Da Vinci - Coverage Requirements Discovery
2.2.1 - STU 2.2

Da Vinci - Coverage Requirements Discovery, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-crd/ and changes regularly. See the Directory of published versions

## Resource Profile: CRD Nutrition Order

Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-nutritionorder | Version: 2.2.1 | Highlight text changes?
Standards status: Trial-use Active as of 2026-03-26 | Maturity Level: 1 | Computable Name: CRDNutritionOrder
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.42.13

This profile specifies extensions and constraints on the NutritionOrder resource to support coverage requirements discovery.

### Usage

CRD Clients SHALL use CRD NutritionOrder profile to resolve references to NutritionOrder resources passed to CRD Servers (e.g. `selections` context references) and to populate `draftOrders` context objects when invoking the following CDS Hooks: §prof-10

- order-select
- order-sign
- order-dispatch

!

Information provided in Must Support elements will commonly be required for CRD Servers to perform coverage requirements discovery.

> This resource is not covered by US Core and there has been no testing or other experience exercising this profile. Implementers should be aware that the constraints in the profile and the provided value sets may not be a good fit for EHR and/or payer requirements. Feedback is welcome.

Usages:

- Use this Profile: CRD CDSHooks Additional Orders Response (Logical Definition), CRD CDSHooks Alternate Request Response (Logical Definition), CRD CDSHooks Coverage Information Response (Logical Definition) and CRD Bundle of Request Resources
- Refer to this Profile: Coverage Information
- CapabilityStatements using this Profile: CRD Client USCDI 1, CRD Client USCDI 3 and CRD Client USCDI 4

