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

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• Detailed Descriptions
• Mappings
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• TTL

Resource Profile: Radiotherapy Treated Phase

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.

Usage:

• Refer to this Resource Profile: Radiotherapy Adverse Event, Radiotherapy Treated Fraction and Radiotherapy Treated Plan
• Examples for this Resource Profile: Procedure/RadiotherapyTreatedPhase-05-Prostate-Phase1, Procedure/RadiotherapyTreatedPhase-101-LeftBreastTang, Procedure/RadiotherapyTreatedPhase-102-LeftBreastBoost, Procedure/RadiotherapyTreatedPhase-103-RightBreastTang... Show 17 more, Procedure/RadiotherapyTreatedPhase-XRTS-01-22B-01-01-Primary-1Fx, Procedure/RadiotherapyTreatedPhase-XRTS-01-22B-01-01-Primary, Procedure/RadiotherapyTreatedPhase-XRTS-02-22B-01-01-Primary-1Fx, Procedure/RadiotherapyTreatedPhase-XRTS-02-22B-01-01-Primary, Procedure/RadiotherapyTreatedPhase-XRTS-02-22B-01-02-PlanChange, Procedure/RadiotherapyTreatedPhase-XRTS-03-22B-01-01-Primary-1Fx, Procedure/RadiotherapyTreatedPhase-XRTS-03-22B-01-01-Primary, Procedure/RadiotherapyTreatedPhase-XRTS-04-22B-01-01-LeftBreastTang-1Fx, Procedure/RadiotherapyTreatedPhase-XRTS-04-22B-01-01-LeftBreastTang, Procedure/RadiotherapyTreatedPhase-XRTS-04-22B-01-02-RightBreastTang, Procedure/RadiotherapyTreatedPhase-XRTS-04-22B-01-03-LeftBreastBoost, Procedure/RadiotherapyTreatedPhase-XRTS-05-22B-01-01-Primary-1Fx, Procedure/RadiotherapyTreatedPhase-XRTS-05-22B-01-01-Primary, Procedure/RadiotherapyTreatedPhase-XRTS-05-22B-02-01-Primary, Procedure/RadiotherapyTreatedPhase-XRTS-06-22B-01-01-Primary-1Fx, Procedure/RadiotherapyTreatedPhase-XRTS-06-22B-01-01-Primary and Procedure/RadiotherapyTreatedPhase-XRTS-07-22B-01-01-Primary

Formal Views of Profile Content

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

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from USCoreProcedureProfile

Name	Flags	Card.	Type	Description & Constraints
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:$this.resolve()
basedOn:planned-phase	S	0..1	Reference(Radiotherapy Planned Phase)	Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.
basedOn:phase-prescription	S	0..1	Reference(Radiotherapy Phase Prescription)	Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.
Slices for partOf		0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event Slice: Unordered, Open by profile:$this.resolve()
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.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Procedure.category	required	RadiotherapyCategoryVS http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs from this IG
Procedure.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySite	extensible	RadiotherapyTreatmentLocationVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs

Constraints

Id	Grade	Path(s)	Details	Requirements
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility. : category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-technique	error	Procedure	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)" : 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-none	error	Procedure	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)" : 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-status	error	Procedure	Only 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'

Name	Flags	Card.	Type	Description & Constraints
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.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
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
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
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
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
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
extension		0..0
url		1..1	uri	"volume"
extension:totalDoseDelivered	S	0..1	Extension	Extension
extension		0..0
url		1..1	uri	"totalDoseDelivered"
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.
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
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
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.
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
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
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)
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
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
performed[x]	SΣC	0..1	Period	(USCDI) When the procedure was performed
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'
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
performer:organization	SΣ	0..*	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(US Core Organization Profile)	Organization that provided the radiotherapy treatment.
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)
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:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manipulated		1..1	Reference(Device)	Device that was changed
focalDevice:seedDevice	S	0..*	BackboneElement	Radiotherapy Seed Device used as part of therapy.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.extension:modalityAndTechnique.extension:modality.value[x]	required	RadiotherapyModalityVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]	required	RadiotherapyTechniqueVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.identifier:displayName.use	required	Pattern: usual http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Procedure.identifier:official.use	required	Pattern: official http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status from the FHIR Standard
Procedure.category	required	RadiotherapyCategoryVS http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs from this IG
Procedure.code	extensible	Pattern: SNOMED-CT Code 1222565005("Radiotherapy treatment phase (regime/therapy)") http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySite	extensible	RadiotherapyTreatmentLocationVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs

Constraints

Id	Grade	Path(s)	Details	Requirements
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility. : category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-technique	error	Procedure	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)" : 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-none	error	Procedure	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)" : 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-status	error	Procedure	Only 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'

Name	Flags	Card.	Type	Description & Constraints
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 Bindings Purpose 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.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Procedure.extension:modalityAndTechnique.extension:modality.value[x]	required	RadiotherapyModalityVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]	required	RadiotherapyTechniqueVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.identifier:displayName.use	required	Pattern: usual http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Procedure.identifier:displayName.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Procedure.identifier:official.use	required	Pattern: official http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Procedure.identifier:official.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status from the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason from the FHIR Standard
Procedure.category	required	RadiotherapyCategoryVS http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs from this IG
Procedure.code	extensible	Pattern: SNOMED-CT Code 1222565005("Radiotherapy treatment phase (regime/therapy)") http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.performer:organization.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySite	extensible	RadiotherapyTreatmentLocationVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome from the FHIR Standard
Procedure.complication	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup from the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.focalDevice:seedDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.usedCode	example	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility. : category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-technique	error	Procedure	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)" : 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-none	error	Procedure	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)" : 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-status	error	Procedure	Only 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:

• Radiotherapy Planned Phase (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-planned-phase)
• Radiotherapy Phase Prescription (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-phase-prescription)
• Radiotherapy Course Summary (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-summary)
• Cancer Patient Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• US Core Location Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-location)
• Radiotherapy Seed Device (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-seed-device)
• Radiotherapy Treatment Device (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-device)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-fractions-delivered
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-reason-for-revision-or-adaptation
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier

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

Name	Flags	Card.	Type	Description & Constraints
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:$this.resolve()
basedOn:planned-phase	S	0..1	Reference(Radiotherapy Planned Phase)	Radiotherapy Planned Phase that planned the treatment summarized in this Radiotherapy Treated Phase.
basedOn:phase-prescription	S	0..1	Reference(Radiotherapy Phase Prescription)	Radiotherapy Phase Prescription that prescribed the treatment summarized in this Radiotherapy Treated Phase.
Slices for partOf		0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event Slice: Unordered, Open by profile:$this.resolve()
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.
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Procedure.category	required	RadiotherapyCategoryVS http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs from this IG
Procedure.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySite	extensible	RadiotherapyTreatmentLocationVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs

Constraints

Id	Grade	Path(s)	Details	Requirements
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility. : category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-technique	error	Procedure	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)" : 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-none	error	Procedure	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)" : 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-status	error	Procedure	Only 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

Name	Flags	Card.	Type	Description & Constraints
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.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
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
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
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
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
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
extension		0..0
url		1..1	uri	"volume"
extension:totalDoseDelivered	S	0..1	Extension	Extension
extension		0..0
url		1..1	uri	"totalDoseDelivered"
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.
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
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
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.
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
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
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)
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
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
performed[x]	SΣC	0..1	Period	(USCDI) When the procedure was performed
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'
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
performer:organization	SΣ	0..*	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(US Core Organization Profile)	Organization that provided the radiotherapy treatment.
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)
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:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manipulated		1..1	Reference(Device)	Device that was changed
focalDevice:seedDevice	S	0..*	BackboneElement	Radiotherapy Seed Device used as part of therapy.
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
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.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.extension:modalityAndTechnique.extension:modality.value[x]	required	RadiotherapyModalityVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]	required	RadiotherapyTechniqueVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.identifier:displayName.use	required	Pattern: usual http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Procedure.identifier:official.use	required	Pattern: official http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status from the FHIR Standard
Procedure.category	required	RadiotherapyCategoryVS http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs from this IG
Procedure.code	extensible	Pattern: SNOMED-CT Code 1222565005("Radiotherapy treatment phase (regime/therapy)") http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySite	extensible	RadiotherapyTreatmentLocationVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs

Constraints

Id	Grade	Path(s)	Details	Requirements
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility. : category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-technique	error	Procedure	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)" : 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-none	error	Procedure	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)" : 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-status	error	Procedure	Only 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

Name	Flags	Card.	Type	Description & Constraints
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 Bindings Purpose 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.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Procedure.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Procedure.extension:modalityAndTechnique.extension:modality.value[x]	required	RadiotherapyModalityVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
Procedure.extension:modalityAndTechnique.extension:technique.value[x]	required	RadiotherapyTechniqueVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
Procedure.identifier:displayName.use	required	Pattern: usual http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Procedure.identifier:displayName.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Procedure.identifier:official.use	required	Pattern: official http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Procedure.identifier:official.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Procedure.status	required	EventStatus http://hl7.org/fhir/ValueSet/event-status from the FHIR Standard
Procedure.statusReason	example	ProcedureNotPerformedReason(SNOMED-CT) http://hl7.org/fhir/ValueSet/procedure-not-performed-reason from the FHIR Standard
Procedure.category	required	RadiotherapyCategoryVS http://hl7.org/fhir/us/codex-radiation-therapy/ValueSet/codexrt-radiotherapy-category-vs from this IG
Procedure.code	extensible	Pattern: SNOMED-CT Code 1222565005("Radiotherapy treatment phase (regime/therapy)") http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code
Procedure.performer.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.performer:organization.function	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
Procedure.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs
Procedure.bodySite	extensible	RadiotherapyTreatmentLocationVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-treatment-location-vs
Procedure.outcome	example	ProcedureOutcomeCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-outcome from the FHIR Standard
Procedure.complication	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
Procedure.followUp	example	ProcedureFollowUpCodes(SNOMEDCT) http://hl7.org/fhir/ValueSet/procedure-followup from the FHIR Standard
Procedure.focalDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.focalDevice:seedDevice.action	preferred	ProcedureDeviceActionCodes http://hl7.org/fhir/ValueSet/device-action from the FHIR Standard
Procedure.usedCode	example	FHIRDeviceTypes http://hl7.org/fhir/ValueSet/device-kind from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
CategoryPreferred	warning	Procedure	This code 108290001 is inactive and should be used only for backward compatibility. : category.exists() and category.coding.exists( code = '108290001' ).not()
codexrt-free-breathing-technique	error	Procedure	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)" : 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-none	error	Procedure	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)" : 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-status	error	Procedure	Only 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:

• Radiotherapy Planned Phase (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-planned-phase)
• Radiotherapy Phase Prescription (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-phase-prescription)
• Radiotherapy Course Summary (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-course-summary)
• Cancer Patient Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient)
• US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization)
• US Core Location Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-location)
• Radiotherapy Seed Device (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-seed-device)
• Radiotherapy Treatment Device (http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-device)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-energy-or-isotope
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-treatment-applicator-type
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-image-guided-radiotherapy-modality
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-fractions-delivered
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-point-dose
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-primary-plan-dose
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiobiologic-metric
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-reason-for-revision-or-adaptation
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-intrafraction-verification
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier

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