US Core Implementation Guide
10.0.0-ballot - STU 10 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 10.0.0-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
2.4 Security
2.5 Requirements Tables
3 Guidance
3.1 USCDI
3.2 General Guidance
3.3 Adverse Events: Clinical Records and Patient Safety Reporting
3.4 Clinical Notes
3.5 Medication List
3.6 Basic Provenance
3.6.1 Using Provenance To Target Resource Elements
3.7 Screening and Assessments
3.8 Relationship With Other IGs
4 Profiles and Extensions
5 Capability Statements and Requirements Resources
6 Search Parameters and Operations
7 Terminology
7.1 VSAC to FHIR Code System Mapping Table
8 Examples
9 Downloads
10 Version History
10.1 Change Log
10.2 Changes Between Versions
11 Looking Ahead
11.1 US Core Roadmap
11.2 Writing Vital Signs
11.3 Writing Documents
11.3.1 Application Feature Framework
11.3.2 `$submit-bundle` Operation
11.4 Patient Data Feed
11.4.1 Patient Data Feed Additional Resources
12 US Core ImplementationGuide Resource
13 Artifacts Summary
13.1 US Core Certifying System
13.2 US Core Requestor (Client)
13.3 US Core Responder (Server)
13.4 US Core Certifying System Requirements
13.5 US Core Client Requirements
13.6 US Core Server Requirements
13.7 US Core Client CapabilityStatement
13.8 US Core Server CapabilityStatement
13.9 US Core Fetch DocumentReference
13.10 USCoreAllergyintoleranceClinicalStatus
13.11 USCoreAllergyintolerancePatient
13.12 USCoreAppointmentDate
13.13 USCoreAppointmentId
13.14 USCoreAppointmentPatient
13.15 USCoreAppointmentStatus
13.16 USCoreCareplanCategory
13.17 USCoreCareplanDate
13.18 USCoreCareplanPatient
13.19 USCoreCareplanStatus
13.20 USCoreCareteamPatient
13.21 USCoreCareTeamRole
13.22 USCoreCareteamStatus
13.23 USCoreConditionAbatementDate
13.24 USCoreConditionAssertedDate
13.25 USCoreConditionCategory
13.26 USCoreConditionClinicalStatus
13.27 USCoreConditionCode
13.28 USCoreConditionEncounter
13.29 USCoreConditionLastUpdated
13.30 USCoreConditionOnsetDate
13.31 USCoreConditionPatient
13.32 USCoreConditionRecordedDate
13.33 USCoreCoveragePatient
13.34 USCoreDevicePatient
13.35 USCoreDevicerequestAuthoredOn
13.36 USCoreDevicerequestCode
13.37 USCoreDevicerequestId
13.38 USCoreDevicerequestPatient
13.39 USCoreDevicerequestStatus
13.40 USCoreDeviceStatus
13.41 USCoreDeviceType
13.42 USCoreDiagnosticreportCategory
13.43 USCoreDiagnosticreportCode
13.44 USCoreDiagnosticreportDate
13.45 USCoreDiagnosticreportIdentifier
13.46 USCoreDiagnosticreportLastUpdated
13.47 USCoreDiagnosticreportPatient
13.48 USCoreDiagnosticreportStatus
13.49 USCoreDocumentreferenceCategory
13.50 USCoreDocumentreferenceDate
13.51 USCoreDocumentreferenceId
13.52 USCoreDocumentreferencePatient
13.53 USCoreDocumentreferencePeriod
13.54 USCoreDocumentreferenceStatus
13.55 USCoreDocumentreferenceType
13.56 USCoreEncounterClass
13.57 USCoreEncounterDate
13.58 USCoreEncounterDischargeDisposition
13.59 USCoreEncounterId
13.60 USCoreEncounterIdentifier
13.61 USCoreEncounterLastUpdated
13.62 USCoreEncounterLocation
13.63 USCoreEncounterPatient
13.64 USCoreEncounterStatus
13.65 USCoreEncounterType
13.66 USCoreEthnicity
13.67 USCoreFamilymemberhistoryCode
13.68 USCoreFamilymemberhistoryPatient
13.69 USCoreGoalDescription
13.70 USCoreGoalLifecycleStatus
13.71 USCoreGoalPatient
13.72 USCoreGoalTargetDate
13.73 USCoreImagingstudyId
