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: Condition: Metastatic Cancer

Official URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Condition-secondaryCancer-eu-pcsp | Version: 1.0.0
Active as of 2025-10-16 | Computable Name: ConditionSecondaryCancerPcsp

This profile defines how to represent metastatic cancer in FHIR for the purpose of the PanCareSurPass project. This profile is inspired from the mCode IG. Records the history of secondary neoplasms, including location(s) and the date of onset of metastases. A secondary cancer results from the spread (metastasization) of cancer from its original site (Definition from: NCI Dictionary of Cancer Terms).

Usages:

- Use this Profile: Bundle: Survivor Passport
- Refer to this Profile: Composition: Survivor Passport
- Examples for this Profile: Condition/ConditionSecCancerMainzZeisig

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
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate |  | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
extension:histologyMorphologyBehavior |  | 0..1 | (Complex) | Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus |  | 0..1 | CodeableConcept | Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType |  | 0..1 | (Complex) | Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
extension:relatedPrimaryCancerCondition |  | 1..1 | (Complex) | Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/condition-related"
value[x] |  | 1..1 | Reference(Condition: Primary Cancer) | Value of extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
code | S Σ | 0..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: ICD-O-3 Topography (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:locationQualifier |  | 0..* | CodeableConcept | Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier |  | 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 (preferred): Qualifiers to specify laterality.
Additional Bindings | Purpose
Laterality Qualifier Value Set | candidate
subject | Σ | 1..1 | Reference(Patient: PCSP) | Who has the condition?
stage | C | 0..* | BackboneElement | Not used in this profile Constraints: con-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.extension:histologyMorphologyBehavior.​value[x] | Base | required | ICD-O-3 Morphology | 📦1.0.0 | This IG
Condition.extension:relapseType.​value[x] | Base | preferred | Relapse type (Local/Distant/Combined) | 📦1.0.0 | This IG
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.code | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
Condition.bodySite | Base | extensible | ICD-O-3 Topography | 📦1.0.0 | This IG
Condition.bodySite.extension:lateralityQualifier.​value[x] | Base | preferred | Laterality Qualifier Value Set | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
con-1 | error | Condition.stage | Stage SHALL have summary or assessment | `summary.exists() or assessment.exists()`
con-3 | best practice | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item | `clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()`
con-4 | error | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission | `abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()`
con-5 | error | Condition | Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Condition | 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 | Condition | 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 | Condition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Condition | 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 Condition

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  |  | Condition |
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate |  | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
extension:histologyMorphologyBehavior |  | 0..1 | (Complex) | Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus |  | 0..1 | CodeableConcept | Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType |  | 0..1 | (Complex) | Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
extension:relatedPrimaryCancerCondition |  | 1..1 | (Complex) | Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
value[x] |  | 1..1 | Reference(Condition: Primary Cancer) | Value of extension
clinicalStatus | S | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
code | S | 0..1 | CodeableConcept | Identification of the condition, problem or diagnosis
bodySite |  | 0..* | CodeableConcept | Anatomical location, if relevant Binding: ICD-O-3 Topography (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:locationQualifier |  | 0..* | CodeableConcept | Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier |  | 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 (preferred): Qualifiers to specify laterality.
Additional Bindings | Purpose
Laterality Qualifier Value Set | candidate
subject |  | 1..1 | Reference(Patient: PCSP) | Who has the condition?
stage |  | 0..* | BackboneElement | Not used in this profile
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Condition.extension:histologyMorphologyBehavior.​value[x] | Base | required | ICD-O-3 Morphology | 📦1.0.0 | This IG
Condition.extension:relapseType.​value[x] | Base | preferred | Relapse type (Local/Distant/Combined) | 📦1.0.0 | This IG
Condition.bodySite | Base | extensible | ICD-O-3 Topography | 📦1.0.0 | This IG
Condition.bodySite.extension:lateralityQualifier.​value[x] | Base | preferred | Laterality Qualifier Value Set | 📦1.0.0 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate |  | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
extension:histologyMorphologyBehavior |  | 0..1 | (Complex) | Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus |  | 0..1 | CodeableConcept | Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType |  | 0..1 | (Complex) | Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
extension:relatedPrimaryCancerCondition |  | 1..1 | (Complex) | Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/condition-related"
value[x] |  | 1..1 | Reference(Condition: Primary Cancer) | Value of extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External Ids for this condition
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
category |  | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
severity |  | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S Σ | 0..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: ICD-O-3 Topography (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:locationQualifier |  | 0..* | CodeableConcept | Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier |  | 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 (preferred): Qualifiers to specify laterality.
Additional Bindings | Purpose
Laterality Qualifier Value Set | candidate
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 1..1 | Reference(Patient: PCSP) | Who has the condition?
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
onset[x] | Σ | 0..1 |  | Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
abatement[x] | C | 0..1 |  | When in resolution/remission
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | Σ | 0..1 | dateTime | Date record was first recorded
recorder | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the condition
asserter | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Person who asserts this condition
stage | C | 0..* | BackboneElement | Not used in this profile Constraints: con-1
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
summary | C | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment | C | 0..* | Reference(ClinicalImpression | DiagnosticReport | Observation) | Formal record of assessment
type |  | 0..1 | CodeableConcept | Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence | C | 0..* | BackboneElement | Supporting evidence Constraints: con-2
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
code | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Condition.extension:histologyMorphologyBehavior.​value[x] | Base | required | ICD-O-3 Morphology | 📦1.0.0 | This IG
Condition.extension:relapseType.​value[x] | Base | preferred | Relapse type (Local/Distant/Combined) | 📦1.0.0 | This IG
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📍4.0.1 | FHIR Std.
Condition.code | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
Condition.bodySite | Base | extensible | ICD-O-3 Topography | 📦1.0.0 | This IG
Condition.bodySite.extension:lateralityQualifier.​value[x] | Base | preferred | Laterality Qualifier Value Set | 📦1.0.0 | This IG
Condition.stage.summary | Base | example | Condition Stage | 📍4.0.1 | FHIR Std.
Condition.stage.type | Base | example | Condition Stage Type | 📍4.0.1 | FHIR Std.
Condition.evidence.code | Base | example | Manifestation and Symptom Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
con-1 | error | Condition.stage | Stage SHALL have summary or assessment | `summary.exists() or assessment.exists()`
con-2 | error | Condition.evidence | evidence SHALL have code or details | `code.exists() or detail.exists()`
con-3 | best practice | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item | `clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()`
con-4 | error | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission | `abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()`
con-5 | error | Condition | Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Condition | 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 | Condition | 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 | Condition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Condition | 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 Condition

