Dental Data Exchange
2.0.0-ballot - CI Build

Dental Data Exchange, published by Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/dental-data-exchange/ and changes regularly. See the Directory of published versions

## Resource Profile: Dental Procedure

Official URL: http://hl7.org/fhir/us/dental-data-exchange/StructureDefinition/dental-procedure | Version: 2.0.0-ballot
Draft as of 2024-08-15 | Computable Name: DentalProcedure

This profile specifies a Dental specialization of the US Core Procedure profile

Usage:

- Examples for this Resource Profile: Procedure/RestorationTooth10-example-dental-procedure, Procedure/RestorationTooth11-example-dental-procedure, Procedure/RestorationTooth12-example-dental-procedure, Procedure/RestorationTooth13-example-dental-procedure... Show 12 more, Procedure/RestorationTooth14-example-dental-procedure, Procedure/RestorationTooth15-example-dental-procedure, Procedure/RestorationTooth2-example-dental-procedure, Procedure/RestorationTooth3-example-dental-procedure, Procedure/RestorationTooth4-example-dental-procedure, Procedure/RestorationTooth5-example-dental-procedure, Procedure/RestorationTooth6-example-dental-procedure, Procedure/RestorationTooth7-example-dental-procedure, Procedure/RestorationTooth8-example-dental-procedure, Procedure/RestorationTooth9-example-dental-procedure, Procedure/RootCanalTooth8-example-dental-procedure and Procedure/buccal-restoration-example-dental-procedure

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Procedure | C | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress'
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:BodyStructure |  | 0..1 | Reference(BodyStructure) | BodyStructure for more complex anatomical locations URL: http://hl7.org/fhir/StructureDefinition/bodySite ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!S Σ C | 1..1 | code | (USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) ele-1: All FHIR elements must have a @value or children
category | Σ | 0..1 | CodeableConcept | Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. ele-1: All FHIR elements must have a @value or children Fixed Value: As shown
id |  | 0..0 | string | Unique id for inter-element referencing
extension |  | 0..0 | Extension | Additional content defined by implementations
coding |  | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..0 | string | Unique id for inter-element referencing
extension |  | 0..0 | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category
version |  | 0..0 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: dental
display |  | 1..1 | string | Representation defined by the system Fixed Value: Dental
userSelected |  | 0..0 | boolean | If this coding was chosen directly by the user
text |  | 0..0 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | (USCDI) Identification of the procedure Binding: Dental Procedure Codes Value Set (extensible) ele-1: All FHIR elements must have a @value or children
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | (USCDI) Who the procedure was performed on ele-1: All FHIR elements must have a @value or children
performed[x] | S Σ C | 0..1 |  | (USCDI) When the procedure was performed ele-1: All FHIR elements must have a @value or children
performedDateTime |  |  | dateTime |
bodySite | S Σ | 0..* | CodeableConcept | Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. ele-1: All FHIR elements must have a @value or children
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Procedure.status | required | EventStatus `http://hl7.org/fhir/ValueSet/event-status` from the FHIR Standard
Procedure.category | example | Fixed Value: dental("Dental") `http://hl7.org/fhir/ValueSet/procedure-category` from the FHIR Standard
Procedure.code | extensible | DentalProcedureCodes `http://hl7.org/fhir/us/dental-data-exchange/ValueSet/dental-procedure-codes-vs` from this IG
Procedure.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Procedure | 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 | Procedure | 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 | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Procedure | 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() |
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

This structure is derived from USCoreProcedureProfile

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Procedure |  | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:BodyStructure |  | 0..1 | Reference(BodyStructure) | BodyStructure for more complex anatomical locations URL: http://hl7.org/fhir/StructureDefinition/bodySite
category |  | 0..1 | CodeableConcept | Classification of the procedure Fixed Value: As shown
coding |  | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: dental
display |  | 1..1 | string | Representation defined by the system Fixed Value: Dental
code |  | 1..1 | CodeableConcept | (USCDI) Identification of the procedure Binding: Dental Procedure Codes Value Set (extensible)
bodySite | S | 0..* | CodeableConcept | Target body sites
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Procedure.code | extensible | DentalProcedureCodes `http://hl7.org/fhir/us/dental-data-exchange/ValueSet/dental-procedure-codes-vs` from this IG

