US Core Implementation Guide
​9.0.0-ballot - United States of America flag

US Core Implementation Guide, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 9.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/US-Core/ and changes regularly. See the Directory of published versions

Table of Contents

Page standards status: Informative
.. 0 Table of Contents
... 1 Home
... 2 Conformance
.... 2.1 General Requirements
.... 2.2 Must Support
..... 2.2.1 Observation Summary Table
.... 2.3 SMART on FHIR Obligations and Capabilities
... 3 Guidance
.... 3.1 USCDI
.... 3.2 General Guidance
.... 3.3 Clinical Notes
.... 3.4 Medication List
.... 3.5 Basic Provenance
..... 3.5.1 Using Provenance To Target Resource Elements
.... 3.6 Screening and Assessments
.... 3.7 Changes Between Versions
.... 3.8 Relationship With Other IGs
... 4 Profiles and Extensions
... 5 Capability Statements
... 6 Search Parameters and Operations
... 7 Terminology
.... 7.1 VSAC to FHIR Code System Mapping Table
... 8 Security
... 9 Examples
... 10 Downloads
... 11 Change Log
... 12 Looking Ahead
.... 12.1 US Core Roadmap
.... 12.2 Writing Vital Signs
.... 12.3 Patient Data Feed
..... 12.3.1 Patient Data Feed Additional Resources
... 13 US Core ImplementationGuide Resource
... 14 Artifacts Summary
.... 14.1 US Core Client CapabilityStatement
.... 14.2 US Core Server CapabilityStatement
.... 14.3 US Core Fetch DocumentReference
.... 14.4 USCoreAllergyintoleranceClinicalStatus
.... 14.5 USCoreAllergyintolerancePatient
.... 14.6 USCoreCareplanCategory
.... 14.7 USCoreCareplanDate
.... 14.8 USCoreCareplanPatient
.... 14.9 USCoreCareplanStatus
.... 14.10 USCoreCareteamPatient
.... 14.11 USCoreCareTeamRole
.... 14.12 USCoreCareteamStatus
.... 14.13 USCoreConditionAbatementDate
.... 14.14 USCoreConditionAssertedDate
.... 14.15 USCoreConditionCategory
.... 14.16 USCoreConditionClinicalStatus
.... 14.17 USCoreConditionCode
.... 14.18 USCoreConditionEncounter
.... 14.19 USCoreConditionLastUpdated
.... 14.20 USCoreConditionOnsetDate
.... 14.21 USCoreConditionPatient
.... 14.22 USCoreConditionRecordedDate
.... 14.23 USCoreCoveragePatient
.... 14.24 USCoreDevicePatient
.... 14.25 USCoreDeviceStatus
.... 14.26 USCoreDeviceType
.... 14.27 USCoreDiagnosticreportCategory
.... 14.28 USCoreDiagnosticreportCode
.... 14.29 USCoreDiagnosticreportDate
.... 14.30 USCoreDiagnosticreportLastUpdated
.... 14.31 USCoreDiagnosticreportPatient
.... 14.32 USCoreDiagnosticreportStatus
.... 14.33 USCoreDocumentreferenceCategory
.... 14.34 USCoreDocumentreferenceDate
.... 14.35 USCoreDocumentreferenceId
.... 14.36 USCoreDocumentreferencePatient
.... 14.37 USCoreDocumentreferencePeriod
.... 14.38 USCoreDocumentreferenceStatus
.... 14.39 USCoreDocumentreferenceType
.... 14.40 USCoreEncounterClass
.... 14.41 USCoreEncounterDate
.... 14.42 USCoreEncounterDischargeDisposition
.... 14.43 USCoreEncounterId
.... 14.44 USCoreEncounterIdentifier
.... 14.45 USCoreEncounterLastUpdated
.... 14.46 USCoreEncounterLocation
.... 14.47 USCoreEncounterPatient
.... 14.48 USCoreEncounterStatus
.... 14.49 USCoreEncounterType
.... 14.50 USCoreEthnicity
.... 14.51 USCoreFamilymemberhistoryCode
.... 14.52 USCoreFamilymemberhistoryPatient
.... 14.53 USCoreGoalDescription
.... 14.54 USCoreGoalLifecycleStatus
.... 14.55 USCoreGoalPatient
.... 14.56 USCoreGoalTargetDate