Summary

Mandatory: 2 elements
Must-Support: 3 elements

Structures

This structure refers to these other structures:

- Condition: Primary Cancer (http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Condition-primaryCancer-eu-pcsp)
- Patient: PCSP (http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Patient-eu-pcsp)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/condition-assertedDate|5.2.0
- http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
- http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus
- http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
- http://hl7.org/fhir/StructureDefinition/condition-related|5.2.0
- http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier
- http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate |  | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
extension:histologyMorphologyBehavior |  | 0..1 | (Complex) | Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus |  | 0..1 | CodeableConcept | Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType |  | 0..1 | (Complex) | Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
extension:relatedPrimaryCancerCondition |  | 1..1 | (Complex) | Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/condition-related"
value[x] |  | 1..1 | Reference(Condition: Primary Cancer) | Value of extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
code | S Σ | 0..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: ICD-O-3 Topography (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:locationQualifier |  | 0..* | CodeableConcept | Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier |  | 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 (preferred): Qualifiers to specify laterality.
Additional Bindings | Purpose
Laterality Qualifier Value Set | candidate
subject | Σ | 1..1 | Reference(Patient: PCSP) | Who has the condition?
stage | C | 0..* | BackboneElement | Not used in this profile Constraints: con-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.extension:histologyMorphologyBehavior.​value[x] | Base | required | ICD-O-3 Morphology | 📦1.0.0 | This IG
Condition.extension:relapseType.​value[x] | Base | preferred | Relapse type (Local/Distant/Combined) | 📦1.0.0 | This IG
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.code | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
Condition.bodySite | Base | extensible | ICD-O-3 Topography | 📦1.0.0 | This IG
Condition.bodySite.extension:lateralityQualifier.​value[x] | Base | preferred | Laterality Qualifier Value Set | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
con-1 | error | Condition.stage | Stage SHALL have summary or assessment | `summary.exists() or assessment.exists()`
con-3 | best practice | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item | `clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()`
con-4 | error | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission | `abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()`
con-5 | error | Condition | Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Condition | 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 | Condition | 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 | Condition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Condition | 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 Condition

