Referral Prescription
1.0.0 - STU

Referral Prescription, published by . This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/referral/ and changes regularly. See the Directory of published versions

## Resource Profile: BeReferralPrescriptionDiagnosticImaging

Official URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-referralprescription-diagnosticimaging | Version: 1.0.0
Draft as of 2021-07-15 | Computable Name: BeReferralPrescriptionDiagnosticImaging

Referral prescription for a generic diagnostic imaging. Please note in .orderDetail, a specific slicing is available to give guidance how to express acquisition modalities if needed. In future iterations of this profile, more slicing might provide additional guidance.

Usages:

- Examples for this Profile: ServiceRequest/diagnostic-imaging-basic-example-concreteWithDetails, ServiceRequest/diagnostic-imaging-basic-example-concreteWithText, ServiceRequest/diagnostic-imaging-basic-example-everything-contained and ServiceRequest/diagnostic-imaging-basic-example-useOfModality

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

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

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | BeReferralPrescription | A request for a service to be performed Constraints: prr-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Open by value:url
extension:statusReason | S | 0..1 | (Complex) | Reason for current status URL: http://hl7.org/fhir/StructureDefinition/request-statusReason
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/request-statusReason"
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: BeVSPrescriptionStatusReason (extensible)
extension:feedback | S | 1..1 | boolean | Give feedback to the prescriber URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-feedback-to-prescriber
extension:coprescriber | S | 0..1 | (Complex) | Info about the other parties that have to take part in the prescription. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-co-prescriber-info
extension:validity | S | 1..1 | Period | Validity period of the prescription URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-validity-period
extension:latest | S | 0..1 | BeYearMonthDay | Request must be executed before URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-latest-end-date
extension:latestDraft | S | 0..1 | BeYearMonthDay | The prescription must have left the draft status befor this moment URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-latest-draft-date
extension:proposalType | S | 0..1 | CodeableConcept | BeProposalType URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-proposal-type Binding: BeVsProposalType (required)
extension:pss | S | 0..1 | (Complex) | BePSSInfo URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-pss-info
extension:recorder | S | 0..1 | Reference(BePatient(2.1.2) | BePractitioner(2.1.2) | BeOrganization(2.1.2) | BePractitionerRole(2.1.2)) | The person responsable for this information, not necessarily the person who recorded the information URL: https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-recorder
extension:performerType | S | 0..* | CodeableConcept | Discipline of provider. Replaces .performerType because of wrong cardinality URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-performer-type Binding: BeVSCdHcParty (extensible)
extension:relevantSupportingInformationAsAnnotationOrCodeableConcept | S | 0..* | Annotation, CodeableConcept | Relevant clinical information in the context of this prescription concerning for example allergies, kidney function, diabetic. This extension allows the use of a codeableConcept or Annotation but when more detailed information can be given, it is RECOMMENDED to express it as structured as possible using the appropriate elements (for general relevant supporting information, this means the use of the .supportingInfo element.) ContraIndications SHALL be expressed using the contraIndication modifierExtension. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-supporting-info
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:contraIndication | ?!S | 1..* | Annotation, CodeableConcept, Reference(Device | Condition | MedicationStatement | BeObservation | BeAllergyIntolerance) | Relevant information in the context of a prescription concerning possible contra indication. For example presence of devices or (suspected) pregnancy. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. If prescriber has no knowledge of contra indication, this SHALL be expressed with a nullFlavor ( e.g. ASKU = Information was sought but not found ) in codeableConcept. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contraindication
