CodeX Radiation Therapy
1.0.0 - STU 1 United States of America flag

This page is part of the CodeX™ Radiation Therapy (v1.0.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: RadiotherapyTreatmentPlan - Detailed Descriptions

Draft as of 2023-07-28

Definitions for the codexrt-radiotherapy-treatment-plan resource profile.

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

1. ServiceRequest
InvariantsDefined on this element
codexrt-free-breathing-technique: The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "Radiotherapy with free breathing (regime/therapy)" (: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://hl7.org/fhir/us/codex-radiation-therapy/CodeSystem/snomed-requested-cs'))))
codexrt-motion-management-none: If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "Radiotherapy without respiratory motion management (regime/therapy)" (: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://hl7.org/fhir/us/codex-radiation-therapy/CodeSystem/snomed-requested-cs'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1)
2. ServiceRequest.extension
Control10..*
Must Supporttrue
SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
3. ServiceRequest.extension:modalityAndTechnique
SliceNamemodalityAndTechnique
Control0..1
TypeExtension(RadiotherapyModalityAndTechnique) (Complex Extension)
Must Supporttrue
4. ServiceRequest.extension:modalityAndTechnique.extension:radiotherapyEnergyOrIsotope
SliceNameradiotherapyEnergyOrIsotope
Control0..*
TypeExtension(RadiotherapyEnergyOrIsotope) (Extension Type: Choice of: CodeableConcept, Quantity(SimpleQuantity))
Must Supporttrue
5. ServiceRequest.extension:modalityAndTechnique.extension:radiotherapyTreatmentApplicatorType
SliceNameradiotherapyTreatmentApplicatorType
Control0..*
TypeExtension(RadiotherapyTreatmentApplicatorType) (Extension Type: CodeableConcept)
Must Supporttrue
6. ServiceRequest.extension:imageGuidedRadiotherapyModality
SliceNameimageGuidedRadiotherapyModality
Control0..*
TypeExtension(ImageGuidedRadiotherapyModality) (Complex Extension)
Must Supporttrue
7. ServiceRequest.extension:radiotherapyFractionsPlanned
SliceNameradiotherapyFractionsPlanned
Control1..1
TypeExtension(RadiotherapyFractionsPlanned) (Extension Type: positiveInt)
Must Supporttrue
8. ServiceRequest.extension:radiotherapyDosePlannedToVolume
SliceNameradiotherapyDosePlannedToVolume
Control0..*
TypeExtension(RadiotherapyDosePlannedToVolume) (Complex Extension)
Must Supporttrue
9. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractions
SliceNamefractions
Definition

Not used in this profile. In a phase, all volumes are involved in all fractions and the number of fractions is defined in extension radiotherapyFractionsPlanned. To achieve different numbers of fractions for different volumes, multiple phases have to be defined.

Control0..0
10. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:pointDose
SliceNamepointDose
Control0..1
TypeExtension(PointDose) (Extension Type: boolean)
Must Supporttrue
11. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:primaryPlanDose
SliceNameprimaryPlanDose
Control0..1
TypeExtension(PrimaryPlanDose) (Extension Type: boolean)
Must Supporttrue
12. ServiceRequest.extension:radiotherapyReasonForRevisionOrAdaptation
SliceNameradiotherapyReasonForRevisionOrAdaptation
Control0..*
TypeExtension(RadiotherapyReasonForRevisionOrAdaptation) (Extension Type: CodeableConcept)
Must Supporttrue
13. ServiceRequest.extension:respiratoryMotionManagement
SliceNamerespiratoryMotionManagement
Definition

Method applied to manage respiratory motion.

Control0..*
TypeExtension(RadiotherapyRespiratoryMotionManagement) (Extension Type: CodeableConcept)
Must Supporttrue
14. ServiceRequest.extension:freeBreathingMotionManagementTechnique
SliceNamefreeBreathingMotionManagementTechnique
Definition

Technique to manage respiratory motion with free-breathing. Only allowed if respiratory motion management is free-breathing.

Control0..*
TypeExtension(RadiotherapyFreeBreathingMotionManagementTechnique) (Extension Type: CodeableConcept)
Must Supporttrue
15. ServiceRequest.extension:radiotherapyDicomPlan
SliceNameradiotherapyDicomPlan
Definition

Reference to a DICOM SOP instance representing a treatment plan such as RT Plan or RT Ion Plan.

Control0..1
TypeExtension(DicomReference) (Complex Extension)
16. ServiceRequest.identifier
Definition

SHALL have a display name with use = usual and at least one globally unique technical identifier, for example, the Conceptual Volume UID used in DICOM.

