
ModalityTextRequiredForOther	error	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest	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	ServiceRequest	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
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ServiceRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ServiceRequest	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present	orderDetail.empty() or code.exists()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed Constraints: prr-1, codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred
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: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:imageGuidedRadiotherapyModality	SC	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality Constraints: IGRTEnergyAllowed
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:radiotherapyDosePlannedToVolume	S	0..*	(Complex)	Planned Dose to a Dose Reference URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:volume	S	1..1	Extension	Volume targeted by the planned dose
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"volume"
value[x]		1..1	Reference(Radiotherapy Volume)	Value of extension
extension:totalDose	S	0..1	Extension	Total Planned Radiation Dose
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"totalDose"
value[x]		1..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:fractions	S	0..1	Extension	Number of Planned Fractions
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"fractions"
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
url		1..1	uri	"http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume"
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
extension:intrafractionVerification	SC	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification Constraints: IntrafractionVerificationQualifierAllowed
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)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	2..*	Identifier	Identifiers assigned to this order 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(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills Slice: Unordered, Open by profile:$this.resolve()
basedOn:course-prescription	SΣ	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that this Radiotherapy Planned Course fulfills.
replaces	Σ	0..*	Reference(Radiotherapy Planned Course)	What request replaces
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: filler-order
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	(USCDI) Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:radiotherapy	SΣ	1..1	CodeableConcept	(USCDI) Classification of service Binding: Radiotherapy Category Code Max Value Set (required)
code	SΣ	1..1	CodeableConcept	(USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible) 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		1..1	string	Representation defined by the system Fixed Value: Radiotherapy course of treatment (regime/therapy)
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(US Core Patient Profile)	(USCDI) Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		(USCDI) When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
authoredOn	SΣ	0..1	dateTime	(USCDI) Date request signed
requester	SΣ	0..1	Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core Organization Profile)	(USCDI) Who/what is requesting service
Slices for performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer Slice: Unordered, Open by profile:$this.resolve()
performer:treatmentOrSeedDevice	SΣ	0..*	Reference(Radiotherapy Treatment Device | Radiotherapy Seed Device)	Radiotherapy Treatment Device or Seed Device used as part of therapy.
locationReference	SΣ	0..*	Reference(US Core Location Profile)	Location where the radiotherapy treatment is requested.
reasonCode	SΣ	0..*	CodeableConcept	(USCDI) Explanation/Justification for procedure or service Binding: Cancer Disorder Value Set (extensible)
reasonReference	SΣ	0..*	Reference(Condition)	(USCDI) US Core Profile that supports the requested service
bodySite	SΣ	0..*	CodeableConcept	Body site that is treated with radiotherapy 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)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.extension:modalityAndTechnique.​extension:modality.value[x]	Base	required	Radiotherapy Modality Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.extension:modalityAndTechnique.​extension:technique.​value[x]	Base	required	Radiotherapy Technique Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.identifier:displayName.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
ServiceRequest.identifier:official.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
ServiceRequest.status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
ServiceRequest.intent	Base	required	RequestIntent	📍4.0.1	FHIR Std.
ServiceRequest.category	Base	example	Service Request Category Codes	📦4.0.1	FHIR Std.
ServiceRequest.category:us-core	Base	required	US Core ServiceRequest Category Codes	📦6.1.0	US Core v6.1
ServiceRequest.category:radiotherapy	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
ServiceRequest.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
ServiceRequest.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.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	ServiceRequest	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
IGRTEnergyAllowed	error	ServiceRequest.extension:imageGuidedRadiotherapyModality	Energy is only allowed for X-Ray, Fluorograph, or CT Modalities.	extension.where(url = 'energy').exists() implies (extension.where(url = 'modality').exists() and extension.where(url = 'modality').value.exists() and extension.where(url = 'modality').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006' or code = '44491008' or code = '77477000' or code = '717193008') ) )
IntrafractionVerificationQualifierAllowed	error	ServiceRequest.extension:intrafractionVerification	Qualifier is only allowed for X-Ray procedure.	extension.where(url = 'qualifier').exists() implies (extension.where(url = 'procedure').exists() and extension.where(url = 'procedure').value.exists() and extension.where(url = 'procedure').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006') ) )
ModalityTextRequiredForOther	error	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest	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	ServiceRequest	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
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ServiceRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ServiceRequest	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present	orderDetail.empty() or code.exists()