.... 14.57 USCoreImmunizationDate
.... 14.58 USCoreImmunizationPatient
.... 14.59 USCoreImmunizationStatus
.... 14.60 USCoreLocationAddress
.... 14.61 USCoreLocationAddressCity
.... 14.62 USCoreLocationAddressPostalcode
.... 14.63 USCoreLocationAddressState
.... 14.64 USCoreLocationName
.... 14.65 USCoreMedicationdispensePatient
.... 14.66 USCoreMedicationdispenseStatus
.... 14.67 USCoreMedicationdispenseType
.... 14.68 USCoreMedicationrequestAuthoredon
.... 14.69 USCoreMedicationrequestEncounter
.... 14.70 USCoreMedicationrequestIntent
.... 14.71 USCoreMedicationrequestPatient
.... 14.72 USCoreMedicationrequestStatus
.... 14.73 USCoreObservationCategory
.... 14.74 USCoreObservationCode
.... 14.75 USCoreObservationDate
.... 14.76 USCoreObservationLastUpdated
.... 14.77 USCoreObservationPatient
.... 14.78 USCoreObservationStatus
.... 14.79 USCoreOrganizationAddress
.... 14.80 USCoreOrganizationName
.... 14.81 USCorePatientBirthdate
.... 14.82 USCorePatientDeathDate
.... 14.83 USCorePatientFamily
.... 14.84 USCorePatientGiven
.... 14.85 USCorePatientId
.... 14.86 USCorePatientIdentifier
.... 14.87 USCorePatientName
.... 14.88 USCorePractitionerId
.... 14.89 USCorePractitionerIdentifier
.... 14.90 USCorePractitionerName
.... 14.91 USCorePractitionerrolePractitioner
.... 14.92 USCorePractitionerroleSpecialty
.... 14.93 USCoreProcedureCode
.... 14.94 USCoreProcedureDate
.... 14.95 USCoreProcedurePatient
.... 14.96 USCoreProcedureStatus
.... 14.97 USCoreQuestionnaireresponseAuthored
.... 14.98 USCoreQuestionnaireresponseId
.... 14.99 USCoreQuestionnaireresponsePatient
.... 14.100 USCoreQuestionnaireresponseQuestionnaire
.... 14.101 USCoreQuestionnaireresponseStatus
.... 14.102 USCoreRace
.... 14.103 USCoreRelatedpersonId
.... 14.104 USCoreRelatedpersonName
.... 14.105 USCoreRelatedpersonPatient
.... 14.106 USCoreServicerequestAuthored
.... 14.107 USCoreServicerequestCategory
.... 14.108 USCoreServicerequestCode
.... 14.109 USCoreServicerequestId
.... 14.110 USCoreServicerequestPatient
.... 14.111 USCoreServicerequestStatus
.... 14.112 USCoreSpecimenId
.... 14.113 USCoreSpecimenPatient
.... 14.114 US Core ADI DocumentReference Profile
.... 14.115 US Core AllergyIntolerance Profile
.... 14.116 US Core Average Blood Pressure Profile
.... 14.117 US Core Blood Pressure Profile
.... 14.118 US Core BMI Profile
.... 14.119 US Core Body Height Profile
.... 14.120 US Core Body Temperature Profile
.... 14.121 US Core Body Weight Profile
.... 14.122 US Core Care Experience Preference Profile
.... 14.123 US Core CarePlan Profile
.... 14.124 US Core CareTeam Profile
.... 14.125 US Core Condition Encounter Diagnosis Profile
.... 14.126 US Core Condition Problems and Health Concerns Profile
.... 14.127 US Core Coverage Profile
.... 14.128 US Core Device Profile
.... 14.129 US Core DiagnosticReport Profile for Laboratory Results Reporting
.... 14.130 US Core DiagnosticReport Profile for Report and Note Exchange
.... 14.131 US Core DocumentReference Profile
.... 14.132 US Core Encounter Profile
.... 14.133 US Core FamilyMemberHistory Profile
.... 14.134 US Core Goal Profile
.... 14.135 US Core Head Circumference Profile
.... 14.136 US Core Heart Rate Profile
.... 14.137 US Core Immunization Profile
.... 14.138 US Core Laboratory Result Observation Profile
.... 14.139 US Core Location Profile