modifierExtension:contrastFluidUse | ?!S | 0..1 | code | Whether the use of contrast fluid in diagnostic imaging can be defined as 'If necessary' or 'Not permitted.' URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contrastfluiduse Binding: BeContrastFluidUse (required)
Slices for identifier | S Σ | 0..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by value:system
identifier:UHMEP | Σ | 0..1 | Identifier | Reference ID of the UHMEP once available there
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: https://www.ehealth.fgov.be/standards/fhir/referral/NamingSystem/uhmep
value | Σ | 1..1 | string | The value that is unique Example General: 123456
basedOn | S Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills
requisition | S Σ | 0..1 | Identifier | If needed to have a common identifier among different prescriptions.
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: BeVsRequestIntent (required)
category | S Σ | 1..1 | CodeableConcept | Classification of service Binding: BeReferralCategory (extensible)
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed
code | S Σ | 0..1 | CodeableConcept | What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service.
Slices for orderDetail | S Σ C | 0..* | CodeableConcept | Additional order information Slice: Unordered, Open by value:coding.system Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
orderDetail:modality | S Σ C | 0..* | CodeableConcept | Acquisition modalities, i.e. those in the DICOM Context Group 29 Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
coding | Σ | 0..* | Coding | Code defined by a terminology system Binding: AcquisitionModality (required): Type of acquired data in the instance.
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code | Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 1..1 | BeContainedOrLogicalReference(BePatient(2.1.2)) | Individual or Entity the service is ordered for
occurrence[x] | S Σ | 0..1 |  | When service shall occur - once this is past, this prescription is no longer valid and the status shall reflect this.
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
occurrenceTiming |  |  | Timing |
authoredOn | S Σ C | 1..1 | dateTime | Date request signed Constraints: be-inv-long-date
requester | S Σ | 1..1 | BeContainedOrLogicalReference(BePractitionerRole(2.1.2)) | Prescriber of the requested service
performer | S Σ | 0..* | BeContainedOrLogicalReference(BePractitionerRole(2.1.2)) | Requested performer - typically reference to practitionerroles
reasonCode | S Σ | 0..1 | CodeableConcept | Diagnostic question, explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
supportingInfo | S | 0..* | Reference(Resource | Procedure | BeObservation | Condition | BeAllergyIntolerance | MedicationStatement | QuestionnaireResponse) | Relevant information in the context of this prescription concerning for example allergies, kidney function, diabetic. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. ContraIndications SHALL be expressed using the contraIndication modifierExtension
bodySite | S Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Slices for extension |  |  |  | Content/Rules for all slices
extension:bodyLaterality |  | 0..1 | Coding | BeExtLaterality URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality Binding: Laterality (required)
note | S | 0..* | BeCodedAnnotation | Comments
Slices for extension |  |  |  | Content/Rules for all slices
extension:code |  | 0..1 | (Complex) | Code URL: https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept"
text | Σ | 1..1 | markdown | The annotation - plain text without markdown is strongly recommended
patientInstruction | S Σ | 0..1 | string | Patient or consumer-oriented instructions
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.extension:statusReason.​value[x] | Base | extensible | BeVSPrescriptionStatusReason | 📦1.0.0 | This IG
ServiceRequest.identifier:UHMEP.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
ServiceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
ServiceRequest.intent | Base | required | BeVsRequestIntent | 📦1.0.0 | This IG
ServiceRequest.category | Base | extensible | BeReferralCategory | 📦1.0.0 | This IG
ServiceRequest.code | Base | example | Procedure Codes (SNOMED CT) | 📦4.0.1 | FHIR Std.
ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.orderDetail:modality | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.orderDetail:modality.​coding | Base | required | AcquisitionModality | ⏿2025.3.20250714 | tx.fhir.org
ServiceRequest.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
be-inv-long-date | error | ServiceRequest.authoredOn | date SHALL contain a long date (YYYY-MM-DDThh:mm:ss+zz:zz) | `empty() or toString().length()=25`
dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present | `orderDetail.empty() or code.exists()`

