Draft PH Core Implementation Guide
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Draft PH Core Implementation Guide, published by UP Manila National TeleHealth Center. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/eabuenaventura/eab-ph-core/ and changes regularly. See the Directory of published versions

Resource Profile: PH Core Procedure - Detailed Descriptions

Draft as of 2026-06-17

Definitions for the ph-core-procedure resource profile

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

0. Procedure
Definition

An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

ShortAn action that is being or was performed on a patient
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-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. Procedure.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. Procedure.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())
6. Procedure.partOf
Definition

A larger event of which this particular procedure is a component or step.

ShortPart of referenced event
Comments

The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

Control0..*
TypeReference(PH Core Procedure, Observation, MedicationAdministration, Procedure, Observation, MedicationAdministration)
Is Modifierfalse
Summarytrue
Alternate Namescontainer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Procedure.status
Definition

A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.

Shortpreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Comments

The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from EventStatushttp://hl7.org/fhir/ValueSet/event-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

A code specifying the state of the procedure.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Obligations
    ObligationsActor
    SHALL:handlePH Core Server
    SHALL:handlePH Core Consumer
    SHALL:able-to-populatePH Core Creator
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    10. Procedure.statusReason
    Definition

    Captures the reason for the current state of the procedure.

    ShortReason for current status
    Comments

    This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

    Control0..1
    BindingFor example codes, see ProcedureNotPerformedReason(SNOMED-CT)http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1
    (example to http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1)

    A code that identifies the reason a procedure was not performed.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Obligations
      ObligationsActor
      SHALL:handlePH Core Server
      SHALL:handlePH Core Consumer
      MAY:able-to-populatePH Core Creator
      Summarytrue
      Alternate NamesSuspended Reason, Cancelled Reason
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Procedure.statusReason.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
      Must Supporttrue
      Obligations
        ObligationsActor
        SHALL:handlePH Core Server
        SHALL:handlePH Core Consumer
        MAY:able-to-populatePH Core Creator
        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()))
        14. Procedure.statusReason.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
        Must Supporttrue
        Obligations
          ObligationsActor
          SHALL:handlePH Core Server
          SHALL:handlePH Core Consumer
          MAY:able-to-populatePH Core Creator
          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()))
          16. Procedure.category
          Definition

          A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").

          ShortClassification of the procedure
          Control0..1
          BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-category|4.0.1
          (example to http://hl7.org/fhir/ValueSet/procedure-category|4.0.1)

          A code that classifies a procedure for searching, sorting and display purposes.

          TypeCodeableConcept
          Is Modifierfalse
          Must Supporttrue
          Obligations
            ObligationsActor
            SHALL:handlePH Core Server
            SHALL:handlePH Core Consumer
            MAY:able-to-populatePH Core Creator
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            18. Procedure.category.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
            Must Supporttrue
            Obligations
              ObligationsActor
              SHALL:handlePH Core Server
              SHALL:handlePH Core Consumer
              MAY:able-to-populatePH Core Creator
              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()))
              20. Procedure.category.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
              Must Supporttrue
              Obligations
                ObligationsActor
                SHALL:handlePH Core Server
                SHALL:handlePH Core Consumer
                MAY:able-to-populatePH Core Creator
                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()))
                22. Procedure.code
                Definition

                The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").

                ShortIdentification of the procedure
                Control0..1
                BindingFor example codes, see ProcedureCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-code|4.0.1
                (example to http://hl7.org/fhir/ValueSet/procedure-code|4.0.1)

                A code to identify a specific procedure .

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Obligations
                  ObligationsActor
                  SHALL:handlePH Core Server
                  SHALL:handlePH Core Consumer
                  MAY:able-to-populatePH Core Creator
                  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. Procedure.code.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
                  Must Supporttrue
                  Obligations
                    ObligationsActor
                    SHALL:handlePH Core Server
                    SHALL:handlePH Core Consumer
                    MAY:able-to-populatePH Core Creator
                    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()))
                    26. Procedure.code.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
                    Must Supporttrue
                    Obligations
                      ObligationsActor
                      SHALL:handlePH Core Server
                      SHALL:handlePH Core Consumer
                      MAY:able-to-populatePH Core Creator
                      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()))
                      28. Procedure.subject
                      Definition

                      The person, animal or group on which the procedure was performed.

                      ShortWho the procedure was performed on
                      Control1..1
                      TypeReference(PH Core Patient, Group, Patient, Group)
                      Is Modifierfalse
                      Must Supporttrue
                      Must Support TypesNo must-support rules about the choice of types/profiles
                      Obligations
                        ObligationsActor
                        SHALL:handlePH Core Server
                        SHALL:handlePH Core Consumer
                        SHALL:able-to-populatePH Core Creator
                        Summarytrue
                        Alternate Namespatient
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        30. Procedure.encounter
                        Definition

                        The Encounter during which this Procedure was created or performed 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.

                        Control0..1
                        TypeReference(PH Core Encounter, Encounter)
                        Is Modifierfalse
                        Must Supporttrue
                        Obligations
                          ObligationsActor
                          SHALL:handlePH Core Server
                          SHALL:handlePH Core Consumer
                          MAY:able-to-populatePH Core Creator
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          32. Procedure.performed[x]
                          Definition

                          Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

                          ShortWhen the procedure was performed
                          Comments

                          Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

                          Control0..1
                          TypeChoice of: dateTime, Period, string, Age, Range
                          [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 TypesNo must-support rules about the choice of types/profiles
                          Obligations
                            ObligationsActor
                            SHALL:handlePH Core Server
                            SHALL:handlePH Core Consumer
                            MAY:able-to-populatePH Core Creator
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            34. Procedure.recorder
                            Definition

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

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

                            Individual who is making the procedure statement.

                            ShortPerson who asserts this procedure
                            Control0..1
                            TypeReference(PH Core Patient, PH Core RelatedPerson, PH Core Practitioner, PH Core PractitionerRole, Patient, RelatedPerson, Practitioner, PractitionerRole)
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            38. Procedure.performer
                            Definition

                            Limited to "real" people rather than equipment.

                            ShortThe people who performed the procedure
                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summarytrue
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            40. Procedure.performer.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. Procedure.performer.function
                            Definition

                            Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.

                            ShortType of performance
                            Control0..1
                            BindingFor example codes, see ProcedurePerformerRoleCodeshttp://hl7.org/fhir/ValueSet/performer-role|4.0.1
                            (example to http://hl7.org/fhir/ValueSet/performer-role|4.0.1)

                            A code that identifies the role of a performer of the procedure.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Obligations
                              ObligationsActor
                              SHALL:handlePH Core Server
                              SHALL:handlePH Core Consumer
                              MAY:able-to-populatePH Core Creator
                              Summarytrue
                              Requirements

                              Allows disambiguation of the types of involvement of different performers.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              44. Procedure.performer.function.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
                              Must Supporttrue
                              Obligations
                                ObligationsActor
                                SHALL:handlePH Core Server
                                SHALL:handlePH Core Consumer
                                MAY:able-to-populatePH Core Creator
                                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()))
                                46. Procedure.performer.function.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
                                Must Supporttrue
                                Obligations
                                  ObligationsActor
                                  SHALL:handlePH Core Server
                                  SHALL:handlePH Core Consumer
                                  MAY:able-to-populatePH Core Creator
                                  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()))
                                  48. Procedure.performer.actor
                                  Definition

                                  The practitioner who was involved in the procedure.