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder | C | 0..* | NutritionOrder | Diet, formula or nutritional supplement request Constraints: nor-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:Coverage-Information | S C | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8, crd-ci-q9
extension:EncounterCategory | S | 0..1 | (Complex) | Encounter Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ActEncounterCode (3.0.0) (required)
extension:ServiceCategory | S | 0..1 | (Complex) | Service Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 Service Type (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | Identifiers assigned to this order
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes identifying the lifecycle stage of the nutrition order. Example General: draft
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a nutrition order.
patient | S Σ | 1..1 | Reference(CRD Patient) | The person who requires the diet, formula or nutritional supplement
encounter | S | 0..1 | Reference(CRD Encounter) | The encounter associated with this nutrition order
dateTime | S Σ | 1..1 | dateTime | Date and time the nutrition order was requested
orderer | S Σ | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who ordered the diet, formula or nutritional supplement
allergyIntolerance | S | 0..* | Reference(US Core AllergyIntolerance Profile(7.0.0)) | List of the patient's food and nutrition-related allergies and intolerances
foodPreferenceModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Types of Edible Substances (extensible)
excludeFoodModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should not be given Binding: Types of Edible Substances (extensible)
oralDiet | S C | 0..1 | BackboneElement | Oral diet components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: Diet Codes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of diet
nutrient | S | 0..* | BackboneElement | Required nutrient modifications
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
modifier | S | 0..1 | CodeableConcept | Type of nutrient that is being modified Binding: Nutrient Codes (extensible)
texture | S | 0..* | BackboneElement | Required texture modifications
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
modifier | S | 0..1 | CodeableConcept | Code to indicate how to alter the texture of the foods, e.g. pureed Binding: TextureModifierCodes (extensible)
foodType | S | 0..1 | CodeableConcept | Concepts that are used to identify an entity that is ingested for nutritional purposes Binding: TextureModifiedFoodTypeCodes (extensible)
supplement | S C | 0..* | BackboneElement | Supplement components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..1 | CodeableConcept | Type of supplement product requested Binding: SupplementTypeCodes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of supplement
quantity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of the nutritional supplement
enteralFormula | S C | 0..1 | BackboneElement | Enteral formula components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
baseFormulaType | S Σ | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: EnteralFormulaTypeCodes (extensible)
additiveType | S | 0..1 | CodeableConcept | Type of modular component to add to the feeding Binding: EnteralFormulaAdditiveTypeCode (extensible)
caloricDensity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of energy per specified volume that is required
routeofAdministration | S | 0..1 | CodeableConcept | How the formula should enter the patient's gastrointestinal tract Binding: EnteralRouteCodes (extensible)
administration | S | 0..* | BackboneElement | Formula feeding instruction as structured data
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
schedule | S | 0..1 | CRDTiming | Scheduled frequency of enteral feeding
quantity | S | 0..1 | SimpleQuantity(4.0.1) | The volume of formula to provide
Slices for rate[x] |  | 0..1 |  | Speed with which the formula is provided per period of time Slice: Unordered, Open by type:$this
rateQuantity |  |  | Quantity(SimpleQuantity) |
rateRatio |  |  | Ratio |
rate[x]:rateRatio | S | 0..1 | Ratio | Speed with which the formula is provided per period of time
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
NutritionOrder.extension:EncounterCategory.​value[x] | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.1
NutritionOrder.extension:ServiceCategory.​value[x] | Base | required | X12 Service Type | 📦2.2.1 | This IG
NutritionOrder.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
NutritionOrder.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
NutritionOrder.foodPreferenceModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.excludeFoodModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​type | Base | extensible | Diet Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​nutrient.modifier | Base | extensible | Nutrient Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​texture.modifier | Base | extensible | Texture Modifier Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.oralDiet.​texture.foodType | Base | extensible | Texture Modified Food Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.supplement.​type | Base | extensible | Supplement Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​baseFormulaType | Base | extensible | Enteral Formula Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​additiveType | Base | extensible | Enteral Formula Additive Type Code | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​routeofAdministration | Base | extensible | Enteral Route Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
crd-ci-q1 | error | NutritionOrder.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists | `extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()`
crd-ci-q2 | error | NutritionOrder.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. | `extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()`
crd-ci-q3 | error | NutritionOrder.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()`
crd-ci-q4 | error | NutritionOrder.extension:Coverage-Information | If 'pa-needed' is 'satisfied', 'noauth', or 'not-covered', then 'Doc-purpose' cannot be 'withpa'. | `extension.where(url = 'pa-needed' and (value = 'satisfied' or value = 'noauth' or value = 'not-covered')) and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa')`
crd-ci-q5 | error | NutritionOrder.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. | `extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()`
crd-ci-q6 | error | NutritionOrder.extension:Coverage-Information | If 'info-needed' is OTH, then reason must be specified | `extension.where(url = 'info-needed' and value = 'OTH').exists() implies extension.where(url = 'reason').exists()`
crd-ci-q7 | error | NutritionOrder.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present | `extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')`
crd-ci-q8 | error | NutritionOrder.extension:Coverage-Information | If doc-purpose is present with a value other than 'conditional', then reason must be present | `extension.where(url = 'doc-purpose' and value != 'conditional').exists() implies extension.where(url = 'reason').exists()`
crd-ci-q9 | error | NutritionOrder.extension:Coverage-Information | If any of 'covered', 'pa-needed', or 'doc-needed' is set to 'indeterminate', then reason must be present to explain the issue that is preventing the payer from making a coverage determination. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'indeterminate').count() >= 1 implies extension.where(url = 'reason').exists()`