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  |  | Condition |
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate |  | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
extension:histologyMorphologyBehavior |  | 0..1 | (Complex) | Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus |  | 0..1 | CodeableConcept | Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType |  | 0..1 | (Complex) | Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
extension:relatedPrimaryCancerCondition |  | 1..1 | (Complex) | Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
value[x] |  | 1..1 | Reference(Condition: Primary Cancer) | Value of extension
clinicalStatus | S | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
code | S | 0..1 | CodeableConcept | Identification of the condition, problem or diagnosis
bodySite |  | 0..* | CodeableConcept | Anatomical location, if relevant Binding: ICD-O-3 Topography (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:locationQualifier |  | 0..* | CodeableConcept | Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier |  | 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 (preferred): Qualifiers to specify laterality.
Additional Bindings | Purpose
Laterality Qualifier Value Set | candidate
subject |  | 1..1 | Reference(Patient: PCSP) | Who has the condition?
stage |  | 0..* | BackboneElement | Not used in this profile
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Condition.extension:histologyMorphologyBehavior.​value[x] | Base | required | ICD-O-3 Morphology | 📦1.0.0 | This IG
Condition.extension:relapseType.​value[x] | Base | preferred | Relapse type (Local/Distant/Combined) | 📦1.0.0 | This IG
Condition.bodySite | Base | extensible | ICD-O-3 Topography | 📦1.0.0 | This IG
Condition.bodySite.extension:lateralityQualifier.​value[x] | Base | preferred | Laterality Qualifier Value Set | 📦1.0.0 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | Condition | Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
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 |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:assertedDate |  | 0..1 | dateTime | Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
extension:histologyMorphologyBehavior |  | 0..1 | (Complex) | Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x] |  | 1..1 | CodeableConcept | Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus |  | 0..1 | CodeableConcept | Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType |  | 0..1 | (Complex) | Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType"
value[x] |  | 0..1 | CodeableConcept | Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
extension:relatedPrimaryCancerCondition |  | 1..1 | (Complex) | Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
id |  | 0..1 | id | Unique id for inter-element referencing
extension |  | 0..0 |  |
url |  | 1..1 | uri | "http://hl7.org/fhir/StructureDefinition/condition-related"
value[x] |  | 1..1 | Reference(Condition: Primary Cancer) | Value of extension
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External Ids for this condition
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
category |  | 0..* | CodeableConcept | problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
severity |  | 0..1 | CodeableConcept | Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code | S Σ | 0..1 | CodeableConcept | Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: ICD-O-3 Topography (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:locationQualifier |  | 0..* | CodeableConcept | Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier |  | 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 (preferred): Qualifiers to specify laterality.
Additional Bindings | Purpose
Laterality Qualifier Value Set | candidate
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
subject | Σ | 1..1 | Reference(Patient: PCSP) | Who has the condition?
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
onset[x] | Σ | 0..1 |  | Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
abatement[x] | C | 0..1 |  | When in resolution/remission
abatementDateTime |  |  | dateTime |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | Σ | 0..1 | dateTime | Date record was first recorded
recorder | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the condition
asserter | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Person who asserts this condition
stage | C | 0..* | BackboneElement | Not used in this profile Constraints: con-1
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
summary | C | 0..1 | CodeableConcept | Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment | C | 0..* | Reference(ClinicalImpression | DiagnosticReport | Observation) | Formal record of assessment
type |  | 0..1 | CodeableConcept | Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence | C | 0..* | BackboneElement | Supporting evidence Constraints: con-2
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
code | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Condition.extension:histologyMorphologyBehavior.​value[x] | Base | required | ICD-O-3 Morphology | 📦1.0.0 | This IG
Condition.extension:relapseType.​value[x] | Base | preferred | Relapse type (Local/Distant/Combined) | 📦1.0.0 | This IG
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📍4.0.1 | FHIR Std.
Condition.code | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
Condition.bodySite | Base | extensible | ICD-O-3 Topography | 📦1.0.0 | This IG
Condition.bodySite.extension:lateralityQualifier.​value[x] | Base | preferred | Laterality Qualifier Value Set | 📦1.0.0 | This IG
Condition.stage.summary | Base | example | Condition Stage | 📍4.0.1 | FHIR Std.
Condition.stage.type | Base | example | Condition Stage Type | 📍4.0.1 | FHIR Std.
Condition.evidence.code | Base | example | Manifestation and Symptom Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
con-1 | error | Condition.stage | Stage SHALL have summary or assessment | `summary.exists() or assessment.exists()`
con-2 | error | Condition.evidence | evidence SHALL have code or details | `code.exists() or detail.exists()`
con-3 | best practice | Condition | Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item | `clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()`
con-4 | error | Condition | If condition is abated, then clinicalStatus must be either inactive, resolved, or remission | `abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()`
con-5 | error | Condition | Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | Condition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Condition | 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 | Condition | 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 | Condition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Condition | 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 Condition

Summary

Mandatory: 2 elements
Must-Support: 3 elements

Structures

This structure refers to these other structures:

- Condition: Primary Cancer (http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Condition-primaryCancer-eu-pcsp)
- Patient: PCSP (http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Patient-eu-pcsp)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/condition-assertedDate|5.2.0
- http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
- http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus
- http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
- http://hl7.org/fhir/StructureDefinition/condition-related|5.2.0
- http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier
- http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier

Other representations of profile: CSV, Excel, Schematron