This structure is derived from BeReferralPrescription

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest |  | 0..* | BeReferralPrescription | A request for a service to be performed
Slices for extension |  |  |  | Content/Rules for all slices
extension:relevantSupportingInformationAsAnnotationOrCodeableConcept | S | 0..* | Annotation, CodeableConcept | Relevant clinical information in the context of this prescription concerning for example allergies, kidney function, diabetic. This extension allows the use of a codeableConcept or Annotation but when more detailed information can be given, it is RECOMMENDED to express it as structured as possible using the appropriate elements (for general relevant supporting information, this means the use of the .supportingInfo element.) ContraIndications SHALL be expressed using the contraIndication modifierExtension. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-supporting-info
Slices for modifierExtension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:contraIndication | S | 1..* | Annotation, CodeableConcept, Reference(Device | Condition | MedicationStatement | BeObservation | BeAllergyIntolerance) | Relevant information in the context of a prescription concerning possible contra indication. For example presence of devices or (suspected) pregnancy. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. If prescriber has no knowledge of contra indication, this SHALL be expressed with a nullFlavor ( e.g. ASKU = Information was sought but not found ) in codeableConcept. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contraindication
modifierExtension:contrastFluidUse | S | 0..1 | code | Whether the use of contrast fluid in diagnostic imaging can be defined as 'If necessary' or 'Not permitted.' URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contrastfluiduse Binding: BeContrastFluidUse (required)
category |  |  |  |
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code |  | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 363679005
Slices for orderDetail |  | 0..* | CodeableConcept | Additional order information Slice: Unordered, Open by value:coding.system
orderDetail:modality | S | 0..* | CodeableConcept | Acquisition modalities, i.e. those in the DICOM Context Group 29
coding |  | 0..* | Coding | Code defined by a terminology system Binding: AcquisitionModality (required): Type of acquired data in the instance.
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code |  | 1..1 | code | Symbol in syntax defined by the system
reasonCode |  | 0..1 | CodeableConcept | Diagnostic question, explanation/Justification for procedure or service
supportingInfo |  | 0..* | Reference(Resource | Procedure | BeObservation | Condition | BeAllergyIntolerance | MedicationStatement | QuestionnaireResponse) | Relevant information in the context of this prescription concerning for example allergies, kidney function, diabetic. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. ContraIndications SHALL be expressed using the contraIndication modifierExtension
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.orderDetail:modality.​coding | Base | required | AcquisitionModality | ⏿2025.3.20250714 | tx.fhir.org