dom-2 | error | NutritionOrder | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | NutritionOrder | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | NutritionOrder | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
nor-1 | warning | NutritionOrder | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class | `oralDiet.exists() or supplement.exists() or enteralFormula.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder |  |  | NutritionOrder |
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:Coverage-Information | S | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
extension:EncounterCategory | S | 0..1 | (Complex) | Encounter Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ActEncounterCode (3.0.0) (required)
extension:ServiceCategory | S | 0..1 | (Complex) | Service Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 Service Type (required)
identifier | S | 0..* | Identifier | Identifiers assigned to this order
status | S | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Example General: draft
patient | S | 1..1 | Reference(CRD Patient) | The person who requires the diet, formula or nutritional supplement
encounter | S | 0..1 | Reference(CRD Encounter) | The encounter associated with this nutrition order
dateTime | S | 1..1 | dateTime | Date and time the nutrition order was requested
orderer | S | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who ordered the diet, formula or nutritional supplement
allergyIntolerance | S | 0..* | Reference(US Core AllergyIntolerance Profile(7.0.0)) | List of the patient's food and nutrition-related allergies and intolerances
foodPreferenceModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Types of Edible Substances (extensible)
excludeFoodModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should not be given Binding: Types of Edible Substances (extensible)
oralDiet | S | 0..1 | BackboneElement | Oral diet components
type | S | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: Diet Codes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of diet
nutrient | S | 0..* | BackboneElement | Required nutrient modifications
modifier | S | 0..1 | CodeableConcept | Type of nutrient that is being modified Binding: Nutrient Codes (extensible)
texture | S | 0..* | BackboneElement | Required texture modifications
modifier | S | 0..1 | CodeableConcept | Code to indicate how to alter the texture of the foods, e.g. pureed Binding: TextureModifierCodes (extensible)
foodType | S | 0..1 | CodeableConcept | Concepts that are used to identify an entity that is ingested for nutritional purposes Binding: TextureModifiedFoodTypeCodes (extensible)
supplement | S | 0..* | BackboneElement | Supplement components
type | S | 0..1 | CodeableConcept | Type of supplement product requested Binding: SupplementTypeCodes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of supplement
quantity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of the nutritional supplement
enteralFormula | S | 0..1 | BackboneElement | Enteral formula components
baseFormulaType | S | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: EnteralFormulaTypeCodes (extensible)
additiveType | S | 0..1 | CodeableConcept | Type of modular component to add to the feeding Binding: EnteralFormulaAdditiveTypeCode (extensible)
caloricDensity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of energy per specified volume that is required
routeofAdministration | S | 0..1 | CodeableConcept | How the formula should enter the patient's gastrointestinal tract Binding: EnteralRouteCodes (extensible)
administration | S | 0..* | BackboneElement | Formula feeding instruction as structured data
schedule | S | 0..1 | CRDTiming | Scheduled frequency of enteral feeding
quantity | S | 0..1 | SimpleQuantity(4.0.1) | The volume of formula to provide
Slices for rate[x] |  | 0..1 | SimpleQuantity(4.0.1), Ratio | Speed with which the formula is provided per period of time Slice: Unordered, Open by type:$this
rate[x]:rateRatio | S | 0..1 | Ratio | Speed with which the formula is provided per period of time
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
NutritionOrder.extension:EncounterCategory.​value[x] | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.1
NutritionOrder.extension:ServiceCategory.​value[x] | Base | required | X12 Service Type | 📦2.2.1 | This IG
NutritionOrder.foodPreferenceModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.excludeFoodModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​type | Base | extensible | Diet Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​nutrient.modifier | Base | extensible | Nutrient Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​texture.modifier | Base | extensible | Texture Modifier Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.oralDiet.​texture.foodType | Base | extensible | Texture Modified Food Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.supplement.​type | Base | extensible | Supplement Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​baseFormulaType | Base | extensible | Enteral Formula Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​additiveType | Base | extensible | Enteral Formula Additive Type Code | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​routeofAdministration | Base | extensible | Enteral Route Codes | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder | C | 0..* | NutritionOrder | Diet, formula or nutritional supplement request Constraints: nor-1
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:Coverage-Information | S C | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8, crd-ci-q9
extension:EncounterCategory | S | 0..1 | (Complex) | Encounter Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ActEncounterCode (3.0.0) (required)
extension:ServiceCategory | S | 0..1 | (Complex) | Service Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 Service Type (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | Identifiers assigned to this order
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
instantiates |  | 0..* | uri | Instantiates protocol or definition
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes identifying the lifecycle stage of the nutrition order. Example General: draft
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a nutrition order.
patient | S Σ | 1..1 | Reference(CRD Patient) | The person who requires the diet, formula or nutritional supplement
encounter | S | 0..1 | Reference(CRD Encounter) | The encounter associated with this nutrition order
dateTime | S Σ | 1..1 | dateTime | Date and time the nutrition order was requested
orderer | S Σ | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who ordered the diet, formula or nutritional supplement
allergyIntolerance | S | 0..* | Reference(US Core AllergyIntolerance Profile(7.0.0)) | List of the patient's food and nutrition-related allergies and intolerances
foodPreferenceModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Types of Edible Substances (extensible)
excludeFoodModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should not be given Binding: Types of Edible Substances (extensible)
oralDiet | S C | 0..1 | BackboneElement | Oral diet components
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
