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

## Resource Profile: US Quality Core Service Not Requested

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-servicenotrequested | Version: 0.5.0
Active as of 2026-05-15 | Computable Name: USQualityCoreServiceNotRequested

Negation profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

### Guidance

Reference Guidance for use of the Service Not Requested profile can be found here.

- See the Social Determinants of Health (SDOH) Guidance Page for more information when exchanging Social Determinants of Health (SDOH) Service Requests.
- The `ServiceRequest.category` binding must support at a minimum the US Core ServiceRequest Category Codes. However, this valueset can be treated as extensible and other category codes can be used instead.
- The `ServiceRequest.code.extension:notDoneValueSet` valueset identifies a set of possible coded values representing activities that were not requested, ordered, or performed.
- The `ServiceRequest.subject` is Must Support with Must Support reference to US Quality Core Patient

Usage

The ServiceRequest and ServiceNotRequested profiles represent the positive and negative statements for a service request.

See the patterns page for implementation and usage patterns.

### Examples

Negation Example with valueset | Service discontinued; indicates that none of the services in the given not done value set were requested.
Negation Example with code | Service discontinued; indicates that the given service, by code, was not requested.

Both of these example instances meet measure intent for exclusion as defined in the following illustrative CQL (informational; not part of conformance requirements):

    define "Intermittent Pneumatic Compression Devices Not Ordered":
      ["ServiceNotRequested": "Application of intermittent pneumatic compression devices (IPC)"] DeviceNotOrdered
        where (DeviceNotOrdered.reasonRefused() in "Medical Reason"
          or DeviceNotOrdered.reasonRefused() in "Patient Refusal")
          and DeviceNotOrdered.status in { 'active', 'completed', 'on-hold' }

For a more complete discussion of representation of negation within US Quality Core and quality improvement artifacts, see the Negation in US Quality Core topic.

USCDI+ Quality Elements:

- status: (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
- code: (USCDI+ Quality) (USCDI) What is being requested/ordered
- authoredOn: (USCDI+ Quality) (USCDI) Date request signed
- reasonCode: (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
- reasonReference: (USCDI+ Quality) (USCDI) Explanation/Justification for service or service

Usages:

- Examples for this Profile: ServiceRequest/negation-example-code and ServiceRequest/negation-example
- CapabilityStatements using this Profile: US Quality Core Client CapabilityStatement and US Quality Core Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | USCoreServiceRequestProfile(6.1.0) | A request for a service to be performed Constraints: prr-1, snr-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:reasonRefused |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent | ?!S Σ | 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.
Slices for category | S Σ | 0..* | CodeableConcept | (USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 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
doNotPerform | ?!Σ | 1..1 | boolean | True if service/procedure should not be performed Fixed Value: true
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | What was not requested URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) Individual or Entity the service is ordered for
occurrence[x] | S Σ | 0..1 |  | (USCDI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
occurrenceTiming |  |  | Timing |
authoredOn | S Σ | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester | S Σ | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | (USCDI)
reasonCode | Σ | 0..* | CodeableConcept | (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference | Σ | 0..* | Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) | (USCDI+ Quality) (USCDI) Explanation/Justification for service or service
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
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 | 📦7.0.0 | US Core v7.0
ServiceRequest.code | Base | extensible | US Core Procedure Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.reasonCode | Base | extensible | US Core Condition Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
snr-1 | error | ServiceRequest | to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`

