# US Quality Core Procedure Not Done - 2026 US Quality Core Implementation Guide v0.5.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **US Quality Core Procedure Not Done**

## Resource Profile: US Quality Core Procedure Not Done 

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

 
Profile of Procedure for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors. 

**Usage**
The Procedure and ProcedureNotDone profiles represent the positive and negative statements for a procedure. 

The following example illustrates the use of the ProcedureNotDone profile:

```
define "Intermittent Pneumatic Compression Devices Not Applied":
  [ProcedureNotDone: "Application of Intermittent Pneumatic Compression Devices (IPC)"] DeviceNotApplied
    where DeviceNotApplied.statusReason in "Medical Reason"
      or DeviceNotApplied.statusReason in "Patient Refusal"
```

  See the [patterns](patterns.md) page for implementation and usage patterns.  

### Examples

 

| | |
| :--- | :--- |
| [Negation Example with valuset](Procedure-negation-example.md) | Procedure not performed due to complications; indicates that none of the procedures in the given not done value set were performed. |
| [Negation Example with code](Procedure-negation-with-code-example.md) | Procedure not performed due to complications; indicates that a specific procedure, by code, was not performed. |

 

For a more complete discussion of representation of negation within US Quality Core and quality improvement artifacts, see the [Negation in US Quality Core](general-requirements.md#negation-in-us-quality-core) topic.

**USCDI+ Quality Elements:**

* extension:recorded: (USCDI+ Quality) When the procedure was first captured in the subject's record
* partOf: (USCDI+ Quality) Part of referenced event
* status: (USCDI+ Quality) (USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
* statusReason: (USCDI+ Quality) Reason for the current status
* code: (USCDI+ Quality) (USCDI) Identification of the procedure
* performed[x]: (USCDI+ Quality) (USCDI) When the procedure was performed
* reasonCode: (USCDI+ Quality) Coded reason procedure performed
* reasonReference: (USCDI+ Quality) US Core Profile justifying the reason procedure performed

**Usages:**

* Examples for this Profile: [Procedure/negation-example](Procedure-negation-example.md) and [Procedure/negation-with-code-example](Procedure-negation-with-code-example.md)
* CapabilityStatements using this Profile: [US Quality Core Client CapabilityStatement](CapabilityStatement-us-quality-core-client.md) and [US Quality Core Server CapabilityStatement](CapabilityStatement-us-quality-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/fhir.onc.us-quality-core|current/StructureDefinition/StructureDefinition-us-quality-core-procedurenotdone.json)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-us-quality-core-procedurenotdone.csv), [Excel](StructureDefinition-us-quality-core-procedurenotdone.xlsx), [Schematron](StructureDefinition-us-quality-core-procedurenotdone.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "us-quality-core-procedurenotdone",
  "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-procedurenotdone",
  "version" : "0.5.0",
  "name" : "USQualityCoreProcedureNotDone",
  "title" : "US Quality Core Procedure Not Done",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-05-15",
  "publisher" : "Office of the National Coordinator for Health Information Technology (ONC)",
  "contact" : [{
    "name" : "Office of the National Coordinator for Health Information Technology (ONC)",
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.healthit.gov/feedback"
    }]
  }],
  "description" : "Profile of Procedure for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US",
      "display" : "United States of America"
    }],
    "text" : "USA"
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Procedure",
  "baseDefinition" : "http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure|6.1.0",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Procedure",
      "path" : "Procedure",
      "constraint" : [{
        "key" : "pnd-1",
        "severity" : "error",
        "human" : "to indicate what procedure was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided",
        "expression" : "code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()"
      }],
      "mustSupport" : false
    },
    {
      "id" : "Procedure.extension:recorded",
      "extension" : [{
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "Procedure.extension",
      "sliceName" : "recorded",
      "short" : "(USCDI+ Quality) When the procedure was first captured in the subject's record",
      "definition" : "The date the occurrence of the procedure was first captured in the record regardless of Procedure.status (potentially after the occurrence of the event).",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-recorded"]
      }]
    },
    {
      "id" : "Procedure.basedOn",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "Procedure.basedOn",
      "short" : "(USCDI) A request for this procedure",
      "definition" : "A reference to a resource that contains details of the request for this procedure.",
      "alias" : ["fulfills"],
      "min" : 0,
      "max" : "*",
      "base" : {
        "path" : "Procedure.basedOn",
        "min" : 0,
        "max" : "*"
      },
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-careplan",
        "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-servicerequest"]
      }],
      "mustSupport" : false,
      "isModifier" : false,
      "isSummary" : true
    },
    {
      "id" : "Procedure.partOf",
      "extension" : [{
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "Procedure.partOf",
      "short" : "(USCDI+ Quality) Part of referenced event"
    },
    {
      "id" : "Procedure.status",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "Procedure.status",
      "short" : "(USCDI+ Quality) (USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "code"
      }],
      "fixedCode" : "not-done"
    },
    {
      "id" : "Procedure.statusReason",
      "extension" : [{
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "Procedure.statusReason",
      "short" : "(USCDI+ Quality) Reason for the current status",
      "min" : 1,
      "max" : "1",
      "binding" : {
        "strength" : "extensible",
        "description" : "The reason the procedure was not done",
        "valueSet" : "http://fhir.org/guides/onc/us-quality-core/ValueSet/us-quality-core-negation-reason"
      }
    },
    {
      "id" : "Procedure.category",
      "path" : "Procedure.category",
      "short" : "Classification of the procedure"
    },
    {
      "id" : "Procedure.code",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "Procedure.code",
      "short" : "(USCDI+ Quality) (USCDI) Identification of the procedure",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "condition" : ["pnd-1"]
    },
    {
      "id" : "Procedure.code.extension:notDoneValueSet",
      "path" : "Procedure.code.extension",
      "sliceName" : "notDoneValueSet",
      "short" : "What was not performed",
      "definition" : "Specifies the value set that characterizes the events or activities that did not occur or were not performed.",
      "requirements" : "Must be able to indicate the value set from which the expected event would be drawn, had it occurred.",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet"]
      }],
      "condition" : ["pnd-1"]
    },
    {
      "id" : "Procedure.subject",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      }],
      "path" : "Procedure.subject",
      "short" : "(USCDI) Who the procedure was performed on",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient"]
      }]
    },
    {
      "id" : "Procedure.performed[x]",
      "extension" : [{
        "url" : "http://hl7.org/fhir/us/core/StructureDefinition/uscdi-requirement",
        "valueBoolean" : true
      },
      {
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "Procedure.performed[x]",
      "short" : "(USCDI+ Quality) (USCDI) When the procedure was performed"
    },
    {
      "id" : "Procedure.reasonCode",
      "extension" : [{
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "Procedure.reasonCode",
      "short" : "(USCDI+ Quality) Coded reason procedure performed"
    },
    {
      "id" : "Procedure.reasonReference",
      "extension" : [{
        "url" : "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/uscdiplusquality",
        "valueBoolean" : true
      }],
      "path" : "Procedure.reasonReference",
      "short" : "(USCDI+ Quality) US Core Profile justifying the reason procedure performed"
    }]
  }
}

```
