minimal Common Oncology Data Elements (mCODE) Implementation Guide, published by HL7 International / Clinical Interoperability Council. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-mCODE-ig/ and changes regularly. See the Directory of published versions

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Resource Profile: Cancer-Related Medication Administration Profile

An episode of medication administration for a patient whose condition is related to a primary or secondary cancer condition. In the context of chemotherapy drugs, the medication administration in most cases is performed and documented by the provider.

Usage:

• Examples for this Resource Profile: MedicationAdministration/cancer-related-medication-admin-cyclophosphamide-brian-l, MedicationAdministration/cancer-related-medication-admin-cyclophosphamide-jenny-m, MedicationAdministration/cancer-related-medication-admin-doxorubicin-jenny-m, MedicationAdministration/cancer-related-medication-admin-idarubicin-brian-l... Show 3 more, MedicationAdministration/cancer-related-medication-admin-paclitaxel-jenny-m, MedicationAdministration/cancer-related-medication-admin-prednisone-brian-l and MedicationAdministration/cancer-related-medication-admin-vincristine-brian-l

Formal Views of Profile Content

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

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

This structure is derived from MedicationAdministration

Name	Flags	Card.	Type	Description & Constraints
MedicationAdministration	C	0..*	MedicationAdministration	Administration of medication to a patient mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
normalizationBasis		0..1	CodeableConcept	Normalization Basis Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-normalization-basis Binding: Normalization Basis Value Set (required)
status	S	1..1	code	in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
statusReason	S	0..*	CodeableConcept	Reason administration not performed Binding: Treatment Termination Reason Value Set (preferred)
medication[x]	S	1..1	CodeableConcept, Reference(Medication)	What was administered Binding: Medication Clinical Drug (extensible)
subject	S	1..1	Reference(Cancer Patient Profile)	Who received medication
effective[x]	S	1..1	dateTime, Period	Start and end time of administration
reasonCode	S	0..*	CodeableConcept	Reason administration performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	S	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	Condition or observation that supports why the medication was administered
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationAdministration.statusReason	preferred	TreatmentTerminationReasonVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-treatment-termination-reason-vs from this IG
MedicationAdministration.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationAdministration.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
mcode-reason-required	warning	MedicationAdministration	One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	MedicationAdministration	When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	MedicationAdministration	Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'

Name	Flags	Card.	Type	Description & Constraints
MedicationAdministration	C	0..*	MedicationAdministration	Administration of medication to a patient mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
normalizationBasis		0..1	CodeableConcept	Normalization Basis Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-normalization-basis Binding: Normalization Basis Value Set (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.
statusReason	S	0..*	CodeableConcept	Reason administration not performed Binding: Treatment Termination Reason Value Set (preferred)
medication[x]	SΣ	1..1		What was administered Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
subject	SΣ	1..1	Reference(Cancer Patient Profile)	Who received medication
effective[x]	SΣ	1..1		Start and end time of administration
effectiveDateTime			dateTime
effectivePeriod			Period
reasonCode	S	0..*	CodeableConcept	Reason administration performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	S	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	Condition or observation that supports why the medication was administered
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationAdministration.status	required	MedicationAdministration Status Codes http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1 from the FHIR Standard
MedicationAdministration.statusReason	preferred	TreatmentTerminationReasonVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-treatment-termination-reason-vs from this IG
MedicationAdministration.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationAdministration.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
mcode-reason-required	warning	MedicationAdministration	One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	MedicationAdministration	When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	MedicationAdministration	Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'