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | BeReferralPrescription | A request for a service to be performed Constraints: prr-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Open by value:url
extension:statusReason | S | 0..1 | (Complex) | Reason for current status URL: http://hl7.org/fhir/StructureDefinition/request-statusReason
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/request-statusReason"
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: BeVSPrescriptionStatusReason (extensible)
extension:feedback | S | 1..1 | boolean | Give feedback to the prescriber URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-feedback-to-prescriber
extension:coprescriber | S | 0..1 | (Complex) | Info about the other parties that have to take part in the prescription. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-co-prescriber-info
extension:validity | S | 1..1 | Period | Validity period of the prescription URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-validity-period
extension:latest | S | 0..1 | BeYearMonthDay | Request must be executed before URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-latest-end-date
extension:latestDraft | S | 0..1 | BeYearMonthDay | The prescription must have left the draft status befor this moment URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-latest-draft-date
extension:proposalType | S | 0..1 | CodeableConcept | BeProposalType URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-proposal-type Binding: BeVsProposalType (required)
extension:pss | S | 0..1 | (Complex) | BePSSInfo URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-pss-info
extension:recorder | S | 0..1 | Reference(BePatient(2.1.2) | BePractitioner(2.1.2) | BeOrganization(2.1.2) | BePractitionerRole(2.1.2)) | The person responsable for this information, not necessarily the person who recorded the information URL: https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-recorder
extension:performerType | S | 0..* | CodeableConcept | Discipline of provider. Replaces .performerType because of wrong cardinality URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-performer-type Binding: BeVSCdHcParty (extensible)
extension:relevantSupportingInformationAsAnnotationOrCodeableConcept | S | 0..* | Annotation, CodeableConcept | Relevant clinical information in the context of this prescription concerning for example allergies, kidney function, diabetic. This extension allows the use of a codeableConcept or Annotation but when more detailed information can be given, it is RECOMMENDED to express it as structured as possible using the appropriate elements (for general relevant supporting information, this means the use of the .supportingInfo element.) ContraIndications SHALL be expressed using the contraIndication modifierExtension. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-supporting-info
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:contraIndication | ?!S | 1..* | Annotation, CodeableConcept, Reference(Device | Condition | MedicationStatement | BeObservation | BeAllergyIntolerance) | Relevant information in the context of a prescription concerning possible contra indication. For example presence of devices or (suspected) pregnancy. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. If prescriber has no knowledge of contra indication, this SHALL be expressed with a nullFlavor ( e.g. ASKU = Information was sought but not found ) in codeableConcept. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contraindication
modifierExtension:contrastFluidUse | ?!S | 0..1 | code | Whether the use of contrast fluid in diagnostic imaging can be defined as 'If necessary' or 'Not permitted.' URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contrastfluiduse Binding: BeContrastFluidUse (required)
Slices for identifier | S Σ | 0..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by value:system
identifier:UHMEP | Σ | 0..1 | Identifier | Reference ID of the UHMEP once available there
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: https://www.ehealth.fgov.be/standards/fhir/referral/NamingSystem/uhmep
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | S Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces
requisition | S Σ | 0..1 | Identifier | If needed to have a common identifier among different prescriptions.
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: BeVsRequestIntent (required)
category | S Σ | 1..1 | CodeableConcept | Classification of service Binding: BeReferralCategory (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 363679005
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed
code | S Σ | 0..1 | CodeableConcept | What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service.
Slices for orderDetail | S Σ C | 0..* | CodeableConcept | Additional order information Slice: Unordered, Open by value:coding.system Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
orderDetail:modality | S Σ C | 0..* | CodeableConcept | Acquisition modalities, i.e. those in the DICOM Context Group 29 Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system Binding: AcquisitionModality (required): Type of acquired data in the instance.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
quantity[x] | Σ | 0..1 |  | Service amount
quantityQuantity |  |  | Quantity |
quantityRatio |  |  | Ratio |
quantityRange |  |  | Range |
subject | S Σ | 1..1 | BeContainedOrLogicalReference(BePatient(2.1.2)) | Individual or Entity the service is ordered for
encounter | Σ | 0..1 | Reference(Encounter) | Encounter in which the request was created
occurrence[x] | S Σ | 0..1 |  | When service shall occur - once this is past, this prescription is no longer valid and the status shall reflect this.
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
occurrenceTiming |  |  | Timing |
asNeeded[x] | Σ | 0..1 |  | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
authoredOn | S Σ C | 1..1 | dateTime | Date request signed Constraints: be-inv-long-date
requester | S Σ | 1..1 | BeContainedOrLogicalReference(BePractitionerRole(2.1.2)) | Prescriber of the requested service
performer | S Σ | 0..* | BeContainedOrLogicalReference(BePractitionerRole(2.1.2)) | Requested performer - typically reference to practitionerroles
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference | Σ | 0..* | Reference(Location) | Requested location
reasonCode | S Σ | 0..1 | CodeableConcept | Diagnostic question, explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
supportingInfo | S | 0..* | Reference(Resource | Procedure | BeObservation | Condition | BeAllergyIntolerance | MedicationStatement | QuestionnaireResponse) | Relevant information in the context of this prescription concerning for example allergies, kidney function, diabetic. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. ContraIndications SHALL be expressed using the contraIndication modifierExtension
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples
bodySite | S Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:bodyLaterality |  | 0..1 | Coding | BeExtLaterality URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality Binding: Laterality (required)
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
note | S | 0..* | BeCodedAnnotation | Comments
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:code |  | 0..1 | (Complex) | Code URL: https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: BeVSRequestNoteType (required)
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | The annotation - plain text without markdown is strongly recommended
patientInstruction | S Σ | 0..1 | string | Patient or consumer-oriented instructions
relevantHistory |  | 0..* | Reference(Provenance) | Request provenance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
ServiceRequest.extension:statusReason.​value[x] | Base | extensible | BeVSPrescriptionStatusReason | 📦1.0.0 | This IG
ServiceRequest.identifier:UHMEP.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
ServiceRequest.identifier:UHMEP.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
ServiceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
ServiceRequest.intent | Base | required | BeVsRequestIntent | 📦1.0.0 | This IG
ServiceRequest.category | Base | extensible | BeReferralCategory | 📦1.0.0 | This IG
ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
ServiceRequest.code | Base | example | Procedure Codes (SNOMED CT) | 📦4.0.1 | FHIR Std.
ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.orderDetail:modality | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.orderDetail:modality.​coding | Base | required | AcquisitionModality | ⏿2025.3.20250714 | tx.fhir.org
ServiceRequest.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.locationCode | Base | example | ServiceDeliveryLocationRoleType | 📦3.0.0 | THO v6.5
ServiceRequest.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
ServiceRequest.note.​extension:code.value[x] | Base | required | BeVSRequestNoteType | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
be-inv-long-date | error | ServiceRequest.authoredOn | date SHALL contain a long date (YYYY-MM-DDThh:mm:ss+zz:zz) | `empty() or toString().length()=25`
dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present | `orderDetail.empty() or code.exists()`