                                  ShortThe reference to the practitioner
                                  Control1..1
                                  TypeReference(PH Core Practitioner, PH Core PractitionerRole, PH Core Organization, PH Core Patient, PH Core RelatedPerson, Device, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  A reference to Device supports use cases, such as pacemakers.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  50. Procedure.performer.onBehalfOf
                                  Definition

                                  The organization the device or practitioner was acting on behalf of.

                                  ShortOrganization the device or practitioner was acting for
                                  Control0..1
                                  TypeReference(PH Core Organization, Organization)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Requirements

                                  Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.

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

                                  The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.

                                  ShortWhere the procedure happened
                                  Control0..1
                                  TypeReference(PH Core Location, Location)
                                  Is Modifierfalse
                                  Summarytrue
                                  Requirements

                                  Ties a procedure to where the records are likely kept.

                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  54. Procedure.reasonCode
                                  Definition

                                  The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text.

                                  ShortCoded reason procedure performed
                                  Comments

                                  Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

                                  Control0..*
                                  BindingFor example codes, see ProcedureReasonCodeshttp://hl7.org/fhir/ValueSet/procedure-reason|4.0.1
                                  (example to http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1)

                                  A code that identifies the reason a procedure is required.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Obligations
                                    ObligationsActor
                                    SHALL:handlePH Core Server
                                    SHALL:handlePH Core Consumer
                                    MAY:able-to-populatePH Core Creator
                                    Summarytrue
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    56. Procedure.reasonCode.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
                                    Must Supporttrue
                                    Obligations
                                      ObligationsActor
                                      SHALL:handlePH Core Server
                                      SHALL:handlePH Core Consumer
                                      MAY:able-to-populatePH Core Creator
                                      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()))
                                      58. Procedure.reasonCode.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
                                      Must Supporttrue
                                      Obligations
                                        ObligationsActor
                                        SHALL:handlePH Core Server
                                        SHALL:handlePH Core Consumer
                                        MAY:able-to-populatePH Core Creator
                                        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()))
                                        60. Procedure.reasonReference
                                        Definition

                                        The justification of why the procedure was performed.

                                        ShortThe justification that the procedure was performed
                                        Comments

                                        It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

                                        Control0..*
                                        TypeReference(Condition, PH Core Observation, PH Core Procedure, DiagnosticReport, DocumentReference, Condition, Observation, Procedure, DiagnosticReport, DocumentReference)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Obligations
                                          ObligationsActor
                                          SHALL:handlePH Core Server
                                          SHALL:handlePH Core Consumer
                                          MAY:able-to-populatePH Core Creator
                                          Summarytrue
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          62. Procedure.bodySite
                                          Definition

                                          Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.

                                          ShortTarget body sites
                                          Comments

                                          If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

                                          Control0..*
                                          BindingFor example codes, see SNOMEDCTBodyStructureshttp://hl7.org/fhir/ValueSet/body-site|4.0.1
                                          (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

                                          Codes describing anatomical locations. May include laterality.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Obligations
                                            ObligationsActor
                                            SHALL:handlePH Core Server
                                            SHALL:handlePH Core Consumer
                                            MAY:able-to-populatePH Core Creator
                                            Summarytrue
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            64. Procedure.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
                                            Must Supporttrue
                                            Obligations
                                              ObligationsActor
                                              SHALL:handlePH Core Server
                                              SHALL:handlePH Core Consumer
                                              MAY:able-to-populatePH Core Creator
                                              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()))
                                              66. Procedure.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
                                              Must Supporttrue
                                              Obligations
                                                ObligationsActor
                                                SHALL:handlePH Core Server
                                                SHALL:handlePH Core Consumer
                                                MAY:able-to-populatePH Core Creator
                                                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()))
                                                68. Procedure.outcome
                                                Definition

                                                The outcome of the procedure - did it resolve the reasons for the procedure being performed?

                                                ShortThe result of procedure
                                                Comments

                                                If outcome contains narrative text only, it can be captured using the CodeableConcept.text.

                                                Control0..1
                                                BindingFor example codes, see ProcedureOutcomeCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-outcome|4.0.1
                                                (example to http://hl7.org/fhir/ValueSet/procedure-outcome|4.0.1)

                                                An outcome of a procedure - whether it was resolved or otherwise.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Obligations
                                                  ObligationsActor
                                                  SHALL:handlePH Core Server
                                                  SHALL:handlePH Core Consumer
                                                  MAY:able-to-populatePH Core Creator
                                                  Summarytrue
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  70. Procedure.outcome.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
                                                  Must Supporttrue
                                                  Obligations
                                                    ObligationsActor
                                                    SHALL:handlePH Core Server
                                                    SHALL:handlePH Core Consumer
                                                    MAY:able-to-populatePH Core Creator
                                                    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()))
                                                    72. Procedure.outcome.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
                                                    Must Supporttrue
                                                    Obligations
                                                      ObligationsActor
                                                      SHALL:handlePH Core Server
                                                      SHALL:handlePH Core Consumer
                                                      MAY:able-to-populatePH Core Creator
                                                      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()))
                                                      74. Procedure.complication
                                                      Definition

                                                      Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.

                                                      ShortComplication following the procedure
                                                      Comments

                                                      If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.

                                                      Control0..*
                                                      BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
                                                      (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                                                      Codes describing complications that resulted from a procedure.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Obligations
                                                        ObligationsActor
                                                        SHALL:handlePH Core Server
                                                        SHALL:handlePH Core Consumer
                                                        MAY:able-to-populatePH Core Creator
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        76. Procedure.complication.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
                                                        Must Supporttrue
                                                        Obligations
                                                          ObligationsActor
                                                          SHALL:handlePH Core Server
                                                          SHALL:handlePH Core Consumer
                                                          MAY:able-to-populatePH Core Creator
                                                          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()))
                                                          78. Procedure.complication.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
                                                          Must Supporttrue
                                                          Obligations
                                                            ObligationsActor
                                                            SHALL:handlePH Core Server
                                                            SHALL:handlePH Core Consumer
                                                            MAY:able-to-populatePH Core Creator
                                                            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()))
                                                            80. Procedure.followUp
                                                            Definition

                                                            If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.

                                                            ShortInstructions for follow up
                                                            Control0..*
                                                            BindingFor example codes, see ProcedureFollowUpCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-followup|4.0.1
                                                            (example to http://hl7.org/fhir/ValueSet/procedure-followup|4.0.1)

                                                            Specific follow up required for a procedure e.g. removal of sutures.