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'
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
extension:BodyStructure |  | 0..1 | Reference(BodyStructure) | BodyStructure for more complex anatomical locations URL: http://hl7.org/fhir/StructureDefinition/bodySite
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External Identifiers for this procedure
instantiatesCanonical | Σ | 0..* | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(US Core CarePlan Profile | US Core ServiceRequest Profile) | (USCDI) A request for this procedure
partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event
status | ?!S Σ C | 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 | 0..1 | CodeableConcept | Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Fixed Value: As shown
id |  | 0..0 | string | Unique id for inter-element referencing
extension |  | 0..0 | Extension | Additional content defined by implementations
coding |  | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..0 | string | Unique id for inter-element referencing
extension |  | 0..0 | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category
version |  | 0..0 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: dental
display |  | 1..1 | string | Representation defined by the system Fixed Value: Dental
userSelected |  | 0..0 | boolean | If this coding was chosen directly by the user
text |  | 0..0 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | (USCDI) Identification of the procedure Binding: Dental Procedure Codes Value Set (extensible)
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | (USCDI) Who the procedure was performed on
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
performed[x] | S Σ C | 0..1 |  | (USCDI) When the procedure was performed
performedDateTime |  |  | dateTime S |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
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
performer | Σ | 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(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization) | Organization the device or practitioner was acting for
location | Σ | 0..1 | Reference(Location) | Where the procedure happened
reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed
bodySite | S Σ | 0..* | CodeableConcept | Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
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
focalDevice |  | 0..* | BackboneElement | Manipulated, implanted, or removed device
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
usedReference |  | 0..* | Reference(Device | Medication | Substance) | Items used during procedure
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 `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
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 | example | Fixed Value: dental("Dental") `http://hl7.org/fhir/ValueSet/procedure-category` from the FHIR Standard
Procedure.code | extensible | DentalProcedureCodes `http://hl7.org/fhir/us/dental-data-exchange/ValueSet/dental-procedure-codes-vs` from this IG
Procedure.performer.function | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` from the FHIR Standard
Procedure.reasonCode | example | ProcedureReasonCodes `http://hl7.org/fhir/ValueSet/procedure-reason` from the FHIR Standard
Procedure.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard
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.usedCode | example | FHIRDeviceTypes `http://hl7.org/fhir/ValueSet/device-kind` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Procedure | 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 | Procedure | 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 | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Procedure | 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() |
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

This structure is derived from USCoreProcedureProfile

Summary

Must-Support: 1 element
Fixed: 1 element

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/bodySite

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Procedure | C | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management us-core-7: Performed SHALL be present if the status is 'completed' or 'in-progress'
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:BodyStructure |  | 0..1 | Reference(BodyStructure) | BodyStructure for more complex anatomical locations URL: http://hl7.org/fhir/StructureDefinition/bodySite ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status | ?!S Σ C | 1..1 | code | (USCDI) preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required) ele-1: All FHIR elements must have a @value or children
category | Σ | 0..1 | CodeableConcept | Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. ele-1: All FHIR elements must have a @value or children Fixed Value: As shown
id |  | 0..0 | string | Unique id for inter-element referencing
extension |  | 0..0 | Extension | Additional content defined by implementations
coding |  | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..0 | string | Unique id for inter-element referencing
extension |  | 0..0 | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category
version |  | 0..0 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: dental
display |  | 1..1 | string | Representation defined by the system Fixed Value: Dental
userSelected |  | 0..0 | boolean | If this coding was chosen directly by the user
text |  | 0..0 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | (USCDI) Identification of the procedure Binding: Dental Procedure Codes Value Set (extensible) ele-1: All FHIR elements must have a @value or children
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | (USCDI) Who the procedure was performed on ele-1: All FHIR elements must have a @value or children
performed[x] | S Σ C | 0..1 |  | (USCDI) When the procedure was performed ele-1: All FHIR elements must have a @value or children
performedDateTime |  |  | dateTime |
bodySite | S Σ | 0..* | CodeableConcept | Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. ele-1: All FHIR elements must have a @value or children
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet / Code | URI
Procedure.status | required | EventStatus `http://hl7.org/fhir/ValueSet/event-status` from the FHIR Standard
Procedure.category | example | Fixed Value: dental("Dental") `http://hl7.org/fhir/ValueSet/procedure-category` from the FHIR Standard
Procedure.code | extensible | DentalProcedureCodes `http://hl7.org/fhir/us/dental-data-exchange/ValueSet/dental-procedure-codes-vs` from this IG
Procedure.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Procedure | 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 | Procedure | 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 | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Procedure | 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() |
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