This structure is derived from USCoreServiceRequestProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | USCoreServiceRequestProfile(6.1.0) | A request for a service to be performed Constraints: snr-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:reasonRefused |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
status |  | 1..1 | code | (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
doNotPerform |  | 1..1 | boolean | True if service/procedure should not be performed Fixed Value: true
code |  | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) What is being requested/ordered
Slices for extension |  |  |  | Content/Rules for all slices
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | What was not requested URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject |  | 1..1 | Reference(US Quality Core Patient) | (USCDI) Individual or Entity the service is ordered for
occurrence[x] |  | 0..1 |  | (USCDI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
occurrenceTiming |  |  | Timing |
authoredOn |  | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester |  | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | (USCDI)
reasonCode |  | 0..* | CodeableConcept | (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference | Σ | 0..* | Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) | (USCDI+ Quality) (USCDI) Explanation/Justification for service or service
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.reasonCode | Base | extensible | US Core Condition Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
snr-1 | error | ServiceRequest | to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | USCoreServiceRequestProfile(6.1.0) | A request for a service to be performed Constraints: prr-1, snr-1
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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:reasonRefused |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Identifiers assigned to this order
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces
requisition | Σ | 0..1 | Identifier | Composite Request ID
status | ?!S Σ | 1..1 | code | (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent | ?!S Σ | 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.
Slices for category | S Σ | 0..* | CodeableConcept | (USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 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
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 1..1 | boolean | True if service/procedure should not be performed Fixed Value: true
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) What is being requested/ordered Binding: US Core Procedure Codes (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:notDoneValueSet | C | 0..1 | canonical(ValueSet) | What was not requested URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
orderDetail | Σ C | 0..* | CodeableConcept | Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x] | Σ | 0..1 |  | Service amount
quantityQuantity |  |  | Quantity |
quantityRatio |  |  | Ratio |
quantityRange |  |  | Range |
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) Individual or Entity the service is ordered for
encounter | Σ | 0..1 | Reference(Encounter) | Encounter in which the request was created
occurrence[x] | S Σ | 0..1 |  | (USCDI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
occurrenceTiming |  |  | Timing |
asNeeded[x] | Σ | 0..1 |  | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
authoredOn | S Σ | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester | S Σ | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | (USCDI)
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.
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested performer
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: V3 Value SetServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference | Σ | 0..* | Reference(Location) | Requested location
reasonCode | Σ | 0..* | CodeableConcept | (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference | Σ | 0..* | Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) | (USCDI+ Quality) (USCDI) Explanation/Justification for service or service
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
supportingInfo |  | 0..* | Reference(Resource) | Additional clinical information
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples
bodySite | Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
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.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 | 📦7.0.0 | US Core v7.0
ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
ServiceRequest.code | Base | extensible | US Core Procedure Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.performerType | Base | example | Participant Roles | 📦4.0.1 | FHIR Std.
ServiceRequest.locationCode | Base | example | V3 Value SetServiceDeliveryLocationRoleType | 📦2014-03-26 | FHIR Std.
ServiceRequest.reasonCode | Base | extensible | US Core Condition Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
snr-1 | error | ServiceRequest | to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`

This structure is derived from USCoreServiceRequestProfile

Summary

Mandatory: 3 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Practitioner (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitioner)
- US Quality Core PractitionerRole (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitionerrole)
- US Quality Core Organization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization)
- US Quality Core RelatedPerson (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson)
- US Quality Core Device (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-device)
- US Core Implantable Device Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device|6.1.0)
- US Quality Core Condition Encounter Diagnosis (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis)
- US Quality Core Condition Problems Health Concerns (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | USCoreServiceRequestProfile(6.1.0) | A request for a service to be performed Constraints: prr-1, snr-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:reasonRefused |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!S Σ | 1..1 | code | (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent | ?!S Σ | 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.
Slices for category | S Σ | 0..* | CodeableConcept | (USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 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
doNotPerform | ?!Σ | 1..1 | boolean | True if service/procedure should not be performed Fixed Value: true
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) What is being requested/ordered Binding: US Core Procedure Codes (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | What was not requested URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) Individual or Entity the service is ordered for
occurrence[x] | S Σ | 0..1 |  | (USCDI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
occurrenceTiming |  |  | Timing |
authoredOn | S Σ | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester | S Σ | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | (USCDI)
reasonCode | Σ | 0..* | CodeableConcept | (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference | Σ | 0..* | Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) | (USCDI+ Quality) (USCDI) Explanation/Justification for service or service
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
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 | 📦7.0.0 | US Core v7.0
ServiceRequest.code | Base | extensible | US Core Procedure Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.reasonCode | Base | extensible | US Core Condition Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
snr-1 | error | ServiceRequest | to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`