type | S Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: Diet Codes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of diet
nutrient | S | 0..* | BackboneElement | Required nutrient modifications
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
modifier | S | 0..1 | CodeableConcept | Type of nutrient that is being modified Binding: Nutrient Codes (extensible)
amount |  | 0..1 | SimpleQuantity(4.0.1) | Quantity of the specified nutrient
texture | S | 0..* | BackboneElement | Required texture modifications
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
modifier | S | 0..1 | CodeableConcept | Code to indicate how to alter the texture of the foods, e.g. pureed Binding: TextureModifierCodes (extensible)
foodType | S | 0..1 | CodeableConcept | Concepts that are used to identify an entity that is ingested for nutritional purposes Binding: TextureModifiedFoodTypeCodes (extensible)
fluidConsistencyType |  | 0..* | CodeableConcept | The required consistency of fluids and liquids provided to the patient Binding: FluidConsistencyTypeCodes (example): Codes used to represent the consistency of fluids and liquids provided to the patient.
instruction | Σ | 0..1 | string | Instructions or additional information about the oral diet
supplement | S C | 0..* | BackboneElement | Supplement components
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
type | S Σ | 0..1 | CodeableConcept | Type of supplement product requested Binding: SupplementTypeCodes (extensible)
productName |  | 0..1 | string | Product or brand name of the nutritional supplement
schedule | S | 0..* | CRDTiming | Scheduled frequency of supplement
quantity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of the nutritional supplement
instruction | Σ | 0..1 | string | Instructions or additional information about the oral supplement
enteralFormula | S C | 0..1 | BackboneElement | Enteral formula components
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
baseFormulaType | S Σ | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: EnteralFormulaTypeCodes (extensible)
baseFormulaProductName |  | 0..1 | string | Product or brand name of the enteral or infant formula
additiveType | S | 0..1 | CodeableConcept | Type of modular component to add to the feeding Binding: EnteralFormulaAdditiveTypeCode (extensible)
additiveProductName |  | 0..1 | string | Product or brand name of the modular additive
caloricDensity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of energy per specified volume that is required
routeofAdministration | S | 0..1 | CodeableConcept | How the formula should enter the patient's gastrointestinal tract Binding: EnteralRouteCodes (extensible)
administration | S | 0..* | BackboneElement | Formula feeding instruction as structured data
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
schedule | S | 0..1 | CRDTiming | Scheduled frequency of enteral feeding
quantity | S | 0..1 | SimpleQuantity(4.0.1) | The volume of formula to provide
Slices for rate[x] |  | 0..1 |  | Speed with which the formula is provided per period of time Slice: Unordered, Open by type:$this
rateQuantity |  |  | Quantity(SimpleQuantity) |
rateRatio |  |  | Ratio |
rate[x]:rateRatio | S | 0..1 | Ratio | Speed with which the formula is provided per period of time
maxVolumeToDeliver |  | 0..1 | SimpleQuantity(4.0.1) | Upper limit on formula volume per unit of time
administrationInstruction | Σ | 0..1 | string | Formula feeding instructions expressed as text
note |  | 0..* | Annotation | Comments
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
NutritionOrder.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
NutritionOrder.extension:EncounterCategory.​value[x] | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.1
NutritionOrder.extension:ServiceCategory.​value[x] | Base | required | X12 Service Type | 📦2.2.1 | This IG
NutritionOrder.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
NutritionOrder.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
NutritionOrder.foodPreferenceModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.excludeFoodModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​type | Base | extensible | Diet Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​nutrient.modifier | Base | extensible | Nutrient Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​texture.modifier | Base | extensible | Texture Modifier Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.oralDiet.​texture.foodType | Base | extensible | Texture Modified Food Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.oralDiet.​fluidConsistencyType | Base | example | Fluid Consistency Type Codes | 📍4.0.1 | FHIR Std.
NutritionOrder.supplement.​type | Base | extensible | Supplement Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​baseFormulaType | Base | extensible | Enteral Formula Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​additiveType | Base | extensible | Enteral Formula Additive Type Code | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​routeofAdministration | Base | extensible | Enteral Route Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
crd-ci-q1 | error | NutritionOrder.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists | `extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()`
crd-ci-q2 | error | NutritionOrder.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. | `extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()`
crd-ci-q3 | error | NutritionOrder.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()`
crd-ci-q4 | error | NutritionOrder.extension:Coverage-Information | If 'pa-needed' is 'satisfied', 'noauth', or 'not-covered', then 'Doc-purpose' cannot be 'withpa'. | `extension.where(url = 'pa-needed' and (value = 'satisfied' or value = 'noauth' or value = 'not-covered')) and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa')`
crd-ci-q5 | error | NutritionOrder.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. | `extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()`
crd-ci-q6 | error | NutritionOrder.extension:Coverage-Information | If 'info-needed' is OTH, then reason must be specified | `extension.where(url = 'info-needed' and value = 'OTH').exists() implies extension.where(url = 'reason').exists()`
crd-ci-q7 | error | NutritionOrder.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present | `extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')`
crd-ci-q8 | error | NutritionOrder.extension:Coverage-Information | If doc-purpose is present with a value other than 'conditional', then reason must be present | `extension.where(url = 'doc-purpose' and value != 'conditional').exists() implies extension.where(url = 'reason').exists()`
crd-ci-q9 | error | NutritionOrder.extension:Coverage-Information | If any of 'covered', 'pa-needed', or 'doc-needed' is set to 'indeterminate', then reason must be present to explain the issue that is preventing the payer from making a coverage determination. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'indeterminate').count() >= 1 implies extension.where(url = 'reason').exists()`
dom-2 | error | NutritionOrder | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | NutritionOrder | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | NutritionOrder | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
nor-1 | warning | NutritionOrder | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class | `oralDiet.exists() or supplement.exists() or enteralFormula.exists()`