                                                            TypeCodeableConcept
                                                            Is Modifierfalse
                                                            Must Supporttrue
                                                            Obligations
                                                              ObligationsActor
                                                              SHALL:handlePH Core Server
                                                              SHALL:handlePH Core Consumer
                                                              MAY:able-to-populatePH Core Creator
                                                              Summaryfalse
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              82. Procedure.followUp.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
                                                              Must Supporttrue
                                                              Obligations
                                                                ObligationsActor
                                                                SHALL:handlePH Core Server
                                                                SHALL:handlePH Core Consumer
                                                                MAY:able-to-populatePH Core Creator
                                                                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()))
                                                                84. Procedure.followUp.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
                                                                Must Supporttrue
                                                                Obligations
                                                                  ObligationsActor
                                                                  SHALL:handlePH Core Server
                                                                  SHALL:handlePH Core Consumer
                                                                  MAY:able-to-populatePH Core Creator
                                                                  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()))
                                                                  86. Procedure.focalDevice
                                                                  Definition

                                                                  A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

                                                                  ShortManipulated, implanted, or removed device
                                                                  Control0..*
                                                                  TypeBackboneElement
                                                                  Is Modifierfalse
                                                                  Summaryfalse
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  88. Procedure.focalDevice.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())
                                                                  90. Procedure.focalDevice.action
                                                                  Definition

                                                                  The kind of change that happened to the device during the procedure.

                                                                  ShortKind of change to device
                                                                  Control0..1
                                                                  BindingThe codes SHOULD be taken from ProcedureDeviceActionCodeshttp://hl7.org/fhir/ValueSet/device-action|4.0.1
                                                                  (preferred to http://hl7.org/fhir/ValueSet/device-action|4.0.1)

                                                                  A kind of change that happened to the device during the procedure.

                                                                  TypeCodeableConcept
                                                                  Is Modifierfalse
                                                                  Must Supporttrue
                                                                  Obligations
                                                                    ObligationsActor
                                                                    SHALL:handlePH Core Server
                                                                    SHALL:handlePH Core Consumer
                                                                    MAY:able-to-populatePH Core Creator
                                                                    Summaryfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    92. Procedure.focalDevice.action.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
                                                                    Must Supporttrue
                                                                    Obligations
                                                                      ObligationsActor
                                                                      SHALL:handlePH Core Server
                                                                      SHALL:handlePH Core Consumer
                                                                      MAY:able-to-populatePH Core Creator
                                                                      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()))
                                                                      94. Procedure.focalDevice.action.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
                                                                      Must Supporttrue
                                                                      Obligations
                                                                        ObligationsActor
                                                                        SHALL:handlePH Core Server
                                                                        SHALL:handlePH Core Consumer
                                                                        MAY:able-to-populatePH Core Creator
                                                                        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()))
                                                                        96. Procedure.focalDevice.manipulated
                                                                        Definition

                                                                        The device that was manipulated (changed) during the procedure.

                                                                        ShortDevice that was changed
                                                                        Control1..1
                                                                        TypeReference(Device)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        98. Procedure.usedReference
                                                                        Definition

                                                                        Identifies medications, devices and any other substance used as part of the procedure.

                                                                        ShortItems used during procedure
                                                                        Comments

                                                                        For devices actually implanted or removed, use Procedure.device.

                                                                        Control0..*
                                                                        TypeReference(Device, PH Core Medication, Substance, Device, Medication, Substance)
                                                                        Is Modifierfalse
                                                                        Summaryfalse
                                                                        Requirements

                                                                        Used for tracking contamination, etc.

                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        100. Procedure.usedCode
                                                                        Definition

                                                                        Identifies coded items that were used as part of the procedure.

                                                                        ShortCoded items used during the procedure
                                                                        Comments

                                                                        For devices actually implanted or removed, use Procedure.device.

                                                                        Control0..*
                                                                        BindingFor example codes, see FHIRDeviceTypeshttp://hl7.org/fhir/ValueSet/device-kind|4.0.1
                                                                        (example to http://hl7.org/fhir/ValueSet/device-kind|4.0.1)

                                                                        Codes describing items used during a procedure.

                                                                        TypeCodeableConcept
                                                                        Is Modifierfalse
                                                                        Must Supporttrue
                                                                        Obligations
                                                                          ObligationsActor
                                                                          SHALL:handlePH Core Server
                                                                          SHALL:handlePH Core Consumer
                                                                          MAY:able-to-populatePH Core Creator
                                                                          Summaryfalse
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          102. Procedure.usedCode.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
                                                                          Must Supporttrue
                                                                          Obligations
                                                                            ObligationsActor
                                                                            SHALL:handlePH Core Server
                                                                            SHALL:handlePH Core Consumer
                                                                            MAY:able-to-populatePH Core Creator
                                                                            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()))
                                                                            104. Procedure.usedCode.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
                                                                            Must Supporttrue
                                                                            Obligations
                                                                              ObligationsActor
                                                                              SHALL:handlePH Core Server
                                                                              SHALL:handlePH Core Consumer
                                                                              MAY:able-to-populatePH Core Creator
                                                                              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()))

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

                                                                              0. Procedure
                                                                              2. Procedure.partOf
                                                                              TypeReference(PH Core Procedure, Observation, MedicationAdministration)
                                                                              4. Procedure.status
                                                                              Must Supporttrue
                                                                              Obligations
                                                                                ObligationsActor
                                                                                SHALL:handlePH Core Server
                                                                                SHALL:handlePH Core Consumer
                                                                                SHALL:able-to-populatePH Core Creator
                                                                                6. Procedure.statusReason
                                                                                Must Supporttrue
                                                                                Obligations
                                                                                  ObligationsActor
                                                                                  SHALL:handlePH Core Server
                                                                                  SHALL:handlePH Core Consumer
                                                                                  MAY:able-to-populatePH Core Creator
                                                                                  8. Procedure.statusReason.coding
                                                                                  Must Supporttrue
                                                                                  Obligations
                                                                                    ObligationsActor
                                                                                    SHALL:handlePH Core Server
                                                                                    SHALL:handlePH Core Consumer
                                                                                    MAY:able-to-populatePH Core Creator
                                                                                    10. Procedure.statusReason.text
                                                                                    Must Supporttrue
                                                                                    Obligations
                                                                                      ObligationsActor
                                                                                      SHALL:handlePH Core Server
                                                                                      SHALL:handlePH Core Consumer
                                                                                      MAY:able-to-populatePH Core Creator
                                                                                      12. Procedure.category
                                                                                      Must Supporttrue
                                                                                      Obligations
                                                                                        ObligationsActor
                                                                                        SHALL:handlePH Core Server
                                                                                        SHALL:handlePH Core Consumer
                                                                                        MAY:able-to-populatePH Core Creator
                                                                                        14. Procedure.category.coding
                                                                                        Must Supporttrue
                                                                                        Obligations
                                                                                          ObligationsActor
                                                                                          SHALL:handlePH Core Server
                                                                                          SHALL:handlePH Core Consumer
                                                                                          MAY:able-to-populatePH Core Creator
                                                                                          16. Procedure.category.text
                                                                                          Must Supporttrue
                                                                                          Obligations
                                                                                            ObligationsActor
                                                                                            SHALL:handlePH Core Server
                                                                                            SHALL:handlePH Core Consumer
                                                                                            MAY:able-to-populatePH Core Creator
                                                                                            18. Procedure.code
                                                                                            Must Supporttrue
                                                                                            Obligations
                                                                                              ObligationsActor
                                                                                              SHALL:handlePH Core Server
                                                                                              SHALL:handlePH Core Consumer
                                                                                              MAY:able-to-populatePH Core Creator
                                                                                              20. Procedure.code.coding
                                                                                              Must Supporttrue
                                                                                              Obligations
                                                                                                ObligationsActor
                                                                                                SHALL:handlePH Core Server
                                                                                                SHALL:handlePH Core Consumer
                                                                                                MAY:able-to-populatePH Core Creator
                                                                                                22. Procedure.code.text
                                                                                                Must Supporttrue
                                                                                                Obligations
                                                                                                  ObligationsActor
                                                                                                  SHALL:handlePH Core Server
                                                                                                  SHALL:handlePH Core Consumer
                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                  24. Procedure.subject
                                                                                                  TypeReference(PH Core Patient, Group)
                                                                                                  Must Supporttrue
                                                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                  Obligations
                                                                                                    ObligationsActor
                                                                                                    SHALL:handlePH Core Server
                                                                                                    SHALL:handlePH Core Consumer
                                                                                                    SHALL:able-to-populatePH Core Creator
                                                                                                    26. Procedure.encounter
                                                                                                    TypeReference(PH Core Encounter)
                                                                                                    Must Supporttrue
                                                                                                    Obligations
                                                                                                      ObligationsActor
                                                                                                      SHALL:handlePH Core Server
                                                                                                      SHALL:handlePH Core Consumer
                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                      28. Procedure.performed[x]
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Must Supporttrue
                                                                                                      Obligations
                                                                                                        ObligationsActor
                                                                                                        SHALL:handlePH Core Server
                                                                                                        SHALL:handlePH Core Consumer
                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                        30. Procedure.recorder
                                                                                                        TypeReference(PH Core Patient, PH Core RelatedPerson, PH Core Practitioner, PH Core PractitionerRole)
                                                                                                        32. Procedure.asserter
                                                                                                        TypeReference(PH Core Patient, PH Core RelatedPerson, PH Core Practitioner, PH Core PractitionerRole)
                                                                                                        34. Procedure.performer
                                                                                                        36. Procedure.performer.function
                                                                                                        Must Supporttrue
                                                                                                        Obligations
                                                                                                          ObligationsActor
                                                                                                          SHALL:handlePH Core Server
                                                                                                          SHALL:handlePH Core Consumer
                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                          38. Procedure.performer.function.coding
                                                                                                          Must Supporttrue
                                                                                                          Obligations
                                                                                                            ObligationsActor
                                                                                                            SHALL:handlePH Core Server
                                                                                                            SHALL:handlePH Core Consumer
                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                            40. Procedure.performer.function.text
                                                                                                            Must Supporttrue
                                                                                                            Obligations
                                                                                                              ObligationsActor
                                                                                                              SHALL:handlePH Core Server
                                                                                                              SHALL:handlePH Core Consumer
                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                              42. Procedure.performer.actor
                                                                                                              TypeReference(PH Core Practitioner, PH Core PractitionerRole, PH Core Organization, PH Core Patient, PH Core RelatedPerson, Device)
                                                                                                              44. Procedure.performer.onBehalfOf
                                                                                                              TypeReference(PH Core Organization)
                                                                                                              46. Procedure.location
                                                                                                              TypeReference(PH Core Location)
                                                                                                              48. Procedure.reasonCode
                                                                                                              Must Supporttrue
                                                                                                              Obligations
                                                                                                                ObligationsActor
                                                                                                                SHALL:handlePH Core Server
                                                                                                                SHALL:handlePH Core Consumer
                                                                                                                MAY:able-to-populatePH Core Creator
                                                                                                                50. Procedure.reasonCode.coding
                                                                                                                Must Supporttrue
                                                                                                                Obligations
                                                                                                                  ObligationsActor
                                                                                                                  SHALL:handlePH Core Server
                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                  52. Procedure.reasonCode.text
                                                                                                                  Must Supporttrue
                                                                                                                  Obligations
                                                                                                                    ObligationsActor
                                                                                                                    SHALL:handlePH Core Server
                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                    54. Procedure.reasonReference
                                                                                                                    TypeReference(Condition, PH Core Observation, PH Core Procedure, DiagnosticReport, DocumentReference)
                                                                                                                    Must Supporttrue
                                                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                                    Obligations
                                                                                                                      ObligationsActor
                                                                                                                      SHALL:handlePH Core Server
                                                                                                                      SHALL:handlePH Core Consumer
                                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                                      56. Procedure.bodySite
                                                                                                                      Must Supporttrue
                                                                                                                      Obligations
                                                                                                                        ObligationsActor
                                                                                                                        SHALL:handlePH Core Server
                                                                                                                        SHALL:handlePH Core Consumer
                                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                                        58. Procedure.bodySite.coding
                                                                                                                        Must Supporttrue
                                                                                                                        Obligations
                                                                                                                          ObligationsActor
                                                                                                                          SHALL:handlePH Core Server
                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                          60. Procedure.bodySite.text
                                                                                                                          Must Supporttrue
                                                                                                                          Obligations
                                                                                                                            ObligationsActor
                                                                                                                            SHALL:handlePH Core Server
                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                            62. Procedure.outcome
                                                                                                                            Must Supporttrue
                                                                                                                            Obligations
                                                                                                                              ObligationsActor
                                                                                                                              SHALL:handlePH Core Server
                                                                                                                              SHALL:handlePH Core Consumer
                                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                                              64. Procedure.outcome.coding
                                                                                                                              Must Supporttrue
                                                                                                                              Obligations
                                                                                                                                ObligationsActor
                                                                                                                                SHALL:handlePH Core Server
                                                                                                                                SHALL:handlePH Core Consumer
                                                                                                                                MAY:able-to-populatePH Core Creator
                                                                                                                                66. Procedure.outcome.text
                                                                                                                                Must Supporttrue
                                                                                                                                Obligations
                                                                                                                                  ObligationsActor
                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                  68. Procedure.complication
                                                                                                                                  Must Supporttrue
                                                                                                                                  Obligations
                                                                                                                                    ObligationsActor
                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                    70. Procedure.complication.coding
                                                                                                                                    Must Supporttrue
                                                                                                                                    Obligations
                                                                                                                                      ObligationsActor
                                                                                                                                      SHALL:handlePH Core Server
                                                                                                                                      SHALL:handlePH Core Consumer
                                                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                                                      72. Procedure.complication.text
                                                                                                                                      Must Supporttrue
                                                                                                                                      Obligations
                                                                                                                                        ObligationsActor
                                                                                                                                        SHALL:handlePH Core Server
                                                                                                                                        SHALL:handlePH Core Consumer
                                                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                                                        74. Procedure.followUp
                                                                                                                                        Must Supporttrue
                                                                                                                                        Obligations
                                                                                                                                          ObligationsActor
                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                          76. Procedure.followUp.coding
                                                                                                                                          Must Supporttrue
                                                                                                                                          Obligations
                                                                                                                                            ObligationsActor
                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                                            78. Procedure.followUp.text
                                                                                                                                            Must Supporttrue
                                                                                                                                            Obligations
                                                                                                                                              ObligationsActor
                                                                                                                                              SHALL:handlePH Core Server
                                                                                                                                              SHALL:handlePH Core Consumer
                                                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                                                              80. Procedure.focalDevice
                                                                                                                                              82. Procedure.focalDevice.action
                                                                                                                                              Must Supporttrue
                                                                                                                                              Obligations
                                                                                                                                                ObligationsActor
                                                                                                                                                SHALL:handlePH Core Server
                                                                                                                                                SHALL:handlePH Core Consumer
                                                                                                                                                MAY:able-to-populatePH Core Creator
                                                                                                                                                84. Procedure.focalDevice.action.coding
                                                                                                                                                Must Supporttrue
                                                                                                                                                Obligations
                                                                                                                                                  ObligationsActor
                                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                                  86. Procedure.focalDevice.action.text
                                                                                                                                                  Must Supporttrue
                                                                                                                                                  Obligations
                                                                                                                                                    ObligationsActor
                                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                                    88. Procedure.usedReference
                                                                                                                                                    TypeReference(Device, PH Core Medication, Substance)
                                                                                                                                                    90. Procedure.usedCode
                                                                                                                                                    Must Supporttrue
                                                                                                                                                    Obligations
                                                                                                                                                      ObligationsActor
                                                                                                                                                      SHALL:handlePH Core Server
                                                                                                                                                      SHALL:handlePH Core Consumer
                                                                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                                                                      92. Procedure.usedCode.coding
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Obligations
                                                                                                                                                        ObligationsActor
                                                                                                                                                        SHALL:handlePH Core Server
                                                                                                                                                        SHALL:handlePH Core Consumer
                                                                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                                                                        94. Procedure.usedCode.text
                                                                                                                                                        Must Supporttrue
                                                                                                                                                        Obligations
                                                                                                                                                          ObligationsActor
                                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                                          MAY:able-to-populatePH Core Creator

