2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## : Encounter example - JSON Representation

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    {
      "resourceType" : "Encounter",
      "id" : "example",
      "meta" : {
        "profile" : [
          🔗 "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter"
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Encounter example</b></p><a name=\"example\"> </a><a name=\"hcexample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-us-quality-core-encounter.html\">US Quality Core Encounter</a></p></div><p><b>identifier</b>: <code>http://example.org/encounters</code>/ENC-20130404-appendicitis</p><p><b>status</b>: Finished</p><p><b>class</b>: <a href=\"http://hl7.org/fhir/R4/v3/ActCode/cs.html#v3-ActCode-IMP\">v3 Code System ActCode: IMP</a> (inpatient encounter)</p><p><b>type</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 99223}\">Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.</span></p><p><b>subject</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Social Security number\u00a0(use:\u00a0usual,\u00a0period:\u00a02001-05-06 --&gt; (ongoing)))</a></p><p><b>period</b>: 2013-04-04 18:00:00-0400 --&gt; 2013-04-06 11:00:00-0400</p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Condition</b></td></tr><tr><td style=\"display: none\">*</td><td/><td><a href=\"Condition-appendicitis-example.html\">Condition Appendicitis (disorder)</a></td></tr></table><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/discharge-disposition home}\">Home</span></td></tr></table><h3>Locations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Location</b></td><td><b>Status</b></td><td><b>Period</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Location-example.html\">South Wing, second floor</a></td><td>Completed</td><td>2013-04-04 18:00:00-0400 --&gt; 2013-04-06 11:00:00-0400</td></tr></table></div>"
      },
      "identifier" : [
        {
          "system" : "http://example.org/encounters",
          "value" : "ENC-20130404-appendicitis"
        }
      ],
      "status" : "finished",
      "class" : {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code" : "IMP",
        "display" : "inpatient encounter"
      },
      "type" : [
        {
          "coding" : [
            {
              "system" : "http://www.ama-assn.org/go/cpt",
              "code" : "99223",
              "display" : "Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded."
            }
          ]
        }
      ],
      "subject" : {
        🔗 "reference" : "Patient/example"
      },
      "period" : {
        "start" : "2013-04-04T18:00:00-04:00",
        "end" : "2013-04-06T11:00:00-04:00"
      },
      "diagnosis" : [
        {
          "extension" : [
            {
              "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding",
                    "code" : "Y"
                  }
                ]
              }
            }
          ],
          "condition" : {
            🔗 "reference" : "Condition/appendicitis-example"
          }
        }
      ],
      "hospitalization" : {
        "dischargeDisposition" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/discharge-disposition",
              "code" : "home",
              "display" : "Home"
            }
          ]
        }
      },
      "location" : [
        {
          "location" : {
            🔗 "reference" : "Location/example",
            "display" : "South Wing, second floor"
          },
          "status" : "completed",
          "period" : {
            "start" : "2013-04-04T18:00:00-04:00",
            "end" : "2013-04-06T11:00:00-04:00"
          }
        }
      ]
    }