Summary

Mandatory: 1 element
Must-Support: 34 elements

Structures

This structure refers to these other structures:

- CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
- CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)
- CRD Practitioner (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner)
- HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)
- US Core AllergyIntolerance Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance|7.0.0)
- CRD Timing Data Type (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-timing)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of NutritionOrder.enteralFormula.administration.rate[x]

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder | C | 0..* | NutritionOrder | Diet, formula or nutritional supplement request Constraints: nor-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:Coverage-Information | S C | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8, crd-ci-q9
extension:EncounterCategory | S | 0..1 | (Complex) | Encounter Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ActEncounterCode (3.0.0) (required)
extension:ServiceCategory | S | 0..1 | (Complex) | Service Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 Service Type (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | Identifiers assigned to this order
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes identifying the lifecycle stage of the nutrition order. Example General: draft
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a nutrition order.
patient | S Σ | 1..1 | Reference(CRD Patient) | The person who requires the diet, formula or nutritional supplement
encounter | S | 0..1 | Reference(CRD Encounter) | The encounter associated with this nutrition order
dateTime | S Σ | 1..1 | dateTime | Date and time the nutrition order was requested
orderer | S Σ | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who ordered the diet, formula or nutritional supplement
allergyIntolerance | S | 0..* | Reference(US Core AllergyIntolerance Profile(7.0.0)) | List of the patient's food and nutrition-related allergies and intolerances
foodPreferenceModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Types of Edible Substances (extensible)
excludeFoodModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should not be given Binding: Types of Edible Substances (extensible)
oralDiet | S C | 0..1 | BackboneElement | Oral diet components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: Diet Codes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of diet
nutrient | S | 0..* | BackboneElement | Required nutrient modifications
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
modifier | S | 0..1 | CodeableConcept | Type of nutrient that is being modified Binding: Nutrient Codes (extensible)
texture | S | 0..* | BackboneElement | Required texture modifications
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
modifier | S | 0..1 | CodeableConcept | Code to indicate how to alter the texture of the foods, e.g. pureed Binding: TextureModifierCodes (extensible)
foodType | S | 0..1 | CodeableConcept | Concepts that are used to identify an entity that is ingested for nutritional purposes Binding: TextureModifiedFoodTypeCodes (extensible)
supplement | S C | 0..* | BackboneElement | Supplement components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..1 | CodeableConcept | Type of supplement product requested Binding: SupplementTypeCodes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of supplement
quantity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of the nutritional supplement
enteralFormula | S C | 0..1 | BackboneElement | Enteral formula components
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
baseFormulaType | S Σ | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: EnteralFormulaTypeCodes (extensible)
additiveType | S | 0..1 | CodeableConcept | Type of modular component to add to the feeding Binding: EnteralFormulaAdditiveTypeCode (extensible)
caloricDensity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of energy per specified volume that is required
routeofAdministration | S | 0..1 | CodeableConcept | How the formula should enter the patient's gastrointestinal tract Binding: EnteralRouteCodes (extensible)
administration | S | 0..* | BackboneElement | Formula feeding instruction as structured data
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
schedule | S | 0..1 | CRDTiming | Scheduled frequency of enteral feeding
quantity | S | 0..1 | SimpleQuantity(4.0.1) | The volume of formula to provide
Slices for rate[x] |  | 0..1 |  | Speed with which the formula is provided per period of time Slice: Unordered, Open by type:$this
rateQuantity |  |  | Quantity(SimpleQuantity) |
rateRatio |  |  | Ratio |
rate[x]:rateRatio | S | 0..1 | Ratio | Speed with which the formula is provided per period of time
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
NutritionOrder.extension:EncounterCategory.​value[x] | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.1
NutritionOrder.extension:ServiceCategory.​value[x] | Base | required | X12 Service Type | 📦2.2.1 | This IG
NutritionOrder.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
NutritionOrder.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
NutritionOrder.foodPreferenceModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.excludeFoodModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​type | Base | extensible | Diet Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​nutrient.modifier | Base | extensible | Nutrient Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​texture.modifier | Base | extensible | Texture Modifier Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.oralDiet.​texture.foodType | Base | extensible | Texture Modified Food Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.supplement.​type | Base | extensible | Supplement Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​baseFormulaType | Base | extensible | Enteral Formula Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​additiveType | Base | extensible | Enteral Formula Additive Type Code | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​routeofAdministration | Base | extensible | Enteral Route Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
crd-ci-q1 | error | NutritionOrder.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists | `extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()`
crd-ci-q2 | error | NutritionOrder.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. | `extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()`
crd-ci-q3 | error | NutritionOrder.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()`