13.74 USCoreImagingstudyIdentifier
13.75 USCoreImagingstudyPatient
13.76 USCoreImmunizationDate
13.77 USCoreImmunizationPatient
13.78 USCoreImmunizationStatus
13.79 USCoreLocationAddress
13.80 USCoreLocationAddressCity
13.81 USCoreLocationAddressPostalcode
13.82 USCoreLocationAddressState
13.83 USCoreLocationName
13.84 USCoreMedicationadministrationEffectiveTime
13.85 USCoreMedicationadministrationId
13.86 USCoreMedicationadministrationPatient
13.87 USCoreMedicationadministrationStatus
13.88 USCoreMedicationdispensePatient
13.89 USCoreMedicationdispenseStatus
13.90 USCoreMedicationdispenseType
13.91 USCoreMedicationrequestAuthoredon
13.92 USCoreMedicationrequestEncounter
13.93 USCoreMedicationrequestIntent
13.94 USCoreMedicationrequestPatient
13.95 USCoreMedicationrequestStatus
13.96 USCoreNutritionorderDatetime
13.97 USCoreNutritionorderId
13.98 USCoreNutritionorderOraldiet
13.99 USCoreNutritionorderPatient
13.100 USCoreNutritionorderStatus
13.101 USCoreObservationCategory
13.102 USCoreObservationCode
13.103 USCoreObservationDate
13.104 USCoreObservationLastUpdated
13.105 USCoreObservationPatient
13.106 USCoreObservationStatus
13.107 USCoreOrganizationAddress
13.108 USCoreOrganizationName
13.109 USCorePatientBirthdate
13.110 USCorePatientDeathDate
13.111 USCorePatientFamily
13.112 USCorePatientGiven
13.113 USCorePatientId
13.114 USCorePatientIdentifier
13.115 USCorePatientName
13.116 USCorePractitionerId
13.117 USCorePractitionerIdentifier
13.118 USCorePractitionerName
13.119 USCorePractitionerrolePractitioner
13.120 USCorePractitionerroleSpecialty
13.121 USCoreProcedureCode
13.122 USCoreProcedureDate
13.123 USCoreProcedurePatient
13.124 USCoreProcedureStatus
13.125 USCoreQuestionnaireresponseAuthored
13.126 USCoreQuestionnaireresponseId
13.127 USCoreQuestionnaireresponsePatient
13.128 USCoreQuestionnaireresponseQuestionnaire
13.129 USCoreQuestionnaireresponseStatus
13.130 USCoreRace
13.131 USCoreRelatedpersonId
13.132 USCoreRelatedpersonName
13.133 USCoreRelatedpersonPatient
13.134 USCoreServicerequestAuthored
13.135 USCoreServicerequestCategory
13.136 USCoreServicerequestCode
13.137 USCoreServicerequestId
13.138 USCoreServicerequestIdentifier
13.139 USCoreServicerequestPatient
13.140 USCoreServicerequestStatus
13.141 USCoreSpecimenId
13.142 USCoreSpecimenPatient
13.143 US Core ADI DocumentReference Profile
13.144 US Core AllergyIntolerance Profile
13.145 US Core Appointment Profile
13.146 US Core Average Blood Pressure Profile
13.147 US Core Blood Pressure Profile
13.148 US Core BMI Profile
13.149 US Core Body Height Profile
13.150 US Core Body Temperature Profile
13.151 US Core Body Weight Profile
13.152 US Core Care Experience Preference Profile
13.153 US Core CarePlan Profile
13.154 US Core CareTeam Profile
13.155 US Core Condition Encounter Diagnosis Profile
13.156 US Core Condition Problems and Health Concerns Profile
13.157 US Core Coverage Profile
13.158 US Core Device Profile
13.159 US Core DeviceRequest Profile
13.160 US Core DiagnosticReport Profile for Laboratory Results Reporting
13.161 US Core DiagnosticReport Profile for Report and Note Exchange
13.162 US Core DocumentReference Profile
13.163 US Core Encounter Profile
13.164 US Core FamilyMemberHistory Profile
13.165 US Core Goal Profile
13.166 US Core Head Circumference Profile
13.167 US Core Heart Rate Profile
13.168 US Core ImagingStudy Profile
13.169 US Core Immunization Profile
13.170 US Core Laboratory Result Observation Profile
13.171 US Core Location Profile
13.172 US Core Medication Profile
13.173 US Core MedicationAdministration Profile
13.174 US Core MedicationDispense Profile
13.175 US Core MedicationRequest Profile
13.176 US Core NutritionOrder Profile
13.177 US Core Observation ADI Documentation Profile
13.178 US Core Observation Clinical Result Profile
13.179 US Core Observation Occupation Profile
13.180 US Core Observation Pregnancy Intent Profile
13.181 US Core Observation Pregnancy Status Profile
13.182 US Core Observation Screening Assessment Profile
13.183 US Core Observation Sexual Orientation Profile
13.184 US Core Organization Profile
13.185 US Core Patient Accommodation Profile
13.186 US Core Patient Profile
13.187 US Core Pediatric BMI for Age Observation Profile
13.188 US Core Pediatric Head Occipital Frontal Circumference Percentile Profile
13.189 US Core Pediatric Weight for Height Observation Profile
13.190 US Core Practitioner Profile
13.191 US Core PractitionerRole Profile
13.192 US Core Procedure Profile
13.193 US Core Provenance Profile
13.194 US Core Pulse Oximetry Profile
13.195 US Core QuestionnaireResponse Profile
13.196 US Core RelatedPerson Profile
13.197 US Core Respiratory Rate Profile
13.198 US Core ServiceRequest Profile
13.199 US Core Simple Observation Profile
13.200 US Core Specimen Profile
13.201 US Core Tobacco And Nicotine Use Observation Profile
13.202 US Core Treatment Intervention Preference Profile
13.203 US Core Vital Signs Profile
13.204 US Core Authentication Time Extension
13.205 US Core Birth Sex Extension
13.206 US Core Direct email Extension
13.207 US Core Ethnicity Extension
13.208 US Core Extension Questionnaire URI
13.209 US Core FamilyMemberHistory Recorder Extension
13.210 US Core Gender Identity Extension
13.211 US Core Individual Sex Extension
13.212 US Core Interpreter Needed Extension
13.213 US Core Jurisdiction Extension
13.214 US Core Medication Adherence Extension
13.215 US Core Race Extension
13.216 US Core Sex Extension
13.217 US Core Tribal Affiliation Extension
13.218 US Core USCDI Requirement Extension
13.219 US Core Clinical Note Type
13.220 US Core Clinical Result Observation Category
13.221 US Core Condition Codes
13.222 US Core Diagnostic Report Category Codes
13.223 US Core DocumentReference Category
13.224 US Core DocumentReference Type
13.225 US Core Laboratory Test Codes
13.226 US Core Location Type Codes
13.227 US Core Narrative Status
13.228 US Core Non Laboratory Codes
13.229 US Core Practitioner Role Specialty Codes
13.230 US Core Problem or Health Concern
13.231 US Core Procedure Codes
13.232 US Core Screening Assessment Condition Category
13.233 US Core Screening Assessment Observation Category
13.234 US Core Screening Assessment Observation Maximum Category
13.235 US Core ServiceRequest Category Codes
13.236 US Core Simple Observation Category
13.237 US Core Specimen Condition
13.238 US Core Tobacco And Nicotine Observation Status
13.239 US Core CarePlan Category Extension Codes
13.240 US Core Category
13.241 US Core Condition Category Extension Codes
13.242 US Core DocumentReferences Category Codes
13.243 10 minute Apgar Color Example
13.244 10 minute Apgar Heart Rate Example
13.245 10 minute Apgar Muscle Tone Example
13.246 10 minute Apgar Reflex Irritability Example
