PanCareSurPass Project HL7 FHIR Implementation Guide
1.0.0 - release 150

PanCareSurPass Project HL7 FHIR Implementation Guide, published by PanCareSurPass Project. 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-eu/pcsp/ and changes regularly. See the Directory of published versions

Resource Profile: Procedure: Surgery

Official URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Procedure-surgery-eu-pcsp Version: 1.0.0
Active as of 2025-10-16 Computable Name: ProcedureSurgeryPcsp

This profile defines how to represent Procedures in FHIR for describing a set of Surgery data required by the PanCareSurPass algorithm to generate the care plan. It is used also to provide inforamtion about shunt, amputation, and other procedures

Usages:

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.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Procedure 0..* Procedure An action that is being or was performed on a patient
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Textual description of the surgical procedure
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:sacrifiedOrgan 0..* CodeableConcept Sacrified organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/surgery-sacrifiedOrgan
Binding: Sacrified Organs (surgery) (extensible)
.... extension:notAffectedOrgan 0..* CodeableConcept Not affected Organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/procedure-notAffectedOrgan
Binding: Affected Organs (surgery) (preferred)
... identifier Σ 0..* Identifier External Identifiers for this surgical procedure
... partOf Σ 0..* Reference(Procedure: Surgery) Reference to the parent surgery procedure
... status ?!SΣ 1..1 code preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required): A code specifying the state of the procedure.
... category Σ 1..1 CodeableConcept Classification of the procedure
Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 387713003
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code Σ 0..1 CodeableConcept Identification of the procedure.
Binding: Surgical Procedure Type (extensible)
... subject SΣ 1..1 Reference(Patient: PCSP) Who the procedure was performed on
... Slices for performed[x] Σ 1..1 dateTime When the procedure was performed
Slice: Unordered, Closed by type:$this
.... performed[x]:performedDateTime Σ 1..1 dateTime Date of the surgical procedure
... location Σ 0..1 Reference(Location: PCSP) Where the procedure happened
... reasonReference SΣ 1..* Reference(Condition: Primary Cancer) The justification that the procedure was performed
... bodySite Σ 0..* CodeableConcept Target body sites
Binding: Affected Organs (surgery) (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:laterality 0..1 (Complex) Laterality Qualifier
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
...... extension 0..0
...... url 1..1 uri "http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier"
...... value[x] 1..1 CodeableConcept Value of extension
Binding: Laterality Qualifier Value Set (required)
... focalDevice 0..* BackboneElement Implanted or removed device
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... action 0..1 CodeableConcept Kind of change to device
Binding: Surgical Actions (extensible)
.... manipulated 1..1 Reference(Device) Device manipulated
... usedCode 0..* CodeableConcept Coded items used during the procedure
Binding: Prosthesis Type (extensible)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Procedure.status Base required EventStatus 📍4.0.1 FHIR Std.
Procedure.category Base example Procedure Category Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Procedure.code Base extensible Surgical Procedure Type 📦1.0.0 This IG
Procedure.bodySite Base extensible Affected Organs (surgery) 📦1.0.0 This IG
Procedure.bodySite.extension:laterality.​value[x] Base required Laterality Qualifier Value Set 📦4.0.0 minimal Common Oncology Data Elements v4.0
Procedure.focalDevice.​action Base extensible Surgical Actions 📦1.0.0 This IG
Procedure.usedCode Base extensible Prosthesis Type 📦1.0.0 This IG