crd-ci-q4 | error | NutritionOrder.extension:Coverage-Information | If 'pa-needed' is 'satisfied', 'noauth', or 'not-covered', then 'Doc-purpose' cannot be 'withpa'. | `extension.where(url = 'pa-needed' and (value = 'satisfied' or value = 'noauth' or value = 'not-covered')) and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa')`
crd-ci-q5 | error | NutritionOrder.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. | `extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()`
crd-ci-q6 | error | NutritionOrder.extension:Coverage-Information | If 'info-needed' is OTH, then reason must be specified | `extension.where(url = 'info-needed' and value = 'OTH').exists() implies extension.where(url = 'reason').exists()`
crd-ci-q7 | error | NutritionOrder.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present | `extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')`
crd-ci-q8 | error | NutritionOrder.extension:Coverage-Information | If doc-purpose is present with a value other than 'conditional', then reason must be present | `extension.where(url = 'doc-purpose' and value != 'conditional').exists() implies extension.where(url = 'reason').exists()`
crd-ci-q9 | error | NutritionOrder.extension:Coverage-Information | If any of 'covered', 'pa-needed', or 'doc-needed' is set to 'indeterminate', then reason must be present to explain the issue that is preventing the payer from making a coverage determination. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'indeterminate').count() >= 1 implies extension.where(url = 'reason').exists()`
dom-2 | error | NutritionOrder | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | NutritionOrder | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | NutritionOrder | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
nor-1 | warning | NutritionOrder | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class | `oralDiet.exists() or supplement.exists() or enteralFormula.exists()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder |  |  | NutritionOrder |
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:Coverage-Information | S | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
extension:EncounterCategory | S | 0..1 | (Complex) | Encounter Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ActEncounterCode (3.0.0) (required)
extension:ServiceCategory | S | 0..1 | (Complex) | Service Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 Service Type (required)
identifier | S | 0..* | Identifier | Identifiers assigned to this order
status | S | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Example General: draft
patient | S | 1..1 | Reference(CRD Patient) | The person who requires the diet, formula or nutritional supplement
encounter | S | 0..1 | Reference(CRD Encounter) | The encounter associated with this nutrition order
dateTime | S | 1..1 | dateTime | Date and time the nutrition order was requested
orderer | S | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who ordered the diet, formula or nutritional supplement
allergyIntolerance | S | 0..* | Reference(US Core AllergyIntolerance Profile(7.0.0)) | List of the patient's food and nutrition-related allergies and intolerances
foodPreferenceModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Types of Edible Substances (extensible)
excludeFoodModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should not be given Binding: Types of Edible Substances (extensible)
oralDiet | S | 0..1 | BackboneElement | Oral diet components
type | S | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: Diet Codes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of diet
nutrient | S | 0..* | BackboneElement | Required nutrient modifications
modifier | S | 0..1 | CodeableConcept | Type of nutrient that is being modified Binding: Nutrient Codes (extensible)
texture | S | 0..* | BackboneElement | Required texture modifications
modifier | S | 0..1 | CodeableConcept | Code to indicate how to alter the texture of the foods, e.g. pureed Binding: TextureModifierCodes (extensible)
foodType | S | 0..1 | CodeableConcept | Concepts that are used to identify an entity that is ingested for nutritional purposes Binding: TextureModifiedFoodTypeCodes (extensible)
supplement | S | 0..* | BackboneElement | Supplement components
type | S | 0..1 | CodeableConcept | Type of supplement product requested Binding: SupplementTypeCodes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of supplement
quantity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of the nutritional supplement
enteralFormula | S | 0..1 | BackboneElement | Enteral formula components
baseFormulaType | S | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: EnteralFormulaTypeCodes (extensible)
additiveType | S | 0..1 | CodeableConcept | Type of modular component to add to the feeding Binding: EnteralFormulaAdditiveTypeCode (extensible)
caloricDensity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of energy per specified volume that is required
routeofAdministration | S | 0..1 | CodeableConcept | How the formula should enter the patient's gastrointestinal tract Binding: EnteralRouteCodes (extensible)
administration | S | 0..* | BackboneElement | Formula feeding instruction as structured data
schedule | S | 0..1 | CRDTiming | Scheduled frequency of enteral feeding
quantity | S | 0..1 | SimpleQuantity(4.0.1) | The volume of formula to provide
Slices for rate[x] |  | 0..1 | SimpleQuantity(4.0.1), Ratio | Speed with which the formula is provided per period of time Slice: Unordered, Open by type:$this
rate[x]:rateRatio | S | 0..1 | Ratio | Speed with which the formula is provided per period of time
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
NutritionOrder.extension:EncounterCategory.​value[x] | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.1
NutritionOrder.extension:ServiceCategory.​value[x] | Base | required | X12 Service Type | 📦2.2.1 | This IG
NutritionOrder.foodPreferenceModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.excludeFoodModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​type | Base | extensible | Diet Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​nutrient.modifier | Base | extensible | Nutrient Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​texture.modifier | Base | extensible | Texture Modifier Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.oralDiet.​texture.foodType | Base | extensible | Texture Modified Food Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.supplement.​type | Base | extensible | Supplement Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​baseFormulaType | Base | extensible | Enteral Formula Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​additiveType | Base | extensible | Enteral Formula Additive Type Code | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​routeofAdministration | Base | extensible | Enteral Route Codes | 📦4.0.1 | FHIR Std.

