minimal Common Oncology Data Elements (mCODE) Implementation Guide
4.0.0-ballot - STU4 Ballot United States of America flag

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

Resource Profile: PrimaryCancerCondition - Detailed Descriptions

Active as of 2024-10-30 Maturity Level: 4

Definitions for the mcode-primary-cancer-condition resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Condition
2. Condition.extension
Must Supporttrue
4. Condition.extension:histologyMorphologyBehavior
Slice NamehistologyMorphologyBehavior
Control0..1
TypeExtension(Histology-Morphology-Behavior Extension) (Extension Type: CodeableConcept)
Must Supporttrue
6. Condition.code
BindingUnless not suitable, these codes SHALL be taken from Primary Cancer Disorder Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-primary-cancer-disorder-vs)
8. Condition.bodySite
BindingUnless not suitable, these codes SHALL be taken from Cancer Body Location Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
Must Supporttrue
10. Condition.bodySite.extension:locationQualifier
Slice NamelocationQualifier
Definition

General location qualifier (excluding laterality) for this bodySite

ShortGeneral location qualifier (excluding laterality) for this bodySite
Control0..*
TypeExtension(Body Location Qualifier Extension) (Extension Type: CodeableConcept)
Must Supporttrue
12. Condition.bodySite.extension:lateralityQualifier
Slice NamelateralityQualifier
Definition

Laterality qualifier for this bodySite

ShortLaterality qualifier for this bodySite
Control0..1
TypeExtension(Laterality Qualifier Extension) (Extension Type: CodeableConcept)
Must Supporttrue
14. Condition.stage
Must Supporttrue
16. Condition.stage.summary
Definition

Most recent overall cancer stage, such as stage group IIA in TNM staging. More detailed staging information (such as the individual T, N, and M categories) SHOULD be captured in a separate Observation resource, referenced by stage.assessment, conforming to CancerStage profile.

ShortStage at time of last staging.
18. Condition.stage.assessment
TypeReference(Cancer Stage Profile)
Must Supporttrue
20. Condition.stage.type
Definition

The type of stage reported in stage.summary, or the staging method used to arrive at the stage.summary value.

ShortThe type of stage Staging system or method used.
BindingUnless not suitable, these codes SHALL be taken from Cancer Staging Method Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs)
22. Condition.evidence
24. Condition.evidence.code
BindingThe codes SHALL be taken from Cancer Disease Status Evidence Type Value Set
(required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disease-status-evidence-type-vs)

Guidance on how to interpret the contents of this table can be found here

0. Condition
Definition

-


A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

ShortDetailed information about conditions, problems or diagnoses
Comments

-

Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantscon-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item (clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty())
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists())
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item (clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty())
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists())
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty())
2. Condition.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Condition.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Condition.extension:assertedDate
    Slice NameassertedDate
    Definition

    The date on which the existence of the Condition was first asserted or acknowledged.

    Short(USCDI) Date the condition was first asserted
    Comments

    The assertedDate is in the context of the recording practitioner and might not be the same as the recordedDate.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Condition Asserted Date) (Extension Type: dateTime)
    Is Modifierfalse
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Condition.extension:histologyMorphologyBehavior
    Slice NamehistologyMorphologyBehavior
    Definition

    An extension describing the morphologic and behavioral characteristics of the cancer.

    ShortHistology-Morphology-Behavior Extension
    Control0..1
    TypeExtension(Histology-Morphology-Behavior Extension) (Extension Type: CodeableConcept)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Condition.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Condition.clinicalStatus
    Definition

    The clinical status of the condition.

    Short(USCDI) active | recurrence | relapse | inactive | remission | resolvedactive | recurrence | relapse | inactive | remission | resolved
    Comments

    The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

    Control0..1
    This element is affected by the following invariants: con-3, con-4, con-5
    BindingThe codes SHALL be taken from ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
    (required to http://hl7.org/fhir/ValueSet/condition-clinical)
    TypeCodeableConcept
    Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Condition.verificationStatus
    Definition

    The verification status to support the clinical status of the condition.

    Short(USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-errorunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
    Comments

    verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

    Control0..1
    This element is affected by the following invariants: con-3, con-5
    BindingThe codes SHALL be taken from ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/condition-ver-status)
    TypeCodeableConcept
    Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Condition.category
    Definition

    A category assigned to the condition.

    Short(USCDI) category codesproblem-list-item | encounter-diagnosis
    Comments

    The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

    Control10..*
    BindingUnless not suitable, these codes SHALL be taken from ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-category
    (extensible to http://hl7.org/fhir/ValueSet/condition-category)

    A category assigned to the condition.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Condition.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ $this
    • 18. Condition.category:us-core
      Slice Nameus-core
      Definition

      A category assigned to the condition.