This structure is derived from BeReferralPrescription

Summary

Mandatory: 2 elements(2 nested mandatory elements)
Must-Support: 4 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

- BeObservation (https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-observation)
- BeAllergyIntolerance (https://www.ehealth.fgov.be/standards/fhir/allergy/StructureDefinition/be-allergyintolerance)

Extensions

This structure refers to these extensions:

- https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-supporting-info
- https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contraindication (Modifier)
- https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contrastfluiduse (Modifier)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of ServiceRequest.orderDetail

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | BeReferralPrescription | A request for a service to be performed Constraints: prr-1
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Open by value:url
extension:statusReason | S | 0..1 | (Complex) | Reason for current status URL: http://hl7.org/fhir/StructureDefinition/request-statusReason
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/request-statusReason"
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: BeVSPrescriptionStatusReason (extensible)
extension:feedback | S | 1..1 | boolean | Give feedback to the prescriber URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-feedback-to-prescriber
extension:coprescriber | S | 0..1 | (Complex) | Info about the other parties that have to take part in the prescription. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-co-prescriber-info
extension:validity | S | 1..1 | Period | Validity period of the prescription URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-validity-period
extension:latest | S | 0..1 | BeYearMonthDay | Request must be executed before URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-latest-end-date
extension:latestDraft | S | 0..1 | BeYearMonthDay | The prescription must have left the draft status befor this moment URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-latest-draft-date
extension:proposalType | S | 0..1 | CodeableConcept | BeProposalType URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-proposal-type Binding: BeVsProposalType (required)
extension:pss | S | 0..1 | (Complex) | BePSSInfo URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-pss-info
extension:recorder | S | 0..1 | Reference(BePatient(2.1.2) | BePractitioner(2.1.2) | BeOrganization(2.1.2) | BePractitionerRole(2.1.2)) | The person responsable for this information, not necessarily the person who recorded the information URL: https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-recorder
extension:performerType | S | 0..* | CodeableConcept | Discipline of provider. Replaces .performerType because of wrong cardinality URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-performer-type Binding: BeVSCdHcParty (extensible)
extension:relevantSupportingInformationAsAnnotationOrCodeableConcept | S | 0..* | Annotation, CodeableConcept | Relevant clinical information in the context of this prescription concerning for example allergies, kidney function, diabetic. This extension allows the use of a codeableConcept or Annotation but when more detailed information can be given, it is RECOMMENDED to express it as structured as possible using the appropriate elements (for general relevant supporting information, this means the use of the .supportingInfo element.) ContraIndications SHALL be expressed using the contraIndication modifierExtension. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-supporting-info
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:contraIndication | ?!S | 1..* | Annotation, CodeableConcept, Reference(Device | Condition | MedicationStatement | BeObservation | BeAllergyIntolerance) | Relevant information in the context of a prescription concerning possible contra indication. For example presence of devices or (suspected) pregnancy. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. If prescriber has no knowledge of contra indication, this SHALL be expressed with a nullFlavor ( e.g. ASKU = Information was sought but not found ) in codeableConcept. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contraindication
modifierExtension:contrastFluidUse | ?!S | 0..1 | code | Whether the use of contrast fluid in diagnostic imaging can be defined as 'If necessary' or 'Not permitted.' URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contrastfluiduse Binding: BeContrastFluidUse (required)
Slices for identifier | S Σ | 0..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by value:system
identifier:UHMEP | Σ | 0..1 | Identifier | Reference ID of the UHMEP once available there
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: https://www.ehealth.fgov.be/standards/fhir/referral/NamingSystem/uhmep
value | Σ | 1..1 | string | The value that is unique Example General: 123456
basedOn | S Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills
requisition | S Σ | 0..1 | Identifier | If needed to have a common identifier among different prescriptions.
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: BeVsRequestIntent (required)
category | S Σ | 1..1 | CodeableConcept | Classification of service Binding: BeReferralCategory (extensible)
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed
code | S Σ | 0..1 | CodeableConcept | What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service.
Slices for orderDetail | S Σ C | 0..* | CodeableConcept | Additional order information Slice: Unordered, Open by value:coding.system Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
orderDetail:modality | S Σ C | 0..* | CodeableConcept | Acquisition modalities, i.e. those in the DICOM Context Group 29 Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
coding | Σ | 0..* | Coding | Code defined by a terminology system Binding: AcquisitionModality (required): Type of acquired data in the instance.
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code | Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 1..1 | BeContainedOrLogicalReference(BePatient(2.1.2)) | Individual or Entity the service is ordered for
occurrence[x] | S Σ | 0..1 |  | When service shall occur - once this is past, this prescription is no longer valid and the status shall reflect this.
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
occurrenceTiming |  |  | Timing |
authoredOn | S Σ C | 1..1 | dateTime | Date request signed Constraints: be-inv-long-date
requester | S Σ | 1..1 | BeContainedOrLogicalReference(BePractitionerRole(2.1.2)) | Prescriber of the requested service
performer | S Σ | 0..* | BeContainedOrLogicalReference(BePractitionerRole(2.1.2)) | Requested performer - typically reference to practitionerroles
reasonCode | S Σ | 0..1 | CodeableConcept | Diagnostic question, explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
supportingInfo | S | 0..* | Reference(Resource | Procedure | BeObservation | Condition | BeAllergyIntolerance | MedicationStatement | QuestionnaireResponse) | Relevant information in the context of this prescription concerning for example allergies, kidney function, diabetic. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. ContraIndications SHALL be expressed using the contraIndication modifierExtension
bodySite | S Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Slices for extension |  |  |  | Content/Rules for all slices
extension:bodyLaterality |  | 0..1 | Coding | BeExtLaterality URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality Binding: Laterality (required)
note | S | 0..* | BeCodedAnnotation | Comments
Slices for extension |  |  |  | Content/Rules for all slices
extension:code |  | 0..1 | (Complex) | Code URL: https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept"
text | Σ | 1..1 | markdown | The annotation - plain text without markdown is strongly recommended
patientInstruction | S Σ | 0..1 | string | Patient or consumer-oriented instructions
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.extension:statusReason.​value[x] | Base | extensible | BeVSPrescriptionStatusReason | 📦1.0.0 | This IG
ServiceRequest.identifier:UHMEP.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
ServiceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
ServiceRequest.intent | Base | required | BeVsRequestIntent | 📦1.0.0 | This IG
ServiceRequest.category | Base | extensible | BeReferralCategory | 📦1.0.0 | This IG
ServiceRequest.code | Base | example | Procedure Codes (SNOMED CT) | 📦4.0.1 | FHIR Std.
ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.orderDetail:modality | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.orderDetail:modality.​coding | Base | required | AcquisitionModality | ⏿2025.3.20250714 | tx.fhir.org
ServiceRequest.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
be-inv-long-date | error | ServiceRequest.authoredOn | date SHALL contain a long date (YYYY-MM-DDThh:mm:ss+zz:zz) | `empty() or toString().length()=25`
dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present | `orderDetail.empty() or code.exists()`