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

                                                                                                                                                          0. Procedure
                                                                                                                                                          Definition

                                                                                                                                                          An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.

                                                                                                                                                          ShortAn action that is being or was performed on a patient
                                                                                                                                                          Control0..*
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summaryfalse
                                                                                                                                                          Invariantsdom-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. Procedure.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. Procedure.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. Procedure.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. Procedure.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|4.0.1)

                                                                                                                                                          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. Procedure.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. Procedure.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. Procedure.extension
                                                                                                                                                          Definition

                                                                                                                                                          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.

                                                                                                                                                          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())
                                                                                                                                                          16. Procedure.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())
                                                                                                                                                          18. Procedure.identifier
                                                                                                                                                          Definition

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

                                                                                                                                                          ShortExternal Identifiers for this procedure
                                                                                                                                                          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 Person resource instances 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 procedure 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()))
                                                                                                                                                          20. Procedure.instantiatesCanonical
                                                                                                                                                          Definition

                                                                                                                                                          The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

                                                                                                                                                          ShortInstantiates FHIR protocol or definition
                                                                                                                                                          Control0..*
                                                                                                                                                          Typecanonical(PlanDefinition, ActivityDefinition, Measure, OperationDefinition, Questionnaire)
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          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()))
                                                                                                                                                          22. Procedure.instantiatesUri
                                                                                                                                                          Definition

                                                                                                                                                          The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.

                                                                                                                                                          ShortInstantiates external protocol or definition
                                                                                                                                                          Comments

                                                                                                                                                          This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

                                                                                                                                                          Control0..*
                                                                                                                                                          Typeuri
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          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()))
                                                                                                                                                          24. Procedure.basedOn
                                                                                                                                                          Definition

                                                                                                                                                          A reference to a resource that contains details of the request for this procedure.

                                                                                                                                                          ShortA request for this procedure
                                                                                                                                                          Control0..*
                                                                                                                                                          TypeReference(CarePlan, ServiceRequest)
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summarytrue
                                                                                                                                                          Alternate Namesfulfills
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          26. Procedure.partOf
                                                                                                                                                          Definition

                                                                                                                                                          A larger event of which this particular procedure is a component or step.

                                                                                                                                                          ShortPart of referenced event
                                                                                                                                                          Comments

                                                                                                                                                          The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference. For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure). For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).

                                                                                                                                                          Control0..*
                                                                                                                                                          TypeReference(PH Core Procedure, Observation, MedicationAdministration)
                                                                                                                                                          Is Modifierfalse
                                                                                                                                                          Summarytrue
                                                                                                                                                          Alternate Namescontainer
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          28. Procedure.status
                                                                                                                                                          Definition

                                                                                                                                                          A code specifying the state of the procedure. Generally, this will be the in-progress or completed state.

                                                                                                                                                          Shortpreparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
                                                                                                                                                          Comments

                                                                                                                                                          The "unknown" code is not to be used to convey other statuses. The "unknown" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.

                                                                                                                                                          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                                                                                                                          Control1..1
                                                                                                                                                          BindingThe codes SHALL be taken from EventStatus
                                                                                                                                                          (required to http://hl7.org/fhir/ValueSet/event-status|4.0.1)

                                                                                                                                                          A code specifying the state of the procedure.

                                                                                                                                                          Typecode
                                                                                                                                                          Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                          Must Supporttrue
                                                                                                                                                          Obligations
                                                                                                                                                            ObligationsActor
                                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                                            SHALL:able-to-populatePH Core Creator
                                                                                                                                                            Summarytrue
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            30. Procedure.statusReason
                                                                                                                                                            Definition

                                                                                                                                                            Captures the reason for the current state of the procedure.

                                                                                                                                                            ShortReason for current status
                                                                                                                                                            Comments

                                                                                                                                                            This is generally only used for "exception" statuses such as "not-done", "suspended" or "aborted". The reason for performing the event at all is captured in reasonCode, not here.

                                                                                                                                                            Control0..1
                                                                                                                                                            BindingFor example codes, see ProcedureNotPerformedReason(SNOMED-CT)
                                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/procedure-not-performed-reason|4.0.1)

                                                                                                                                                            A code that identifies the reason a procedure was not performed.

                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                            Is Modifierfalse
                                                                                                                                                            Must Supporttrue
                                                                                                                                                            Obligations
                                                                                                                                                              ObligationsActor
                                                                                                                                                              SHALL:handlePH Core Server
                                                                                                                                                              SHALL:handlePH Core Consumer
                                                                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                                                                              Summarytrue
                                                                                                                                                              Alternate NamesSuspended Reason, Cancelled Reason
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              32. Procedure.statusReason.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
                                                                                                                                                              34. Procedure.statusReason.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 Procedure.statusReason.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                              • value @ url
                                                                                                                                                              • 36. Procedure.statusReason.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
                                                                                                                                                                Must Supporttrue
                                                                                                                                                                Obligations
                                                                                                                                                                  ObligationsActor
                                                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                                                  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()))
                                                                                                                                                                  38. Procedure.statusReason.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
                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                  Obligations
                                                                                                                                                                    ObligationsActor
                                                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                                                    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()))
                                                                                                                                                                    40. Procedure.category
                                                                                                                                                                    Definition

                                                                                                                                                                    A code that classifies the procedure for searching, sorting and display purposes (e.g. "Surgical Procedure").

                                                                                                                                                                    ShortClassification of the procedure
                                                                                                                                                                    Control0..1
                                                                                                                                                                    BindingFor example codes, see ProcedureCategoryCodes(SNOMEDCT)
                                                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/procedure-category|4.0.1)

                                                                                                                                                                    A code that classifies a procedure for searching, sorting and display purposes.

