minimal Common Oncology Data Elements (mCODE) Implementation Guide, published by HL7 International / Clinical Interoperability Council. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-mCODE-ig/ and changes regularly. See the Directory of published versions

Release Notes

For a history of changes prior to STU4, please see the prior change logs in the appropriate versions.

Support for Staging Systems

See the section on cancer staging.

Addition of Risk Assessment Profiles

Risk assessments have been identified as an essential piece of information to represent a cancer patient. To address this, an abstract, generic profile was created for risk assessment, and specific risk assessment profiles were added for illustrative purposes:

• CancerRiskAssessment
• RhabdomyosarcomaRiskAssessment
• ALLRiskAssessment

Addition of Histology Profiles

Three new profiles were added for histologic reporting. HistologicBehaviorAndType reports the morphology and type of the tumor using ICD-O-3 codes and the proper suffix, while HistologicGrade reports the grade of the tumor. Both profiles are referenced in a summary with the TumorMorphology profile.

• HistologicBehaviorAndType
• HistologicGrade
• TumorMorphology

Modification of Medication Profiles

The normalization basis for medication dosage is important, especially for pediatric oncology. As a result, the CancerRelatedMedicationAdministration and CancerRelatedMedicationRequest profiles were modified to include an extension for the normalization basis used.

Addition of Lansky Play Performance Profile

The Lansky Play Performance assessment was identified as a key performance assessment used when treating pediatric cancer patients. As a result, the LanskyPlayPerformanceStatus profile was added.

Addition of Deauville Scale Profile

Deauville Scale is a common assessment performed for lymphoma cancer patients, and as a result, a DeauvilleScale profile was added to mCODE.

Addition of Body Surface Area Profile

Body surface area is measured/calculated commonly for pediatric patients and used to determine medication dosage. As a result, a BodySurfaceArea profile was added to mCODE.

Clarified Codes for Cancer Disease Status

Adjusted the ConditionStatusTrendVS to avoid confusion. In mCODE STU3, some of the values can be true at the same time (example: a patient’s condition could have improved AND be in full remission). However, value[x] is 0.1. As a result, the codes for in full remission, partial remission, and distant metastasis present were moved into a maximum value set to ensure backward compatibility with this change.