Differential View

This structure is derived from BeReferralPrescription

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest |  | 0..* | BeReferralPrescription | A request for a service to be performed
Slices for extension |  |  |  | Content/Rules for all slices
extension:relevantSupportingInformationAsAnnotationOrCodeableConcept | S | 0..* | Annotation, CodeableConcept | Relevant clinical information in the context of this prescription concerning for example allergies, kidney function, diabetic. This extension allows the use of a codeableConcept or Annotation but when more detailed information can be given, it is RECOMMENDED to express it as structured as possible using the appropriate elements (for general relevant supporting information, this means the use of the .supportingInfo element.) ContraIndications SHALL be expressed using the contraIndication modifierExtension. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-supporting-info
Slices for modifierExtension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:contraIndication | S | 1..* | Annotation, CodeableConcept, Reference(Device | Condition | MedicationStatement | BeObservation | BeAllergyIntolerance) | Relevant information in the context of a prescription concerning possible contra indication. For example presence of devices or (suspected) pregnancy. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. If prescriber has no knowledge of contra indication, this SHALL be expressed with a nullFlavor ( e.g. ASKU = Information was sought but not found ) in codeableConcept. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contraindication
modifierExtension:contrastFluidUse | S | 0..1 | code | Whether the use of contrast fluid in diagnostic imaging can be defined as 'If necessary' or 'Not permitted.' URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contrastfluiduse Binding: BeContrastFluidUse (required)
category |  |  |  |
coding |  |  |  |
system |  | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
code |  | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 363679005
Slices for orderDetail |  | 0..* | CodeableConcept | Additional order information Slice: Unordered, Open by value:coding.system
orderDetail:modality | S | 0..* | CodeableConcept | Acquisition modalities, i.e. those in the DICOM Context Group 29
coding |  | 0..* | Coding | Code defined by a terminology system Binding: AcquisitionModality (required): Type of acquired data in the instance.
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code |  | 1..1 | code | Symbol in syntax defined by the system
reasonCode |  | 0..1 | CodeableConcept | Diagnostic question, explanation/Justification for procedure or service
supportingInfo |  | 0..* | Reference(Resource | Procedure | BeObservation | Condition | BeAllergyIntolerance | MedicationStatement | QuestionnaireResponse) | Relevant information in the context of this prescription concerning for example allergies, kidney function, diabetic. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. ContraIndications SHALL be expressed using the contraIndication modifierExtension
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.orderDetail:modality.​coding | Base | required | AcquisitionModality | ⏿2025.3.20250714 | tx.fhir.org