Constraints

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

This structure is derived from Procedure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Procedure Procedure
... text 0..1 Narrative Textual description of the surgical procedure
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:sacrifiedOrgan 0..* CodeableConcept Sacrified organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/surgery-sacrifiedOrgan
Binding: Sacrified Organs (surgery) (extensible)
.... extension:notAffectedOrgan 0..* CodeableConcept Not affected Organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/procedure-notAffectedOrgan
Binding: Affected Organs (surgery) (preferred)
... identifier 0..* Identifier External Identifiers for this surgical procedure
... status S 1..1 code preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
... category 1..1 CodeableConcept Classification of the procedure
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 387713003
... code 0..1 CodeableConcept Identification of the procedure.
Binding: Surgical Procedure Type (extensible)
... subject S 1..1 Reference(Patient: PCSP) Who the procedure was performed on
... Slices for performed[x] 1..1 dateTime When the procedure was performed
Slice: Unordered, Open by type:$this
.... performed[x]:performedDateTime 1..1 dateTime Date of the surgical procedure
... location 0..1 Reference(Location: PCSP) Where the procedure happened
... reasonReference S 1..* Reference(Condition: Primary Cancer) The justification that the procedure was performed
... bodySite 0..* CodeableConcept Target body sites
Binding: Affected Organs (surgery) (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:laterality 0..1 (Complex) Laterality Qualifier
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
...... value[x] 1..1 CodeableConcept Value of extension
Binding: Laterality Qualifier Value Set (required)
... focalDevice 0..* BackboneElement Implanted or removed device
.... action 0..1 CodeableConcept Kind of change to device
Binding: Surgical Actions (extensible)
.... manipulated 1..1 Reference(Device) Device manipulated
... usedCode 0..* CodeableConcept Coded items used during the procedure
Binding: Prosthesis Type (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Procedure.code Base extensible Surgical Procedure Type 📦1.0.0 This IG
Procedure.bodySite Base extensible Affected Organs (surgery) 📦1.0.0 This IG
Procedure.bodySite.extension:laterality.​value[x] Base required Laterality Qualifier Value Set 📦4.0.0 minimal Common Oncology Data Elements v4.0
Procedure.focalDevice.​action Base extensible Surgical Actions 📦1.0.0 This IG
Procedure.usedCode Base extensible Prosthesis Type 📦1.0.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Procedure 0..* Procedure An action that is being or was performed on a patient
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Textual description of the surgical procedure
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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:sacrifiedOrgan 0..* CodeableConcept Sacrified organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/surgery-sacrifiedOrgan
Binding: Sacrified Organs (surgery) (extensible)
.... extension:notAffectedOrgan 0..* CodeableConcept Not affected Organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/procedure-notAffectedOrgan
Binding: Affected Organs (surgery) (preferred)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Identifiers for this surgical procedure
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest) A request for this procedure
... partOf Σ 0..* Reference(Procedure: Surgery) Reference to the parent surgery procedure
... status ?!SΣ 1..1 code preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required): A code specifying the state of the procedure.
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
... category Σ 1..1 CodeableConcept Classification of the procedure
Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 387713003
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code Σ 0..1 CodeableConcept Identification of the procedure.
Binding: Surgical Procedure Type (extensible)
... subject SΣ 1..1 Reference(Patient: PCSP) Who the procedure was performed on
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... Slices for performed[x] Σ 1..1 dateTime When the procedure was performed
Slice: Unordered, Closed by type:$this
.... performed[x]:performedDateTime Σ 1..1 dateTime Date of the surgical procedure
... recorder Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Who recorded the procedure
... asserter Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Person who asserts this procedure
... performer Σ 0..* BackboneElement The people who performed the procedure
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function Σ 0..1 CodeableConcept Type of performance
Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
.... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) The reference to the practitioner
.... onBehalfOf 0..1 Reference(Organization) Organization the device or practitioner was acting for
... location Σ 0..1 Reference(Location: PCSP) Where the procedure happened
... reasonCode Σ 0..* CodeableConcept Coded reason procedure performed
Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
... reasonReference SΣ 1..* Reference(Condition: Primary Cancer) The justification that the procedure was performed
... bodySite Σ 0..* CodeableConcept Target body sites
Binding: Affected Organs (surgery) (extensible)
.... 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:laterality 0..1 (Complex) Laterality Qualifier
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..0
...... url 1..1 uri "http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier"
...... value[x] 1..1 CodeableConcept Value of extension
Binding: Laterality Qualifier Value Set (required)
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... outcome Σ 0..1 CodeableConcept The result of procedure
Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
... report 0..* Reference(DiagnosticReport | DocumentReference | Composition) Any report resulting from the procedure
... complication 0..* CodeableConcept Complication following the procedure
Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
... complicationDetail 0..* Reference(Condition) A condition that is a result of the procedure
... followUp 0..* CodeableConcept Instructions for follow up
Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
... note 0..* Annotation Additional information about the procedure
... focalDevice 0..* BackboneElement Implanted or removed device
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... action 0..1 CodeableConcept Kind of change to device
Binding: Surgical Actions (extensible)
.... manipulated 1..1 Reference(Device) Device manipulated
... usedReference 0..* Reference(Device | Medication | Substance) Items used during procedure
... usedCode 0..* CodeableConcept Coded items used during the procedure
Binding: Prosthesis Type (extensible)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Procedure.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Procedure.status Base required EventStatus 📍4.0.1 FHIR Std.
Procedure.statusReason Base example Procedure Not Performed Reason (SNOMED-CT) 📍4.0.1 FHIR Std.
Procedure.category Base example Procedure Category Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Procedure.code Base extensible Surgical Procedure Type 📦1.0.0 This IG
Procedure.performer.​function Base example Procedure Performer Role Codes 📍4.0.1 FHIR Std.
Procedure.reasonCode Base example Procedure Reason Codes 📍4.0.1 FHIR Std.
Procedure.bodySite Base extensible Affected Organs (surgery) 📦1.0.0 This IG
Procedure.bodySite.extension:laterality.​value[x] Base required Laterality Qualifier Value Set 📦4.0.0 minimal Common Oncology Data Elements v4.0
Procedure.outcome Base example Procedure Outcome Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Procedure.complication Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.
Procedure.followUp Base example Procedure Follow up Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Procedure.focalDevice.​action Base extensible Surgical Actions 📦1.0.0 This IG
Procedure.usedCode Base extensible Prosthesis Type 📦1.0.0 This IG