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed Constraints: codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:modalityAndTechnique	S	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
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:imageGuidedRadiotherapyModality	S	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
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:radiotherapyDosePlannedToVolume	S	0..*	(Complex)	Planned Dose to a Dose Reference URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
Slices for extension				Content/Rules for all slices
extension:fractionDose		0..0		Not used in this profile. See Planned Phase for detailed fractionation.
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:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
extension:intrafractionVerification	S	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
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)
Slices for identifier	S	2..*	Identifier	Identifiers assigned to this order 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(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills Slice: Unordered, Open by profile:$this.resolve()
basedOn:course-prescription	S	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that this Radiotherapy Planned Course fulfills.
replaces		0..*	Reference(Radiotherapy Planned Course)	What request replaces
intent		1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Required Pattern: filler-order
Slices for category		1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this
category:radiotherapy		1..1	CodeableConcept	(USCDI) Classification of service Binding: Radiotherapy Category Code Max Value Set (required)
doNotPerform		0..0		True if service/procedure should not be performed
code		1..1	CodeableConcept	(USCDI) What is being requested/ordered Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy course of treatment (regime/therapy)
quantity[x]		0..0		Service amount
asNeeded[x]		0..0		Preconditions for service
requester		0..1	Reference(US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile)	(USCDI) Who/what is requesting service
Slices for performer	S	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer Slice: Unordered, Open by profile:$this.resolve()
performer:treatmentOrSeedDevice	S	0..*	Reference(Radiotherapy Treatment Device | Radiotherapy Seed Device)	Radiotherapy Treatment Device or Seed Device used as part of therapy.
locationReference	S	0..*	Reference(US Core Location Profile)	Location where the radiotherapy treatment is requested.
reasonCode	S	0..*	CodeableConcept	(USCDI) Explanation/Justification for procedure or service Binding: Cancer Disorder Value Set (extensible)
reasonReference	S	0..*	Reference(Condition)	(USCDI) US Core Profile that supports the requested service
specimen		0..0		Procedure Samples
bodySite	S	0..*	CodeableConcept	Body site that is treated with radiotherapy 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)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.category:radiotherapy	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
ServiceRequest.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.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	ServiceRequest	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	ServiceRequest	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	ServiceRequest	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

