CodeX Radiation Therapy
2.0.0 - STU2 United States of America flag

CodeX Radiation Therapy, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/codex-radiation-therapy/ and changes regularly. See the Directory of published versions

Resource Profile: Radiotherapy Treated Phase

Official URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treated-phase Version: 2.0.0
Draft as of 2024-12-18 Computable Name: RadiotherapyTreatedPhase
Other Identifiers: OID:2.16.840.1.113883.4.642.40.14.42.31

A summary of a phase of radiotherapy treatment that has been delivered. A phase consists of a set of identical fractions. In this context, identical means that each fraction uses the same modality, technique, dose per fraction, and is applied to the same treatment volume or volumes. Because of their spatial relationship or the technique used, all treatment volumes do not necessarily receive the same total dose during a phase.

This profile is used to capture a phase of radiotherapy delivered to a patient. An overview of radiotherapy courses, phases, and treatment plans is shown here. The relationships between the various radiotherapy profiles are shown here.

Conformance

Procedure resources whose code is SNOMEDCT 1222565005 (Radiotherapy treatment phase (regime/therapy)) MUST conform to this profile. Any resource intended to conform to this profile SHOULD populate meta.profile accordingly.

Usage:

Formal Views of Profile Content

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

This structure is derived from USCoreProcedureProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure C 0..* USCoreProcedureProfile An action that is being or was performed on a patient
codexrt-procedure-status: Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed
codexrt-motion-management-none: If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
codexrt-free-breathing-technique: The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
CategoryPreferred: This code 108290001 is inactive and should be used only for backward compatibility.
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modalityAndTechnique S 0..1 (Complex) Radiotherapy Modality And Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
..... Slices for extension Content/Rules for all slices
...... radiotherapyEnergyOrIsotope S 0..* SimpleQuantity Radiotherapy Energy or Isotope
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
Binding: Radiotherapy Energy Unit Value Set (required)
...... radiotherapyTreatmentApplicatorType S 0..* CodeableConcept Radiotherapy Treatment Applicator Type
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
Binding: Brachytherapy Applicator Type Value Set (extensible)
.... imageGuidedRadiotherapyModality S 0..* (Complex) Image Guided Radiotherapy Modality
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
.... fractionsDelivered S 0..1 unsignedInt Number of Fractions Delivered
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-fractions-delivered
.... doseDeliveredToVolume S 0..* (Complex) Radiotherapy Dose Delivered To Volume Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
..... Slices for extension Content/Rules for all slices
...... extension:totalDoseDelivered 0..1 Extension Extension
...... extension:fractionsDelivered 0..0
...... pointDose S 0..1 boolean Point Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
...... primaryPlanDose S 0..1 boolean Primary Plan Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
...... radiobiologicMetric S 0..* Quantity Radiotherapy Biologically Effective Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
.... radiotherapyReasonForRevisionOrAdaptation S 0..* CodeableConcept Reason for Revision or Adaptation
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-reason-for-revision-or-adaptation
Binding: Radiotherapy Reason for Revision or Adaptation Value Set (extensible)
.... respiratoryMotionManagement S 0..* CodeableConcept Respiratory Motion Management
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
Binding: Radiotherapy Respiratory Motion Management Value Set (required)
.... freeBreathingMotionManagementTechnique S 0..* CodeableConcept Free-Breathing Motion Management Technique
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
.... intrafractionVerification S 0..* (Complex) Intrafraction Verification
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
... Slices for identifier S 2..* Identifier External Identifiers for this procedure
Slice: Unordered, Open by value:use
.... identifier:displayName S 1..1 Identifier The name that is displayed to the user.
..... use 1..1 code usual | official | temp | secondary | old (If known)
Required Pattern: usual
..... system S 1..1 uri The namespace for the identifier value
..... value S 1..1 string The value that is unique
.... identifier:official S 1..* Identifier A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
..... use 1..1 code usual | official | temp | secondary | old (If known)
Required Pattern: official
..... system S 1..1 uri The namespace for the identifier value
..... value S 1..1 string The value that is unique
... Slices for basedOn 0..* Reference(US Core CarePlan Profile | US Core ServiceRequest Profile) (USCDI) A request for this procedure
Slice: Unordered, Open by profile:$this.resolve()
.... basedOn:planned-phase S 0..1 Reference(Radiotherapy Planned Phase) Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.
.... basedOn:phase-prescription S 0..1 Reference(Radiotherapy Phase Prescription) Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.
.... partOf:course-summary S 0..1 Reference(Radiotherapy Course Summary) Radiotherapy Course Summary that summarizes the course of which this Radiotherapy Treated Phase is a part.
... category 1..1 CodeableConcept Classification of the procedure
Binding: Radiotherapy Category Code Max Value Set (required)
... code 1..1 CodeableConcept (USCDI) Identification of the procedure
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 1222565005
..... display 1..1 string Representation defined by the system
Fixed Value: Radiotherapy treatment phase (regime/therapy)
... subject 1..1 Reference(Cancer Patient Profile) (USCDI) Who the procedure was performed on
... performed[x] 0..1 Period (USCDI) When the procedure was performed
.... start S 0..1 dateTime The date and time when the first therapeutic radiation was delivered.
.... end S 0..1 dateTime An end date is expected if the status is 'stopped' or 'completed'
... Slices for performer S 0..* BackboneElement The people who performed the procedure
Slice: Unordered, Open by profile:actor.resolve()
.... performer:organization S 0..* BackboneElement The people who performed the procedure
..... actor 1..1 Reference(US Core Organization Profile) Organization that provided the radiotherapy treatment.
... location S 0..1 Reference(US Core Location Profile) Location where the radiotherapy treatment was performed.
... reasonCode S 0..* CodeableConcept Coded reason procedure performed
Binding: Cancer Disorder Value Set (extensible)
... reasonReference S 0..* Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) The justification that the procedure was performed
... bodySite S 0..* CodeableConcept All body structure(s) treated with this procedure.
Binding: Radiotherapy Treatment Location Value Set (extensible)
.... Slices for extension Content/Rules for all slices
..... locationQualifier 0..* CodeableConcept General location qualifier (excluding laterality) for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier
Binding: Body Location Qualifier Value Set (required)
..... lateralityQualifier 0..1 CodeableConcept Laterality qualifier for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier
Binding: Laterality Qualifier Value Set (required)
... Slices for focalDevice 0..* BackboneElement Manipulated, implanted, or removed device
Slice: Unordered, Open by profile:manipulated.resolve()
.... focalDevice:seedDevice S 0..* BackboneElement Radiotherapy Seed Device used as part of therapy.
..... manipulated 1..1 Reference(Radiotherapy Seed Device) Device that was changed
... Slices for usedReference S 0..* Reference(Device | Medication | Substance) Items used during procedure
Slice: Unordered, Open by profile:$this.resolve()
.... usedReference:treatmentDevice S 0..* Reference(Radiotherapy Treatment Device) Radiotherapy Treatment Device used as part of therapy.