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control20..*
Must Supporttrue
SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ use
17. ServiceRequest.identifier:displayName
SliceNamedisplayName
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
Must Supporttrue
18. ServiceRequest.identifier:displayName.use
Control1..?
Pattern Valueusual
19. ServiceRequest.identifier:displayName.system
Control1..?
Must Supporttrue
20. ServiceRequest.identifier:displayName.value
Control1..?
Must Supporttrue
21. ServiceRequest.identifier:official
SliceNameofficial
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
Must Supporttrue
22. ServiceRequest.identifier:official.use
Control1..?
Pattern Valueofficial
23. ServiceRequest.identifier:official.system
Control1..?
Must Supporttrue
24. ServiceRequest.identifier:official.value
Control1..?
Must Supporttrue
25. ServiceRequest.basedOn
SlicingThis element introduces a set of slices on ServiceRequest.basedOn. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ $this.resolve()
26. ServiceRequest.basedOn:plan-prescription
SliceNameplan-prescription
Control0..1
TypeReference(RadiotherapyPlanPrescription)
Must Supporttrue
27. ServiceRequest.basedOn:planned-phase
SliceNameplanned-phase
Control0..1
TypeReference(RadiotherapyPlannedPhase)
Must Supporttrue
28. ServiceRequest.basedOn:planned-course
SliceNameplanned-course
Control0..1
TypeReference(RadiotherapyPlannedCourse)
Must Supporttrue
29. ServiceRequest.replaces
TypeReference(RadiotherapyTreatmentPlan|ServiceRequest)
Must Supporttrue
30. ServiceRequest.status
Must Supporttrue
31. ServiceRequest.intent
Must Supporttrue
Pattern Valuefiller-order
32. ServiceRequest.category
Control10..*
Must Supporttrue
SlicingThis element introduces a set of slices on ServiceRequest.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
33. ServiceRequest.category:required
SliceNamerequired
Control1..1
Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://snomed.info/sct"/>
    <code value="108290001"/>
    <display value="Radiation oncology AND/OR radiotherapy"/>
  </coding>
</valueCodeableConcept>
34. ServiceRequest.doNotPerform
Control0..01
35. ServiceRequest.code
Control10..1
Must Supporttrue
Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://snomed.info/sct"/>
    <code value="1255724003"/>
    <display value="Radiotherapy treatment plan (regime/therapy)"/>
  </coding>
</valueCodeableConcept>
36. ServiceRequest.quantity[x]
Control0..01
[x] NoteSee Choice of Data Types for further information about how to use [x]
37. ServiceRequest.subject
TypeReference(USCorePatientProfile|Patient|Group|Location|Device)
Must Supporttrue
38. ServiceRequest.asNeeded[x]
Control0..01
[x] NoteSee Choice of Data Types for further information about how to use [x]
39. ServiceRequest.requester
TypeReference(USCorePractitionerProfile|USCorePractitionerRoleProfile|USCoreOrganizationProfile|Practitioner|PractitionerRole|Organization|Patient|RelatedPerson|Device)
40. ServiceRequest.performer
Must Supporttrue
SlicingThis element introduces a set of slices on ServiceRequest.performer. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ $this.resolve()
41. ServiceRequest.performer:treatmentOrSeedDevice
SliceNametreatmentOrSeedDevice
Control0..*
TypeReference(RadiotherapyTreatmentDevice|RadiotherapySeedDevice)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
42. ServiceRequest.locationReference
TypeReference(USCoreLocation|Location)
Must Supporttrue
43. ServiceRequest.reasonCode
BindingThe codes SHALL be taken from Cancer Disorder Value Set; other codes may be used where these codes are not suitableFor example codes, see ProcedureReasonCodes
Must Supporttrue
44. ServiceRequest.reasonReference
TypeReference(Condition|Observation|DiagnosticReport|DocumentReference)
Must Supporttrue
45. ServiceRequest.specimen
Control0..0*
46. ServiceRequest.bodySite
BindingThe codes SHALL be taken from Radiotherapy Treatment Location Value SetFor example codes, see SNOMEDCTBodyStructures
Must Supporttrue
47. ServiceRequest.bodySite.extension:locationQualifier
SliceNamelocationQualifier
Definition

General location qualifier (excluding laterality) for this bodySite

Control0..*
TypeExtension(BodyLocationQualifier) (Extension Type: CodeableConcept)
48. ServiceRequest.bodySite.extension:lateralityQualifier
SliceNamelateralityQualifier
Definition

Laterality qualifier for this bodySite

Control0..1
TypeExtension(LateralityQualifier) (Extension Type: CodeableConcept)

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

1. ServiceRequest
Definition

A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

Control0..*
Summaryfalse
Alternate Namesdiagnostic request, referral, referral request, transfer of care request
InvariantsDefined on this element
codexrt-free-breathing-technique: The extension for the technique of free-breathing motion management is only allowed if motion management is free-breathing. SNOMEDCT code 721071000124104 is "Radiotherapy with free breathing (regime/therapy)" (: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-free-breathing-motion-mgmt-technique') implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721071000124104' and system = 'http://hl7.org/fhir/us/codex-radiation-therapy/CodeSystem/snomed-requested-cs'))))
codexrt-motion-management-none: If the respiratory motion management is 'none', then no other respiratory motion management extensions are allowed. They would also be 'none' or contradict the 'none'. SNOMEDCT code 721031000124102 is "Radiotherapy without respiratory motion management (regime/therapy)" (: extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management' and value.exists(coding.exists(code = '721031000124102' and system = 'http://hl7.org/fhir/us/codex-radiation-therapy/CodeSystem/snomed-requested-cs'))) implies extension.where(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-respiratory-motion-management').count() = 1)
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.`div`.exists())
prr-1: orderDetail SHALL only be present if code is present (: orderDetail.empty() or code.exists())
2. ServiceRequest.implicitRules
Definition

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

Control0..1
Typeuri
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
3. ServiceRequest.extension
Definition

An Extension

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

Control10..*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
4. ServiceRequest.extension:modalityAndTechnique
SliceNamemodalityAndTechnique
Definition

Extension capturing modality and technique of a given radiotherapy procedure. The allowed combinations of modality and technique are constrained by invariants, one per modality.

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

Control0..1* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyModalityAndTechnique) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '1156529004' or coding.code = '1156528007' or coding.code='1204242009')))
TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '1162782007' or coding.code = '1156526006' or coding.code = '168524008')))
TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(coding.system = 'http://snomed.info/sct' and ( coding.code = '384692006' or coding.code = '1156382005' or coding.code = '113120007' or coding.code = '1156383000' or coding.code = '384691004' or coding.code = '168524008' or coding.code = '14473006')))
TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(coding.system = 'http://snomed.info/sct' and ( coding.code = '384692006' or coding.code = '1156382005' or coding.code = '113120007' or coding.code = '384691004' or coding.code = '168524008' or coding.code = '14473006')))
TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '113120007')))
TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(coding.system = 'http://snomed.info/sct' and ( coding.code = '384692006' or coding.code = '113120007' or coding.code = '14473006')))
TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '169317000' or coding.code = '1162782007')))
TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(( coding.code = '441799006' or coding.code = '1156530009' or coding.code = '1162782007' or coding.code = '1156526006' or coding.code = '168524008' or coding.code = '1156530009')))
TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '1156529004' or coding.code = '1156528007' or coding.code = '1204242009')))
TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(coding.system = 'http://snomed.info/sct' and ( coding.code = '384692006' or coding.code = '113120007')))
TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists( coding.code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '16560241000119104' or coding.code = '1156383000' or coding.code = '384692006' or coding.code = '113120007')))
ele-1: (: )
ext-1: (: )
5. ServiceRequest.extension:modalityAndTechnique.extension
Definition

An Extension

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

Control10..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. ServiceRequest.extension:modalityAndTechnique.extension:modality
SliceNamemodality
Definition

Extension capturing a modality of external beam or brachytherapy radiation procedures.

Control1..1
TypeExtension(RadiotherapyModality) (Extension Type: CodeableConcept)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
7. ServiceRequest.extension:modalityAndTechnique.extension:modality.extension
Definition

An Extension

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

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
8. ServiceRequest.extension:modalityAndTechnique.extension:modality.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
9. ServiceRequest.extension:modalityAndTechnique.extension:modality.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from Radiotherapy Modality Value SetFor codes, see (unbound)
TypeChoice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
10. ServiceRequest.extension:modalityAndTechnique.extension:technique
SliceNametechnique
Definition

Extension capturing a technique of external beam or brachytherapy radiation procedures.

Control0..*
TypeExtension(RadiotherapyTechnique) (Extension Type: CodeableConcept)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. ServiceRequest.extension:modalityAndTechnique.extension:technique.extension
Definition

An Extension

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

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
12. ServiceRequest.extension:modalityAndTechnique.extension:technique.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
13. ServiceRequest.extension:modalityAndTechnique.extension:technique.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
BindingThe codes SHALL be taken from Radiotherapy Technique Value SetFor codes, see (unbound)
TypeChoice of: CodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. ServiceRequest.extension:modalityAndTechnique.extension:radiotherapyEnergyOrIsotope
SliceNameradiotherapyEnergyOrIsotope
Definition

The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum accelaration voltage, or the used isotope.

Control0..*
TypeExtension(RadiotherapyEnergyOrIsotope) (Extension Type: Choice of: CodeableConcept, Quantity(SimpleQuantity))
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
15. ServiceRequest.extension:modalityAndTechnique.extension:radiotherapyTreatmentApplicatorType
SliceNameradiotherapyTreatmentApplicatorType
Definition

Radiotherapy Treatment Applicator Type.

Control0..*
TypeExtension(RadiotherapyTreatmentApplicatorType) (Extension Type: CodeableConcept)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
16. ServiceRequest.extension:modalityAndTechnique.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
17. ServiceRequest.extension:modalityAndTechnique.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..01
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. ServiceRequest.extension:imageGuidedRadiotherapyModality
SliceNameimageGuidedRadiotherapyModality
Definition

The modality and associated energy used for imaging in Image Guided Radiotherapy (IGRT)

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

Control This element is affected by the following invariants: ele-1
TypeExtension(ImageGuidedRadiotherapyModality) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
IGRTEnergyAllowed: Energy is only allowed for X-Ray, Fluorograph, or CT Modalities. (: extension.where(url = 'energy').exists() implies (extension.where(url = 'modality').exists() and extension.where(url = 'modality').value.exists() and extension.where(url = 'modality').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006' or code = '44491008' or code = '77477000' or code = '717193008') ) ))
ele-1: (: )
ext-1: (: )
19. ServiceRequest.extension:radiotherapyFractionsPlanned
SliceNameradiotherapyFractionsPlanned
Definition

The number of planned fractions in this scope. This extension SHALL only be present if the treatment is structured as countable fractions, for example in a Radiotherapy Planned Phase or in a Radiotherapy Treatment Plan.

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyFractionsPlanned) (Extension Type: positiveInt)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
20. ServiceRequest.extension:radiotherapyDosePlannedToVolume
SliceNameradiotherapyDosePlannedToVolume
Definition

Dose parameters planned for one radiotherapy volume.

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

Control This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyDosePlannedToVolume) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
ele-1: (: )
ext-1: (: )
21. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension
Definition

An Extension

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

Control10..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
22. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume
SliceNamevolume
Definition

A BodyStructure resource representing the body structure to be treated, for example, Chest Wall Lymph Nodes.

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

Control10..1*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
23. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume.extension
Definition

An Extension

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

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
24. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuevolume
25. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
TypeChoice of: Reference(RadiotherapyVolume), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractionDose
SliceNamefractionDose
Definition

The dose planned per fraction to this volume.

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

Control0..1*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
27. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractionDose.extension
Definition

An Extension

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

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
28. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractionDose.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValuefractionDose
29. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose
SliceNametotalDose
Definition

The total dose planned to this volume within the scope of this ServiceRequest.

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

Control0..1*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
30. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose.extension
Definition

An Extension

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

Control0..0*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
31. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValuetotalDose
32. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control10..1
TypeChoice of: Quantity, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
Pattern Value<valueQuantity xmlns="http://hl7.org/fhir">
  <system value="http://unitsofmeasure.org"/>
  <code value="cGy"/>
</valueQuantity>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractions
SliceNamefractions
Definition

Not used in this profile. In a phase, all volumes are involved in all fractions and the number of fractions is defined in extension radiotherapyFractionsPlanned. To achieve different numbers of fractions for different volumes, multiple phases have to be defined.

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

Control0..0*
TypeExtension
Must Supporttrue
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
34. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:pointDose
SliceNamepointDose
Definition

This flag is true if the dose is determined at a single point. Point doses are often used to check dose at a specific point in a calculated 3D dose distribution. Since point doses mostly have a technical role, high-level summaries may decide to exclude them from displays.

Control0..1
TypeExtension(PointDose) (Extension Type: boolean)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
35. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:primaryPlanDose
SliceNameprimaryPlanDose
Definition

This flag is true if the dose is the primary plan dose in a radiotherapy treatment plan. For a single treatment plan, the primary plan dose serves as the main dose value for tracking delivered dose vs. planned dose. In summaries over multiple treatment plans, the flag indicates that the dose is a primary plan dose in any of the summarized plans.