Differential View

This structure is derived from USCoreServiceRequestProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | USCoreServiceRequestProfile(6.1.0) | A request for a service to be performed Constraints: snr-1
Slices for extension |  |  |  | Content/Rules for all slices
extension:reasonRefused |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
status |  | 1..1 | code | (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
doNotPerform |  | 1..1 | boolean | True if service/procedure should not be performed Fixed Value: true
code |  | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) What is being requested/ordered
Slices for extension |  |  |  | Content/Rules for all slices
extension:notDoneValueSet | C | 0..1 | canonical(ValueSet) | What was not requested URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
subject |  | 1..1 | Reference(US Quality Core Patient) | (USCDI) Individual or Entity the service is ordered for
occurrence[x] |  | 0..1 |  | (USCDI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
occurrenceTiming |  |  | Timing |
authoredOn |  | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester |  | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | (USCDI)
reasonCode |  | 0..* | CodeableConcept | (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference | Σ | 0..* | Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) | (USCDI+ Quality) (USCDI) Explanation/Justification for service or service
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.reasonCode | Base | extensible | US Core Condition Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
snr-1 | error | ServiceRequest | to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | USCoreServiceRequestProfile(6.1.0) | A request for a service to be performed Constraints: prr-1, snr-1
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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:reasonRefused |  | 1..1 | CodeableConcept | Extension URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Identifiers assigned to this order
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces
requisition | Σ | 0..1 | Identifier | Composite Request ID
status | ?!S Σ | 1..1 | code | (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent | ?!S Σ | 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.
Slices for category | S Σ | 0..* | CodeableConcept | (USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 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
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 1..1 | boolean | True if service/procedure should not be performed Fixed Value: true
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) What is being requested/ordered Binding: US Core Procedure Codes (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:notDoneValueSet | C | 0..1 | canonical(ValueSet) | What was not requested URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
orderDetail | Σ C | 0..* | CodeableConcept | Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x] | Σ | 0..1 |  | Service amount
quantityQuantity |  |  | Quantity |
quantityRatio |  |  | Ratio |
quantityRange |  |  | Range |
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) Individual or Entity the service is ordered for
encounter | Σ | 0..1 | Reference(Encounter) | Encounter in which the request was created
occurrence[x] | S Σ | 0..1 |  | (USCDI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
occurrenceTiming |  |  | Timing |
asNeeded[x] | Σ | 0..1 |  | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
authoredOn | S Σ | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester | S Σ | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) | (USCDI)
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.
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) | Requested performer
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: V3 Value SetServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference | Σ | 0..* | Reference(Location) | Requested location
reasonCode | Σ | 0..* | CodeableConcept | (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service Binding: US Core Condition Codes (extensible)
reasonReference | Σ | 0..* | Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) | (USCDI+ Quality) (USCDI) Explanation/Justification for service or service
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
supportingInfo |  | 0..* | Reference(Resource) | Additional clinical information
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples
bodySite | Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
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.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 | 📦7.0.0 | US Core v7.0
ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
ServiceRequest.code | Base | extensible | US Core Procedure Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📦4.0.1 | FHIR Std.
ServiceRequest.performerType | Base | example | Participant Roles | 📦4.0.1 | FHIR Std.
ServiceRequest.locationCode | Base | example | V3 Value SetServiceDeliveryLocationRoleType | 📦2014-03-26 | FHIR Std.
ServiceRequest.reasonCode | Base | extensible | US Core Condition Codes | 📦7.0.0 | US Core v7.0
ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
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()`
snr-1 | error | ServiceRequest | to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided | `code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()`

This structure is derived from USCoreServiceRequestProfile

Summary

Mandatory: 3 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Practitioner (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitioner)
- US Quality Core PractitionerRole (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitionerrole)
- US Quality Core Organization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization)
- US Quality Core RelatedPerson (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson)
- US Quality Core Device (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-device)
- US Core Implantable Device Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device|6.1.0)
- US Quality Core Condition Encounter Diagnosis (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis)
- US Quality Core Condition Problems Health Concerns (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet

Other representations of profile: CSV, Excel, Schematron