13.247 10 minute Apgar Respiratory effort Example
13.248 10 Minute Apgar Score Example
13.249 10 Minute Apgar Score Panel Example
13.250 ADI Observation Presence ADI Example
13.251 Ahc-Hrsn Item Observation Example 68517-2
13.252 Alcohol Use Disorder Identification Test - Consumption (AUDIT-C) Questionnaire Example
13.253 Alcohol Use Disorder Identification Test - Consumption (AUDIT-C) QuestionnaireResponse Example
13.254 Alcohol Use Status Example
13.255 Alcoholic Drinks Per Day Example
13.256 AllergyIntolerance Example
13.257 AllergyIntolerance Non-pharmacologic Agent Example
13.258 AllergyIntolerance Provenance Example 1
13.259 AllergyIntolerance Provenance Example 2
13.260 Appointment From Referral Example
13.261 Appointment Resulting In An Encounter Example
13.262 ASL Interpreter Accommodation Example
13.263 At Home In Vitro Test Example
13.264 Audit-C Item Example 68517-2
13.265 Audit-C Item Example 68519-8
13.266 Audit-C Item Example 68520-6
13.267 Audit-C Item Example 75626-2
13.268 Audit-C Panel Example 72109-2
13.269 Average Blood Pressure Example
13.270 Basic Metabolic Panel Example
13.271 Blood Pressure Example
13.272 BMI Example
13.273 Booked Future Appointment Example
13.274 BP Data Absent Example
13.275 Cancelled Appointment Example
13.276 Capillary refill Time Nail Bed Example
13.277 Care Experience Preference Example
13.278 CarePlan Ulcer Example
13.279 CareTeam Example
13.280 CBC Example
13.281 Chest Xray Example
13.282 Cigarette Pack-Years Example
13.283 Clinician Authored Discharge Summary Example
13.284 Colonoscopy Example
13.285 Condition Duodenal Resolved Ulcer Example
13.286 Condition Duodenal Ulcer Example
13.287 Coverage Example
13.288 Deceased Patient Example
13.289 Defibrillator Device Example
13.290 Device Infusion Pump Example
13.291 Device Walker Example
13.292 DeviceRequest CPAP Example
13.293 DeviceRequest Walker Example
13.294 DiagnosticReport Cardiology Report Example
13.295 DiagnosticReport Chest Xray Report Example
13.296 DICOMweb WADO-RS Endpoint Example
13.297 Docref Example 1
13.298 Docref Example 2
13.299 DocumentReference DNR
13.300 DocumentReference Living Will
13.301 DocumentReference POLST (PDF)
13.302 DXA Bone density quantitative measurement panel Example
13.303 DXA Femur-L ArMass BMD Example
13.304 DXA Femur-L T-score BMD Example
13.305 DXA Femur-L Z-score BMD Example
13.306 DXA Hip-L ArMass BMD Example
13.307 DXA Hip-L T-score BMD Example
13.308 DXA Hip-L Z-score BMD Example
13.309 EKG impression Example
13.310 EKG lead Example
13.311 EKG Strip Image
13.312 Electronic Cigarette User Example
13.313 Encounter 1 Example
13.314 Encounter 1036 Example
13.315 Encounter Delivery Example
13.316 Encounter Diagnosis Example 1
13.317 Encounter Diagnosis Example 2
13.318 Encounter From Appointment Example
13.319 Episode Summary Example
13.320 Erythrocytes Example
13.321 Evs Item Example 68516-4
13.322 Evs Item Example 89555-7
13.323 Evs Panel Example 89574-8
13.324 Exercise Per Day Example
13.325 Exercise Per Week Example
13.326 Exercise Vital Sign Questionnaire Example
13.327 Exercise Vital Sign QuestionnaireResponse Example
13.328 FamilyMemberHistory Example
13.329 Goal 1 Example
13.330 Goal 2 Example
13.331 Head Circumference Example
13.332 Health Concern Example
13.333 Healthcare Agent CareTeam Example
13.334 Healthcare Agent CareTeam Example Using the Durable Power of Attorney Role Code