Control0..1
TypeExtension(PrimaryPlanDose) (Extension Type: boolean)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
36. ServiceRequest.extension:radiotherapyDosePlannedToVolume.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
37. ServiceRequest.extension:radiotherapyDosePlannedToVolume.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..01
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. ServiceRequest.extension:radiotherapyReasonForRevisionOrAdaptation
SliceNameradiotherapyReasonForRevisionOrAdaptation
Definition

The reason a planned or prescribed radiotherapy treatment was revised, superceded, or adapted.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyReasonForRevisionOrAdaptation) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
39. ServiceRequest.extension:respiratoryMotionManagement
SliceNamerespiratoryMotionManagement
Definition

Method applied to manage respiratory motion.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyRespiratoryMotionManagement) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
40. ServiceRequest.extension:freeBreathingMotionManagementTechnique
SliceNamefreeBreathingMotionManagementTechnique
Definition

Technique to manage respiratory motion with free-breathing. Only allowed if respiratory motion management is free-breathing.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyFreeBreathingMotionManagementTechnique) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
41. ServiceRequest.extension:radiotherapyDicomPlan
SliceNameradiotherapyDicomPlan
Definition

Reference to a DICOM SOP instance representing a treatment plan such as RT Plan or RT Ion Plan.

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

Control0..1* This element is affected by the following invariants: ele-1
TypeExtension(DicomReference) (Complex Extension)
InvariantsDefined on this element
ele-1: (: )
ext-1: (: )
42. ServiceRequest.modifierExtension
Definition

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

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

Control0..*
TypeExtension
Is Modifiertrue
Summaryfalse
Requirements

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

Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
43. ServiceRequest.identifier
Definition

SHALL have a display name with use = usual and at least one globally unique technical identifier, for example, the Conceptual Volume UID used in DICOM.

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control20..*
TypeIdentifier
Must Supporttrue
Summarytrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ use
44. ServiceRequest.identifier:displayName
SliceNamedisplayName
Definition

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..1*
TypeIdentifier
Must Supporttrue
Summarytrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. ServiceRequest.identifier:displayName.use
Definition

The purpose of this identifier.

Control10..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Pattern Valueusual
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. ServiceRequest.identifier:displayName.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control10..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. ServiceRequest.identifier:displayName.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control10..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. ServiceRequest.identifier:official
SliceNameofficial
Definition

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
TypeIdentifier
Must Supporttrue
Summarytrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. ServiceRequest.identifier:official.use
Definition

The purpose of this identifier.

Control10..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Pattern Valueofficial
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. ServiceRequest.identifier:official.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control10..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. ServiceRequest.identifier:official.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control10..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. ServiceRequest.basedOn
Definition

Plan/proposal/order fulfilled by this request.

Control0..*
TypeReference(CarePlan|ServiceRequest|MedicationRequest)
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.basedOn. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ $this.resolve()
53. ServiceRequest.basedOn:plan-prescription
SliceNameplan-prescription
Definition

Plan/proposal/order fulfilled by this request.

Control0..1*
TypeReference(RadiotherapyPlanPrescription|CarePlan|ServiceRequest|MedicationRequest)
Must Supporttrue
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. ServiceRequest.basedOn:planned-phase
SliceNameplanned-phase
Definition

Plan/proposal/order fulfilled by this request.

Control0..1*
TypeReference(RadiotherapyPlannedPhase|CarePlan|ServiceRequest|MedicationRequest)
Must Supporttrue
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. ServiceRequest.basedOn:planned-course
SliceNameplanned-course
Definition

Plan/proposal/order fulfilled by this request.

Control0..1*
TypeReference(RadiotherapyPlannedCourse|CarePlan|ServiceRequest|MedicationRequest)
Must Supporttrue
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
56. ServiceRequest.replaces
Definition

The request takes the place of the referenced completed or terminated request(s).

Control0..*
TypeReference(RadiotherapyTreatmentPlan|ServiceRequest)
Must Supporttrue
Summarytrue
Alternate Namessupersedes, prior, renewed order
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. ServiceRequest.status
Definition

The status of the order.

Control1..1
BindingThe codes SHALL be taken from RequestStatus

The status of a service order.

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
58. ServiceRequest.intent
Definition

Whether the request is a proposal, plan, an original order or a reflex order.

Control1..1
BindingThe codes SHALL be taken from RequestIntent

The kind of service request.

Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

Pattern Valuefiller-order
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. ServiceRequest.category
Definition

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

Control10..*
BindingFor example codes, see ServiceRequestCategoryCodes

Classification of the requested service.

TypeCodeableConcept
Must Supporttrue
Summarytrue
Requirements

Used for filtering what service request are retrieved and displayed.

Comments

There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
60. ServiceRequest.category:required
SliceNamerequired
Definition

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

Control10..1*
BindingFor example codes, see ServiceRequestCategoryCodes

Classification of the requested service.

TypeCodeableConcept
Summarytrue
Requirements

Used for filtering what service request are retrieved and displayed.

Comments

There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://snomed.info/sct"/>
    <code value="108290001"/>
    <display value="Radiation oncology AND/OR radiotherapy"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. ServiceRequest.doNotPerform
Definition

Set this to true if the record is saying that the service/procedure should NOT be performed.

Control0..01
Typeboolean
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

Comments

In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
62. ServiceRequest.code
Definition

A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

Control10..1
BindingFor example codes, see ProcedureCodes(SNOMEDCT)

Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.

Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here.

TypeCodeableConcept
Must Supporttrue
Summarytrue
Alternate Namesservice requested
Comments

Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://snomed.info/sct"/>
    <code value="1255724003"/>
    <display value="Radiotherapy treatment plan (regime/therapy)"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. ServiceRequest.quantity[x]
Definition

An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).

Control0..01
TypeChoice of: Quantity, Ratio, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Requirements

When ordering a service the number of service items may need to be specified separately from the the service item.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. ServiceRequest.subject
Definition

On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

Control1..1
TypeReference(USCorePatientProfile|Patient|Group|Location|Device)
Must Supporttrue
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. ServiceRequest.asNeeded[x]
Definition

If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

Control0..01
BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes

A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

TypeChoice of: boolean, CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. ServiceRequest.requester
Definition

The individual who initiated the request and has responsibility for its activation.