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Procedure.categoryrequiredRadiotherapyCategoryVS
http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs
from this IG
Procedure.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySiteextensibleRadiotherapyTreatmentLocationVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs

Constraints

IdGradePath(s)DetailsRequirements
CategoryPreferredwarningProcedureThis code 108290001 is inactive and should be used only for backward compatibility.
: category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-techniqueerrorProcedureThe extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-noneerrorProcedureIf the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-statuserrorProcedureOnly the following status values are supported: in-progress | not-done | on-hold | stopped | completed
: status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'
NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure C 0..* USCoreProcedureProfile An action that is being or was performed on a patient
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress'
codexrt-procedure-status: Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed
codexrt-motion-management-none: If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
codexrt-free-breathing-technique: The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
CategoryPreferred: This code 108290001 is inactive and should be used only for backward compatibility.
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... modalityAndTechnique SC 0..1 (Complex) Radiotherapy Modality And Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality
TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality
TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality
TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality
TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality
TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds
TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source
TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate
TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate
TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic
TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical
ModalityTextRequiredForOther: Require a text literal for code other
TechniqueTextRequiredForOther: Require a text literal for code other
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... modality S 1..1 (Complex) Radiotherapy Modality Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... extension 0..0
....... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
....... value[x] 1..1 CodeableConcept Value of extension
Binding: Radiotherapy Modality Value Set (required)
ele-1: All FHIR elements must have a @value or children
...... technique S 0..* (Complex) Radiotherapy Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... extension 0..0
....... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
....... value[x] 1..1 CodeableConcept Value of extension
Binding: Radiotherapy Technique Value Set (required)
ele-1: All FHIR elements must have a @value or children
...... radiotherapyEnergyOrIsotope S 0..* SimpleQuantity Radiotherapy Energy or Isotope
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
Binding: Radiotherapy Energy Unit Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... radiotherapyTreatmentApplicatorType S 0..* CodeableConcept Radiotherapy Treatment Applicator Type
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
Binding: Brachytherapy Applicator Type Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
.... imageGuidedRadiotherapyModality SC 0..* (Complex) Image Guided Radiotherapy Modality
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
IGRTEnergyAllowed: Energy is only allowed for X-Ray, Fluorograph, or CT Modalities.
.... fractionsDelivered S 0..1 unsignedInt Number of Fractions Delivered
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-fractions-delivered
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... doseDeliveredToVolume S 0..* (Complex) Radiotherapy Dose Delivered To Volume Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... extension:volume S 1..1 Extension Volume in the body where radiation was delivered
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... extension 0..0
....... url 1..1 uri "volume"
...... extension:totalDoseDelivered S 0..1 Extension Extension
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... extension 0..0
....... url 1..1 uri "totalDoseDelivered"
....... value[x] 0..1 Quantity Value of extension
ele-1: All FHIR elements must have a @value or children
Required Pattern: At least the following
........ system 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
........ code 1..1 code Coded form of the unit
Fixed Value: cGy
...... pointDose S 0..1 boolean Point Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... primaryPlanDose S 0..1 boolean Primary Plan Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... radiobiologicMetric S 0..* Quantity Radiotherapy Biologically Effective Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
.... radiotherapyReasonForRevisionOrAdaptation S 0..* CodeableConcept Reason for Revision or Adaptation
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-reason-for-revision-or-adaptation
Binding: Radiotherapy Reason for Revision or Adaptation Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... respiratoryMotionManagement S 0..* CodeableConcept Respiratory Motion Management
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
Binding: Radiotherapy Respiratory Motion Management Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... freeBreathingMotionManagementTechnique S 0..* CodeableConcept Free-Breathing Motion Management Technique
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... intrafractionVerification SC 0..* (Complex) Intrafraction Verification
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
IntrafractionVerificationQualifierAllowed: Qualifier is only allowed for X-Ray procedure.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... identifier:displayName SΣ 1..1 Identifier The name that is displayed to the user.
ele-1: All FHIR elements must have a @value or children
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
Required Pattern: usual
..... system SΣ 1..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
ele-1: All FHIR elements must have a @value or children
Example General: 123456
.... identifier:official SΣ 1..* Identifier A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
ele-1: All FHIR elements must have a @value or children
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
Required Pattern: official
..... system SΣ 1..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
ele-1: All FHIR elements must have a @value or children
Example General: 123456
... Slices for basedOn Σ 0..* Reference(US Core CarePlan Profile | US Core ServiceRequest Profile) (USCDI) A request for this procedure
Slice: Unordered, Open by profile:$this.resolve()
ele-1: All FHIR elements must have a @value or children
.... basedOn:planned-phase SΣ 0..1 Reference(Radiotherapy Planned Phase) Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.
ele-1: All FHIR elements must have a @value or children
.... basedOn:phase-prescription SΣ 0..1 Reference(Radiotherapy Phase Prescription) Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.
ele-1: All FHIR elements must have a @value or children
... Slices for partOf Σ 0..* Reference(Procedure | Observation | MedicationAdministration) Part of referenced event
Slice: Unordered, Open by profile:$this.resolve()
ele-1: All FHIR elements must have a @value or children
.... partOf:course-summary SΣ 0..1 Reference(Radiotherapy Course Summary) Radiotherapy Course Summary that summarizes the course of which this Radiotherapy Treated Phase is a part.
ele-1: All FHIR elements must have a @value or children
... status ?!SΣC 1..1 code (USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required)
ele-1: All FHIR elements must have a @value or children
... category Σ 1..1 CodeableConcept Classification of the procedure
Binding: Radiotherapy Category Code Max Value Set (required)
ele-1: All FHIR elements must have a @value or children
... code SΣ 1..1 CodeableConcept (USCDI) Identification of the procedure
Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure


ele-1: All FHIR elements must have a @value or children
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 1222565005
..... display 1..1 string Representation defined by the system
Fixed Value: Radiotherapy treatment phase (regime/therapy)
... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who the procedure was performed on
ele-1: All FHIR elements must have a @value or children
... performed[x] SΣC 0..1 Period (USCDI) When the procedure was performed
ele-1: All FHIR elements must have a @value or children
.... start SΣC 0..1 dateTime The date and time when the first therapeutic radiation was delivered.
ele-1: All FHIR elements must have a @value or children
.... end SΣC 0..1 dateTime An end date is expected if the status is 'stopped' or 'completed'
ele-1: All FHIR elements must have a @value or children
... Slices for performer SΣ 0..* BackboneElement The people who performed the procedure
Slice: Unordered, Open by profile:actor.resolve()
ele-1: All FHIR elements must have a @value or children
.... performer:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) The reference to the practitioner
ele-1: All FHIR elements must have a @value or children
.... performer:organization SΣ 0..* BackboneElement The people who performed the procedure
ele-1: All FHIR elements must have a @value or children
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... actor Σ 1..1 Reference(US Core Organization Profile) Organization that provided the radiotherapy treatment.
ele-1: All FHIR elements must have a @value or children
... location SΣ 0..1 Reference(US Core Location Profile) Location where the radiotherapy treatment was performed.
ele-1: All FHIR elements must have a @value or children
... reasonCode SΣ 0..* CodeableConcept Coded reason procedure performed
Binding: Cancer Disorder Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
... reasonReference SΣ 0..* Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) The justification that the procedure was performed
ele-1: All FHIR elements must have a @value or children
... bodySite SΣ 0..* CodeableConcept All body structure(s) treated with this procedure.
Binding: Radiotherapy Treatment Location Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
.... Slices for extension Content/Rules for all slices
..... locationQualifier 0..* CodeableConcept General location qualifier (excluding laterality) for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier
Binding: Body Location Qualifier Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... lateralityQualifier 0..1 CodeableConcept Laterality qualifier for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier
Binding: Laterality Qualifier Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... Slices for focalDevice 0..* BackboneElement Manipulated, implanted, or removed device
Slice: Unordered, Open by profile:manipulated.resolve()
ele-1: All FHIR elements must have a @value or children
.... focalDevice:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... manipulated 1..1 Reference(Device) Device that was changed
ele-1: All FHIR elements must have a @value or children
.... focalDevice:seedDevice S 0..* BackboneElement Radiotherapy Seed Device used as part of therapy.
ele-1: All FHIR elements must have a @value or children
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... manipulated 1..1 Reference(Radiotherapy Seed Device) Device that was changed
ele-1: All FHIR elements must have a @value or children
... Slices for usedReference S 0..* Reference(Device | Medication | Substance) Items used during procedure
Slice: Unordered, Open by profile:$this.resolve()
ele-1: All FHIR elements must have a @value or children
.... usedReference:treatmentDevice S 0..* Reference(Radiotherapy Treatment Device) Radiotherapy Treatment Device used as part of therapy.
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Procedure.extension:modalityAndTechnique.extension:modality.value[x]requiredRadiotherapyModalityVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]requiredRadiotherapyTechniqueVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.identifier:displayName.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Procedure.identifier:official.userequiredPattern: official
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Procedure.statusrequiredEventStatus
http://hl7.org/fhir/ValueSet/event-status
from the FHIR Standard
Procedure.categoryrequiredRadiotherapyCategoryVS
http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs
from this IG
Procedure.codeextensiblePattern: SNOMED-CT Code 1222565005("Radiotherapy treatment phase (regime/therapy)")
http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySiteextensibleRadiotherapyTreatmentLocationVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs

Constraints

IdGradePath(s)DetailsRequirements
CategoryPreferredwarningProcedureThis code 108290001 is inactive and should be used only for backward compatibility.
: category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-techniqueerrorProcedureThe extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-noneerrorProcedureIf the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-statuserrorProcedureOnly the following status values are supported: in-progress | not-done | on-hold | stopped | completed
: status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'
NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure C 0..* USCoreProcedureProfile An action that is being or was performed on a patient
us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress'
codexrt-procedure-status: Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed
codexrt-motion-management-none: If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
codexrt-free-breathing-technique: The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
CategoryPreferred: This code 108290001 is inactive and should be used only for backward compatibility.
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modalityAndTechnique SC 0..1 (Complex) Radiotherapy Modality And Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality
TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality
TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality
TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality
TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality
TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds
TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source
TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate
TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate
TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic
TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical
ModalityTextRequiredForOther: Require a text literal for code other
TechniqueTextRequiredForOther: Require a text literal for code other
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
...... modality S 1..1 (Complex) Radiotherapy Modality Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
....... value[x] 1..1 CodeableConcept Value of extension
Binding: Radiotherapy Modality Value Set (required)
...... technique S 0..* (Complex) Radiotherapy Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
....... value[x] 1..1 CodeableConcept Value of extension
Binding: Radiotherapy Technique Value Set (required)
...... radiotherapyEnergyOrIsotope S 0..* SimpleQuantity Radiotherapy Energy or Isotope
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
Binding: Radiotherapy Energy Unit Value Set (required)
...... radiotherapyTreatmentApplicatorType S 0..* CodeableConcept Radiotherapy Treatment Applicator Type
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
Binding: Brachytherapy Applicator Type Value Set (extensible)
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
.... imageGuidedRadiotherapyModality SC 0..* (Complex) Image Guided Radiotherapy Modality
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
IGRTEnergyAllowed: Energy is only allowed for X-Ray, Fluorograph, or CT Modalities.
.... fractionsDelivered S 0..1 unsignedInt Number of Fractions Delivered
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-fractions-delivered
.... doseDeliveredToVolume S 0..* (Complex) Radiotherapy Dose Delivered To Volume Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:volume S 1..1 Extension Volume in the body where radiation was delivered
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "volume"
....... value[x] 0..1 Reference(Radiotherapy Volume Profile) Value of extension
...... extension:totalDoseDelivered S 0..1 Extension Extension
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "totalDoseDelivered"
....... value[x] 0..1 Quantity Value of extension
Required Pattern: At least the following
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ value 0..1 decimal Numerical value (with implicit precision)
........ comparator 0..1 code < | <= | >= | > - how to understand the value
........ unit 0..1 string Unit representation
........ system 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
........ code 1..1 code Coded form of the unit
Fixed Value: cGy
...... pointDose S 0..1 boolean Point Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
...... primaryPlanDose S 0..1 boolean Primary Plan Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
...... radiobiologicMetric S 0..* Quantity Radiotherapy Biologically Effective Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
.... radiotherapyReasonForRevisionOrAdaptation S 0..* CodeableConcept Reason for Revision or Adaptation
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-reason-for-revision-or-adaptation
Binding: Radiotherapy Reason for Revision or Adaptation Value Set (extensible)
.... respiratoryMotionManagement S 0..* CodeableConcept Respiratory Motion Management
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
Binding: Radiotherapy Respiratory Motion Management Value Set (required)
.... freeBreathingMotionManagementTechnique S 0..* CodeableConcept Free-Breathing Motion Management Technique
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
.... intrafractionVerification SC 0..* (Complex) Intrafraction Verification
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
IntrafractionVerificationQualifierAllowed: Qualifier is only allowed for X-Ray procedure.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 2..* Identifier External Identifiers for this procedure
Slice: Unordered, Open by value:use
.... identifier:displayName SΣ 1..1 Identifier The name that is displayed to the user.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:official SΣ 1..* Identifier A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: official
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... Slices for basedOn Σ 0..* Reference(US Core CarePlan Profile | US Core ServiceRequest Profile) (USCDI) A request for this procedure
Slice: Unordered, Open by profile:$this.resolve()
.... basedOn:planned-phase SΣ 0..1 Reference(Radiotherapy Planned Phase) Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.
.... basedOn:phase-prescription SΣ 0..1 Reference(Radiotherapy Phase Prescription) Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.
... Slices for partOf Σ 0..* Reference(Procedure | Observation | MedicationAdministration) Part of referenced event
Slice: Unordered, Open by profile:$this.resolve()
.... partOf:course-summary SΣ 0..1 Reference(Radiotherapy Course Summary) Radiotherapy Course Summary that summarizes the course of which this Radiotherapy Treated Phase is a part.
... status ?!SΣC 1..1 code (USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required)
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.