13.335 Healthcare Agent CareTeam Example Using the Healthcare Power of Attorney Role Code
13.336 Heart Rate Example
13.337 Heart rate rhythm Example
13.338 Height Example
13.339 Hematocrit Example
13.340 Hemoglobin Example
13.341 HL7East Example
13.342 Hospital Location
13.343 HVS Item Example 88122-7
13.344 HVS Item Example 88123-5
13.345 HVS Item Example 88124-3
13.346 HVSPanel Example 88121-9
13.347 ImagingStudy Chest Xray Example
13.348 ImagingStudy Multi-series CT Example
13.349 Immunization Example 1
13.350 Immunization Not Done Example
13.351 Jugular vein distension Example
13.352 Length Example
13.353 Leukocytes Example
13.354 Lipemic Serum Specimen Example
13.355 MCH Example
13.356 MCHC Example
13.357 MCV Example
13.358 Medication Dispense Example
13.359 MedicationAdministration Dose Not Given Example
13.360 MedicationAdministration In Progress Vancomycin Example
13.361 MedicationAdministration Inpatient IV Cefazolin Example
13.362 MedicationAdministration PRN Acetaminophen Example
13.363 MedicationRequest Coded Oral Axid Example
13.364 MedicationRequest Contained Oral Axid Example
13.365 MedicationRequest Referenced Oral Axid Example
13.366 MedicationRequest Self Tylenol Example
13.367 Missing Coded Data Example
13.368 No ADI Observation Example
13.369 Nutrition Assessment Item Example 75292-3
13.370 Nutrition Assessment Item Example 75298-0
13.371 Nutrition Assessment Item Example 75303-8
13.372 Nutrition Assessment Item Example 80467-4
13.373 Nutrition Assessment Item Example 9058-9
13.374 Nutrition Assessment Panel Example 75282-4
13.375 NutritionOrder Cardiac Diet Example
13.376 NutritionOrder Whole Food Diet Example
13.377 Observation SatO2 FiO2 Example
13.378 Occupation Observation Example
13.379 Occupation Observation Example: Industry Unknown
13.380 Occupation Observation Example: Unknown Occupation
13.381 OFC Percentile Example
13.382 Office Visit Follow-up Appointment Example
13.383 Organization 2 Example
13.384 Organization Acme Lab Example
13.385 Organization Acme Payer Example
13.386 Organization Holy Healthcare Example
13.387 Oxygen Saturation Example
13.388 P-R interval {EKG lead} Example
13.389 Patient Child Example
13.390 Patient Example
13.391 Patient Infant Example
13.392 Patient Niece As Durable Power Of Attorney Example
13.393 Patient Niece As Healthcare Power Of Attorney Example
13.394 Patient Niece Example
13.395 Pediatric BMI Example
13.396 Pediatric Wt Example
13.397 PHQ9 Item Example 44250-9
13.398 PHQ9 Item Example 44251-7
13.399 PHQ9 Item Example 44252-5
13.400 PHQ9 Item Example 44253-3
13.401 PHQ9 Item Example 44254-1
13.402 PHQ9 Item Example 44255-8
13.403 PHQ9 Item Example 44258-2
13.404 PHQ9 Item Example 44259-0
13.405 PHQ9 Item Example 44260-8
13.406 PHQ9 Item Example 44261-6
13.407 PHQ9 Item Example 69722-7
13.408 PHQ9 Panel Example 44249-1
13.409 Platelets Example
13.410 Practitioner 1 Example
13.411 Practitioner 2 Example
13.412 Practitioner 3 Example
13.413 Practitioner Pharmacist Example
13.414 PractitionerRole_Practitioner_Endpoint_Bundle_Example Example
13.415 Prapare Item Example 54899-0
13.416 Prapare Item Example 56051-6
13.417 Prapare Item Example 56799-0
13.418 Prapare Item Example 63512-8
13.419 Prapare Item Example 63586-2
13.420 Prapare Item Example 67875-5
13.421 Prapare Item Example 71802-3
13.422 Prapare Item Example 76437-3