                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                    Must Supporttrue
                                                                                                                                                                    Obligations
                                                                                                                                                                      ObligationsActor
                                                                                                                                                                      SHALL:handlePH Core Server
                                                                                                                                                                      SHALL:handlePH Core Consumer
                                                                                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                                                                                      Summarytrue
                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      42. Procedure.category.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
                                                                                                                                                                      44. Procedure.category.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 Procedure.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                      • value @ url
                                                                                                                                                                      • 46. Procedure.category.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
                                                                                                                                                                        Must Supporttrue
                                                                                                                                                                        Obligations
                                                                                                                                                                          ObligationsActor
                                                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                                                          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()))
                                                                                                                                                                          48. Procedure.category.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
                                                                                                                                                                          Must Supporttrue
                                                                                                                                                                          Obligations
                                                                                                                                                                            ObligationsActor
                                                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                                                                            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()))
                                                                                                                                                                            50. Procedure.code
                                                                                                                                                                            Definition

                                                                                                                                                                            The specific procedure that is performed. Use text if the exact nature of the procedure cannot be coded (e.g. "Laparoscopic Appendectomy").

                                                                                                                                                                            ShortIdentification of the procedure
                                                                                                                                                                            Control0..1
                                                                                                                                                                            BindingFor example codes, see ProcedureCodes(SNOMEDCT)
                                                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/procedure-code|4.0.1)

                                                                                                                                                                            A code to identify a specific procedure .

                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                            Must Supporttrue
                                                                                                                                                                            Obligations
                                                                                                                                                                              ObligationsActor
                                                                                                                                                                              SHALL:handlePH Core Server
                                                                                                                                                                              SHALL:handlePH Core Consumer
                                                                                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                                                                                              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()))
                                                                                                                                                                              52. Procedure.code.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
                                                                                                                                                                              54. Procedure.code.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 Procedure.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                              • value @ url
                                                                                                                                                                              • 56. Procedure.code.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
                                                                                                                                                                                Must Supporttrue
                                                                                                                                                                                Obligations
                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                                                                  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()))
                                                                                                                                                                                  58. Procedure.code.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
                                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                                  Obligations
                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                                                                    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()))
                                                                                                                                                                                    60. Procedure.subject
                                                                                                                                                                                    Definition

                                                                                                                                                                                    The person, animal or group on which the procedure was performed.

                                                                                                                                                                                    ShortWho the procedure was performed on
                                                                                                                                                                                    Control1..1
                                                                                                                                                                                    TypeReference(PH Core Patient, Group)
                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                    Must Supporttrue
                                                                                                                                                                                    Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                                                                                                    Obligations
                                                                                                                                                                                      ObligationsActor
                                                                                                                                                                                      SHALL:handlePH Core Server
                                                                                                                                                                                      SHALL:handlePH Core Consumer
                                                                                                                                                                                      SHALL:able-to-populatePH Core Creator
                                                                                                                                                                                      Summarytrue
                                                                                                                                                                                      Alternate Namespatient
                                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                      62. Procedure.encounter
                                                                                                                                                                                      Definition

                                                                                                                                                                                      The Encounter during which this Procedure was created or performed 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.

                                                                                                                                                                                      Control0..1
                                                                                                                                                                                      TypeReference(PH Core Encounter)
                                                                                                                                                                                      Is Modifierfalse
                                                                                                                                                                                      Must Supporttrue
                                                                                                                                                                                      Obligations
                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                        SHALL:handlePH Core Server
                                                                                                                                                                                        SHALL:handlePH Core Consumer
                                                                                                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                                                                                                        Summarytrue
                                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                        64. Procedure.performed[x]
                                                                                                                                                                                        Definition

                                                                                                                                                                                        Estimated or actual date, date-time, period, or age when the procedure was performed. Allows a period to support complex procedures that span more than one date, and also allows for the length of the procedure to be captured.

                                                                                                                                                                                        ShortWhen the procedure was performed
                                                                                                                                                                                        Comments

                                                                                                                                                                                        Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old. dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.

                                                                                                                                                                                        Control0..1
                                                                                                                                                                                        TypeChoice of: dateTime, Period, string, Age, Range
                                                                                                                                                                                        [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 TypesNo must-support rules about the choice of types/profiles
                                                                                                                                                                                        Obligations
                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                                                                          Summarytrue
                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                          66. Procedure.recorder
                                                                                                                                                                                          Definition

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

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

                                                                                                                                                                                          Individual who is making the procedure statement.

                                                                                                                                                                                          ShortPerson who asserts this procedure
                                                                                                                                                                                          Control0..1
                                                                                                                                                                                          TypeReference(PH Core Patient, PH Core RelatedPerson, PH Core Practitioner, PH Core PractitionerRole)
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          Summarytrue
                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                          70. Procedure.performer
                                                                                                                                                                                          Definition

                                                                                                                                                                                          Limited to "real" people rather than equipment.

                                                                                                                                                                                          ShortThe people who performed the procedure
                                                                                                                                                                                          Control0..*
                                                                                                                                                                                          TypeBackboneElement
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          Summarytrue
                                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                          72. Procedure.performer.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
                                                                                                                                                                                          74. Procedure.performer.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())
                                                                                                                                                                                          76. Procedure.performer.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())
                                                                                                                                                                                          78. Procedure.performer.function
                                                                                                                                                                                          Definition

                                                                                                                                                                                          Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.

                                                                                                                                                                                          ShortType of performance
                                                                                                                                                                                          Control0..1
                                                                                                                                                                                          BindingFor example codes, see ProcedurePerformerRoleCodes
                                                                                                                                                                                          (example to http://hl7.org/fhir/ValueSet/performer-role|4.0.1)

                                                                                                                                                                                          A code that identifies the role of a performer of the procedure.

                                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                          Must Supporttrue
                                                                                                                                                                                          Obligations
                                                                                                                                                                                            ObligationsActor
                                                                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                                                                                            Summarytrue
                                                                                                                                                                                            Requirements

                                                                                                                                                                                            Allows disambiguation of the types of involvement of different performers.

                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                            80. Procedure.performer.function.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
                                                                                                                                                                                            82. Procedure.performer.function.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 Procedure.performer.function.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                            • value @ url
                                                                                                                                                                                            • 84. Procedure.performer.function.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
                                                                                                                                                                                              Must Supporttrue
                                                                                                                                                                                              Obligations
                                                                                                                                                                                                ObligationsActor
                                                                                                                                                                                                SHALL:handlePH Core Server
                                                                                                                                                                                                SHALL:handlePH Core Consumer
                                                                                                                                                                                                MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                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()))
                                                                                                                                                                                                86. Procedure.performer.function.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
                                                                                                                                                                                                Must Supporttrue
                                                                                                                                                                                                Obligations
                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                  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()))
                                                                                                                                                                                                  88. Procedure.performer.actor
                                                                                                                                                                                                  Definition

                                                                                                                                                                                                  The practitioner who was involved in the procedure.

                                                                                                                                                                                                  ShortThe reference to the practitioner
                                                                                                                                                                                                  Control1..1
                                                                                                                                                                                                  TypeReference(PH Core Practitioner, PH Core PractitionerRole, PH Core Organization, PH Core Patient, PH Core RelatedPerson, Device)
                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                  A reference to Device supports use cases, such as pacemakers.

                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                  90. Procedure.performer.onBehalfOf
                                                                                                                                                                                                  Definition

                                                                                                                                                                                                  The organization the device or practitioner was acting on behalf of.