      Short(USCDI) problem-list-item | health-concernproblem-list-item | encounter-diagnosis
      Comments

      The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

      Control10..*
      BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from US Core Problem or Health Concernhttp://hl7.org/fhir/ValueSet/condition-category
      (required to http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern)

      Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


      A category assigned to the condition.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      20. Condition.category:screening-assessment
      Slice Namescreening-assessment
      Definition

      Categories that a provider may use in their workflow to classify that this Condition is related to a USCDI Health Status/Assessments Data Class.


      A category assigned to the condition.

      Short(USCDI) USCDI Health Status/Assessments Data Classproblem-list-item | encounter-diagnosis
      Comments

      The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

      Control0..*
      BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from US Core Screening Assessment Condition Categoryhttp://hl7.org/fhir/ValueSet/condition-category
      (required to http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category)

      Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


      A category assigned to the condition.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Requirements

      Used for filtering condition

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Condition.code
      Definition

      Identification of the condition, problem or diagnosis.

      Short(USCDI) Identification of the condition, problem or diagnosisIdentification of the condition, problem or diagnosis
      Control10..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see Primary Cancer Disorder Value Sethttp://hl7.org/fhir/ValueSet/condition-code
      (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-primary-cancer-disorder-vs)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      0..1 to account for primarily narrative only resources.

      Alternate Namestype
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Condition.bodySite
      Definition

      The anatomical location where this condition manifests itself.

      ShortAnatomical location, if relevant
      Comments

      Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

      Control0..*
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see Cancer Body Location Value Sethttp://hl7.org/fhir/ValueSet/body-site
      (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Condition.bodySite.extension:locationQualifier
      Slice NamelocationQualifier
      Definition

      General location qualifier (excluding laterality) for this bodySite

      ShortGeneral location qualifier (excluding laterality) for this bodySite
      Control0..*
      TypeExtension(Body Location Qualifier Extension) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      28. Condition.bodySite.extension:lateralityQualifier
      Slice NamelateralityQualifier
      Definition

      Laterality qualifier for this bodySite

      ShortLaterality qualifier for this bodySite
      Control0..1
      TypeExtension(Laterality Qualifier Extension) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      30. Condition.subject
      Definition

      Indicates the patient or group who the condition record is associated with.

      Short(USCDI) Who has the condition?Who has the condition?
      Control1..1
      TypeReference(US Core Patient Profile, Patient, Group)
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Group is typically used for veterinary or public health use cases.

      Alternate Namespatient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. Condition.onset[x]
      Definition

      Estimated or actual date or date-time the condition began, in the opinion of the clinician.

      Short(USCDI) Estimated or actual date, date-time, or ageEstimated or actual date, date-time, or age
      Comments

      Age is generally used when the patient reports an age at which the Condition began to occur.

      Control0..1
      TypeChoice of: dateTime, Age, Period, Range, string
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Must Support TypesdateTime
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. Condition.abatement[x]
      Definition

      The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

      Short(USCDI) When in resolution/remissionWhen in resolution/remission
      Comments

      There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

      Control0..1
      This element is affected by the following invariants: con-4
      TypeChoice of: dateTime, Age, Period, Range, string
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Must Support TypesdateTime
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Condition.recordedDate
      Definition

      The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

      Short(USCDI) Date record was first recordedDate record was first recorded
      Control0..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Condition.stage
      Definition

      Clinical stage or grade of a condition. May include formal severity assessments.

      ShortStage/grade, usually assessed formally
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantscon-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      con-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
      40. Condition.stage.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      42. Condition.stage.summary
      Definition

      Most recent overall cancer stage, such as stage group IIA in TNM staging. More detailed staging information (such as the individual T, N, and M categories) SHOULD be captured in a separate Observation resource, referenced by stage.assessment, conforming to CancerStage profile.


      A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

      ShortStage at time of last staging.Simple summary (disease specific)
      Control0..1
      This element is affected by the following invariants: con-1
      BindingFor example codes, see ConditionStagehttp://hl7.org/fhir/ValueSet/condition-stage
      (example to http://hl7.org/fhir/ValueSet/condition-stage)

      Codes describing condition stages (e.g. Cancer stages).

      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. Condition.stage.assessment
      Definition

      Reference to a formal record of the evidence on which the staging assessment is based.

      ShortFormal record of assessment
      Control0..*
      This element is affected by the following invariants: con-1
      TypeReference(Cancer Stage Profile, ClinicalImpression, DiagnosticReport, Observation)
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. Condition.stage.type
      Definition

      The type of stage reported in stage.summary, or the staging method used to arrive at the stage.summary value.


      The kind of staging, such as pathological or clinical staging.