Differential View

This structure is derived from USCoreProcedureProfile

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Procedure |  | 0..* | USCoreProcedureProfile | An action that is being or was performed on a patient
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:BodyStructure |  | 0..1 | Reference(BodyStructure) | BodyStructure for more complex anatomical locations URL: http://hl7.org/fhir/StructureDefinition/bodySite
category |  | 0..1 | CodeableConcept | Classification of the procedure Fixed Value: As shown
coding |  | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: dental
display |  | 1..1 | string | Representation defined by the system Fixed Value: Dental
code |  | 1..1 | CodeableConcept | (USCDI) Identification of the procedure Binding: Dental Procedure Codes Value Set (extensible)
bodySite | S | 0..* | CodeableConcept | Target body sites
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
Procedure.code | extensible | DentalProcedureCodes `http://hl7.org/fhir/us/dental-data-exchange/ValueSet/dental-procedure-codes-vs` from this IG

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'
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
extension:BodyStructure |  | 0..1 | Reference(BodyStructure) | BodyStructure for more complex anatomical locations URL: http://hl7.org/fhir/StructureDefinition/bodySite
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External Identifiers for this procedure
instantiatesCanonical | Σ | 0..* | canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(US Core CarePlan Profile | US Core ServiceRequest Profile) | (USCDI) A request for this procedure
partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event
status | ?!S Σ C | 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 | 0..1 | CodeableConcept | Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Fixed Value: As shown
id |  | 0..0 | string | Unique id for inter-element referencing
extension |  | 0..0 | Extension | Additional content defined by implementations
coding |  | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex)
id |  | 0..0 | string | Unique id for inter-element referencing
extension |  | 0..0 | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/dental-data-exchange/CodeSystem/dental-category
version |  | 0..0 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: dental
display |  | 1..1 | string | Representation defined by the system Fixed Value: Dental
userSelected |  | 0..0 | boolean | If this coding was chosen directly by the user
text |  | 0..0 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | (USCDI) Identification of the procedure Binding: Dental Procedure Codes Value Set (extensible)
subject | S Σ | 1..1 | Reference(US Core Patient Profile) | (USCDI) Who the procedure was performed on
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
performed[x] | S Σ C | 0..1 |  | (USCDI) When the procedure was performed
performedDateTime |  |  | dateTime S |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
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
performer | Σ | 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(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | The reference to the practitioner
onBehalfOf |  | 0..1 | Reference(Organization) | Organization the device or practitioner was acting for
location | Σ | 0..1 | Reference(Location) | Where the procedure happened
reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference | Σ | 0..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference) | The justification that the procedure was performed
bodySite | S Σ | 0..* | CodeableConcept | Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
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
focalDevice |  | 0..* | BackboneElement | Manipulated, implanted, or removed device
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
usedReference |  | 0..* | Reference(Device | Medication | Substance) | Items used during procedure
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 `http://hl7.org/fhir/ValueSet/languages` from the FHIR Standard
Additional Bindings | Purpose
AllLanguages | Max Binding
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 | example | Fixed Value: dental("Dental") `http://hl7.org/fhir/ValueSet/procedure-category` from the FHIR Standard
Procedure.code | extensible | DentalProcedureCodes `http://hl7.org/fhir/us/dental-data-exchange/ValueSet/dental-procedure-codes-vs` from this IG
Procedure.performer.function | example | ProcedurePerformerRoleCodes `http://hl7.org/fhir/ValueSet/performer-role` from the FHIR Standard
Procedure.reasonCode | example | ProcedureReasonCodes `http://hl7.org/fhir/ValueSet/procedure-reason` from the FHIR Standard
Procedure.bodySite | example | SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` from the FHIR Standard
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.usedCode | example | FHIRDeviceTypes `http://hl7.org/fhir/ValueSet/device-kind` from the FHIR Standard

#### Constraints

Id | Grade | Path(s) | Details | Requirements
dom-2 | error | Procedure | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() |
dom-3 | error | Procedure | 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 | Procedure | 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 | Procedure | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() |
dom-6 | best practice | Procedure | 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() |
us-core-7 | error | Procedure | Performed SHALL be present if the status is 'completed' or 'in-progress' : (status='completed' or status='in-progress') implies performed.exists() |

This structure is derived from USCoreProcedureProfile

Summary

Must-Support: 1 element
Fixed: 1 element

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/bodySite

Other representations of profile: CSV, Excel, Schematron