.... 14.140 US Core Medication Profile
.... 14.141 US Core MedicationDispense Profile
.... 14.142 US Core MedicationRequest Profile
.... 14.143 US Core Observation ADI Documentation Profile
.... 14.144 US Core Observation Clinical Result Profile
.... 14.145 US Core Observation Occupation Profile
.... 14.146 US Core Observation Pregnancy Intent Profile
.... 14.147 US Core Observation Pregnancy Status Profile
.... 14.148 US Core Observation Screening Assessment Profile
.... 14.149 US Core Observation Sexual Orientation Profile
.... 14.150 US Core Organization Profile
.... 14.151 US Core Patient Profile
.... 14.152 US Core Pediatric BMI for Age Observation Profile
.... 14.153 US Core Pediatric Head Occipital Frontal Circumference Percentile Profile
.... 14.154 US Core Pediatric Weight for Height Observation Profile
.... 14.155 US Core PMO ServiceRequest Profile
.... 14.156 US Core Practitioner Profile
.... 14.157 US Core PractitionerRole Profile
.... 14.158 US Core Procedure Profile
.... 14.159 US Core Provenance Profile
.... 14.160 US Core Pulse Oximetry Profile
.... 14.161 US Core QuestionnaireResponse Profile
.... 14.162 US Core RelatedPerson Profile
.... 14.163 US Core Respiratory Rate Profile
.... 14.164 US Core ServiceRequest Profile
.... 14.165 US Core Simple Observation Profile
.... 14.166 US Core Smoking Status Observation Profile
.... 14.167 US Core Specimen Profile
.... 14.168 US Core Treatment Intervention Preference Profile
.... 14.169 US Core Vital Signs Profile
.... 14.170 US Core Authentication Time Extension
.... 14.171 US Core Birth Sex Extension
.... 14.172 US Core Direct email Extension
.... 14.173 US Core Ethnicity Extension
.... 14.174 US Core Extension Questionnaire URI
.... 14.175 US Core FamilyMemberHistory Recorder Extension
.... 14.176 US Core Gender Identity Extension
.... 14.177 US Core Individual Sex Extension
.... 14.178 US Core Interpreter Needed Extension
.... 14.179 US Core Jurisdiction Extension
.... 14.180 US Core Medication Adherence Extension
.... 14.181 US Core Race Extension
.... 14.182 US Core Sex Extension
.... 14.183 US Core Tribal Affiliation Extension
.... 14.184 US Core USCDI Requirement Extension
.... 14.185 US Core Clinical Note Type
.... 14.186 US Core Clinical Result Observation Category
.... 14.187 US Core Condition Codes
.... 14.188 US Core Condition Codes Current
.... 14.189 US Core Diagnostic Report Category Codes
.... 14.190 US Core DocumentReference Category
.... 14.191 US Core DocumentReference Type
.... 14.192 US Core Goal Codes
.... 14.193 US Core Laboratory Test Codes
.... 14.194 US Core Narrative Status
.... 14.195 US Core Non Laboratory Codes
.... 14.196 US Core Problem or Health Concern
.... 14.197 US Core Procedure Codes
.... 14.198 US Core Provenance Participant Type Codes
.... 14.199 US Core Screening Assessment Condition Category
.... 14.200 US Core Screening Assessment Observation Category
.... 14.201 US Core Screening Assessment Observation Maximum Category
.... 14.202 US Core ServiceRequest Category Codes
.... 14.203 US Core Simple Observation Category
.... 14.204 US Core Specimen Condition
.... 14.205 US Core Status for Smoking Status Observation
.... 14.206 US Core CarePlan Category Extension Codes
.... 14.207 US Core Category
.... 14.208 US Core Condition Category Extension Codes