      ShortThe type of stage Staging system or method used.Kind of staging
      Control0..1
      BindingUnless not suitable, these codes SHALL be taken from For example codes, see Cancer Staging Method Value Sethttp://hl7.org/fhir/ValueSet/condition-stage-type
      (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs)
      TypeCodeableConcept
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be found here

      0. Condition
      Definition

      -

      ShortDetailed information about conditions, problems or diagnoses
      Comments

      -

      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantscon-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item (clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty())
      con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists())
      con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty())
      dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      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 (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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Condition.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control0..1
      Typeid
      Is Modifierfalse
      Summarytrue
      4. Condition.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Condition.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Condition.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHOULD be taken from CommonLanguages
      (preferred to http://hl7.org/fhir/ValueSet/languages)

      A human language.

      Additional BindingsPurpose
      AllLanguagesMax Binding
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Condition.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      TypeNarrative
      Is Modifierfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Condition.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

      Control0..*
      TypeResource
      Is Modifierfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Condition.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. Condition.extension:assertedDate
        Slice NameassertedDate
        Definition

        The date on which the existence of the Condition was first asserted or acknowledged.

        Short(USCDI) Date the condition was first asserted
        Comments

        The assertedDate is in the context of the recording practitioner and might not be the same as the recordedDate.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Condition Asserted Date) (Extension Type: dateTime)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. Condition.extension:histologyMorphologyBehavior
        Slice NamehistologyMorphologyBehavior
        Definition

        An extension describing the morphologic and behavioral characteristics of the cancer.

        ShortHistology-Morphology-Behavior Extension
        Control0..1
        TypeExtension(Histology-Morphology-Behavior Extension) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. Condition.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        22. Condition.identifier
        Definition

        Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

        ShortExternal Ids for this condition
        Comments

        This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Summarytrue
        Requirements

        Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Condition.clinicalStatus
        Definition

        The clinical status of the condition.

        Short(USCDI) active | recurrence | relapse | inactive | remission | resolved
        Comments

        The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

        Control0..1
        This element is affected by the following invariants: con-3, con-4, con-5
        BindingThe codes SHALL be taken from ConditionClinicalStatusCodes
        (required to http://hl7.org/fhir/ValueSet/condition-clinical)
        TypeCodeableConcept
        Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Condition.verificationStatus
        Definition

        The verification status to support the clinical status of the condition.

        Short(USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
        Comments

        verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

        Control0..1
        This element is affected by the following invariants: con-3, con-5
        BindingThe codes SHALL be taken from ConditionVerificationStatus
        (required to http://hl7.org/fhir/ValueSet/condition-ver-status)
        TypeCodeableConcept
        Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Condition.category
        Definition

        A category assigned to the condition.

        Short(USCDI) category codes
        Comments

        The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

        Control1..*
        BindingUnless not suitable, these codes SHALL be taken from ConditionCategoryCodes
        (extensible to http://hl7.org/fhir/ValueSet/condition-category)

        A category assigned to the condition.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on Condition.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • pattern @ $this
        • 30. Condition.category:us-core
          Slice Nameus-core
          Definition

          A category assigned to the condition.

          Short(USCDI) problem-list-item | health-concern
          Comments

          The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

          Control1..*
          BindingThe codes SHALL be taken from US Core Problem or Health Concern
          (required to http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern)

          Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          32. Condition.category:screening-assessment
          Slice Namescreening-assessment
          Definition

          Categories that a provider may use in their workflow to classify that this Condition is related to a USCDI Health Status/Assessments Data Class.

          Short(USCDI) USCDI Health Status/Assessments Data Class
          Comments

          The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

          Control0..*
          BindingThe codes SHALL be taken from US Core Screening Assessment Condition Category
          (required to http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category)

          Note that other codes are permitted, see Required Bindings When Slicing by Value Sets

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Requirements

          Used for filtering condition

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          34. Condition.severity
          Definition

          A subjective assessment of the severity of the condition as evaluated by the clinician.

          ShortSubjective severity of condition
          Comments

          Coding of the severity with a terminology is preferred, where possible.

          Control0..1
          BindingThe codes SHOULD be taken from Condition/DiagnosisSeverity
          (preferred to http://hl7.org/fhir/ValueSet/condition-severity)

          A subjective assessment of the severity of the condition as evaluated by the clinician.

          TypeCodeableConcept
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          36. Condition.code
          Definition

          Identification of the condition, problem or diagnosis.

          Short(USCDI) Identification of the condition, problem or diagnosis
          Control1..1
          BindingUnless not suitable, these codes SHALL be taken from Primary Cancer Disorder Value Set
          (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-primary-cancer-disorder-vs)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          0..1 to account for primarily narrative only resources.

          Alternate Namestype
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          38. Condition.bodySite
          Definition

          The anatomical location where this condition manifests itself.