Name	Flags	Card.	Type	Description & Constraints
MedicationAdministration	C	0..*	MedicationAdministration	Administration of medication to a patient mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped
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	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
normalizationBasis		0..1	CodeableConcept	Normalization Basis Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-normalization-basis Binding: Normalization Basis Value Set (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
instantiates	Σ	0..*	uri	Instantiates protocol or definition
partOf	Σ	0..*	Reference(MedicationAdministration | Procedure)	Part of referenced event
status	?!SΣ	1..1	code	in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.
statusReason	S	0..*	CodeableConcept	Reason administration not performed Binding: Treatment Termination Reason Value Set (preferred)
category		0..1	CodeableConcept	Type of medication usage Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.
medication[x]	SΣ	1..1		What was administered Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
subject	SΣ	1..1	Reference(Cancer Patient Profile)	Who received medication
context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter or Episode of Care administered as part of
supportingInformation		0..*	Reference(Resource)	Additional information to support administration
effective[x]	SΣ	1..1		Start and end time of administration
effectiveDateTime			dateTime
effectivePeriod			Period
performer	Σ	0..*	BackboneElement	Who performed the medication administration and what they did
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		0..1	CodeableConcept	Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device)	Who performed the medication administration
reasonCode	S	0..*	CodeableConcept	Reason administration performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	S	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	Condition or observation that supports why the medication was administered
request		0..1	Reference(MedicationRequest)	Request administration performed against
device		0..*	Reference(Device)	Device used to administer
note		0..*	Annotation	Information about the administration
dosage	C	0..1	BackboneElement	Details of how medication was taken mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
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
text		0..1	string	Free text dosage instructions e.g. SIG
site		0..1	CodeableConcept	Body site administered to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route		0..1	CodeableConcept	Path of substance into body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method		0..1	CodeableConcept	How drug was administered Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
dose		0..1	SimpleQuantity	Amount of medication per dose
rate[x]		0..1		Dose quantity per unit of time
rateRatio			Ratio
rateQuantity			Quantity(SimpleQuantity)
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationAdministration.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationAdministration.status	required	MedicationAdministration Status Codes http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1 from the FHIR Standard
MedicationAdministration.statusReason	preferred	TreatmentTerminationReasonVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-treatment-termination-reason-vs from this IG
MedicationAdministration.category	preferred	MedicationAdministration Category Codes http://hl7.org/fhir/ValueSet/medication-admin-category from the FHIR Standard
MedicationAdministration.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationAdministration.performer.function	example	MedicationAdministration Performer Function Codes http://hl7.org/fhir/ValueSet/med-admin-perform-function from the FHIR Standard
MedicationAdministration.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs from this IG
MedicationAdministration.dosage.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationAdministration.dosage.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationAdministration.dosage.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
mcode-reason-required	warning	MedicationAdministration	One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	MedicationAdministration	When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	MedicationAdministration	Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'

This structure is derived from MedicationAdministration

Summary

Must-Support: 9 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient)
• US Core Condition Problems and Health Concerns Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-normalization-basis