Constraints

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

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Procedure 0..* Procedure An action that is being or was performed on a patient
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Textual description of the surgical procedure
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:sacrifiedOrgan 0..* CodeableConcept Sacrified organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/surgery-sacrifiedOrgan
Binding: Sacrified Organs (surgery) (extensible)
.... extension:notAffectedOrgan 0..* CodeableConcept Not affected Organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/procedure-notAffectedOrgan
Binding: Affected Organs (surgery) (preferred)
... identifier Σ 0..* Identifier External Identifiers for this surgical procedure
... partOf Σ 0..* Reference(Procedure: Surgery) Reference to the parent surgery procedure
... status ?!SΣ 1..1 code preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required): A code specifying the state of the procedure.
... category Σ 1..1 CodeableConcept Classification of the procedure
Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 387713003
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code Σ 0..1 CodeableConcept Identification of the procedure.
Binding: Surgical Procedure Type (extensible)
... subject SΣ 1..1 Reference(Patient: PCSP) Who the procedure was performed on
... Slices for performed[x] Σ 1..1 dateTime When the procedure was performed
Slice: Unordered, Closed by type:$this
.... performed[x]:performedDateTime Σ 1..1 dateTime Date of the surgical procedure
... location Σ 0..1 Reference(Location: PCSP) Where the procedure happened
... reasonReference SΣ 1..* Reference(Condition: Primary Cancer) The justification that the procedure was performed
... bodySite Σ 0..* CodeableConcept Target body sites
Binding: Affected Organs (surgery) (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:laterality 0..1 (Complex) Laterality Qualifier
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
...... extension 0..0
...... url 1..1 uri "http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier"
...... value[x] 1..1 CodeableConcept Value of extension
Binding: Laterality Qualifier Value Set (required)
... focalDevice 0..* BackboneElement Implanted or removed device
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... action 0..1 CodeableConcept Kind of change to device
Binding: Surgical Actions (extensible)
.... manipulated 1..1 Reference(Device) Device manipulated
... usedCode 0..* CodeableConcept Coded items used during the procedure
Binding: Prosthesis Type (extensible)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Procedure.status Base required EventStatus 📍4.0.1 FHIR Std.
Procedure.category Base example Procedure Category Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Procedure.code Base extensible Surgical Procedure Type 📦1.0.0 This IG
Procedure.bodySite Base extensible Affected Organs (surgery) 📦1.0.0 This IG
Procedure.bodySite.extension:laterality.​value[x] Base required Laterality Qualifier Value Set 📦4.0.0 minimal Common Oncology Data Elements v4.0
Procedure.focalDevice.​action Base extensible Surgical Actions 📦1.0.0 This IG
Procedure.usedCode Base extensible Prosthesis Type 📦1.0.0 This IG