          ShortAnatomical location, if relevant
          Comments

          Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

          Control0..*
          BindingUnless not suitable, these codes SHALL be taken from Cancer Body Location Value Set
          (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          40. Condition.bodySite.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          42. Condition.bodySite.extension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Condition.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 44. Condition.bodySite.extension:locationQualifier
            Slice NamelocationQualifier
            Definition

            General location qualifier (excluding laterality) for this bodySite

            ShortGeneral location qualifier (excluding laterality) for this bodySite
            Control0..*
            TypeExtension(Body Location Qualifier Extension) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            46. Condition.bodySite.extension:lateralityQualifier
            Slice NamelateralityQualifier
            Definition

            Laterality qualifier for this bodySite

            ShortLaterality qualifier for this bodySite
            Control0..1
            TypeExtension(Laterality Qualifier Extension) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            48. Condition.bodySite.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control0..*
            TypeCoding
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. Condition.bodySite.text
            Definition

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

            ShortPlain text representation of the concept
            Comments

            Very often the text is the same as a displayName of one of the codings.

            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. Condition.subject
            Definition

            Indicates the patient or group who the condition record is associated with.

            Short(USCDI) Who has the condition?
            Control1..1
            TypeReference(US Core Patient Profile)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Group is typically used for veterinary or public health use cases.

            Alternate Namespatient
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. Condition.encounter
            Definition

            The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

            ShortEncounter created as part of
            Comments

            This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

            Control0..1
            TypeReference(Encounter)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            56. Condition.onset[x]
            Definition

            Estimated or actual date or date-time the condition began, in the opinion of the clinician.

            Short(USCDI) Estimated or actual date, date-time, or age
            Comments

            Age is generally used when the patient reports an age at which the Condition began to occur.

            Control0..1
            TypeChoice of: dateTime, Age, Period, Range, string
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Must Support TypesdateTime
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Condition.abatement[x]
            Definition

            The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

            Short(USCDI) When in resolution/remission
            Comments

            There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

            Control0..1
            This element is affected by the following invariants: con-4
            TypeChoice of: dateTime, Age, Period, Range, string
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Must Support TypesdateTime
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Condition.recordedDate
            Definition

            The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

            Short(USCDI) Date record was first recorded
            Control0..1
            TypedateTime
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. Condition.recorder
            Definition

            Individual who recorded the record and takes responsibility for its content.

            ShortWho recorded the condition
            Control0..1
            TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            64. Condition.asserter
            Definition

            Individual who is making the condition statement.

            ShortPerson who asserts this condition
            Control0..1
            TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. Condition.stage
            Definition

            Clinical stage or grade of a condition. May include formal severity assessments.

            ShortStage/grade, usually assessed formally
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantscon-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. Condition.stage.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            70. Condition.stage.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            72. Condition.stage.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            74. Condition.stage.summary
            Definition

            Most recent overall cancer stage, such as stage group IIA in TNM staging. More detailed staging information (such as the individual T, N, and M categories) SHOULD be captured in a separate Observation resource, referenced by stage.assessment, conforming to CancerStage profile.

            ShortStage at time of last staging.
            Control0..1
            This element is affected by the following invariants: con-1
            BindingFor example codes, see ConditionStage
            (example to http://hl7.org/fhir/ValueSet/condition-stage)

            Codes describing condition stages (e.g. Cancer stages).

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. Condition.stage.assessment
            Definition

            Reference to a formal record of the evidence on which the staging assessment is based.

            ShortFormal record of assessment
            Control0..*
            This element is affected by the following invariants: con-1
            TypeReference(Cancer Stage Profile)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. Condition.stage.type
            Definition

            The type of stage reported in stage.summary, or the staging method used to arrive at the stage.summary value.

            ShortThe type of stage Staging system or method used.
            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from Cancer Staging Method Value Set
            (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs)
            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. Condition.evidence
            Definition

            Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

            ShortSupporting evidence
            Comments

            The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Invariantscon-2: evidence SHALL have code or details (code.exists() or detail.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            82. Condition.evidence.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            84. Condition.evidence.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            86. Condition.evidence.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            88. Condition.evidence.code
            Definition

            A manifestation or symptom that led to the recording of this condition.

            ShortManifestation/symptom
            Control0..*
            This element is affected by the following invariants: con-2
            BindingThe codes SHALL be taken from Cancer Disease Status Evidence Type Value Set
            (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disease-status-evidence-type-vs)
            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. Condition.evidence.detail
            Definition

            Links to other relevant information, including pathology reports.

            ShortSupporting information found elsewhere
            Control0..*
            This element is affected by the following invariants: con-2
            TypeReference(Resource)
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. Condition.note
            Definition

            Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

            ShortAdditional information about the Condition
            Control0..*
            TypeAnnotation
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))