                                                                                                                                                                                                  ShortOrganization the device or practitioner was acting for
                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                  TypeReference(PH Core Organization)
                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                  Summaryfalse
                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                  Practitioners and Devices can be associated with multiple organizations. This element indicates which organization they were acting on behalf of when performing the action.

                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                  92. Procedure.location
                                                                                                                                                                                                  Definition

                                                                                                                                                                                                  The location where the procedure actually happened. E.g. a newborn at home, a tracheostomy at a restaurant.

                                                                                                                                                                                                  ShortWhere the procedure happened
                                                                                                                                                                                                  Control0..1
                                                                                                                                                                                                  TypeReference(PH Core Location)
                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                                  Requirements

                                                                                                                                                                                                  Ties a procedure to where the records are likely kept.

                                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                  94. Procedure.reasonCode
                                                                                                                                                                                                  Definition

                                                                                                                                                                                                  The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text.

                                                                                                                                                                                                  ShortCoded reason procedure performed
                                                                                                                                                                                                  Comments

                                                                                                                                                                                                  Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

                                                                                                                                                                                                  Control0..*
                                                                                                                                                                                                  BindingFor example codes, see ProcedureReasonCodes
                                                                                                                                                                                                  (example to http://hl7.org/fhir/ValueSet/procedure-reason|4.0.1)

                                                                                                                                                                                                  A code that identifies the reason a procedure is required.

                                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                                  Is Modifierfalse
                                                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                                                  Obligations
                                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                    Summarytrue
                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                    96. Procedure.reasonCode.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
                                                                                                                                                                                                    98. Procedure.reasonCode.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 Procedure.reasonCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                    • value @ url
                                                                                                                                                                                                    • 100. Procedure.reasonCode.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
                                                                                                                                                                                                      Must Supporttrue
                                                                                                                                                                                                      Obligations
                                                                                                                                                                                                        ObligationsActor
                                                                                                                                                                                                        SHALL:handlePH Core Server
                                                                                                                                                                                                        SHALL:handlePH Core Consumer
                                                                                                                                                                                                        MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                        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()))
                                                                                                                                                                                                        102. Procedure.reasonCode.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
                                                                                                                                                                                                        Must Supporttrue
                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                          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()))
                                                                                                                                                                                                          104. Procedure.reasonReference
                                                                                                                                                                                                          Definition

                                                                                                                                                                                                          The justification of why the procedure was performed.

                                                                                                                                                                                                          ShortThe justification that the procedure was performed
                                                                                                                                                                                                          Comments

                                                                                                                                                                                                          It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). Use Procedure.reasonCode when a code sufficiently describes the reason. Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative. For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used. Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference. Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.

                                                                                                                                                                                                          Control0..*
                                                                                                                                                                                                          TypeReference(Condition, PH Core Observation, PH Core Procedure, DiagnosticReport, DocumentReference)
                                                                                                                                                                                                          Is Modifierfalse
                                                                                                                                                                                                          Must Supporttrue
                                                                                                                                                                                                          Must Support TypesNo must-support rules about the choice of types/profiles
                                                                                                                                                                                                          Obligations
                                                                                                                                                                                                            ObligationsActor
                                                                                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                            Summarytrue
                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                            106. Procedure.bodySite
                                                                                                                                                                                                            Definition

                                                                                                                                                                                                            Detailed and structured anatomical location information. Multiple locations are allowed - e.g. multiple punch biopsies of a lesion.

                                                                                                                                                                                                            ShortTarget body sites
                                                                                                                                                                                                            Comments

                                                                                                                                                                                                            If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension procedure-targetbodystructure.

                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                            BindingFor example codes, see SNOMEDCTBodyStructures
                                                                                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

                                                                                                                                                                                                            Codes describing anatomical locations. May include laterality.

                                                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                            Must Supporttrue
                                                                                                                                                                                                            Obligations
                                                                                                                                                                                                              ObligationsActor
                                                                                                                                                                                                              SHALL:handlePH Core Server
                                                                                                                                                                                                              SHALL:handlePH Core Consumer
                                                                                                                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                              Summarytrue
                                                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                              108. Procedure.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
                                                                                                                                                                                                              110. Procedure.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 Procedure.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                              • value @ url
                                                                                                                                                                                                              • 112. Procedure.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
                                                                                                                                                                                                                Must Supporttrue
                                                                                                                                                                                                                Obligations
                                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                  114. Procedure.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
                                                                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                                                                  Obligations
                                                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                    116. Procedure.outcome
                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                    The outcome of the procedure - did it resolve the reasons for the procedure being performed?

                                                                                                                                                                                                                    ShortThe result of procedure
                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                    If outcome contains narrative text only, it can be captured using the CodeableConcept.text.

                                                                                                                                                                                                                    Control0..1
                                                                                                                                                                                                                    BindingFor example codes, see ProcedureOutcomeCodes(SNOMEDCT)
                                                                                                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/procedure-outcome|4.0.1)

                                                                                                                                                                                                                    An outcome of a procedure - whether it was resolved or otherwise.

                                                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                    Must Supporttrue
                                                                                                                                                                                                                    Obligations
                                                                                                                                                                                                                      ObligationsActor
                                                                                                                                                                                                                      SHALL:handlePH Core Server
                                                                                                                                                                                                                      SHALL:handlePH Core Consumer
                                                                                                                                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                      Summarytrue
                                                                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                      118. Procedure.outcome.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
                                                                                                                                                                                                                      120. Procedure.outcome.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 Procedure.outcome.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                      • value @ url
                                                                                                                                                                                                                      • 122. Procedure.outcome.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
                                                                                                                                                                                                                        Must Supporttrue
                                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                          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()))
                                                                                                                                                                                                                          124. Procedure.outcome.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
                                                                                                                                                                                                                          Must Supporttrue
                                                                                                                                                                                                                          Obligations
                                                                                                                                                                                                                            ObligationsActor
                                                                                                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                            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()))
                                                                                                                                                                                                                            126. Procedure.report
                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                            This could be a histology result, pathology report, surgical report, etc.

                                                                                                                                                                                                                            ShortAny report resulting from the procedure
                                                                                                                                                                                                                            Comments

                                                                                                                                                                                                                            There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.

                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                            TypeReference(DiagnosticReport, DocumentReference, Composition)
                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                            128. Procedure.complication
                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                            Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.

                                                                                                                                                                                                                            ShortComplication following the procedure
                                                                                                                                                                                                                            Comments

                                                                                                                                                                                                                            If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.

                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                            BindingFor example codes, see Condition/Problem/DiagnosisCodes
                                                                                                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/condition-code|4.0.1)

                                                                                                                                                                                                                            Codes describing complications that resulted from a procedure.

                                                                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                            Must Supporttrue
                                                                                                                                                                                                                            Obligations
                                                                                                                                                                                                                              ObligationsActor
                                                                                                                                                                                                                              SHALL:handlePH Core Server
                                                                                                                                                                                                                              SHALL:handlePH Core Consumer
                                                                                                                                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                              Summaryfalse
                                                                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                              130. Procedure.complication.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
                                                                                                                                                                                                                              132. Procedure.complication.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 Procedure.complication.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                              • value @ url
                                                                                                                                                                                                                              • 134. Procedure.complication.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
                                                                                                                                                                                                                                Must Supporttrue
                                                                                                                                                                                                                                Obligations
                                                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                                  136. Procedure.complication.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
                                                                                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                                                                                  Obligations
                                                                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                    138. Procedure.complicationDetail
                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                    Any complications that occurred during the procedure, or in the immediate post-performance period.