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
ServiceRequest | C | 0..* | BeReferralPrescription | A request for a service to be performed Constraints: prr-1
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 2..* | Extension | Extension Slice: Unordered, Open by value:url
extension:statusReason | S | 0..1 | (Complex) | Reason for current status URL: http://hl7.org/fhir/StructureDefinition/request-statusReason
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/request-statusReason"
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: BeVSPrescriptionStatusReason (extensible)
extension:feedback | S | 1..1 | boolean | Give feedback to the prescriber URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-feedback-to-prescriber
extension:coprescriber | S | 0..1 | (Complex) | Info about the other parties that have to take part in the prescription. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-co-prescriber-info
extension:validity | S | 1..1 | Period | Validity period of the prescription URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-validity-period
extension:latest | S | 0..1 | BeYearMonthDay | Request must be executed before URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-latest-end-date
extension:latestDraft | S | 0..1 | BeYearMonthDay | The prescription must have left the draft status befor this moment URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-latest-draft-date
extension:proposalType | S | 0..1 | CodeableConcept | BeProposalType URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-proposal-type Binding: BeVsProposalType (required)
extension:pss | S | 0..1 | (Complex) | BePSSInfo URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-pss-info
extension:recorder | S | 0..1 | Reference(BePatient(2.1.2) | BePractitioner(2.1.2) | BeOrganization(2.1.2) | BePractitionerRole(2.1.2)) | The person responsable for this information, not necessarily the person who recorded the information URL: https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-recorder
extension:performerType | S | 0..* | CodeableConcept | Discipline of provider. Replaces .performerType because of wrong cardinality URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-performer-type Binding: BeVSCdHcParty (extensible)
extension:relevantSupportingInformationAsAnnotationOrCodeableConcept | S | 0..* | Annotation, CodeableConcept | Relevant clinical information in the context of this prescription concerning for example allergies, kidney function, diabetic. This extension allows the use of a codeableConcept or Annotation but when more detailed information can be given, it is RECOMMENDED to express it as structured as possible using the appropriate elements (for general relevant supporting information, this means the use of the .supportingInfo element.) ContraIndications SHALL be expressed using the contraIndication modifierExtension. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-supporting-info
Slices for modifierExtension | ?! | 1..* | Extension | Extension Slice: Unordered, Open by value:url
modifierExtension:contraIndication | ?!S | 1..* | Annotation, CodeableConcept, Reference(Device | Condition | MedicationStatement | BeObservation | BeAllergyIntolerance) | Relevant information in the context of a prescription concerning possible contra indication. For example presence of devices or (suspected) pregnancy. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. If prescriber has no knowledge of contra indication, this SHALL be expressed with a nullFlavor ( e.g. ASKU = Information was sought but not found ) in codeableConcept. URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contraindication
modifierExtension:contrastFluidUse | ?!S | 0..1 | code | Whether the use of contrast fluid in diagnostic imaging can be defined as 'If necessary' or 'Not permitted.' URL: https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contrastfluiduse Binding: BeContrastFluidUse (required)
Slices for identifier | S Σ | 0..* | Identifier | Identifiers assigned to this order Slice: Unordered, Open by value:system
identifier:UHMEP | Σ | 0..1 | Identifier | Reference ID of the UHMEP once available there
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | Σ | 1..1 | uri | The namespace for the identifier value Fixed Value: https://www.ehealth.fgov.be/standards/fhir/referral/NamingSystem/uhmep
value | Σ | 1..1 | string | The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
instantiatesCanonical | Σ | 0..* | canonical(ActivityDefinition | PlanDefinition) | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | S Σ | 0..* | Reference(CarePlan | ServiceRequest | MedicationRequest) | What request fulfills
replaces | Σ | 0..* | Reference(ServiceRequest) | What request replaces
requisition | S Σ | 0..1 | Identifier | If needed to have a common identifier among different prescriptions.
status | ?!S Σ | 1..1 | code | draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent | ?!S Σ | 1..1 | code | proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: BeVsRequestIntent (required)
category | S Σ | 1..1 | CodeableConcept | Classification of service Binding: BeReferralCategory (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 0..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 0..1 | code | Symbol in syntax defined by the system Fixed Value: 363679005
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if service/procedure should not be performed
code | S Σ | 0..1 | CodeableConcept | What is being requested/ordered Binding: ProcedureCodes(SNOMEDCT) (example): Codes for tests or services that can be carried out by a designated individual, organization or healthcare service.
Slices for orderDetail | S Σ C | 0..* | CodeableConcept | Additional order information Slice: Unordered, Open by value:coding.system Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
orderDetail:modality | S Σ C | 0..* | CodeableConcept | Acquisition modalities, i.e. those in the DICOM Context Group 29 Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
coding | Σ | 0..* | Coding | Code defined by a terminology system Binding: AcquisitionModality (required): Type of acquired data in the instance.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version | Σ | 0..1 | string | Version of the system - if relevant
code | Σ | 1..1 | code | Symbol in syntax defined by the system
