The US Core Service Requst sets minimum expectations for the ServiceRequest resource to record, search, and fetch service requests associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile. In addition to the requirements set forth in US Core Service Requst this derived profile is designed to add requirements to the following elements:

• MCCServiceRequest.extension:resource-pertainsToGoal (Must Support) to encourage linking to the goal the medication hopes to facilitate and/or to encourage systems to be able to receive and understand a goal linkage if present.

No additional value sets were defined for use in this profile beyond the the value set bindings in the US Core Procedure profile, but please see the MCC Procedure and Service Request Value Set library page for guidance on use of procedure terminology in this guide.

Comments are welcome with respect to the pragmatic use of the “Must Support” rules defined on these elements.

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

This structure is derived from USCoreServiceRequestProfile

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest		0..*	USCoreServiceRequestProfile	A request for a service to be performed
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by type:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by type:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
Slices for category	SΣ	1..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	Classification of service Binding: US Core ServiceRequest Category Codes (required)
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	What is being requested/ordered Binding: US Core Procedure Codes (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		When service should occur
occurrencePeriod			Period
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	0..1	Reference(US Core Practitioner Profile)	Who/what is requesting service
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	RequestIntent
ServiceRequest.category	example	ServiceRequestCategoryCodes
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes
ServiceRequest.code	extensible	USCoreProcedureCodes

Constraints

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

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by type:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifiers assigned to this order
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
Slices for category	SΣ	1..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	Classification of service Binding: US Core ServiceRequest Category Codes (required)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	What is being requested/ordered Binding: US Core Procedure Codes (extensible)
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	SΣ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	SΣ	0..1		When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	0..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device)	Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	Σ	0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	RequestIntent
ServiceRequest.category	example	ServiceRequestCategoryCodes
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes
ServiceRequest.priority	required	RequestPriority
ServiceRequest.code	extensible	USCoreProcedureCodes
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerType	example	ParticipantRoles
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	example	ProcedureReasonCodes
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from USCoreServiceRequestProfile

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest		0..*	USCoreServiceRequestProfile	A request for a service to be performed
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by type:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by type:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
Slices for category	SΣ	1..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	Classification of service Binding: US Core ServiceRequest Category Codes (required)
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	What is being requested/ordered Binding: US Core Procedure Codes (extensible)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
occurrence[x]	SΣ	0..1		When service should occur
occurrencePeriod			Period
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	0..1	Reference(US Core Practitioner Profile)	Who/what is requesting service
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	RequestIntent
ServiceRequest.category	example	ServiceRequestCategoryCodes
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes
ServiceRequest.code	extensible	USCoreProcedureCodes

Constraints

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

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
ServiceRequest	C	0..*	USCoreServiceRequestProfile	A request for a service to be performed
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by type:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Identifiers assigned to this order
instantiatesCanonical	Σ	0..*	canonical(ActivityDefinition | PlanDefinition)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest | MedicationRequest)	What request fulfills
replaces	Σ	0..*	Reference(ServiceRequest)	What request replaces
requisition	Σ	0..1	Identifier	Composite Request ID
status	?!SΣ	1..1	code	draft | active | on-hold | revoked | completed | entered-in-error | unknown Binding: RequestStatus (required): The status of a service order.
intent	?!SΣ	1..1	code	proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option Binding: RequestIntent (required): The kind of service request.
Slices for category	SΣ	1..*	CodeableConcept	Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core	SΣ	0..*	CodeableConcept	Classification of service Binding: US Core ServiceRequest Category Codes (required)
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if service/procedure should not be performed
code	SΣ	1..1	CodeableConcept	What is being requested/ordered Binding: US Core Procedure Codes (extensible)
orderDetail	ΣC	0..*	CodeableConcept	Additional order information Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
quantity[x]	Σ	0..1		Service amount
quantityQuantity			Quantity
quantityRatio			Ratio
quantityRange			Range
subject	SΣ	1..1	Reference(US Core Patient Profile)	Individual or Entity the service is ordered for
encounter	Σ	0..1	Reference(Encounter)	Encounter in which the request was created
occurrence[x]	SΣ	0..1		When service should occur
occurrencePeriod			Period S
occurrenceDateTime			dateTime
occurrenceTiming			Timing
asNeeded[x]	Σ	0..1		Preconditions for service Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
authoredOn	SΣ	0..1	dateTime	Date request signed
requester	SΣ	0..1	Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core RelatedPerson Profile | Device)	Who/what is requesting service
performerType	Σ	0..1	CodeableConcept	Performer role Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson)	Requested performer
locationCode	Σ	0..*	CodeableConcept	Requested location Binding: ServiceDeliveryLocationRoleType (example): A location type where services are delivered.
locationReference	Σ	0..*	Reference(Location)	Requested location
reasonCode	Σ	0..*	CodeableConcept	Explanation/Justification for procedure or service Binding: ProcedureReasonCodes (example): Diagnosis or problem codes justifying the reason for requesting the service investigation.
reasonReference	Σ	0..*	Reference(Condition | Observation | DiagnosticReport | DocumentReference)	Explanation/Justification for service or service
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
supportingInfo		0..*	Reference(Resource)	Additional clinical information
specimen	Σ	0..*	Reference(Specimen)	Procedure Samples
bodySite	Σ	0..*	CodeableConcept	Location on Body Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
note		0..*	Annotation	Comments
patientInstruction	Σ	0..1	string	Patient or consumer-oriented instructions
relevantHistory		0..*	Reference(Provenance)	Request provenance
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
ServiceRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
ServiceRequest.status	required	RequestStatus
ServiceRequest.intent	required	RequestIntent
ServiceRequest.category	example	ServiceRequestCategoryCodes
ServiceRequest.category:us-core	required	USCoreServiceRequestCategoryCodes
ServiceRequest.priority	required	RequestPriority
ServiceRequest.code	extensible	USCoreProcedureCodes
ServiceRequest.orderDetail	example	ServiceRequestOrderDetailsCodes
ServiceRequest.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
ServiceRequest.performerType	example	ParticipantRoles
ServiceRequest.locationCode	example	ServiceDeliveryLocationRoleType
ServiceRequest.reasonCode	example	ProcedureReasonCodes
ServiceRequest.bodySite	example	SNOMEDCTBodyStructures

Constraints

Id	Grade	Path(s)	Details	Requirements
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USCoreServiceRequestProfile

Summary

Must-Support: 1 element

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal