Radiotherapy Course Prescription - Definitions - CodeX Radiation Therapy v2.0.0

Is Modifier false

Summary true

4. ServiceRequest.meta

Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

Short Metadata about the resource

Control 0..1

Meta

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

6. ServiceRequest.implicitRules

Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Short A set of rules under which this content was created

Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control 0..1

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

8. ServiceRequest.language

Definition

The base language in which the resource is written.

Short Language of the resource content

Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control 0..1

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages)

A human language.

Additional Bindings

Purpose

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

10. ServiceRequest.text

Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Short Text summary of the resource, for human interpretation

Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control 0..1

Narrative

Is Modifier false

Summary false

Alternate Names narrative, html, xhtml, display

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

12. ServiceRequest.contained

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Short Contained, inline Resources

Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control 0..*

Resource

Is Modifier false

Summary false

Alternate Names inline resources, anonymous resources, contained resources

14. ServiceRequest.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Must Support true

Summary false

This element introduces a set of slices on ServiceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

16. ServiceRequest.extension:intrafractionVerification

Slice Name intrafractionVerification

Definition

Verification of the patient or target position during a treatment fraction.

Short Intrafraction Verification

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Intrafraction Verification) (Complex Extension)

Is Modifier false

Must Support true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
IntrafractionVerificationQualifierAllowed: Qualifier is only allowed for X-Ray procedure. (extension.where(url = 'qualifier').exists() implies (extension.where(url = 'procedure').exists() and extension.where(url = 'procedure').value.exists() and extension.where(url = 'procedure').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006') ) ))

18. ServiceRequest.extension:respiratoryMotionManagement

Slice Name respiratoryMotionManagement

Definition

Method applied to manage respiratory motion.

Short Respiratory Motion Management

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Respiratory Motion Management) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

20. ServiceRequest.extension:freeBreathingMotionManagementTechnique

Slice Name freeBreathingMotionManagementTechnique

Definition

Technique to manage respiratory motion with free-breathing. Only allowed if respiratory motion management is free-breathing.

Short Free-Breathing Motion Management Technique

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Free-Breathing Motion Management Technique) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

22. ServiceRequest.extension:modalityAndTechnique

Slice Name modalityAndTechnique

Definition

Extension capturing modality and technique of a given radiotherapy procedure. The allowed combinations of modality and technique are constrained by invariants, one per modality.

Short Radiotherapy Modality And Technique Extension

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Radiotherapy Modality And Technique Extension) (Complex Extension)

Is Modifier false

Must Support true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007'))
TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007'))
TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007'))
TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009'))
TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007'))
TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007'))
TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006'))
TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007'))
TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006'))
TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006'))
TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007'))
ModalityTextRequiredForOther: Require a text literal for code other (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists())
TechniqueTextRequiredForOther: Require a text literal for code other (extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists())

24. ServiceRequest.extension:modalityAndTechnique.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

26. ServiceRequest.extension:modalityAndTechnique.extension

Definition

An Extension

Short Extension

Control 1..*

Is Modifier false

Summary false

This element introduces a set of slices on ServiceRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

28. ServiceRequest.extension:modalityAndTechnique.extension:modality

Slice Name modality

Definition

Extension capturing a modality of external beam or brachytherapy radiation procedures.

Short Radiotherapy Modality Extension

Control 1..1

Type Extension(Radiotherapy Modality Extension) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Summary false

30. ServiceRequest.extension:modalityAndTechnique.extension:modality.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

32. ServiceRequest.extension:modalityAndTechnique.extension:modality.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

34. ServiceRequest.extension:modalityAndTechnique.extension:modality.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality

36. ServiceRequest.extension:modalityAndTechnique.extension:modality.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1

Binding The codes SHALL be taken from Radiotherapy Modality Value Set
(required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

38. ServiceRequest.extension:modalityAndTechnique.extension:technique

Slice Name technique

Definition

Extension capturing a technique of external beam or brachytherapy radiation procedures.

Short Radiotherapy Technique Extension

Control 0..*

Type Extension(Radiotherapy Technique Extension) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Summary false

40. ServiceRequest.extension:modalityAndTechnique.extension:technique.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

42. ServiceRequest.extension:modalityAndTechnique.extension:technique.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

44. ServiceRequest.extension:modalityAndTechnique.extension:technique.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique

46. ServiceRequest.extension:modalityAndTechnique.extension:technique.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1

Binding The codes SHALL be taken from Radiotherapy Technique Value Set
(required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

48. ServiceRequest.extension:modalityAndTechnique.extension:radiotherapyEnergyOrIsotope

Slice Name radiotherapyEnergyOrIsotope

Definition

The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum acceleration voltage, or the used isotope.

Short Radiotherapy Energy or Isotope

Control 0..*

Type Extension(Energy or Isotope) (Extension Type: Choice of: CodeableConcept, Quantity(SimpleQuantity))

Is Modifier false

Must Support true

Summary false

50. ServiceRequest.extension:modalityAndTechnique.extension:radiotherapyTreatmentApplicatorType

Slice Name radiotherapyTreatmentApplicatorType

Definition

Radiotherapy Treatment Applicator Type.

Short Radiotherapy Treatment Applicator Type

Control 0..*

Type Extension(Treatment Applicator Type) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

Summary false

52. ServiceRequest.extension:modalityAndTechnique.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique

54. ServiceRequest.extension:modalityAndTechnique.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..0

Type Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

56. ServiceRequest.extension:imageGuidedRadiotherapyModality

Slice Name imageGuidedRadiotherapyModality

Definition

The modality and associated energy used for imaging in Image Guided Radiotherapy (IGRT)

Short Image Guided Radiotherapy Modality

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Image Guided Radiotherapy Modality) (Complex Extension)

Is Modifier false

Must Support true

58. ServiceRequest.extension:treatmentIntent

Slice Name treatmentIntent

Definition

The purpose of a treatment, medication, or procedure.

Short Procedure Intent Extension

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Procedure Intent Extension) (Extension Type: CodeableConcept)

Is Modifier false

Must Support true

60. ServiceRequest.extension:radiotherapyDosePrescribedToVolume

Slice Name radiotherapyDosePrescribedToVolume

Definition

Dose parameters prescribed for one radiotherapy volume.

Short Prescribed Dose to a Dose Reference

Control 0..*
This element is affected by the following invariants: ele-1

Type Extension(Dose Prescribed to Volume) (Complex Extension)

Is Modifier false

Must Support true

62. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

64. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension

Definition

An Extension

Short Extension

Control 1..*

Is Modifier false

Summary false

This element introduces a set of slices on ServiceRequest.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

66. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:volume

Slice Name volume

Definition

A BodyStructure resource representing the body structure to be treated, for example, Chest Wall Lymph Nodes.

Short Volume targeted by the prescribed dose

Control 1..1

Is Modifier false

Must Support true

Summary false

68. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:volume.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

70. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:volume.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

72. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:volume.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value volume

74. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:volume.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1

Type Reference(Radiotherapy Volume)

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

76. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:fractionDose

Slice Name fractionDose

Definition

Fraction dose is not defined in the Radiotherapy Course Prescription because dose may not be equal in all fractions in which this volume receives dose.

Short Not used in this profile. See Radiotherapy Phase Prescriptions for detailed fractionation.

Control 0..0

Is Modifier false

Must Support true

Summary false

82. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:totalDose

Slice Name totalDose

Definition

The total dose prescribed to this volume within the scope of this ServiceRequest.

Short Total Radiation Dose Prescribed

Control 0..1

Is Modifier false

Must Support true

Summary false

84. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:totalDose.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

86. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:totalDose.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

88. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:totalDose.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value totalDose

90. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:totalDose.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 1..1

Quantity

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Summary false

Pattern Value { "system" : "http://unitsofmeasure.org", "code" : "cGy" }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

92. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:fractions

Slice Name fractions

Definition

The prescribed number of fractions to deliver the dose. See also extension RadiotherapyFractionsPrescribed which is used instead if fractions are not per volume, e.g. in phases or plans.

Short Number of Prescribed Fractions

Control 0..1

Is Modifier false

Must Support true

Summary false

94. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:fractions.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

96. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:fractions.extension

Definition

An Extension

Short Extension

Control 0..0

Is Modifier false

Summary false

This element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

98. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:fractions.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value fractions

100. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:fractions.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..1

positiveInt

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

102. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.extension:radiobiologicMetric

Slice Name radiobiologicMetric

Definition

Extension providing radiobiologic dose metric using a regular expression: BED, CGE, RBE, RBE(factor = <decimal>), EQD2Gy, EQD2Gy(a/b = <decimal>).

Short Radiotherapy Biologically Effective Dose

Control 0..*

Type Extension(Radiobiologic Metric) (Extension Type: Quantity)

Is Modifier false

Must Support true

Summary false

104. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.url

Definition

Source of the definition for the extension code - a logical name or a URL.

Short identifies the meaning of the extension

Comments

Control 1..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

Fixed Value http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-prescribed-to-volume

106. ServiceRequest.extension:radiotherapyDosePrescribedToVolume.value[x]

Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Short Value of extension

Control 0..0

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

108. ServiceRequest.extension:courseInvolvesReirradiation

Slice Name courseInvolvesReirradiation

Definition

This flag is true if the radiotherapy course of treatment involves reirradiation of targets or organs at risk that were already irradiated in previous courses.

Short Course Involves Reirradiation

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(Course Involves Reirradiation) (Extension Type: boolean)

Is Modifier false

Must Support true

110. ServiceRequest.modifierExtension

Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Short Extensions that cannot be ignored

Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Summary false

Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Names extensions, user content

112. ServiceRequest.identifier

Definition

SHALL have a display name with use = usual and at least one globally unique technical identifier, for example, the Conceptual Volume UID used in DICOM.

Short Identifiers assigned to this order

Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

Note This is a business identifier, not a resource identifier (see discussion)

Control 2..*

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on ServiceRequest.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ use

114. ServiceRequest.identifier:displayName

Slice Name displayName

Definition

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

Short The name that is displayed to the user.

Comments

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..1

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

116. ServiceRequest.identifier:displayName.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

118. ServiceRequest.identifier:displayName.extension

Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on ServiceRequest.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

120. ServiceRequest.identifier:displayName.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 1..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Pattern Value usual

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

122. ServiceRequest.identifier:displayName.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

124. ServiceRequest.identifier:displayName.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short The namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

126. ServiceRequest.identifier:displayName.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

128. ServiceRequest.identifier:displayName.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Period

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

130. ServiceRequest.identifier:displayName.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

132. ServiceRequest.identifier:official

Slice Name official

Definition

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

Short A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.

Comments

Note This is a business identifier, not a resource identifier (see discussion)

Control 1..*

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

134. ServiceRequest.identifier:official.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

136. ServiceRequest.identifier:official.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on ServiceRequest.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

138. ServiceRequest.identifier:official.use

Definition

The purpose of this identifier.

Short usual | official | temp | secondary | old (If known)

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control 1..1

The codes SHALL be taken from IdentifierUse
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Is Modifier true because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Pattern Value official

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

140. ServiceRequest.identifier:official.type

Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Short Description of identifier

Comments

Control 0..1

Unless not suitable, these codes SHALL be taken from Identifier Type Codes
(extensible to http://hl7.org/fhir/ValueSet/identifier-type)

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

Is Modifier false

Summary true

Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

142. ServiceRequest.identifier:official.system

Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Short The namespace for the identifier value

Comments

Identifier.system is always case sensitive.

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example General:http://www.acme.com/identifiers/patient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

144. ServiceRequest.identifier:official.value

Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Short The value that is unique

Comments

Control 1..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Example General:123456

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

146. ServiceRequest.identifier:official.period

Definition

Time period during which identifier is/was valid for use.

Short Time period when id is/was valid for use

Control 0..1

Period

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

148. ServiceRequest.identifier:official.assigner

Definition

Organization that issued/manages the identifier.

Short Organization that issued id (may be just text)

Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control 0..1

Type Reference(Organization)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

150. ServiceRequest.instantiatesCanonical

Definition

The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.

Short Instantiates FHIR protocol or definition

Comments

Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Control 0..*

Type canonical(ActivityDefinition, PlanDefinition)

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

152. ServiceRequest.instantiatesUri

Definition

The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.

Short Instantiates external protocol or definition

Comments

This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

Control 0..*

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

154. ServiceRequest.basedOn

Definition

Plan/proposal/order fulfilled by this request.

Short What request fulfills

Control 0..*

Type Reference(CarePlan, ServiceRequest, MedicationRequest)

Is Modifier false

Summary true

Alternate Names fulfills

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

156. ServiceRequest.replaces

Definition

The request takes the place of the referenced completed or terminated request(s).

Short Previous retired prescription that is replaced by this prescription

Control 0..*

Type Reference(Radiotherapy Course Prescription)

Is Modifier false

Must Support true

Summary true

Alternate Names supersedes, prior, renewed order

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

158. ServiceRequest.requisition

Definition

A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.

Short Composite Request ID

Comments

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

Control 0..1

Is Modifier false

Summary true

Requirements

Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

Alternate Names grouperId, groupIdentifier

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

160. ServiceRequest.status

Definition

The status of the order.

Comments

The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

Control 1..1

The codes SHALL be taken from RequestStatus
(required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

The status of a service order.

Is Modifier true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

162. ServiceRequest.intent

Definition

Whether the request is a proposal, plan, an original order or a reflex order.

Comments

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

Control 1..1

The codes SHALL be taken from RequestIntent
(required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

The kind of service request.

Is Modifier true because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Pattern Value original-order

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

164. ServiceRequest.category

Definition

A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

Short (USCDI) Classification of service

Comments

There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

Control 1..*

For example codes, see ServiceRequestCategoryCodes
(example to http://hl7.org/fhir/ValueSet/servicerequest-category)

Classification of the requested service.

Is Modifier false

Must Support true

Summary true

Requirements

Used for filtering what service request are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on ServiceRequest.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:

pattern @ $this

166. ServiceRequest.category:us-core

Slice Name us-core

Definition

A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

Short (USCDI) Classification of service

Comments

Control 0..*

The codes SHALL be taken from US Core ServiceRequest Category Codes
(required to http://hl7.org/fhir/us/core/ValueSet/us-core-servicerequest-category)

Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

Is Modifier false

Must Support true

Summary true

Requirements

Used for filtering what service request are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

168. ServiceRequest.category:radiotherapy

Slice Name radiotherapy

Definition

A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

Short (USCDI) Classification of service

Comments

Control 1..1

Binding The codes SHALL be taken from Radiotherapy Category Code Max Value Set
(required to http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs)

Is Modifier false

Must Support true

Summary true

Requirements

Used for filtering what service request are retrieved and displayed.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

170. ServiceRequest.priority

Definition

Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

Short routine | urgent | asap | stat

Control 0..1

The codes SHALL be taken from RequestPriority
(required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

Identifies the level of importance to be assigned to actioning the request.

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Meaning if Missing If missing, this task should be performed with normal priority

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

172. ServiceRequest.doNotPerform

Definition

Set this to true if the record is saying that the service/procedure should NOT be performed.

Short True if service/procedure should not be performed

Comments

In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

Control 0..0

boolean

Is Modifier true because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

Meaning if Missing If missing, the request is a positive request e.g. "do perform"

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

174. ServiceRequest.code

Definition

A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

Short (USCDI) What is being requested/ordered

Comments

Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

Control 1..1

Binding Unless not suitable, these codes SHALL be taken from US Core Procedure Codes
(extensible to http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code)

Is Modifier false

Must Support true

Summary true

Alternate Names service requested

Pattern Value { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "1217123003", "display" : "Radiotherapy course of treatment (regime/therapy)" }] }

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

176. ServiceRequest.orderDetail

Definition

Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied.

Short Additional order information

Comments

For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

Control 0..*
This element is affected by the following invariants: prr-1

For example codes, see ServiceRequestOrderDetailsCodes
(example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail)

Codified order entry details which are based on order context.

Is Modifier false

Summary true

Alternate Names detailed instructions

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

178. ServiceRequest.quantity[x]

Definition

An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).

Short Service amount

Control 0..0

Type Choice of: Quantity, Ratio, Range

Is Modifier false

Summary true

Requirements

When ordering a service the number of service items may need to be specified separately from the the service item.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

180. ServiceRequest.subject

Definition

On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

Short (USCDI) Individual or Entity the service is ordered for

Control 1..1

Type Reference(US Core Patient Profile)

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

182. ServiceRequest.encounter

Definition

An encounter that provides additional information about the healthcare context in which this request is made.

Short Encounter in which the request was created

Control 0..1

Type Reference(Encounter)

Is Modifier false

Summary true

Alternate Names context

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

184. ServiceRequest.occurrence[x]

Definition

The date/time at which the requested service should occur.

Short (USCDI) When service should occur

Control 0..1

Type Choice of: Period, dateTime, Timing

[x] Note SeeChoice of Data Typesfor further information about how to use [x]

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Must Support Types

Period

Summary true

Alternate Names schedule

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

186. ServiceRequest.asNeeded[x]

Definition

If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

Short Preconditions for service

Control 0..0

For example codes, see SNOMEDCTMedicationAsNeededReasonCodes
(example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

Type Choice of: boolean, CodeableConcept

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

188. ServiceRequest.authoredOn

Definition

When the request transitioned to being actionable.

Short (USCDI) Date request signed

Control 0..1

dateTime

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support true

Summary true

Alternate Names orderedOn

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

190. ServiceRequest.requester

Definition

The individual who initiated the request and has responsibility for its activation.

Short (USCDI) Who/what is requesting service

Comments

This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

Control 0..1

Type Reference(US Core Practitioner Profile, US Core PractitionerRole Profile, US Core Organization Profile)

Is Modifier false

Must Support true

Must Support Types Reference(US Core Practitioner Profile)

Summary true

Alternate Names author, orderer

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

192. ServiceRequest.performerType

Definition

Desired type of performer for doing the requested service.

Short Performer role

Comments

This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

Control 0..1

For example codes, see ParticipantRoles
(example to http://hl7.org/fhir/ValueSet/participant-role)

Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

Is Modifier false

Summary true

Alternate Names specialty

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

194. ServiceRequest.performer

Definition

The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

Short Requested performer

Comments

If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

Control 0..*

Type Reference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)

Is Modifier false

Must Support true

Must Support Types No must-support rules about the choice of types/profiles

Summary true

Alternate Names request recipient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

This element introduces a set of slices on ServiceRequest.performer. The slices areUnordered and Open, and can be differentiated using the following discriminators:

profile @ $this.resolve()

196. ServiceRequest.performer:treatmentOrSeedDevice

Slice Name treatmentOrSeedDevice

Definition

The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

Short Radiotherapy Treatment Device or Seed Device used as part of therapy.

Comments

Control 0..*

Type Reference(Radiotherapy Treatment Device, Radiotherapy Seed Device)

Is Modifier false

Must Support true

Must Support Types No must-support rules about the choice of types/profiles

Summary true

Alternate Names request recipient

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

198. ServiceRequest.locationCode

Definition

The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.

Short Requested location

Control 0..*

For example codes, see ServiceDeliveryLocationRoleType
(example to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

A location type where services are delivered.

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

200. ServiceRequest.locationReference

Definition

A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

Short Location where the radiotherapy treatment is requested.

Control 0..*

Type Reference(US Core Location Profile)

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

202. ServiceRequest.reasonCode

Definition

An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

Short (USCDI) Explanation/Justification for procedure or service

Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

Control 0..*

Binding Unless not suitable, these codes SHALL be taken from Cancer Disorder Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs)

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

204. ServiceRequest.reasonReference

Definition

Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

Short (USCDI) US Core Profile that supports the requested service

Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

Control 0..*

Type Reference(Condition)

Is Modifier false

Must Support true

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

206. ServiceRequest.insurance

Definition

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.

Short Associated insurance coverage

Control 0..*

Type Reference(Coverage, ClaimResponse)

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

208. ServiceRequest.supportingInfo

Definition

Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

Short Additional clinical information

Comments

To represent information about how the services are to be delivered use the instructions element.

Control 0..*

Type Reference(Resource)

Is Modifier false

Summary false

Alternate Names Ask at order entry question, AOE

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

210. ServiceRequest.specimen

Definition

One or more specimens that the laboratory procedure will use.

Short Procedure Samples

Comments

Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

Control 0..0

Type Reference(Specimen)

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

212. ServiceRequest.bodySite

Definition

Anatomic location where the procedure should be performed. This is the target site.

Short Body site that is treated with radiotherapy

Comments

Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.

Control 0..*

Binding Unless not suitable, these codes SHALL be taken from Radiotherapy Treatment Location Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs)

Is Modifier false

Must Support true

Summary true

Requirements

Knowing where the procedure is performed is important for tracking if multiple sites are possible.

Alternate Names location

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

214. ServiceRequest.bodySite.id

Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

216. ServiceRequest.bodySite.extension

Definition

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

This element introduces a set of slices on ServiceRequest.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

218. ServiceRequest.bodySite.extension:locationQualifier

Slice Name locationQualifier

Definition

General location qualifier (excluding laterality) for this bodySite

Short General location qualifier (excluding laterality) for this bodySite

Control 0..*

Type Extension(Body Location Qualifier Extension) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

220. ServiceRequest.bodySite.extension:lateralityQualifier

Slice Name lateralityQualifier

Definition

Laterality qualifier for this bodySite

Short Laterality qualifier for this bodySite

Control 0..1

Type Extension(Laterality Qualifier Extension) (Extension Type: CodeableConcept)

Is Modifier false

Summary false

222. ServiceRequest.bodySite.coding

Definition

A reference to a code defined by a terminology system.

Short Code defined by a terminology system

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Control 0..*

Coding

Is Modifier false

Summary true

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

224. ServiceRequest.bodySite.text

Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Short Plain text representation of the concept

Comments

Very often the text is the same as a displayName of one of the codings.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

226. ServiceRequest.note

Definition

Any other notes and comments made about the service request. For example, internal billing notes.

Short Comments

Control 0..*

Annotation

Is Modifier false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

228. ServiceRequest.patientInstruction

Definition

Instructions in terms that are understood by the patient or consumer.

Short Patient or consumer-oriented instructions

Control 0..1