.... 14.209 US Core DocumentReferences Category Codes
.... 14.210 US Core Provenance Participant Type Extension Codes
.... 14.211 10 minute Apgar Color Example
.... 14.212 10 minute Apgar Heart Rate Example
.... 14.213 10 minute Apgar Muscle Tone Example
.... 14.214 10 minute Apgar Reflex Irritability Example
.... 14.215 10 minute Apgar Respiratory effort Example
.... 14.216 10 Minute Apgar Score Example
.... 14.217 10 Minute Apgar Score Panel Example
.... 14.218 ADI Observation Presence ADI Example
.... 14.219 ADI Observation Presence No ADI Example
.... 14.220 Ahc-Hrsn Item Observation Example 68517-2
.... 14.221 Alcohol Use Disorder Identification Test - Consumption (AUDIT-C) Questionnaire Example
.... 14.222 Alcohol Use Disorder Identification Test - Consumption (AUDIT-C) QuestionnaireResponse Example
.... 14.223 Alcohol Use Status Example
.... 14.224 Alcoholic Drinks Per Day Example
.... 14.225 AllergyIntolerance Example
.... 14.226 AllergyIntolerance Non-pharmacologic Agent Example
.... 14.227 AllergyIntolerance Provenance Example 1
.... 14.228 AllergyIntolerance Provenance Example 2
.... 14.229 At Home In Vitro Test Example
.... 14.230 Audit-C Item Example 68517-2
.... 14.231 Audit-C Item Example 68519-8
.... 14.232 Audit-C Item Example 68520-6
.... 14.233 Audit-C Item Example 75626-2
.... 14.234 Audit-C Panel Example 72109-2
.... 14.235 Average Blood Pressure Example
.... 14.236 Basic Metabolic Panel Example
.... 14.237 Blood Pressure Example
.... 14.238 BMI Example
.... 14.239 BP Data Absent Example
.... 14.240 Capillary refill Time Nail Bed Example
.... 14.241 Care Experience Preference Example
.... 14.242 CarePlan Ulcer Example
.... 14.243 CareTeam Example
.... 14.244 CBC Example
.... 14.245 Chest Xray Example
.... 14.246 Cigarette Pack-Years Example
.... 14.247 Colonoscopy Example
.... 14.248 Condition Duodenal Resolved Ulcer Example
.... 14.249 Condition Duodenal Ulcer Example
.... 14.250 Coverage Example
.... 14.251 Deceased Patient Example
.... 14.252 Defibrillator Device Example
.... 14.253 Device Infusion Pump Example
.... 14.254 Device Walker Example
.... 14.255 DiagnosticReport Cardiology Report Example
.... 14.256 DiagnosticReport Chest Xray Report Example
.... 14.257 Discharge Summary Example
.... 14.258 Docref Example 1
.... 14.259 Docref Example 2
.... 14.260 DocumentReference DNR
.... 14.261 DocumentReference Living Will
.... 14.262 DocumentReference POLST (PDF)
.... 14.263 DXA Bone density quantitative measurement panel Example
.... 14.264 DXA Femur-L ArMass BMD Example
.... 14.265 DXA Femur-L T-score BMD Example
.... 14.266 DXA Femur-L Z-score BMD Example
.... 14.267 DXA Hip-L ArMass BMD Example
.... 14.268 DXA Hip-L T-score BMD Example
.... 14.269 DXA Hip-L Z-score BMD Example
.... 14.270 EKG impression Example
.... 14.271 EKG lead Example
.... 14.272 EKG Strip Image
.... 14.273 Encounter 1 Example
.... 14.274 Encounter 1036 Example
.... 14.275 Encounter Delivery Example
.... 14.276 Encounter Diagnosis Example 1
.... 14.277 Encounter Diagnosis Example 2
.... 14.278 Episode Summary Example
.... 14.279 Erythrocytes Example
.... 14.280 Evs Item Example 68516-4
.... 14.281 Evs Item Example 89555-7
.... 14.282 Evs Panel Example 89574-8
.... 14.283 Exercise Per Day Example
.... 14.284 Exercise Per Week Example
.... 14.285 Exercise Vital Sign Questionnaire Example