Control0..1
TypeReference(USCorePractitionerProfile|USCorePractitionerRoleProfile|USCoreOrganizationProfile|Practitioner|PractitionerRole|Organization|Patient|RelatedPerson|Device)
Summarytrue
Alternate Namesauthor, orderer
Comments

This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. ServiceRequest.performer
Definition

The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

Control0..*
TypeReference(Practitioner|PractitionerRole|Organization|CareTeam|HealthcareService|Patient|Device|RelatedPerson)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Alternate Namesrequest recipient
Comments

If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.performer. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ $this.resolve()
68. ServiceRequest.performer:treatmentOrSeedDevice
SliceNametreatmentOrSeedDevice
Definition

The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

Control0..*
TypeReference(RadiotherapyTreatmentDevice|RadiotherapySeedDevice|Practitioner|PractitionerRole|Organization|CareTeam|HealthcareService|Patient|Device|RelatedPerson)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Alternate Namesrequest recipient
Comments

If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. ServiceRequest.locationReference
Definition

A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

Control0..*
TypeReference(USCoreLocation|Location)
Must Supporttrue
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
70. ServiceRequest.reasonCode
Definition

An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

Control0..*
BindingThe codes SHALL be taken from Cancer Disorder Value Set; other codes may be used where these codes are not suitableFor example codes, see ProcedureReasonCodes
TypeCodeableConcept
Must Supporttrue
Summarytrue
Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
71. ServiceRequest.reasonReference
Definition

Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

Control0..*
TypeReference(Condition|Observation|DiagnosticReport|DocumentReference)
Must Supporttrue
Summarytrue
Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
72. ServiceRequest.specimen
Definition

One or more specimens that the laboratory procedure will use.

Control0..0*
TypeReference(Specimen)
Summarytrue
Comments

Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. ServiceRequest.bodySite
Definition

Anatomic location where the procedure should be performed. This is the target site.

Control0..*
BindingThe codes SHALL be taken from Radiotherapy Treatment Location Value SetFor example codes, see SNOMEDCTBodyStructures
TypeCodeableConcept
Must Supporttrue
Summarytrue
Requirements

Knowing where the procedure is performed is important for tracking if multiple sites are possible.

Alternate Nameslocation
Comments

Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. ServiceRequest.bodySite.extension:locationQualifier
SliceNamelocationQualifier
Definition

General location qualifier (excluding laterality) for this bodySite

Control0..*
TypeExtension(BodyLocationQualifier) (Extension Type: CodeableConcept)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
75. ServiceRequest.bodySite.extension:lateralityQualifier
SliceNamelateralityQualifier
Definition

Laterality qualifier for this bodySite

Control0..1
TypeExtension(LateralityQualifier) (Extension Type: CodeableConcept)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())

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

1. ServiceRequest
Definition

A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

Control0..*
Summaryfalse
Alternate Namesdiagnostic request, referral, referral request, transfer of care request
2. ServiceRequest.id
Definition

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

Control0..1
Typeid
Summarytrue
Comments

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

3. ServiceRequest.meta
Definition

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

Control0..1
TypeMeta
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. ServiceRequest.implicitRules
Definition

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

Control0..1
Typeuri
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. ServiceRequest.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages A human language
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. ServiceRequest.text
Definition

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

Control0..1
TypeNarrative
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. ServiceRequest.contained
Definition

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

Control0..*
TypeResource
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
Comments

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

8. ServiceRequest.extension
Definition

An Extension

Control1..*
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. ServiceRequest.extension:modalityAndTechnique
SliceNamemodalityAndTechnique
Definition

Extension capturing modality and technique of a given radiotherapy procedure. The allowed combinations of modality and technique are constrained by invariants, one per modality.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyModalityAndTechnique) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '1156529004' or coding.code = '1156528007' or coding.code='1204242009')))
TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '1162782007' or coding.code = '1156526006' or coding.code = '168524008')))
TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(coding.system = 'http://snomed.info/sct' and ( coding.code = '384692006' or coding.code = '1156382005' or coding.code = '113120007' or coding.code = '1156383000' or coding.code = '384691004' or coding.code = '168524008' or coding.code = '14473006')))
TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(coding.system = 'http://snomed.info/sct' and ( coding.code = '384692006' or coding.code = '1156382005' or coding.code = '113120007' or coding.code = '384691004' or coding.code = '168524008' or coding.code = '14473006')))
TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '113120007')))
TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(coding.system = 'http://snomed.info/sct' and ( coding.code = '384692006' or coding.code = '113120007' or coding.code = '14473006')))
TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '169317000' or coding.code = '1162782007')))
TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(( coding.code = '441799006' or coding.code = '1156530009' or coding.code = '1162782007' or coding.code = '1156526006' or coding.code = '168524008' or coding.code = '1156530009')))
TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '1156529004' or coding.code = '1156528007' or coding.code = '1204242009')))
TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists(coding.system = 'http://snomed.info/sct' and coding.code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists(coding.system = 'http://snomed.info/sct' and ( coding.code = '384692006' or coding.code = '113120007')))
TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical (: extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists( coding.code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists( ( coding.code = '16560241000119104' or coding.code = '1156383000' or coding.code = '384692006' or coding.code = '113120007')))
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. ServiceRequest.extension:modalityAndTechnique.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
11. ServiceRequest.extension:modalityAndTechnique.extension
Definition

An Extension

Control1..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
12. ServiceRequest.extension:modalityAndTechnique.extension:modality
SliceNamemodality
Definition

Extension capturing a modality of external beam or brachytherapy radiation procedures.

Control1..1
TypeExtension(RadiotherapyModality) (Extension Type: CodeableConcept)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. ServiceRequest.extension:modalityAndTechnique.extension:modality.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
14. ServiceRequest.extension:modalityAndTechnique.extension:modality.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
15. ServiceRequest.extension:modalityAndTechnique.extension:modality.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
16. ServiceRequest.extension:modalityAndTechnique.extension:modality.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from Radiotherapy Modality Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. ServiceRequest.extension:modalityAndTechnique.extension:technique
SliceNametechnique
Definition

Extension capturing a technique of external beam or brachytherapy radiation procedures.