                                                                                                                                                                                                                                    ShortA condition that is a result of the procedure
                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                    TypeReference(Condition)
                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                    Requirements

                                                                                                                                                                                                                                    This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.

                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                    140. Procedure.followUp
                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                    If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.

                                                                                                                                                                                                                                    ShortInstructions for follow up
                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                    BindingFor example codes, see ProcedureFollowUpCodes(SNOMEDCT)
                                                                                                                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/procedure-followup|4.0.1)

                                                                                                                                                                                                                                    Specific follow up required for a procedure e.g. removal of sutures.

                                                                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                    Must Supporttrue
                                                                                                                                                                                                                                    Obligations
                                                                                                                                                                                                                                      ObligationsActor
                                                                                                                                                                                                                                      SHALL:handlePH Core Server
                                                                                                                                                                                                                                      SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                      Summaryfalse
                                                                                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                      142. Procedure.followUp.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
                                                                                                                                                                                                                                      144. Procedure.followUp.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 Procedure.followUp.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                                      • value @ url
                                                                                                                                                                                                                                      • 146. Procedure.followUp.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
                                                                                                                                                                                                                                        Must Supporttrue
                                                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                          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()))
                                                                                                                                                                                                                                          148. Procedure.followUp.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
                                                                                                                                                                                                                                          Must Supporttrue
                                                                                                                                                                                                                                          Obligations
                                                                                                                                                                                                                                            ObligationsActor
                                                                                                                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                            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()))
                                                                                                                                                                                                                                            150. Procedure.note
                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                            Any other notes and comments about the procedure.

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

                                                                                                                                                                                                                                            A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.

                                                                                                                                                                                                                                            ShortManipulated, implanted, or removed device
                                                                                                                                                                                                                                            Control0..*
                                                                                                                                                                                                                                            TypeBackboneElement
                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                            Summaryfalse
                                                                                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                            154. Procedure.focalDevice.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
                                                                                                                                                                                                                                            156. Procedure.focalDevice.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())
                                                                                                                                                                                                                                            158. Procedure.focalDevice.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())
                                                                                                                                                                                                                                            160. Procedure.focalDevice.action
                                                                                                                                                                                                                                            Definition

                                                                                                                                                                                                                                            The kind of change that happened to the device during the procedure.

                                                                                                                                                                                                                                            ShortKind of change to device
                                                                                                                                                                                                                                            Control0..1
                                                                                                                                                                                                                                            BindingThe codes SHOULD be taken from ProcedureDeviceActionCodes
                                                                                                                                                                                                                                            (preferred to http://hl7.org/fhir/ValueSet/device-action|4.0.1)

                                                                                                                                                                                                                                            A kind of change that happened to the device during the procedure.

                                                                                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                                                                                            Is Modifierfalse
                                                                                                                                                                                                                                            Must Supporttrue
                                                                                                                                                                                                                                            Obligations
                                                                                                                                                                                                                                              ObligationsActor
                                                                                                                                                                                                                                              SHALL:handlePH Core Server
                                                                                                                                                                                                                                              SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                              MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                              Summaryfalse
                                                                                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                              162. Procedure.focalDevice.action.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
                                                                                                                                                                                                                                              164. Procedure.focalDevice.action.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 Procedure.focalDevice.action.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                                              • value @ url
                                                                                                                                                                                                                                              • 166. Procedure.focalDevice.action.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
                                                                                                                                                                                                                                                Must Supporttrue
                                                                                                                                                                                                                                                Obligations
                                                                                                                                                                                                                                                  ObligationsActor
                                                                                                                                                                                                                                                  SHALL:handlePH Core Server
                                                                                                                                                                                                                                                  SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                                  MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                                  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()))
                                                                                                                                                                                                                                                  168. Procedure.focalDevice.action.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
                                                                                                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                                                                                                  Obligations
                                                                                                                                                                                                                                                    ObligationsActor
                                                                                                                                                                                                                                                    SHALL:handlePH Core Server
                                                                                                                                                                                                                                                    SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                                    MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                                    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()))
                                                                                                                                                                                                                                                    170. Procedure.focalDevice.manipulated
                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                    The device that was manipulated (changed) during the procedure.

                                                                                                                                                                                                                                                    ShortDevice that was changed
                                                                                                                                                                                                                                                    Control1..1
                                                                                                                                                                                                                                                    TypeReference(Device)
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                    172. Procedure.usedReference
                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                    Identifies medications, devices and any other substance used as part of the procedure.

                                                                                                                                                                                                                                                    ShortItems used during procedure
                                                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                                                    For devices actually implanted or removed, use Procedure.device.

                                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                                    TypeReference(Device, PH Core Medication, Substance)
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Summaryfalse
                                                                                                                                                                                                                                                    Requirements

                                                                                                                                                                                                                                                    Used for tracking contamination, etc.

                                                                                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                    174. Procedure.usedCode
                                                                                                                                                                                                                                                    Definition

                                                                                                                                                                                                                                                    Identifies coded items that were used as part of the procedure.

                                                                                                                                                                                                                                                    ShortCoded items used during the procedure
                                                                                                                                                                                                                                                    Comments

                                                                                                                                                                                                                                                    For devices actually implanted or removed, use Procedure.device.

                                                                                                                                                                                                                                                    Control0..*
                                                                                                                                                                                                                                                    BindingFor example codes, see FHIRDeviceTypes
                                                                                                                                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/device-kind|4.0.1)

                                                                                                                                                                                                                                                    Codes describing items used during a procedure.

                                                                                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                                                                                    Is Modifierfalse
                                                                                                                                                                                                                                                    Must Supporttrue
                                                                                                                                                                                                                                                    Obligations
                                                                                                                                                                                                                                                      ObligationsActor
                                                                                                                                                                                                                                                      SHALL:handlePH Core Server
                                                                                                                                                                                                                                                      SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                                      MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                                      Summaryfalse
                                                                                                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                                                                                      176. Procedure.usedCode.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
                                                                                                                                                                                                                                                      178. Procedure.usedCode.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 Procedure.usedCode.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                                                                                      • value @ url
                                                                                                                                                                                                                                                      • 180. Procedure.usedCode.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
                                                                                                                                                                                                                                                        Must Supporttrue
                                                                                                                                                                                                                                                        Obligations
                                                                                                                                                                                                                                                          ObligationsActor
                                                                                                                                                                                                                                                          SHALL:handlePH Core Server
                                                                                                                                                                                                                                                          SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                                          MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                                          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()))
                                                                                                                                                                                                                                                          182. Procedure.usedCode.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
                                                                                                                                                                                                                                                          Must Supporttrue
                                                                                                                                                                                                                                                          Obligations
                                                                                                                                                                                                                                                            ObligationsActor
                                                                                                                                                                                                                                                            SHALL:handlePH Core Server
                                                                                                                                                                                                                                                            SHALL:handlePH Core Consumer
                                                                                                                                                                                                                                                            MAY:able-to-populatePH Core Creator
                                                                                                                                                                                                                                                            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()))