.... 14.286 Exercise Vital Sign QuestionnaireResponse Example
.... 14.287 FamilyMemberHistory Example
.... 14.288 Goal 1 Example
.... 14.289 Goal 2 Example
.... 14.290 Head Circumference Example
.... 14.291 Health Concern Example
.... 14.292 Heart Rate Example
.... 14.293 Heart rate rhythm Example
.... 14.294 Height Example
.... 14.295 Hematocrit Example
.... 14.296 Hemoglobin Example
.... 14.297 HL7East Example
.... 14.298 Hospital Location
.... 14.299 HVS Item Example 88122-7
.... 14.300 HVS Item Example 88123-5
.... 14.301 HVS Item Example 88124-3
.... 14.302 HVSPanel Example 88121-9
.... 14.303 Immunization Example 1
.... 14.304 Jugular vein distension Example
.... 14.305 Length Example
.... 14.306 Leukocytes Example
.... 14.307 Lipemic Serum Specimen Example
.... 14.308 MCH Example
.... 14.309 MCHC Example
.... 14.310 MCV Example
.... 14.311 Medication Dispense Example
.... 14.312 MedicationRequest Coded Oral Axid Example
.... 14.313 MedicationRequest Contained Oral Axid Example
.... 14.314 MedicationRequest Referenced Oral Axid Example
.... 14.315 MedicationRequest Self Tylenol Example
.... 14.316 Missing Coded Data Example
.... 14.317 Observation SatO2 FiO2 Example
.... 14.318 Occupation Observation Example
.... 14.319 Occupation Observation Example: Industry Unknown
.... 14.320 Occupation Observation Example: Unknown Occupation
.... 14.321 OFC Percentile Example
.... 14.322 Organization 2 Example
.... 14.323 Organization Acme Lab Example
.... 14.324 Organization Acme Payer Example
.... 14.325 Organization Holy Healthcare Example
.... 14.326 Oxygen Saturation Example
.... 14.327 P-R interval {EKG lead} Example
.... 14.328 Patient Child Example
.... 14.329 Patient Example
.... 14.330 Patient Infant Example
.... 14.331 Patient Niece Example
.... 14.332 Pediatric BMI Example
.... 14.333 Pediatric Wt Example
.... 14.334 PHQ9 Item Example 44250-9
.... 14.335 PHQ9 Item Example 44251-7
.... 14.336 PHQ9 Item Example 44252-5
.... 14.337 PHQ9 Item Example 44253-3
.... 14.338 PHQ9 Item Example 44254-1
.... 14.339 PHQ9 Item Example 44255-8
.... 14.340 PHQ9 Item Example 44258-2
.... 14.341 PHQ9 Item Example 44259-0
.... 14.342 PHQ9 Item Example 44260-8
.... 14.343 PHQ9 Item Example 44261-6
.... 14.344 PHQ9 Item Example 69722-7
.... 14.345 PHQ9 Panel Example 44249-1
.... 14.346 Platelets Example
.... 14.347 Practitioner 1 Example
.... 14.348 Practitioner 2 Example
.... 14.349 Practitioner Pharmacist Example
.... 14.350 PractitionerRole_Practitioner_Endpoint_Bundle_Example Example
.... 14.351 Prapare Item Example 54899-0
.... 14.352 Prapare Item Example 56051-6
.... 14.353 Prapare Item Example 56799-0
.... 14.354 Prapare Item Example 63512-8
.... 14.355 Prapare Item Example 63586-2
.... 14.356 Prapare Item Example 67875-5
.... 14.357 Prapare Item Example 71802-3
.... 14.358 Prapare Item Example 76437-3
.... 14.359 Prapare Item Example 76501-6
.... 14.360 Prapare Item Example 82589-3
.... 14.361 Prapare Item Example 93026-3
.... 14.362 Prapare Item Example 93027-1
.... 14.363 Prapare Item Example 93028-9
.... 14.364 Prapare Item Example 93029-7
.... 14.365 Prapare Item Example 93030-5
.... 14.366 Prapare Item Example 93033-9
.... 14.367 Prapare Item Example 93034-7
.... 14.368 Prapare Item Example 93035-4
.... 14.369 Prapare Item Example 93038-8
.... 14.370 Prapare Multiselect-Item Example 32624-9-Answer0