display | Σ | 0..1 | string | Representation defined by the system
userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user
text | Σ | 0..1 | string | Plain text representation of the concept
quantity[x] | Σ | 0..1 |  | Service amount
quantityQuantity |  |  | Quantity |
quantityRatio |  |  | Ratio |
quantityRange |  |  | Range |
subject | S Σ | 1..1 | BeContainedOrLogicalReference(BePatient(2.1.2)) | Individual or Entity the service is ordered for
encounter | Σ | 0..1 | Reference(Encounter) | Encounter in which the request was created
occurrence[x] | S Σ | 0..1 |  | When service shall occur - once this is past, this prescription is no longer valid and the status shall reflect this.
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period |
occurrenceTiming |  |  | Timing |
asNeeded[x] | Σ | 0..1 |  | Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
authoredOn | S Σ C | 1..1 | dateTime | Date request signed Constraints: be-inv-long-date
requester | S Σ | 1..1 | BeContainedOrLogicalReference(BePractitionerRole(2.1.2)) | Prescriber of the requested service
performer | S Σ | 0..* | BeContainedOrLogicalReference(BePractitionerRole(2.1.2)) | Requested performer - typically reference to practitionerroles
locationCode | Σ | 0..* | CodeableConcept | Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference | Σ | 0..* | Reference(Location) | Requested location
reasonCode | S Σ | 0..1 | CodeableConcept | Diagnostic question, explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
reasonReference | Σ | 0..* | Reference(Condition | Observation | DiagnosticReport | DocumentReference) | Explanation/Justification for service or service
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
supportingInfo | S | 0..* | Reference(Resource | Procedure | BeObservation | Condition | BeAllergyIntolerance | MedicationStatement | QuestionnaireResponse) | Relevant information in the context of this prescription concerning for example allergies, kidney function, diabetic. When detailed information can be given, it is RECOMMENDED to express it as structured as possible. ContraIndications SHALL be expressed using the contraIndication modifierExtension
specimen | Σ | 0..* | Reference(Specimen) | Procedure Samples
bodySite | S Σ | 0..* | CodeableConcept | Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:bodyLaterality |  | 0..1 | Coding | BeExtLaterality URL: https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-ext-laterality Binding: Laterality (required)
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
note | S | 0..* | BeCodedAnnotation | Comments
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:code |  | 0..1 | (Complex) | Code URL: https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-ext-codeableconcept"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: BeVSRequestNoteType (required)
author[x] | Σ | 0..1 |  | Individual responsible for the annotation
authorReference |  |  | Reference(Practitioner | Patient | RelatedPerson | Organization) |
authorString |  |  | string |
time | Σ | 0..1 | dateTime | When the annotation was made
text | Σ | 1..1 | markdown | The annotation - plain text without markdown is strongly recommended
patientInstruction | S Σ | 0..1 | string | Patient or consumer-oriented instructions
relevantHistory |  | 0..* | Reference(Provenance) | Request provenance
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
ServiceRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
ServiceRequest.extension:statusReason.​value[x] | Base | extensible | BeVSPrescriptionStatusReason | 📦1.0.0 | This IG
ServiceRequest.identifier:UHMEP.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
ServiceRequest.identifier:UHMEP.​type | Base | extensible | IdentifierType | 📍4.0.1 | FHIR Std.
ServiceRequest.status | Base | required | RequestStatus | 📍4.0.1 | FHIR Std.
ServiceRequest.intent | Base | required | BeVsRequestIntent | 📦1.0.0 | This IG
ServiceRequest.category | Base | extensible | BeReferralCategory | 📦1.0.0 | This IG
ServiceRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
ServiceRequest.code | Base | example | Procedure Codes (SNOMED CT) | 📦4.0.1 | FHIR Std.
ServiceRequest.orderDetail | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.orderDetail:modality | Base | example | Service Request Order Details Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.orderDetail:modality.​coding | Base | required | AcquisitionModality | ⏿2025.3.20250714 | tx.fhir.org
ServiceRequest.asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.locationCode | Base | example | ServiceDeliveryLocationRoleType | 📦3.0.0 | THO v6.5
ServiceRequest.reasonCode | Base | example | Procedure Reason Codes | 📍4.0.1 | FHIR Std.
ServiceRequest.bodySite | Base | example | SNOMED CT Body Structures | 📍4.0.1 | FHIR Std.
ServiceRequest.note.​extension:code.value[x] | Base | required | BeVSRequestNoteType | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
be-inv-long-date | error | ServiceRequest.authoredOn | date SHALL contain a long date (YYYY-MM-DDThh:mm:ss+zz:zz) | `empty() or toString().length()=25`
dom-2 | error | ServiceRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | ServiceRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | ServiceRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | ServiceRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
prr-1 | error | ServiceRequest | orderDetail SHALL only be present if code is present | `orderDetail.empty() or code.exists()`

This structure is derived from BeReferralPrescription

Summary

Mandatory: 2 elements(2 nested mandatory elements)
Must-Support: 4 elements
Fixed: 3 elements

Structures

This structure refers to these other structures:

- BeObservation (https://www.ehealth.fgov.be/standards/fhir/core-clinical/StructureDefinition/be-observation)
- BeAllergyIntolerance (https://www.ehealth.fgov.be/standards/fhir/allergy/StructureDefinition/be-allergyintolerance)

Extensions

This structure refers to these extensions:

- https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-supporting-info
- https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contraindication (Modifier)
- https://www.ehealth.fgov.be/standards/fhir/referral/StructureDefinition/be-ext-contrastfluiduse (Modifier)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of ServiceRequest.orderDetail

Other representations of profile: CSV, Excel, Schematron