Maturity: 3

Differential View

This structure is derived from MedicationAdministration

Name	Flags	Card.	Type	Description & Constraints
MedicationAdministration	C	0..*	MedicationAdministration	Administration of medication to a patient mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
normalizationBasis		0..1	CodeableConcept	Normalization Basis Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-normalization-basis Binding: Normalization Basis Value Set (required)
status	S	1..1	code	in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown
statusReason	S	0..*	CodeableConcept	Reason administration not performed Binding: Treatment Termination Reason Value Set (preferred)
medication[x]	S	1..1	CodeableConcept, Reference(Medication)	What was administered Binding: Medication Clinical Drug (extensible)
subject	S	1..1	Reference(Cancer Patient Profile)	Who received medication
effective[x]	S	1..1	dateTime, Period	Start and end time of administration
reasonCode	S	0..*	CodeableConcept	Reason administration performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	S	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	Condition or observation that supports why the medication was administered
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
MedicationAdministration.statusReason	preferred	TreatmentTerminationReasonVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-treatment-termination-reason-vs from this IG
MedicationAdministration.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationAdministration.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
mcode-reason-required	warning	MedicationAdministration	One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	MedicationAdministration	When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	MedicationAdministration	Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationAdministration	C	0..*	MedicationAdministration	Administration of medication to a patient mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
normalizationBasis		0..1	CodeableConcept	Normalization Basis Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-normalization-basis Binding: Normalization Basis Value Set (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.
statusReason	S	0..*	CodeableConcept	Reason administration not performed Binding: Treatment Termination Reason Value Set (preferred)
medication[x]	SΣ	1..1		What was administered Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
subject	SΣ	1..1	Reference(Cancer Patient Profile)	Who received medication
effective[x]	SΣ	1..1		Start and end time of administration
effectiveDateTime			dateTime
effectivePeriod			Period
reasonCode	S	0..*	CodeableConcept	Reason administration performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	S	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	Condition or observation that supports why the medication was administered
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationAdministration.status	required	MedicationAdministration Status Codes http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1 from the FHIR Standard
MedicationAdministration.statusReason	preferred	TreatmentTerminationReasonVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-treatment-termination-reason-vs from this IG
MedicationAdministration.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationAdministration.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
mcode-reason-required	warning	MedicationAdministration	One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	MedicationAdministration	When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	MedicationAdministration	Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationAdministration	C	0..*	MedicationAdministration	Administration of medication to a patient mcode-reason-required: One of reasonCode or reasonReference SHALL be present termination-reason-code-invariant: When status is stopped, only certain statusReason values are allowed termination-reason-invariant: Certain statusReason values are allowed only when status is stopped
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	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
treatmentIntent	S	0..1	CodeableConcept	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Binding: Procedure Intent Value Set (extensible)
normalizationBasis		0..1	CodeableConcept	Normalization Basis Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-normalization-basis Binding: Normalization Basis Value Set (required)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External identifier
instantiates	Σ	0..*	uri	Instantiates protocol or definition
partOf	Σ	0..*	Reference(MedicationAdministration | Procedure)	Part of referenced event
status	?!SΣ	1..1	code	in-progress | not-done | on-hold | completed | entered-in-error | stopped | unknown Binding: MedicationAdministration Status Codes (required): A set of codes indicating the current status of a MedicationAdministration.
statusReason	S	0..*	CodeableConcept	Reason administration not performed Binding: Treatment Termination Reason Value Set (preferred)
category		0..1	CodeableConcept	Type of medication usage Binding: MedicationAdministration Category Codes (preferred): A coded concept describing where the medication administered is expected to occur.
medication[x]	SΣ	1..1		What was administered Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(Medication)
subject	SΣ	1..1	Reference(Cancer Patient Profile)	Who received medication
context		0..1	Reference(Encounter | EpisodeOfCare)	Encounter or Episode of Care administered as part of
supportingInformation		0..*	Reference(Resource)	Additional information to support administration
effective[x]	SΣ	1..1		Start and end time of administration
effectiveDateTime			dateTime
effectivePeriod			Period
performer	Σ	0..*	BackboneElement	Who performed the medication administration and what they did
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		0..1	CodeableConcept	Type of performance Binding: MedicationAdministration Performer Function Codes (example): A code describing the role an individual played in administering the medication.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Device)	Who performed the medication administration
reasonCode	S	0..*	CodeableConcept	Reason administration performed Binding: Cancer Disorder Value Set (extensible)
reasonReference	S	0..*	Reference(US Core Condition Problems and Health Concerns Profile)	Condition or observation that supports why the medication was administered
request		0..1	Reference(MedicationRequest)	Request administration performed against
device		0..*	Reference(Device)	Device used to administer
note		0..*	Annotation	Information about the administration
dosage	C	0..1	BackboneElement	Details of how medication was taken mad-1: SHALL have at least one of dosage.dose or dosage.rate[x]
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
text		0..1	string	Free text dosage instructions e.g. SIG
site		0..1	CodeableConcept	Body site administered to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route		0..1	CodeableConcept	Path of substance into body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method		0..1	CodeableConcept	How drug was administered Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
dose		0..1	SimpleQuantity	Amount of medication per dose
rate[x]		0..1		Dose quantity per unit of time
rateRatio			Ratio
rateQuantity			Quantity(SimpleQuantity)
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationAdministration.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationAdministration.status	required	MedicationAdministration Status Codes http://hl7.org/fhir/ValueSet/medication-admin-status|4.0.1 from the FHIR Standard
MedicationAdministration.statusReason	preferred	TreatmentTerminationReasonVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-treatment-termination-reason-vs from this IG
MedicationAdministration.category	preferred	MedicationAdministration Category Codes http://hl7.org/fhir/ValueSet/medication-admin-category from the FHIR Standard
MedicationAdministration.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationAdministration.performer.function	example	MedicationAdministration Performer Function Codes http://hl7.org/fhir/ValueSet/med-admin-perform-function from the FHIR Standard
MedicationAdministration.reasonCode	extensible	CancerDisorderVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disorder-vs from this IG
MedicationAdministration.dosage.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationAdministration.dosage.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationAdministration.dosage.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
mcode-reason-required	warning	MedicationAdministration	One of reasonCode or reasonReference SHALL be present : reasonCode.exists() or reasonReference.exists()
termination-reason-code-invariant	error	MedicationAdministration	When status is stopped, only certain statusReason values are allowed : status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	MedicationAdministration	Certain statusReason values are allowed only when status is stopped : statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'

This structure is derived from MedicationAdministration

Summary

Must-Support: 9 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient)
• US Core Condition Problems and Health Concerns Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-normalization-basis

Maturity: 3

Other representations of profile: CSV, Excel, Schematron