... category Σ 1..1 CodeableConcept Classification of the procedure
Binding: Radiotherapy Category Code Max Value Set (required)
... code SΣ 1..1 CodeableConcept (USCDI) Identification of the procedure
Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure


Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 1222565005
..... display 1..1 string Representation defined by the system
Fixed Value: Radiotherapy treatment phase (regime/therapy)
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who the procedure was performed on
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... performed[x] SΣC 0..1 Period (USCDI) When the procedure was performed
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣC 0..1 dateTime The date and time when the first therapeutic radiation was delivered.
.... end SΣC 0..1 dateTime An end date is expected if the status is 'stopped' or 'completed'
... recorder Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Who recorded the procedure
... asserter Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Person who asserts this procedure
... Slices for performer SΣ 0..* BackboneElement The people who performed the procedure
Slice: Unordered, Open by profile:actor.resolve()
.... performer:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... function Σ 0..1 CodeableConcept Type of performance
Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.

..... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) The reference to the practitioner
..... onBehalfOf 0..1 Reference(Organization) Organization the device or practitioner was acting for
.... performer:organization SΣ 0..* BackboneElement The people who performed the procedure
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... function Σ 0..1 CodeableConcept Type of performance
Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.

..... actor Σ 1..1 Reference(US Core Organization Profile) Organization that provided the radiotherapy treatment.
..... onBehalfOf 0..1 Reference(Organization) Organization the device or practitioner was acting for
... location SΣ 0..1 Reference(US Core Location Profile) Location where the radiotherapy treatment was performed.
... reasonCode SΣ 0..* CodeableConcept Coded reason procedure performed
Binding: Cancer Disorder Value Set (extensible)
... reasonReference SΣ 0..* Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) The justification that the procedure was performed
... bodySite SΣ 0..* CodeableConcept All body structure(s) treated with this procedure.
Binding: Radiotherapy Treatment Location Value Set (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... locationQualifier 0..* CodeableConcept General location qualifier (excluding laterality) for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier
Binding: Body Location Qualifier Value Set (required)
..... lateralityQualifier 0..1 CodeableConcept Laterality qualifier for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier
Binding: Laterality Qualifier Value Set (required)
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... outcome Σ 0..1 CodeableConcept The result of procedure
Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.

... report 0..* Reference(DiagnosticReport | DocumentReference | Composition) Any report resulting from the procedure
... complication 0..* CodeableConcept Complication following the procedure
Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.


... complicationDetail 0..* Reference(Condition) A condition that is a result of the procedure
... followUp 0..* CodeableConcept Instructions for follow up
Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.


... note 0..* Annotation Additional information about the procedure
... Slices for focalDevice 0..* BackboneElement Manipulated, implanted, or removed device
Slice: Unordered, Open by profile:manipulated.resolve()
.... focalDevice:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... action 0..1 CodeableConcept Kind of change to device
Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.

..... manipulated 1..1 Reference(Device) Device that was changed
.... focalDevice:seedDevice S 0..* BackboneElement Radiotherapy Seed Device used as part of therapy.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... action 0..1 CodeableConcept Kind of change to device
Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.

..... manipulated 1..1 Reference(Radiotherapy Seed Device) Device that was changed
... Slices for usedReference S 0..* Reference(Device | Medication | Substance) Items used during procedure
Slice: Unordered, Open by profile:$this.resolve()
.... usedReference:treatmentDevice S 0..* Reference(Radiotherapy Treatment Device) Radiotherapy Treatment Device used as part of therapy.
... usedCode 0..* CodeableConcept Coded items used during the procedure
Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.



doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Procedure.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Procedure.extension:modalityAndTechnique.extension:modality.value[x]requiredRadiotherapyModalityVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]requiredRadiotherapyTechniqueVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.identifier:displayName.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Procedure.identifier:displayName.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Procedure.identifier:official.userequiredPattern: official
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Procedure.identifier:official.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Procedure.statusrequiredEventStatus
http://hl7.org/fhir/ValueSet/event-status
from the FHIR Standard
Procedure.statusReasonexampleProcedureNotPerformedReason(SNOMED-CT)
http://hl7.org/fhir/ValueSet/procedure-not-performed-reason
from the FHIR Standard
Procedure.categoryrequiredRadiotherapyCategoryVS
http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs
from this IG
Procedure.codeextensiblePattern: SNOMED-CT Code 1222565005("Radiotherapy treatment phase (regime/therapy)")
http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.performer.functionexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
Procedure.performer:organization.functionexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
Procedure.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySiteextensibleRadiotherapyTreatmentLocationVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs
Procedure.outcomeexampleProcedureOutcomeCodes(SNOMEDCT)
http://hl7.org/fhir/ValueSet/procedure-outcome
from the FHIR Standard
Procedure.complicationexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
Procedure.followUpexampleProcedureFollowUpCodes(SNOMEDCT)
http://hl7.org/fhir/ValueSet/procedure-followup
from the FHIR Standard
Procedure.focalDevice.actionpreferredProcedureDeviceActionCodes
http://hl7.org/fhir/ValueSet/device-action
from the FHIR Standard
Procedure.focalDevice:seedDevice.actionpreferredProcedureDeviceActionCodes
http://hl7.org/fhir/ValueSet/device-action
from the FHIR Standard
Procedure.usedCodeexampleFHIRDeviceTypes
http://hl7.org/fhir/ValueSet/device-kind
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
CategoryPreferredwarningProcedureThis code 108290001 is inactive and should be used only for backward compatibility.
: category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-techniqueerrorProcedureThe extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-noneerrorProcedureIf the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-statuserrorProcedureOnly the following status values are supported: in-progress | not-done | on-hold | stopped | completed
: status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'

This structure is derived from USCoreProcedureProfile

Summary

Mandatory: 9 elements
Must-Support: 34 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Procedure.identifier
  • The element 1 is sliced based on the value of Procedure.basedOn
  • The element 1 is sliced based on the value of Procedure.partOf
  • The element 1 is sliced based on the value of Procedure.performer
  • The element 1 is sliced based on the value of Procedure.focalDevice
  • The element 1 is sliced based on the value of Procedure.usedReference