13.423 Prapare Item Example 76501-6
13.424 Prapare Item Example 82589-3
13.425 Prapare Item Example 93026-3
13.426 Prapare Item Example 93027-1
13.427 Prapare Item Example 93028-9
13.428 Prapare Item Example 93029-7
13.429 Prapare Item Example 93030-5
13.430 Prapare Item Example 93033-9
13.431 Prapare Item Example 93034-7
13.432 Prapare Item Example 93035-4
13.433 Prapare Item Example 93038-8
13.434 Prapare Multiselect-Item Example 32624-9-Answer0
13.435 Prapare Multiselect-Item Example 32624-9-Answer1
13.436 Prapare Multiselect-Item Example 93031-3-Answer0
13.437 Prapare Multiselect-Item Example 93031-3-Answer1
13.438 Prapare Panel Example 93025-5
13.439 Prapare Panel Example 93039-6
13.440 Prapare Panel Example 93040-4
13.441 Prapare Panel Example 93041-2
13.442 Prapare Panel Example 93042-0
13.443 PRAPARE Panel Example 93043-8
13.444 Pregnancy Intent Observation Example
13.445 Pregnancy Status Observation Example
13.446 Procedure Defibrillator Implant Example
13.447 Procedure Not Done Example
13.448 Prosthetic Knee Example
13.449 Pulse intensity Palpation Example
13.450 Q-T interval {EKG lead} Example
13.451 QRS dur {EKG lead} Example
13.452 Questionnaire Hunger Vital Sign (HVS) Example
13.453 Questionnaire PHQ-9 Example
13.454 Questionnaire PRAPARE Example
13.455 QuestionnaireResponse Glascow Coma Score Example
13.456 QuestionnaireResponse Hunger Vital Sign (HVS) Example
13.457 QuestionnaireResponse PHQ-9 Example
13.458 QuestionnaireResponse PRAPARE Example
13.459 Rehab Example
13.460 Respiratory Rate Example
13.461 Saint Luke W Endpoint Example
13.462 SDOH Problem/Health Concern Example
13.463 Serum BUN Example
13.464 Serum Calcium Example
13.465 Serum Chloride Example
13.466 Serum CO2 Example
13.467 Serum Creatinine Example
13.468 Serum Glucose Example
13.469 Serum Potassium Example
13.470 Serum Sodium Example
13.471 Serum Specimen Example
13.472 ServiceRequest BMP Example
13.473 ServiceRequest CBC Example
13.474 ServiceRequest Chest XRay Example
13.475 ServiceRequest DNR Example
13.476 ServiceRequest EKG Example
13.477 ServiceRequest Food Pantry Referral Example
13.478 ServiceRequest for Rehab Example
13.479 Simple Observation Cognitive Status Example
13.480 Simple Observation Disability Status Example
13.481 Simple Observation Functional Status Example
13.482 Simple Observation Nutrition Status Example
13.483 Simple Observation SDOH Example
13.484 Some Day Smoker Example
13.485 Substance Use Status Example
13.486 Taps Item Example 75889-6
13.487 Taps Item Example 88037-7
13.488 Taps Item Example 96842-0
13.489 Taps Item Example 96843-8
13.490 Taps Item Example 96844-6
13.491 Taps Panel Example 96841-2
13.492 Telehealth Appointment Example
13.493 Temperature Example
13.494 Tobacco, Alcohol, Prescription medications, and other Substance use screen (TAPS) Questionnaire Example
13.495 Tobacco, Alcohol, Prescription medications, and other Substance use screen (TAPS) QuestionnaireResponse Example
13.496 Treatment Intervention Preference Example
13.497 Urine Specimen Example
13.498 Urobilinogen Example
13.499 US Core Model Definition
13.500 Uscore Med1 Example
13.501 Uscore Med2 Example
13.502 Weight Example
13.503 Wheelchair Assistance Accommodation Example
13.504 Whole Blood Specimen Example
13.505 Xray Chest Findings Example
13.506 Xray Chest Impression Example
13.507 Expansion Parameters