Control0..*
TypeExtension(RadiotherapyTechnique) (Extension Type: CodeableConcept)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
18. ServiceRequest.extension:modalityAndTechnique.extension:technique.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
19. ServiceRequest.extension:modalityAndTechnique.extension:technique.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
20. ServiceRequest.extension:modalityAndTechnique.extension:technique.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
21. ServiceRequest.extension:modalityAndTechnique.extension:technique.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
BindingThe codes SHALL be taken from Radiotherapy Technique Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. ServiceRequest.extension:modalityAndTechnique.extension:radiotherapyEnergyOrIsotope
SliceNameradiotherapyEnergyOrIsotope
Definition

The radiation energy used for radiotherapy. The energy spectrum is characterized by the maximum energy, the maximum accelaration voltage, or the used isotope.

Control0..*
TypeExtension(RadiotherapyEnergyOrIsotope) (Extension Type: Choice of: CodeableConcept, Quantity(SimpleQuantity))
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
23. ServiceRequest.extension:modalityAndTechnique.extension:radiotherapyTreatmentApplicatorType
SliceNameradiotherapyTreatmentApplicatorType
Definition

Radiotherapy Treatment Applicator Type.

Control0..*
TypeExtension(RadiotherapyTreatmentApplicatorType) (Extension Type: CodeableConcept)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
24. ServiceRequest.extension:modalityAndTechnique.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique
25. ServiceRequest.extension:modalityAndTechnique.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..0
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. ServiceRequest.extension:imageGuidedRadiotherapyModality
SliceNameimageGuidedRadiotherapyModality
Definition

The modality and associated energy used for imaging in Image Guided Radiotherapy (IGRT)

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ImageGuidedRadiotherapyModality) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
IGRTEnergyAllowed: Energy is only allowed for X-Ray, Fluorograph, or CT Modalities. (: extension.where(url = 'energy').exists() implies (extension.where(url = 'modality').exists() and extension.where(url = 'modality').value.exists() and extension.where(url = 'modality').value.coding.all( (system = 'http://snomed.info/sct') and (code = '168537006' or code = '44491008' or code = '77477000' or code = '717193008') ) ))
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
27. ServiceRequest.extension:radiotherapyFractionsPlanned
SliceNameradiotherapyFractionsPlanned
Definition

The number of planned fractions in this scope. This extension SHALL only be present if the treatment is structured as countable fractions, for example in a Radiotherapy Planned Phase or in a Radiotherapy Treatment Plan.

Control1..1 This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyFractionsPlanned) (Extension Type: positiveInt)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
28. ServiceRequest.extension:radiotherapyDosePlannedToVolume
SliceNameradiotherapyDosePlannedToVolume
Definition

Dose parameters planned for one radiotherapy volume.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyDosePlannedToVolume) (Complex Extension)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
29. ServiceRequest.extension:radiotherapyDosePlannedToVolume.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
30. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension
Definition

An Extension

Control1..*
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
31. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume
SliceNamevolume
Definition

A BodyStructure resource representing the body structure to be treated, for example, Chest Wall Lymph Nodes.

Control1..1
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
32. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
33. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
34. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuevolume
35. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:volume.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
TypeReference(RadiotherapyVolume)
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractionDose
SliceNamefractionDose
Definition

The dose planned per fraction to this volume.

Control0..1
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
37. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractionDose.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
38. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractionDose.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
39. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractionDose.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValuefractionDose
40. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractionDose.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..1
TypeQuantity
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
Pattern Value<valueQuantity xmlns="http://hl7.org/fhir">
  <system value="http://unitsofmeasure.org"/>
  <code value="cGy"/>
</valueQuantity>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose
SliceNametotalDose
Definition

The total dose planned to this volume within the scope of this ServiceRequest.

Control0..1
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
42. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
43. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose.extension
Definition

An Extension

Control0..0
TypeExtension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
44. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed ValuetotalDose
45. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:totalDose.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control1..1
TypeQuantity
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summaryfalse
Pattern Value<valueQuantity xmlns="http://hl7.org/fhir">
  <system value="http://unitsofmeasure.org"/>
  <code value="cGy"/>
</valueQuantity>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:fractions
SliceNamefractions
Definition

Not used in this profile. In a phase, all volumes are involved in all fractions and the number of fractions is defined in extension radiotherapyFractionsPlanned. To achieve different numbers of fractions for different volumes, multiple phases have to be defined.

Control0..0
TypeExtension
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
47. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:pointDose
SliceNamepointDose
Definition

This flag is true if the dose is determined at a single point. Point doses are often used to check dose at a specific point in a calculated 3D dose distribution. Since point doses mostly have a technical role, high-level summaries may decide to exclude them from displays.

Control0..1
TypeExtension(PointDose) (Extension Type: boolean)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
48. ServiceRequest.extension:radiotherapyDosePlannedToVolume.extension:primaryPlanDose
SliceNameprimaryPlanDose
Definition

This flag is true if the dose is the primary plan dose in a radiotherapy treatment plan. For a single treatment plan, the primary plan dose serves as the main dose value for tracking delivered dose vs. planned dose. In summaries over multiple treatment plans, the flag indicates that the dose is a primary plan dose in any of the summarized plans.