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
NutritionOrder | C | 0..* | NutritionOrder | Diet, formula or nutritional supplement request Constraints: nor-1
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url, value:value
extension:Coverage-Information | S C | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information Constraints: crd-ci-q1, crd-ci-q2, crd-ci-q3, crd-ci-q4, crd-ci-q5, crd-ci-q6, crd-ci-q7, crd-ci-q8, crd-ci-q9
extension:EncounterCategory | S | 0..1 | (Complex) | Encounter Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: ActEncounterCode (3.0.0) (required)
extension:ServiceCategory | S | 0..1 | (Complex) | Service Category URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: X12 Service Type (required)
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | Identifiers assigned to this order
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
instantiates |  | 0..* | uri | Instantiates protocol or definition
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): Codes identifying the lifecycle stage of the nutrition order. Example General: draft
intent | ?!Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): Codes indicating the degree of authority/intentionality associated with a nutrition order.
patient | S Σ | 1..1 | Reference(CRD Patient) | The person who requires the diet, formula or nutritional supplement
encounter | S | 0..1 | Reference(CRD Encounter) | The encounter associated with this nutrition order
dateTime | S Σ | 1..1 | dateTime | Date and time the nutrition order was requested
orderer | S Σ | 1..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Who ordered the diet, formula or nutritional supplement
allergyIntolerance | S | 0..* | Reference(US Core AllergyIntolerance Profile(7.0.0)) | List of the patient's food and nutrition-related allergies and intolerances
foodPreferenceModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should be given Binding: Types of Edible Substances (extensible)
excludeFoodModifier | S | 0..* | CodeableConcept | Order-specific modifier about the type of food that should not be given Binding: Types of Edible Substances (extensible)
oralDiet | S C | 0..1 | BackboneElement | Oral diet components
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
type | S Σ | 0..* | CodeableConcept | Type of oral diet or diet restrictions that describe what can be consumed orally Binding: Diet Codes (extensible)
schedule | S | 0..* | CRDTiming | Scheduled frequency of diet
nutrient | S | 0..* | BackboneElement | Required nutrient modifications
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
modifier | S | 0..1 | CodeableConcept | Type of nutrient that is being modified Binding: Nutrient Codes (extensible)
amount |  | 0..1 | SimpleQuantity(4.0.1) | Quantity of the specified nutrient
texture | S | 0..* | BackboneElement | Required texture modifications
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
modifier | S | 0..1 | CodeableConcept | Code to indicate how to alter the texture of the foods, e.g. pureed Binding: TextureModifierCodes (extensible)
foodType | S | 0..1 | CodeableConcept | Concepts that are used to identify an entity that is ingested for nutritional purposes Binding: TextureModifiedFoodTypeCodes (extensible)
fluidConsistencyType |  | 0..* | CodeableConcept | The required consistency of fluids and liquids provided to the patient Binding: FluidConsistencyTypeCodes (example): Codes used to represent the consistency of fluids and liquids provided to the patient.
instruction | Σ | 0..1 | string | Instructions or additional information about the oral diet
supplement | S C | 0..* | BackboneElement | Supplement components
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
type | S Σ | 0..1 | CodeableConcept | Type of supplement product requested Binding: SupplementTypeCodes (extensible)
productName |  | 0..1 | string | Product or brand name of the nutritional supplement
schedule | S | 0..* | CRDTiming | Scheduled frequency of supplement
quantity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of the nutritional supplement
instruction | Σ | 0..1 | string | Instructions or additional information about the oral supplement
enteralFormula | S C | 0..1 | BackboneElement | Enteral formula components
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
baseFormulaType | S Σ | 0..1 | CodeableConcept | Type of enteral or infant formula Binding: EnteralFormulaTypeCodes (extensible)
baseFormulaProductName |  | 0..1 | string | Product or brand name of the enteral or infant formula
additiveType | S | 0..1 | CodeableConcept | Type of modular component to add to the feeding Binding: EnteralFormulaAdditiveTypeCode (extensible)
additiveProductName |  | 0..1 | string | Product or brand name of the modular additive
caloricDensity | S | 0..1 | SimpleQuantity(4.0.1) | Amount of energy per specified volume that is required
routeofAdministration | S | 0..1 | CodeableConcept | How the formula should enter the patient's gastrointestinal tract Binding: EnteralRouteCodes (extensible)
administration | S | 0..* | BackboneElement | Formula feeding instruction as structured data
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
schedule | S | 0..1 | CRDTiming | Scheduled frequency of enteral feeding
quantity | S | 0..1 | SimpleQuantity(4.0.1) | The volume of formula to provide
Slices for rate[x] |  | 0..1 |  | Speed with which the formula is provided per period of time Slice: Unordered, Open by type:$this
rateQuantity |  |  | Quantity(SimpleQuantity) |
rateRatio |  |  | Ratio |
rate[x]:rateRatio | S | 0..1 | Ratio | Speed with which the formula is provided per period of time
maxVolumeToDeliver |  | 0..1 | SimpleQuantity(4.0.1) | Upper limit on formula volume per unit of time
administrationInstruction | Σ | 0..1 | string | Formula feeding instructions expressed as text