Constraints

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

Differential View

This structure is derived from Procedure

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Procedure Procedure
... text 0..1 Narrative Textual description of the surgical procedure
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:sacrifiedOrgan 0..* CodeableConcept Sacrified organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/surgery-sacrifiedOrgan
Binding: Sacrified Organs (surgery) (extensible)
.... extension:notAffectedOrgan 0..* CodeableConcept Not affected Organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/procedure-notAffectedOrgan
Binding: Affected Organs (surgery) (preferred)
... identifier 0..* Identifier External Identifiers for this surgical procedure
... status S 1..1 code preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
... category 1..1 CodeableConcept Classification of the procedure
Required Pattern: At least the following
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 387713003
... code 0..1 CodeableConcept Identification of the procedure.
Binding: Surgical Procedure Type (extensible)
... subject S 1..1 Reference(Patient: PCSP) Who the procedure was performed on
... Slices for performed[x] 1..1 dateTime When the procedure was performed
Slice: Unordered, Open by type:$this
.... performed[x]:performedDateTime 1..1 dateTime Date of the surgical procedure
... location 0..1 Reference(Location: PCSP) Where the procedure happened
... reasonReference S 1..* Reference(Condition: Primary Cancer) The justification that the procedure was performed
... bodySite 0..* CodeableConcept Target body sites
Binding: Affected Organs (surgery) (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:laterality 0..1 (Complex) Laterality Qualifier
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
...... value[x] 1..1 CodeableConcept Value of extension
Binding: Laterality Qualifier Value Set (required)
... focalDevice 0..* BackboneElement Implanted or removed device
.... action 0..1 CodeableConcept Kind of change to device
Binding: Surgical Actions (extensible)
.... manipulated 1..1 Reference(Device) Device manipulated
... usedCode 0..* CodeableConcept Coded items used during the procedure
Binding: Prosthesis Type (extensible)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Procedure.code Base extensible Surgical Procedure Type 📦1.0.0 This IG
Procedure.bodySite Base extensible Affected Organs (surgery) 📦1.0.0 This IG
Procedure.bodySite.extension:laterality.​value[x] Base required Laterality Qualifier Value Set 📦4.0.0 minimal Common Oncology Data Elements v4.0
Procedure.focalDevice.​action Base extensible Surgical Actions 📦1.0.0 This IG
Procedure.usedCode Base extensible Prosthesis Type 📦1.0.0 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Procedure 0..* Procedure An action that is being or was performed on a patient
... 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Textual description of the surgical procedure
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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:sacrifiedOrgan 0..* CodeableConcept Sacrified organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/surgery-sacrifiedOrgan
Binding: Sacrified Organs (surgery) (extensible)
.... extension:notAffectedOrgan 0..* CodeableConcept Not affected Organ
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/procedure-notAffectedOrgan
Binding: Affected Organs (surgery) (preferred)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Identifiers for this surgical procedure
... instantiatesCanonical Σ 0..* canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest) A request for this procedure
... partOf Σ 0..* Reference(Procedure: Surgery) Reference to the parent surgery procedure
... status ?!SΣ 1..1 code preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
Binding: EventStatus (required): A code specifying the state of the procedure.
... statusReason Σ 0..1 CodeableConcept Reason for current status
Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
... category Σ 1..1 CodeableConcept Classification of the procedure
Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 387713003
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code Σ 0..1 CodeableConcept Identification of the procedure.
Binding: Surgical Procedure Type (extensible)
... subject SΣ 1..1 Reference(Patient: PCSP) Who the procedure was performed on
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... Slices for performed[x] Σ 1..1 dateTime When the procedure was performed
Slice: Unordered, Closed by type:$this
.... performed[x]:performedDateTime Σ 1..1 dateTime Date of the surgical procedure
... recorder Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Who recorded the procedure
... asserter Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Person who asserts this procedure
... performer Σ 0..* BackboneElement The people who performed the procedure
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... function Σ 0..1 CodeableConcept Type of performance
Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
.... actor Σ 1..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) The reference to the practitioner
.... onBehalfOf 0..1 Reference(Organization) Organization the device or practitioner was acting for
... location Σ 0..1 Reference(Location: PCSP) Where the procedure happened
... reasonCode Σ 0..* CodeableConcept Coded reason procedure performed
Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
... reasonReference SΣ 1..* Reference(Condition: Primary Cancer) The justification that the procedure was performed
... bodySite Σ 0..* CodeableConcept Target body sites
Binding: Affected Organs (surgery) (extensible)
.... 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:laterality 0..1 (Complex) Laterality Qualifier
URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..0
...... url 1..1 uri "http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier"
...... value[x] 1..1 CodeableConcept Value of extension
Binding: Laterality Qualifier Value Set (required)
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... outcome Σ 0..1 CodeableConcept The result of procedure
Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
... report 0..* Reference(DiagnosticReport | DocumentReference | Composition) Any report resulting from the procedure
... complication 0..* CodeableConcept Complication following the procedure
Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
... complicationDetail 0..* Reference(Condition) A condition that is a result of the procedure
... followUp 0..* CodeableConcept Instructions for follow up
Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
... note 0..* Annotation Additional information about the procedure
... focalDevice 0..* BackboneElement Implanted or removed device
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... action 0..1 CodeableConcept Kind of change to device
Binding: Surgical Actions (extensible)
.... manipulated 1..1 Reference(Device) Device manipulated
... usedReference 0..* Reference(Device | Medication | Substance) Items used during procedure
... usedCode 0..* CodeableConcept Coded items used during the procedure
Binding: Prosthesis Type (extensible)

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Procedure.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Procedure.status Base required EventStatus 📍4.0.1 FHIR Std.
Procedure.statusReason Base example Procedure Not Performed Reason (SNOMED-CT) 📍4.0.1 FHIR Std.
Procedure.category Base example Procedure Category Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Procedure.code Base extensible Surgical Procedure Type 📦1.0.0 This IG
Procedure.performer.​function Base example Procedure Performer Role Codes 📍4.0.1 FHIR Std.
Procedure.reasonCode Base example Procedure Reason Codes 📍4.0.1 FHIR Std.
Procedure.bodySite Base extensible Affected Organs (surgery) 📦1.0.0 This IG
Procedure.bodySite.extension:laterality.​value[x] Base required Laterality Qualifier Value Set 📦4.0.0 minimal Common Oncology Data Elements v4.0
Procedure.outcome Base example Procedure Outcome Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Procedure.complication Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.
Procedure.followUp Base example Procedure Follow up Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Procedure.focalDevice.​action Base extensible Surgical Actions 📦1.0.0 This IG
Procedure.usedCode Base extensible Prosthesis Type 📦1.0.0 This IG

Constraints

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

 

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