Control0..1
TypeExtension(PrimaryPlanDose) (Extension Type: boolean)
Must Supporttrue
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
49. ServiceRequest.extension:radiotherapyDosePlannedToVolume.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-dose-planned-to-volume
50. ServiceRequest.extension:radiotherapyDosePlannedToVolume.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..0
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. ServiceRequest.extension:radiotherapyReasonForRevisionOrAdaptation
SliceNameradiotherapyReasonForRevisionOrAdaptation
Definition

The reason a planned or prescribed radiotherapy treatment was revised, superceded, or adapted.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyReasonForRevisionOrAdaptation) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
52. ServiceRequest.extension:respiratoryMotionManagement
SliceNamerespiratoryMotionManagement
Definition

Method applied to manage respiratory motion.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyRespiratoryMotionManagement) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
53. ServiceRequest.extension:freeBreathingMotionManagementTechnique
SliceNamefreeBreathingMotionManagementTechnique
Definition

Technique to manage respiratory motion with free-breathing. Only allowed if respiratory motion management is free-breathing.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(RadiotherapyFreeBreathingMotionManagementTechnique) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
54. ServiceRequest.extension:radiotherapyDicomPlan
SliceNameradiotherapyDicomPlan
Definition

Reference to a DICOM SOP instance representing a treatment plan such as RT Plan or RT Ion Plan.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(DicomReference) (Complex Extension)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
55. ServiceRequest.modifierExtension
Definition

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

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

Control0..*
TypeExtension
Is Modifiertrue
Summaryfalse
Requirements

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

Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
56. ServiceRequest.identifier
Definition

SHALL have a display name with use = usual and at least one globally unique technical identifier, for example, the Conceptual Volume UID used in DICOM.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control2..*
TypeIdentifier
Must Supporttrue
Summarytrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ use
57. ServiceRequest.identifier:displayName
SliceNamedisplayName
Definition

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..1
TypeIdentifier
Must Supporttrue
Summarytrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
58. ServiceRequest.identifier:displayName.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
59. ServiceRequest.identifier:displayName.extension
Definition

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

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
60. ServiceRequest.identifier:displayName.use
Definition

The purpose of this identifier.

Control1..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Pattern Valueusual
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. ServiceRequest.identifier:displayName.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose
TypeCodeableConcept
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
62. ServiceRequest.identifier:displayName.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. ServiceRequest.identifier:displayName.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. ServiceRequest.identifier:displayName.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. ServiceRequest.identifier:displayName.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Summarytrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. ServiceRequest.identifier:official
SliceNameofficial
Definition

Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
TypeIdentifier
Must Supporttrue
Summarytrue
Comments

The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. ServiceRequest.identifier:official.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
68. ServiceRequest.identifier:official.extension
Definition

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

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
69. ServiceRequest.identifier:official.use
Definition

The purpose of this identifier.

Control1..1
BindingThe codes SHALL be taken from IdentifierUse Identifies the purpose for this identifier, if known
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Pattern Valueofficial
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
70. ServiceRequest.identifier:official.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

Control0..1
BindingThe codes SHALL be taken from Identifier Type Codes; other codes may be used where these codes are not suitable A coded type for an identifier that can be used to determine which identifier to use for a specific purpose
TypeCodeableConcept
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
71. ServiceRequest.identifier:official.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

Control1..1
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Comments

Identifier.system is always case sensitive.

Example
General:http://www.acme.com/identifiers/patient
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
72. ServiceRequest.identifier:official.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Example
General:123456
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. ServiceRequest.identifier:official.period
Definition

Time period during which identifier is/was valid for use.

Control0..1
TypePeriod
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
74. ServiceRequest.identifier:official.assigner
Definition

Organization that issued/manages the identifier.

Control0..1
TypeReference(Organization)
Summarytrue
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. ServiceRequest.instantiatesCanonical
Definition

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

Control0..*
Typecanonical(ActivityDefinition|PlanDefinition)
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
76. ServiceRequest.instantiatesUri
Definition

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

Control0..*
Typeuri
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
77. ServiceRequest.basedOn
Definition

Plan/proposal/order fulfilled by this request.

Control0..*
TypeReference(CarePlan|ServiceRequest|MedicationRequest)
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.basedOn. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ $this.resolve()
78. ServiceRequest.basedOn:plan-prescription
SliceNameplan-prescription
Definition

Plan/proposal/order fulfilled by this request.

Control0..1
TypeReference(RadiotherapyPlanPrescription)
Must Supporttrue
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. ServiceRequest.basedOn:planned-phase
SliceNameplanned-phase
Definition

Plan/proposal/order fulfilled by this request.

Control0..1
TypeReference(RadiotherapyPlannedPhase)
Must Supporttrue
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. ServiceRequest.basedOn:planned-course
SliceNameplanned-course
Definition

Plan/proposal/order fulfilled by this request.

Control0..1
TypeReference(RadiotherapyPlannedCourse)
Must Supporttrue
Summarytrue
Alternate Namesfulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
81. ServiceRequest.replaces
Definition

The request takes the place of the referenced completed or terminated request(s).

Control0..*
TypeReference(RadiotherapyTreatmentPlan)
Must Supporttrue
Summarytrue
Alternate Namessupersedes, prior, renewed order
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
82. ServiceRequest.requisition
Definition

A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.

Control0..1
TypeIdentifier
Summarytrue
Requirements

Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

Alternate NamesgrouperId, groupIdentifier
Comments

Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
83. ServiceRequest.status
Definition

The status of the order.

Control1..1
BindingThe codes SHALL be taken from RequestStatus The status of a service order
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
84. ServiceRequest.intent
Definition

Whether the request is a proposal, plan, an original order or a reflex order.

Control1..1
BindingThe codes SHALL be taken from RequestIntent The kind of service request
Typecode
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Comments

This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

Pattern Valuefiller-order
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
85. ServiceRequest.category
Definition

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

Control1..*
BindingFor example codes, see ServiceRequestCategoryCodes Classification of the requested service
TypeCodeableConcept
Must Supporttrue
Summarytrue
Requirements

Used for filtering what service request are retrieved and displayed.

Comments

There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.category. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • pattern @ $this
86. ServiceRequest.category:required
SliceNamerequired
Definition

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

Control1..1
BindingFor example codes, see ServiceRequestCategoryCodes Classification of the requested service
TypeCodeableConcept
Summarytrue
Requirements

Used for filtering what service request are retrieved and displayed.

Comments

There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://snomed.info/sct"/>
    <code value="108290001"/>
    <display value="Radiation oncology AND/OR radiotherapy"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
87. ServiceRequest.priority
Definition

Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

Control0..1
BindingThe codes SHALL be taken from RequestPriority Identifies the level of importance to be assigned to actioning the request
Typecode
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Meaning if MissingIf missing, this task should be performed with normal priority
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
88. ServiceRequest.doNotPerform
Definition

Set this to true if the record is saying that the service/procedure should NOT be performed.