note |  | 0..* | Annotation | Comments
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
NutritionOrder.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
NutritionOrder.extension:EncounterCategory.​value[x] | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.1
NutritionOrder.extension:ServiceCategory.​value[x] | Base | required | X12 Service Type | 📦2.2.1 | This IG
NutritionOrder.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
NutritionOrder.intent | Base | required | RequestIntent | 📍4.0.1 | FHIR Std.
NutritionOrder.foodPreferenceModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.excludeFoodModifier | Base | extensible | Types of Edible Substances | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​type | Base | extensible | Diet Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​nutrient.modifier | Base | extensible | Nutrient Codes | 📦2.2.1 | This IG
NutritionOrder.oralDiet.​texture.modifier | Base | extensible | Texture Modifier Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.oralDiet.​texture.foodType | Base | extensible | Texture Modified Food Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.oralDiet.​fluidConsistencyType | Base | example | Fluid Consistency Type Codes | 📍4.0.1 | FHIR Std.
NutritionOrder.supplement.​type | Base | extensible | Supplement Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​baseFormulaType | Base | extensible | Enteral Formula Type Codes | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​additiveType | Base | extensible | Enteral Formula Additive Type Code | 📦4.0.1 | FHIR Std.
NutritionOrder.enteralFormula.​routeofAdministration | Base | extensible | Enteral Route Codes | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
crd-ci-q1 | error | NutritionOrder.extension:Coverage-Information | Questionnaire is only allowed when doc-needed exists | `extension.where(url='questionnaire').exists() implies extension.where(url = 'doc-needed').exists()`
crd-ci-q2 | error | NutritionOrder.extension:Coverage-Information | If covered is set to 'not-covered', then 'pa-needed' must not exist. | `extension.where(url = 'covered' and value = 'not-covered').exists() implies extension.where(url = 'pa-needed').exists().not()`
crd-ci-q3 | error | NutritionOrder.extension:Coverage-Information | 'info-needed' SHALL exist if and only if at least one of 'covered', 'pa-needed', or 'doc-needed' is set to 'conditional'. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'conditional').count() >= 1 implies extension.where(url = 'info-needed').exists()`
crd-ci-q4 | error | NutritionOrder.extension:Coverage-Information | If 'pa-needed' is 'satisfied', 'noauth', or 'not-covered', then 'Doc-purpose' cannot be 'withpa'. | `extension.where(url = 'pa-needed' and (value = 'satisfied' or value = 'noauth' or value = 'not-covered')) and extension.where(url = 'doc-purpose').exists() implies extension.where(url = 'doc-purpose').all(value != 'withpa')`
crd-ci-q5 | error | NutritionOrder.extension:Coverage-Information | 'satisfied-pa-id' must exist if and only if 'pa-needed' is set to 'satisfied'. | `extension.where(url = 'pa-needed' and value = 'satisfied').exists() = extension.where(url = 'satisfied-pa-id').exists()`
crd-ci-q6 | error | NutritionOrder.extension:Coverage-Information | If 'info-needed' is OTH, then reason must be specified | `extension.where(url = 'info-needed' and value = 'OTH').exists() implies extension.where(url = 'reason').exists()`
crd-ci-q7 | error | NutritionOrder.extension:Coverage-Information | If reason.coding is present and is not from the extensible value set, then reason.text must be present | `extension.where(url = 'reason').empty() or extension.where(url = 'reason').value.text.exists() or extension.where(url = 'reason').value.memberOf('http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageAssertionReasons')`
crd-ci-q8 | error | NutritionOrder.extension:Coverage-Information | If doc-purpose is present with a value other than 'conditional', then reason must be present | `extension.where(url = 'doc-purpose' and value != 'conditional').exists() implies extension.where(url = 'reason').exists()`
crd-ci-q9 | error | NutritionOrder.extension:Coverage-Information | If any of 'covered', 'pa-needed', or 'doc-needed' is set to 'indeterminate', then reason must be present to explain the issue that is preventing the payer from making a coverage determination. | `extension.where((url = 'covered' or url = 'pa-needed' or url = 'doc-needed') and value = 'indeterminate').count() >= 1 implies extension.where(url = 'reason').exists()`
dom-2 | error | NutritionOrder | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | NutritionOrder | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | NutritionOrder | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | NutritionOrder | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
nor-1 | warning | NutritionOrder | Nutrition Order SHALL contain either Oral Diet , Supplement, or Enteral Formula class | `oralDiet.exists() or supplement.exists() or enteralFormula.exists()`

Summary

Mandatory: 1 element
Must-Support: 34 elements

Structures

This structure refers to these other structures:

- CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
- CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)
- CRD Practitioner (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner)
- HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)
- US Core AllergyIntolerance Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance|7.0.0)
- CRD Timing Data Type (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-timing)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-request-category

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of NutritionOrder.enteralFormula.administration.rate[x]

Maturity: 1

Other representations of profile: CSV, Excel, Schematron