.... 14.371 Prapare Multiselect-Item Example 32624-9-Answer1
.... 14.372 Prapare Multiselect-Item Example 93031-3-Answer0
.... 14.373 Prapare Multiselect-Item Example 93031-3-Answer1
.... 14.374 Prapare Panel Example 93025-5
.... 14.375 Prapare Panel Example 93039-6
.... 14.376 Prapare Panel Example 93040-4
.... 14.377 Prapare Panel Example 93041-2
.... 14.378 Prapare Panel Example 93042-0
.... 14.379 PRAPARE Panel Example 93043-8
.... 14.380 Pregnancy Intent Observation Example
.... 14.381 Pregnancy Status Observation Example
.... 14.382 Procedure Defibrillator Implant Example
.... 14.383 Prosthetic Knee Example
.... 14.384 Pulse intensity Palpation Example
.... 14.385 Q-T interval {EKG lead} Example
.... 14.386 QRS dur {EKG lead} Example
.... 14.387 Questionnaire Hunger Vital Sign (HVS) Example
.... 14.388 Questionnaire PHQ-9 Example
.... 14.389 Questionnaire PRAPARE Example
.... 14.390 QuestionnaireResponse Glascow Coma Score Example
.... 14.391 QuestionnaireResponse Hunger Vital Sign (HVS) Example
.... 14.392 QuestionnaireResponse PHQ-9 Example
.... 14.393 QuestionnaireResponse PRAPARE Example
.... 14.394 Rehab Example
.... 14.395 Respiratory Rate Example
.... 14.396 Saint Luke W Endpoint Example
.... 14.397 SDOH Problem/Health Concern Example
.... 14.398 Serum BUN Example
.... 14.399 Serum Calcium Example
.... 14.400 Serum Chloride Example
.... 14.401 Serum CO2 Example
.... 14.402 Serum Creatinine Example
.... 14.403 Serum Glucose Example
.... 14.404 Serum Potassium Example
.... 14.405 Serum Sodium Example
.... 14.406 Serum Specimen Example
.... 14.407 ServiceRequest BMP Example
.... 14.408 ServiceRequest CBC Example
.... 14.409 ServiceRequest Chest XRay Example
.... 14.410 ServiceRequest DNR Example
.... 14.411 ServiceRequest EKG Example
.... 14.412 ServiceRequest Food Pantry Referral Example
.... 14.413 ServiceRequest for Rehab Example
.... 14.414 Simple Observation Cognitive Status Example
.... 14.415 Simple Observation Disability Status Example
.... 14.416 Simple Observation Functional Status Example
.... 14.417 Simple Observation SDOH Example
.... 14.418 Some Day Smoker Example
.... 14.419 Substance Use Status Example
.... 14.420 Taps Item Example 75889-6
.... 14.421 Taps Item Example 88037-7
.... 14.422 Taps Item Example 96842-0
.... 14.423 Taps Item Example 96843-8
.... 14.424 Taps Item Example 96844-6
.... 14.425 Taps Panel Example 96841-2
.... 14.426 Temperature Example
.... 14.427 Tobacco, Alcohol, Prescription medications, and other Substance use screen (TAPS) Questionnaire Example
.... 14.428 Tobacco, Alcohol, Prescription medications, and other Substance use screen (TAPS) QuestionnaireResponse Example
.... 14.429 Treatment Intervention Preference Example
.... 14.430 Urine Specimen Example
.... 14.431 Urobilinogen Example
.... 14.432 US Core Version 3.1.1 Model Definition
.... 14.433 US Core Version 4.0.0 Model Definition
.... 14.434 US Core Version 5.0.1 Model Definition
.... 14.435 US Core Version 6.1.0 Model Definition
.... 14.436 US Core Version 7.0.0 Model Definition
.... 14.437 US Core Version 8.0.0 Model Definition
.... 14.438 Uscore Med1 Example
.... 14.439 Uscore Med2 Example
.... 14.440 Weight Example
.... 14.441 Whole Blood Specimen Example
.... 14.442 Xray Chest Findings Example
.... 14.443 Xray Chest Impression Example