Control0..0
Typeboolean
Is Modifiertrue
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

Comments

In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
89. ServiceRequest.code
Definition

A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

Control1..1
BindingFor example codes, see ProcedureCodes(SNOMEDCT) Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred and a valueset using LOINC Order codes is available here
TypeCodeableConcept
Must Supporttrue
Summarytrue
Alternate Namesservice requested
Comments

Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://snomed.info/sct"/>
    <code value="1255724003"/>
    <display value="Radiotherapy treatment plan (regime/therapy)"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
90. ServiceRequest.orderDetail
Definition

Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied.

Control0..* This element is affected by the following invariants: prr-1
BindingFor example codes, see ServiceRequestOrderDetailsCodes Codified order entry details which are based on order context
TypeCodeableConcept
Summarytrue
Alternate Namesdetailed instructions
Comments

For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. ServiceRequest.quantity[x]
Definition

An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).

Control0..0
TypeChoice of: Quantity, Ratio, Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Summarytrue
Requirements

When ordering a service the number of service items may need to be specified separately from the the service item.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
92. ServiceRequest.subject
Definition

On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

Control1..1
TypeReference(USCorePatientProfile)
Must Supporttrue
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
93. ServiceRequest.encounter
Definition

An encounter that provides additional information about the healthcare context in which this request is made.

Control0..1
TypeReference(Encounter)
Summarytrue
Alternate Namescontext
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
94. ServiceRequest.occurrence[x]
Definition

The date/time at which the requested service should occur.

Control0..1
TypeChoice of: dateTime, Period, Timing
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate Namesschedule
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
95. ServiceRequest.asNeeded[x]
Definition

If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

Control0..0
BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc
TypeChoice of: boolean, CodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
96. ServiceRequest.authoredOn
Definition

When the request transitioned to being actionable.

Control0..1
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Alternate NamesorderedOn
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
97. ServiceRequest.requester
Definition

The individual who initiated the request and has responsibility for its activation.

Control0..1
TypeReference(USCorePractitionerProfile|USCorePractitionerRoleProfile|USCoreOrganizationProfile)
Summarytrue
Alternate Namesauthor, orderer
Comments

This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
98. ServiceRequest.performerType
Definition

Desired type of performer for doing the requested service.

Control0..1
BindingFor example codes, see ParticipantRoles Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc
TypeCodeableConcept
Summarytrue
Alternate Namesspecialty
Comments

This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
99. ServiceRequest.performer
Definition

The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

Control0..*
TypeReference(Practitioner|PractitionerRole|Organization|CareTeam|HealthcareService|Patient|Device|RelatedPerson)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Alternate Namesrequest recipient
Comments

If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on ServiceRequest.performer. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • profile @ $this.resolve()
100. ServiceRequest.performer:treatmentOrSeedDevice
SliceNametreatmentOrSeedDevice
Definition

The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

Control0..*
TypeReference(RadiotherapyTreatmentDevice|RadiotherapySeedDevice)
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Summarytrue
Alternate Namesrequest recipient
Comments

If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
101. ServiceRequest.locationCode
Definition

The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.

Control0..*
BindingFor example codes, see ServiceDeliveryLocationRoleType A location type where services are delivered
TypeCodeableConcept
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
102. ServiceRequest.locationReference
Definition

A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

Control0..*
TypeReference(USCoreLocation)
Must Supporttrue
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
103. ServiceRequest.reasonCode
Definition

An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

Control0..*
BindingThe codes SHALL be taken from Cancer Disorder Value Set; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Summarytrue
Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
104. ServiceRequest.reasonReference
Definition

Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

Control0..*
TypeReference(Condition)
Must Supporttrue
Summarytrue
Comments

This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
105. ServiceRequest.insurance
Definition

Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.

Control0..*
TypeReference(Coverage|ClaimResponse)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
106. ServiceRequest.supportingInfo
Definition

Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

Control0..*
TypeReference(Resource)
Summaryfalse
Alternate NamesAsk at order entry question, AOE
Comments

To represent information about how the services are to be delivered use the instructions element.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
107. ServiceRequest.specimen
Definition

One or more specimens that the laboratory procedure will use.

Control0..0
TypeReference(Specimen)
Summarytrue
Comments

Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
108. ServiceRequest.bodySite
Definition

Anatomic location where the procedure should be performed. This is the target site.

Control0..*
BindingThe codes SHALL be taken from Radiotherapy Treatment Location Value Set
TypeCodeableConcept
Must Supporttrue
Summarytrue
Requirements

Knowing where the procedure is performed is important for tracking if multiple sites are possible.

Alternate Nameslocation
Comments

Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
109. ServiceRequest.bodySite.id
Definition

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

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
110. ServiceRequest.bodySite.extension
Definition

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

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.bodySite.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
111. ServiceRequest.bodySite.extension:locationQualifier
SliceNamelocationQualifier
Definition

General location qualifier (excluding laterality) for this bodySite

Control0..*
TypeExtension(BodyLocationQualifier) (Extension Type: CodeableConcept)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
112. ServiceRequest.bodySite.extension:lateralityQualifier
SliceNamelateralityQualifier
Definition

Laterality qualifier for this bodySite

Control0..1
TypeExtension(LateralityQualifier) (Extension Type: CodeableConcept)
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
113. ServiceRequest.bodySite.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Summarytrue
Requirements

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
114. ServiceRequest.bodySite.text
Definition

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

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

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
115. ServiceRequest.note
Definition

Any other notes and comments made about the service request. For example, internal billing notes.

Control0..*
TypeAnnotation
Summaryfalse
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
116. ServiceRequest.patientInstruction
Definition

Instructions in terms that are understood by the patient or consumer.

Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
117. ServiceRequest.relevantHistory
Definition

Key events in the history of the request.

Control0..*
TypeReference(Provenance)
Summaryfalse
Comments

This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))