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed Constraints: prr-1, codexrt-motion-management-none, codexrt-free-breathing-technique, CategoryPreferred
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: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:imageGuidedRadiotherapyModality	SC	0..*	(Complex)	Image Guided Radiotherapy Modality URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality Constraints: IGRTEnergyAllowed
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:radiotherapyDosePlannedToVolume	S	0..*	(Complex)	Planned Dose to a Dose Reference URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:volume	S	1..1	Extension	Volume targeted by the planned dose
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]		1..1	Reference(Radiotherapy Volume)	Value of extension
extension:totalDose	S	0..1	Extension	Total Planned Radiation Dose
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"totalDose"
value[x]		1..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:fractions	S	0..1	Extension	Number of Planned Fractions
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"fractions"
value[x]		0..1	positiveInt	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
url		1..1	uri	"http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume"
extension:courseInvolvesReirradiation	S	0..1	boolean	Course Involves Reirradiation URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-involves-reirradiation
extension:intrafractionVerification	SC	0..*	(Complex)	Intrafraction Verification URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification Constraints: IntrafractionVerificationQualifierAllowed
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)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	SΣ	2..*	Identifier	Identifiers assigned to this order 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(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
Slices for basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills Slice: Unordered, Open by profile:$this.resolve()
basedOn:course-prescription	SΣ	0..1	Reference(Radiotherapy Course Prescription)	Radiotherapy Course Prescription that this Radiotherapy Planned Course fulfills.
replaces	Σ	0..*	Reference(Radiotherapy Planned Course)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	(USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	(USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request. Required Pattern: filler-order
Slices for category	SΣ	1..*	CodeableConcept	(USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	(USCDI) Classification of service Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:radiotherapy	SΣ	1..1	CodeableConcept	(USCDI) Classification of service Binding: Radiotherapy Category Code Max Value Set (required)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
code	SΣ	1..1	CodeableConcept	(USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible) 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		1..1	string	Representation defined by the system Fixed Value: Radiotherapy course of treatment (regime/therapy)
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	SΣ	0..1		(USCDI) When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
authoredOn	SΣ	0..1	dateTime	(USCDI) Date request signed
requester	SΣ	0..1	Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | US Core Organization Profile)	(USCDI) Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
Slices for performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer Slice: Unordered, Open by profile:$this.resolve()
performer:treatmentOrSeedDevice	SΣ	0..*	Reference(Radiotherapy Treatment Device | Radiotherapy Seed Device)	Radiotherapy Treatment Device or Seed Device used as part of therapy.
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	SΣ	0..*	Reference(US Core Location Profile)	Location where the radiotherapy treatment is requested.
reasonCode	SΣ	0..*	CodeableConcept	(USCDI) Explanation/Justification for procedure or service Binding: Cancer Disorder Value Set (extensible)
reasonReference	SΣ	0..*	Reference(Condition)	(USCDI) US Core Profile that supports the requested service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
bodySite	SΣ	0..*	CodeableConcept	Body site that is treated with radiotherapy 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
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
ServiceRequest.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
ServiceRequest.extension:modalityAndTechnique.​extension:modality.value[x]	Base	required	Radiotherapy Modality Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.extension:modalityAndTechnique.​extension:technique.​value[x]	Base	required	Radiotherapy Technique Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.identifier:displayName.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
ServiceRequest.identifier:displayName.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
ServiceRequest.identifier:official.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
ServiceRequest.identifier:official.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
ServiceRequest.status	Base	required	RequestStatus	📍4.0.1	FHIR Std.
ServiceRequest.intent	Base	required	RequestIntent	📍4.0.1	FHIR Std.
ServiceRequest.category	Base	example	Service Request Category Codes	📦4.0.1	FHIR Std.
ServiceRequest.category:us-core	Base	required	US Core ServiceRequest Category Codes	📦6.1.0	US Core v6.1
ServiceRequest.category:radiotherapy	Base	required	Radiotherapy Category Code Max Value Set	📦2.0.0	This IG
ServiceRequest.priority	Base	required	Request priority	📍4.0.1	FHIR Std.
ServiceRequest.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
ServiceRequest.orderDetail	Base	example	Service Request Order Details Codes	📦4.0.1	FHIR Std.
ServiceRequest.performerType	Base	example	Participant Roles	📦4.0.1	FHIR Std.
ServiceRequest.locationCode	Base	example	ServiceDeliveryLocationRoleType	📦3.0.0	THO v7.0
ServiceRequest.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
ServiceRequest.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	ServiceRequest	This code 108290001 is inactive and should be used only for backward compatibility.	category.exists() and category.coding.exists( code = '108290001' ).not()
IGRTEnergyAllowed	error	ServiceRequest.extension:imageGuidedRadiotherapyModality	Energy is only allowed for X-Ray, Fluorograph, or CT Modalities.	extension.where(url = 'energy').exists() implies (extension.where(url = 'modality').exists() and extension.where(url = 'modality').value.exists() and extension.where(url = 'modality').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006' or code = '44491008' or code = '77477000' or code = '717193008') ) )
IntrafractionVerificationQualifierAllowed	error	ServiceRequest.extension:intrafractionVerification	Qualifier is only allowed for X-Ray procedure.	extension.where(url = 'qualifier').exists() implies (extension.where(url = 'procedure').exists() and extension.where(url = 'procedure').value.exists() and extension.where(url = 'procedure').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006') ) )
ModalityTextRequiredForOther	error	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest.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	ServiceRequest	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	ServiceRequest	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
dom-2	error	ServiceRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	ServiceRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	ServiceRequest	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	ServiceRequest	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
prr-1	error	ServiceRequest	orderDetail SHALL only be present if code is present	orderDetail.empty() or code.exists()

Summary

Mandatory: 10 elements
Must-Support: 28 elements
Prohibited: 5 elements

Structures

This structure refers to these other structures:

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

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
• 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-image-guided-radiotherapy-modality
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
• 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-course-involves-reirradiation
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
• 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/mcode/StructureDefinition/mcode-body-location-qualifier
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of ServiceRequest.identifier
• The element 1 is sliced based on the value of ServiceRequest.basedOn
• The element 1 is sliced based on the value of ServiceRequest.category
• The element 1 is sliced based on the value of ServiceRequest.performer