Differential View

This structure is derived from USCoreProcedureProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure C 0..* USCoreProcedureProfile An action that is being or was performed on a patient
codexrt-procedure-status: Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed
codexrt-motion-management-none: If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
codexrt-free-breathing-technique: The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
CategoryPreferred: This code 108290001 is inactive and should be used only for backward compatibility.
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modalityAndTechnique S 0..1 (Complex) Radiotherapy Modality And Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
..... Slices for extension Content/Rules for all slices
...... radiotherapyEnergyOrIsotope S 0..* SimpleQuantity Radiotherapy Energy or Isotope
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
Binding: Radiotherapy Energy Unit Value Set (required)
...... radiotherapyTreatmentApplicatorType S 0..* CodeableConcept Radiotherapy Treatment Applicator Type
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
Binding: Brachytherapy Applicator Type Value Set (extensible)
.... imageGuidedRadiotherapyModality S 0..* (Complex) Image Guided Radiotherapy Modality
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
.... fractionsDelivered S 0..1 unsignedInt Number of Fractions Delivered
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-fractions-delivered
.... doseDeliveredToVolume S 0..* (Complex) Radiotherapy Dose Delivered To Volume Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
..... Slices for extension Content/Rules for all slices
...... extension:totalDoseDelivered 0..1 Extension Extension
...... extension:fractionsDelivered 0..0
...... pointDose S 0..1 boolean Point Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
...... primaryPlanDose S 0..1 boolean Primary Plan Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
...... radiobiologicMetric S 0..* Quantity Radiotherapy Biologically Effective Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
.... radiotherapyReasonForRevisionOrAdaptation S 0..* CodeableConcept Reason for Revision or Adaptation
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-reason-for-revision-or-adaptation
Binding: Radiotherapy Reason for Revision or Adaptation Value Set (extensible)
.... respiratoryMotionManagement S 0..* CodeableConcept Respiratory Motion Management
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
Binding: Radiotherapy Respiratory Motion Management Value Set (required)
.... freeBreathingMotionManagementTechnique S 0..* CodeableConcept Free-Breathing Motion Management Technique
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
.... intrafractionVerification S 0..* (Complex) Intrafraction Verification
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
... Slices for identifier S 2..* Identifier External Identifiers for this procedure
Slice: Unordered, Open by value:use
.... identifier:displayName S 1..1 Identifier The name that is displayed to the user.
..... use 1..1 code usual | official | temp | secondary | old (If known)
Required Pattern: usual
..... system S 1..1 uri The namespace for the identifier value
..... value S 1..1 string The value that is unique
.... identifier:official S 1..* Identifier A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
..... use 1..1 code usual | official | temp | secondary | old (If known)
Required Pattern: official
..... system S 1..1 uri The namespace for the identifier value
..... value S 1..1 string The value that is unique
... Slices for basedOn 0..* Reference(US Core CarePlan Profile | US Core ServiceRequest Profile) (USCDI) A request for this procedure
Slice: Unordered, Open by profile:$this.resolve()
.... basedOn:planned-phase S 0..1 Reference(Radiotherapy Planned Phase) Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.
.... basedOn:phase-prescription S 0..1 Reference(Radiotherapy Phase Prescription) Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.
.... partOf:course-summary S 0..1 Reference(Radiotherapy Course Summary) Radiotherapy Course Summary that summarizes the course of which this Radiotherapy Treated Phase is a part.
... category 1..1 CodeableConcept Classification of the procedure
Binding: Radiotherapy Category Code Max Value Set (required)
... code 1..1 CodeableConcept (USCDI) Identification of the procedure
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 1222565005
..... display 1..1 string Representation defined by the system
Fixed Value: Radiotherapy treatment phase (regime/therapy)
... subject 1..1 Reference(Cancer Patient Profile) (USCDI) Who the procedure was performed on
... performed[x] 0..1 Period (USCDI) When the procedure was performed
.... start S 0..1 dateTime The date and time when the first therapeutic radiation was delivered.
.... end S 0..1 dateTime An end date is expected if the status is 'stopped' or 'completed'
... Slices for performer S 0..* BackboneElement The people who performed the procedure
Slice: Unordered, Open by profile:actor.resolve()
.... performer:organization S 0..* BackboneElement The people who performed the procedure
..... actor 1..1 Reference(US Core Organization Profile) Organization that provided the radiotherapy treatment.
... location S 0..1 Reference(US Core Location Profile) Location where the radiotherapy treatment was performed.
... reasonCode S 0..* CodeableConcept Coded reason procedure performed
Binding: Cancer Disorder Value Set (extensible)
... reasonReference S 0..* Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) The justification that the procedure was performed
... bodySite S 0..* CodeableConcept All body structure(s) treated with this procedure.
Binding: Radiotherapy Treatment Location Value Set (extensible)
.... Slices for extension Content/Rules for all slices
..... locationQualifier 0..* CodeableConcept General location qualifier (excluding laterality) for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier
Binding: Body Location Qualifier Value Set (required)
..... lateralityQualifier 0..1 CodeableConcept Laterality qualifier for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier
Binding: Laterality Qualifier Value Set (required)
... Slices for focalDevice 0..* BackboneElement Manipulated, implanted, or removed device
Slice: Unordered, Open by profile:manipulated.resolve()
.... focalDevice:seedDevice S 0..* BackboneElement Radiotherapy Seed Device used as part of therapy.
..... manipulated 1..1 Reference(Radiotherapy Seed Device) Device that was changed
... Slices for usedReference S 0..* Reference(Device | Medication | Substance) Items used during procedure
Slice: Unordered, Open by profile:$this.resolve()
.... usedReference:treatmentDevice S 0..* Reference(Radiotherapy Treatment Device) Radiotherapy Treatment Device used as part of therapy.

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Procedure.categoryrequiredRadiotherapyCategoryVS
http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs
from this IG
Procedure.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySiteextensibleRadiotherapyTreatmentLocationVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs

Constraints

IdGradePath(s)DetailsRequirements
CategoryPreferredwarningProcedureThis code 108290001 is inactive and should be used only for backward compatibility.
: category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-techniqueerrorProcedureThe extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-noneerrorProcedureIf the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-statuserrorProcedureOnly the following status values are supported: in-progress | not-done | on-hold | stopped | completed
: status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure C 0..* USCoreProcedureProfile An action that is being or was performed on a patient
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress'
codexrt-procedure-status: Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed
codexrt-motion-management-none: If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
codexrt-free-breathing-technique: The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
CategoryPreferred: This code 108290001 is inactive and should be used only for backward compatibility.
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... modalityAndTechnique SC 0..1 (Complex) Radiotherapy Modality And Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality
TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality
TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality
TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality
TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality
TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds
TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source
TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate
TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate
TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic
TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical
ModalityTextRequiredForOther: Require a text literal for code other
TechniqueTextRequiredForOther: Require a text literal for code other
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... modality S 1..1 (Complex) Radiotherapy Modality Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... extension 0..0
....... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
....... value[x] 1..1 CodeableConcept Value of extension
Binding: Radiotherapy Modality Value Set (required)
ele-1: All FHIR elements must have a @value or children
...... technique S 0..* (Complex) Radiotherapy Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... extension 0..0
....... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
....... value[x] 1..1 CodeableConcept Value of extension
Binding: Radiotherapy Technique Value Set (required)
ele-1: All FHIR elements must have a @value or children
...... radiotherapyEnergyOrIsotope S 0..* SimpleQuantity Radiotherapy Energy or Isotope
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
Binding: Radiotherapy Energy Unit Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... radiotherapyTreatmentApplicatorType S 0..* CodeableConcept Radiotherapy Treatment Applicator Type
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
Binding: Brachytherapy Applicator Type Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
.... imageGuidedRadiotherapyModality SC 0..* (Complex) Image Guided Radiotherapy Modality
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
IGRTEnergyAllowed: Energy is only allowed for X-Ray, Fluorograph, or CT Modalities.
.... fractionsDelivered S 0..1 unsignedInt Number of Fractions Delivered
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-fractions-delivered
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... doseDeliveredToVolume S 0..* (Complex) Radiotherapy Dose Delivered To Volume Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... extension:volume S 1..1 Extension Volume in the body where radiation was delivered
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... extension 0..0
....... url 1..1 uri "volume"
...... extension:totalDoseDelivered S 0..1 Extension Extension
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
....... extension 0..0
....... url 1..1 uri "totalDoseDelivered"
....... value[x] 0..1 Quantity Value of extension
ele-1: All FHIR elements must have a @value or children
Required Pattern: At least the following
........ system 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
........ code 1..1 code Coded form of the unit
Fixed Value: cGy
...... pointDose S 0..1 boolean Point Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... primaryPlanDose S 0..1 boolean Primary Plan Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
...... radiobiologicMetric S 0..* Quantity Radiotherapy Biologically Effective Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
.... radiotherapyReasonForRevisionOrAdaptation S 0..* CodeableConcept Reason for Revision or Adaptation
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-reason-for-revision-or-adaptation
Binding: Radiotherapy Reason for Revision or Adaptation Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... respiratoryMotionManagement S 0..* CodeableConcept Respiratory Motion Management
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
Binding: Radiotherapy Respiratory Motion Management Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... freeBreathingMotionManagementTechnique S 0..* CodeableConcept Free-Breathing Motion Management Technique
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... intrafractionVerification SC 0..* (Complex) Intrafraction Verification
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
IntrafractionVerificationQualifierAllowed: Qualifier is only allowed for X-Ray procedure.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... identifier:displayName SΣ 1..1 Identifier The name that is displayed to the user.
ele-1: All FHIR elements must have a @value or children
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
Required Pattern: usual
..... system SΣ 1..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
ele-1: All FHIR elements must have a @value or children
Example General: 123456
.... identifier:official SΣ 1..* Identifier A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
ele-1: All FHIR elements must have a @value or children
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
Required Pattern: official
..... system SΣ 1..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
ele-1: All FHIR elements must have a @value or children
Example General: 123456
... Slices for basedOn Σ 0..* Reference(US Core CarePlan Profile | US Core ServiceRequest Profile) (USCDI) A request for this procedure
Slice: Unordered, Open by profile:$this.resolve()
ele-1: All FHIR elements must have a @value or children
.... basedOn:planned-phase SΣ 0..1 Reference(Radiotherapy Planned Phase) Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.
ele-1: All FHIR elements must have a @value or children
.... basedOn:phase-prescription SΣ 0..1 Reference(Radiotherapy Phase Prescription) Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.
ele-1: All FHIR elements must have a @value or children
... Slices for partOf Σ 0..* Reference(Procedure | Observation | MedicationAdministration) Part of referenced event
Slice: Unordered, Open by profile:$this.resolve()
ele-1: All FHIR elements must have a @value or children
.... partOf:course-summary SΣ 0..1 Reference(Radiotherapy Course Summary) Radiotherapy Course Summary that summarizes the course of which this Radiotherapy Treated Phase is a part.
ele-1: All FHIR elements must have a @value or children
... status ?!SΣC 1..1 code (USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required)
ele-1: All FHIR elements must have a @value or children
... category Σ 1..1 CodeableConcept Classification of the procedure
Binding: Radiotherapy Category Code Max Value Set (required)
ele-1: All FHIR elements must have a @value or children
... code SΣ 1..1 CodeableConcept (USCDI) Identification of the procedure
Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure


ele-1: All FHIR elements must have a @value or children
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 1222565005
..... display 1..1 string Representation defined by the system
Fixed Value: Radiotherapy treatment phase (regime/therapy)
... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who the procedure was performed on
ele-1: All FHIR elements must have a @value or children
... performed[x] SΣC 0..1 Period (USCDI) When the procedure was performed
ele-1: All FHIR elements must have a @value or children
.... start SΣC 0..1 dateTime The date and time when the first therapeutic radiation was delivered.
ele-1: All FHIR elements must have a @value or children
.... end SΣC 0..1 dateTime An end date is expected if the status is 'stopped' or 'completed'
ele-1: All FHIR elements must have a @value or children
... Slices for performer SΣ 0..* BackboneElement The people who performed the procedure
Slice: Unordered, Open by profile:actor.resolve()
ele-1: All FHIR elements must have a @value or children
.... performer:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) The reference to the practitioner
ele-1: All FHIR elements must have a @value or children
.... performer:organization SΣ 0..* BackboneElement The people who performed the procedure
ele-1: All FHIR elements must have a @value or children
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... actor Σ 1..1 Reference(US Core Organization Profile) Organization that provided the radiotherapy treatment.
ele-1: All FHIR elements must have a @value or children
... location SΣ 0..1 Reference(US Core Location Profile) Location where the radiotherapy treatment was performed.
ele-1: All FHIR elements must have a @value or children
... reasonCode SΣ 0..* CodeableConcept Coded reason procedure performed
Binding: Cancer Disorder Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
... reasonReference SΣ 0..* Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) The justification that the procedure was performed
ele-1: All FHIR elements must have a @value or children
... bodySite SΣ 0..* CodeableConcept All body structure(s) treated with this procedure.
Binding: Radiotherapy Treatment Location Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
.... Slices for extension Content/Rules for all slices
..... locationQualifier 0..* CodeableConcept General location qualifier (excluding laterality) for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier
Binding: Body Location Qualifier Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... lateralityQualifier 0..1 CodeableConcept Laterality qualifier for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier
Binding: Laterality Qualifier Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... Slices for focalDevice 0..* BackboneElement Manipulated, implanted, or removed device
Slice: Unordered, Open by profile:manipulated.resolve()
ele-1: All FHIR elements must have a @value or children
.... focalDevice:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... manipulated 1..1 Reference(Device) Device that was changed
ele-1: All FHIR elements must have a @value or children
.... focalDevice:seedDevice S 0..* BackboneElement Radiotherapy Seed Device used as part of therapy.
ele-1: All FHIR elements must have a @value or children
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... manipulated 1..1 Reference(Radiotherapy Seed Device) Device that was changed
ele-1: All FHIR elements must have a @value or children
... Slices for usedReference S 0..* Reference(Device | Medication | Substance) Items used during procedure
Slice: Unordered, Open by profile:$this.resolve()
ele-1: All FHIR elements must have a @value or children
.... usedReference:treatmentDevice S 0..* Reference(Radiotherapy Treatment Device) Radiotherapy Treatment Device used as part of therapy.
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Procedure.extension:modalityAndTechnique.extension:modality.value[x]requiredRadiotherapyModalityVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]requiredRadiotherapyTechniqueVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.identifier:displayName.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Procedure.identifier:official.userequiredPattern: official
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Procedure.statusrequiredEventStatus
http://hl7.org/fhir/ValueSet/event-status
from the FHIR Standard
Procedure.categoryrequiredRadiotherapyCategoryVS
http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs
from this IG
Procedure.codeextensiblePattern: SNOMED-CT Code 1222565005("Radiotherapy treatment phase (regime/therapy)")
http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySiteextensibleRadiotherapyTreatmentLocationVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs

Constraints

IdGradePath(s)DetailsRequirements
CategoryPreferredwarningProcedureThis code 108290001 is inactive and should be used only for backward compatibility.
: category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-techniqueerrorProcedureThe extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-noneerrorProcedureIf the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-statuserrorProcedureOnly the following status values are supported: in-progress | not-done | on-hold | stopped | completed
: status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure C 0..* USCoreProcedureProfile An action that is being or was performed on a patient
us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress'
codexrt-procedure-status: Only the following status values are supported: in-progress | not-done | on-hold | stopped | completed
codexrt-motion-management-none: If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
codexrt-free-breathing-technique: The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
CategoryPreferred: This code 108290001 is inactive and should be used only for backward compatibility.
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... modalityAndTechnique SC 0..1 (Complex) Radiotherapy Modality And Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality
TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality
TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality
TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality
TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality
TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds
TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source
TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate
TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate
TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic
TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical
ModalityTextRequiredForOther: Require a text literal for code other
TechniqueTextRequiredForOther: Require a text literal for code other
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
...... modality S 1..1 (Complex) Radiotherapy Modality Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
....... value[x] 1..1 CodeableConcept Value of extension
Binding: Radiotherapy Modality Value Set (required)
...... technique S 0..* (Complex) Radiotherapy Technique Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
....... value[x] 1..1 CodeableConcept Value of extension
Binding: Radiotherapy Technique Value Set (required)
...... radiotherapyEnergyOrIsotope S 0..* SimpleQuantity Radiotherapy Energy or Isotope
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
Binding: Radiotherapy Energy Unit Value Set (required)
...... radiotherapyTreatmentApplicatorType S 0..* CodeableConcept Radiotherapy Treatment Applicator Type
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
Binding: Brachytherapy Applicator Type Value Set (extensible)
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"
.... imageGuidedRadiotherapyModality SC 0..* (Complex) Image Guided Radiotherapy Modality
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
IGRTEnergyAllowed: Energy is only allowed for X-Ray, Fluorograph, or CT Modalities.
.... fractionsDelivered S 0..1 unsignedInt Number of Fractions Delivered
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-fractions-delivered
.... doseDeliveredToVolume S 0..* (Complex) Radiotherapy Dose Delivered To Volume Extension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
..... id 0..1 string Unique id for inter-element referencing
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
...... extension:volume S 1..1 Extension Volume in the body where radiation was delivered
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "volume"
....... value[x] 0..1 Reference(Radiotherapy Volume Profile) Value of extension
...... extension:totalDoseDelivered S 0..1 Extension Extension
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..0
....... url 1..1 uri "totalDoseDelivered"
....... value[x] 0..1 Quantity Value of extension
Required Pattern: At least the following
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
........ value 0..1 decimal Numerical value (with implicit precision)
........ comparator 0..1 code < | <= | >= | > - how to understand the value
........ unit 0..1 string Unit representation
........ system 1..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
........ code 1..1 code Coded form of the unit
Fixed Value: cGy
...... pointDose S 0..1 boolean Point Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
...... primaryPlanDose S 0..1 boolean Primary Plan Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
...... radiobiologicMetric S 0..* Quantity Radiotherapy Biologically Effective Dose
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
..... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume"
.... radiotherapyReasonForRevisionOrAdaptation S 0..* CodeableConcept Reason for Revision or Adaptation
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-reason-for-revision-or-adaptation
Binding: Radiotherapy Reason for Revision or Adaptation Value Set (extensible)
.... respiratoryMotionManagement S 0..* CodeableConcept Respiratory Motion Management
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
Binding: Radiotherapy Respiratory Motion Management Value Set (required)
.... freeBreathingMotionManagementTechnique S 0..* CodeableConcept Free-Breathing Motion Management Technique
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
Binding: Radiotherapy Free-Breathing Motion Management Technique Value Set (extensible)
.... intrafractionVerification SC 0..* (Complex) Intrafraction Verification
URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
IntrafractionVerificationQualifierAllowed: Qualifier is only allowed for X-Ray procedure.
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... Slices for identifier SΣ 2..* Identifier External Identifiers for this procedure
Slice: Unordered, Open by value:use
.... identifier:displayName SΣ 1..1 Identifier The name that is displayed to the user.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: usual
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
.... identifier:official SΣ 1..* Identifier A business identifier for the request or procedure, which is independent of its FHIR representation, such as a GUID or DICOM UID.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 1..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


Required Pattern: official
..... type Σ 0..1 CodeableConcept Description of identifier
Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

..... system SΣ 1..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... Slices for basedOn Σ 0..* Reference(US Core CarePlan Profile | US Core ServiceRequest Profile) (USCDI) A request for this procedure
Slice: Unordered, Open by profile:$this.resolve()
.... basedOn:planned-phase SΣ 0..1 Reference(Radiotherapy Planned Phase) Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.
.... basedOn:phase-prescription SΣ 0..1 Reference(Radiotherapy Phase Prescription) Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.
... Slices for partOf Σ 0..* Reference(Procedure | Observation | MedicationAdministration) Part of referenced event
Slice: Unordered, Open by profile:$this.resolve()
.... partOf:course-summary SΣ 0..1 Reference(Radiotherapy Course Summary) Radiotherapy Course Summary that summarizes the course of which this Radiotherapy Treated Phase is a part.
... status ?!SΣC 1..1 code (USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required)
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.

... category Σ 1..1 CodeableConcept Classification of the procedure
Binding: Radiotherapy Category Code Max Value Set (required)
... code SΣ 1..1 CodeableConcept (USCDI) Identification of the procedure
Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure


Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 1222565005
..... display 1..1 string Representation defined by the system
Fixed Value: Radiotherapy treatment phase (regime/therapy)
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who the procedure was performed on
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... performed[x] SΣC 0..1 Period (USCDI) When the procedure was performed
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... start SΣC 0..1 dateTime The date and time when the first therapeutic radiation was delivered.
.... end SΣC 0..1 dateTime An end date is expected if the status is 'stopped' or 'completed'
... recorder Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Who recorded the procedure
... asserter Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Person who asserts this procedure
... Slices for performer SΣ 0..* BackboneElement The people who performed the procedure
Slice: Unordered, Open by profile:actor.resolve()
.... performer:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... function Σ 0..1 CodeableConcept Type of performance
Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.

..... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) The reference to the practitioner
..... onBehalfOf 0..1 Reference(Organization) Organization the device or practitioner was acting for
.... performer:organization SΣ 0..* BackboneElement The people who performed the procedure
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... function Σ 0..1 CodeableConcept Type of performance
Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.

..... actor Σ 1..1 Reference(US Core Organization Profile) Organization that provided the radiotherapy treatment.
..... onBehalfOf 0..1 Reference(Organization) Organization the device or practitioner was acting for
... location SΣ 0..1 Reference(US Core Location Profile) Location where the radiotherapy treatment was performed.
... reasonCode SΣ 0..* CodeableConcept Coded reason procedure performed
Binding: Cancer Disorder Value Set (extensible)
... reasonReference SΣ 0..* Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) The justification that the procedure was performed
... bodySite SΣ 0..* CodeableConcept All body structure(s) treated with this procedure.
Binding: Radiotherapy Treatment Location Value Set (extensible)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... locationQualifier 0..* CodeableConcept General location qualifier (excluding laterality) for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier
Binding: Body Location Qualifier Value Set (required)
..... lateralityQualifier 0..1 CodeableConcept Laterality qualifier for this bodySite
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier
Binding: Laterality Qualifier Value Set (required)
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... outcome Σ 0..1 CodeableConcept The result of procedure
Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.

... report 0..* Reference(DiagnosticReport | DocumentReference | Composition) Any report resulting from the procedure
... complication 0..* CodeableConcept Complication following the procedure
Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.


... complicationDetail 0..* Reference(Condition) A condition that is a result of the procedure
... followUp 0..* CodeableConcept Instructions for follow up
Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.


... note 0..* Annotation Additional information about the procedure
... Slices for focalDevice 0..* BackboneElement Manipulated, implanted, or removed device
Slice: Unordered, Open by profile:manipulated.resolve()
.... focalDevice:All Slices Content/Rules for all slices
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... action 0..1 CodeableConcept Kind of change to device
Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.

..... manipulated 1..1 Reference(Device) Device that was changed
.... focalDevice:seedDevice S 0..* BackboneElement Radiotherapy Seed Device used as part of therapy.
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... action 0..1 CodeableConcept Kind of change to device
Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.

..... manipulated 1..1 Reference(Radiotherapy Seed Device) Device that was changed
... Slices for usedReference S 0..* Reference(Device | Medication | Substance) Items used during procedure
Slice: Unordered, Open by profile:$this.resolve()
.... usedReference:treatmentDevice S 0..* Reference(Radiotherapy Treatment Device) Radiotherapy Treatment Device used as part of therapy.
... usedCode 0..* CodeableConcept Coded items used during the procedure
Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.



doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / CodeURI
Procedure.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Procedure.extension:modalityAndTechnique.extension:modality.value[x]requiredRadiotherapyModalityVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]requiredRadiotherapyTechniqueVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.identifier:displayName.userequiredPattern: usual
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Procedure.identifier:displayName.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Procedure.identifier:official.userequiredPattern: official
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Procedure.identifier:official.typeextensibleIdentifier Type Codes
http://hl7.org/fhir/ValueSet/identifier-type
from the FHIR Standard
Procedure.statusrequiredEventStatus
http://hl7.org/fhir/ValueSet/event-status
from the FHIR Standard
Procedure.statusReasonexampleProcedureNotPerformedReason(SNOMED-CT)
http://hl7.org/fhir/ValueSet/procedure-not-performed-reason
from the FHIR Standard
Procedure.categoryrequiredRadiotherapyCategoryVS
http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs
from this IG
Procedure.codeextensiblePattern: SNOMED-CT Code 1222565005("Radiotherapy treatment phase (regime/therapy)")
http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.performer.functionexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
Procedure.performer:organization.functionexampleProcedurePerformerRoleCodes
http://hl7.org/fhir/ValueSet/performer-role
from the FHIR Standard
Procedure.reasonCodeextensibleCancerDisorderVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySiteextensibleRadiotherapyTreatmentLocationVS
http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs
Procedure.outcomeexampleProcedureOutcomeCodes(SNOMEDCT)
http://hl7.org/fhir/ValueSet/procedure-outcome
from the FHIR Standard
Procedure.complicationexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
Procedure.followUpexampleProcedureFollowUpCodes(SNOMEDCT)
http://hl7.org/fhir/ValueSet/procedure-followup
from the FHIR Standard
Procedure.focalDevice.actionpreferredProcedureDeviceActionCodes
http://hl7.org/fhir/ValueSet/device-action
from the FHIR Standard
Procedure.focalDevice:seedDevice.actionpreferredProcedureDeviceActionCodes
http://hl7.org/fhir/ValueSet/device-action
from the FHIR Standard
Procedure.usedCodeexampleFHIRDeviceTypes
http://hl7.org/fhir/ValueSet/device-kind
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
CategoryPreferredwarningProcedureThis code 108290001 is inactive and should be used only for backward compatibility.
: category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-techniqueerrorProcedureThe extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "External beam radiotherapy with free breathing (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://snomed.info/sct')))
codexrt-motion-management-noneerrorProcedureIf the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "External beam radiotherapy without respiratory motion management (procedure)"
: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://snomed.info/sct'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1
codexrt-procedure-statuserrorProcedureOnly the following status values are supported: in-progress | not-done | on-hold | stopped | completed
: status = 'in-progress' or status = 'not-done' or status = 'on-hold' or status = 'stopped' or status = 'completed'

This structure is derived from USCoreProcedureProfile

Summary

Mandatory: 9 elements
Must-Support: 34 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Procedure.identifier
  • The element 1 is sliced based on the value of Procedure.basedOn
  • The element 1 is sliced based on the value of Procedure.partOf
  • The element 1 is sliced based on the value of Procedure.performer
  • The element 1 is sliced based on the value of Procedure.focalDevice
  • The element 1 is sliced based on the value of Procedure.usedReference

 

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