This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v0.9.1: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="obf-Condition"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p><b>Condition Profile</b></p> <p>A condition that is or may be present in a subject. 'Condition' is interpreted broadly and could be a disorder, abnormality, problem, injury, complaint, functionality, illness, disease, ailment, sickness, affliction, upset, difficulty, disorder, symptom, worry, or trouble. The Observation-based class, ConditionAbsent, should be used to describe conditions that are not present or negative findings. This profiled Condition uses the BodyLocation structure that includes not only a code, but optional laterality, direction, and relation to landmark(s).</p> <p><b>Mapping Summary</b></p> <p><pre>obf.Condition maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition: Language maps to language ImplicitRules maps to implicitRules Metadata.VersionId maps to meta.versionId Metadata.SourceSystem maps to meta.source Metadata.Profile maps to meta.profile Metadata.LastUpdated maps to meta.lastUpdated Metadata.SecurityLabel maps to meta.security Metadata.Tag maps to meta.tag Narrative maps to text Identifier maps to identifier ClinicalStatus maps to clinicalStatus Status maps to verificationStatus Category maps to category Severity maps to severity Code maps to code BodyLocation.Code maps to bodySite BodyLocation.Laterality maps to bodySite.extension BodyLocation.AnatomicalOrientation maps to bodySite.extension BodyLocation.RelationToLandmark maps to bodySite.extension SubjectOfRecord maps to subject CareContext maps to encounter Onset maps to onset[x] Abatement maps to abatement[x] StatementDateTime maps to recordedDate Author maps to recorder PersonInformationSource maps to asserter StageInformation maps to stage StageInformation.StageSummary maps to stage.summary StageInformation.StageDetail maps to stage.assessment StageInformation.Type maps to stage.type Evidence.Manifestation maps to evidence.code Evidence.Resource maps to evidence.detail Annotation maps to note DateOfDiagnosis maps to http://hl7.org/fhir/StructureDefinition/condition-assertedDate </pre></p> </div> </text> <url value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Condition"/> <version value="0.9.1"/> <name value="Condition"/> <title value="obf-Condition"/> <status value="active"/> <experimental value="false"/> <date value="2019-08-01T00:00:00-04:00"/> <publisher value="HL7 International Clinical Interoperability Council"/> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/cic"/> </telecom> </contact> <description value="A condition that is or may be present in a subject. 'Condition' is interpreted broadly and could be a disorder, abnormality, problem, injury, complaint, functionality, illness, disease, ailment, sickness, affliction, upset, difficulty, disorder, symptom, worry, or trouble. The Observation-based class, ConditionAbsent, should be used to describe conditions that are not present or negative findings. This profiled Condition uses the BodyLocation structure that includes not only a code, but optional laterality, direction, and relation to landmark(s)."/> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="US"/> <display value="United States of America"/> </coding> </jurisdiction> <fhirVersion value="4.0.0"/> <mapping> <identity value="argonaut-dq-dstu2"/> <uri value="http://unknown.org/Argonaut-DQ-DSTU2"/> <name value="Argonaut-DQ-DSTU2"/> </mapping> <mapping> <identity value="workflow"/> <uri value="http://hl7.org/fhir/workflow"/> <name value="Workflow Pattern"/> </mapping> <mapping> <identity value="sct-concept"/> <uri value="http://snomed.info/conceptdomain"/> <name value="SNOMED CT Concept Domain Binding"/> </mapping> <mapping> <identity value="v2"/> <uri value="http://hl7.org/v2"/> <name value="HL7 v2 Mapping"/> </mapping> <mapping> <identity value="rim"/> <uri value="http://hl7.org/v3"/> <name value="RIM Mapping"/> </mapping> <mapping> <identity value="w5"/> <uri value="http://hl7.org/fhir/fivews"/> <name value="FiveWs Pattern Mapping"/> </mapping> <mapping> <identity value="sct-attr"/> <uri value="http://snomed.org/attributebinding"/> <name value="SNOMED CT Attribute Binding"/> </mapping> <kind value="resource"/> <abstract value="false"/> <type value="Condition"/> <baseDefinition value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition"/> <derivation value="constraint"/> <snapshot> <element id="Condition"> <path value="Condition"/> <short value="obf-Condition"/> <definition value="A condition that is or may be present in a subject. 'Condition' is interpreted broadly and could be a disorder, abnormality, problem, injury, complaint, functionality, illness, disease, ailment, sickness, affliction, upset, difficulty, disorder, symptom, worry, or trouble. The Observation-based class, ConditionAbsent, should be used to describe conditions that are not present or negative findings. This profiled Condition uses the BodyLocation structure that includes not only a code, but optional laterality, direction, and relation to landmark(s)."/> <min value="0"/> <max value="*"/> <base> <path value="Condition"/> <min value="0"/> <max value="*"/> </base> <constraint> <key value="dom-2"/> <severity value="error"/> <human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/> <expression value="contained.contained.empty()"/> <xpath value="not(parent::f:contained and f:contained)"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-4"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/> <expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/> <xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-3"/> <severity value="error"/> <human value="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"/> <expression value="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()"/> <xpath value="not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/> <source value="DomainResource"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/> </extension> <key value="dom-6"/> <severity value="warning"/> <human value="A resource should have narrative for robust management"/> <expression value="text.div.exists()"/> <xpath value="exists(f:text/h:div)"/> <source value="DomainResource"/> </constraint> <constraint> <key value="dom-5"/> <severity value="error"/> <human value="If a resource is contained in another resource, it SHALL NOT have a security label"/> <expression value="contained.meta.security.empty()"/> <xpath value="not(exists(f:contained/*/f:meta/f:security))"/> <source value="DomainResource"/> </constraint> <constraint> <key value="con-5"/> <severity value="error"/> <human value="Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error"/> <expression value="verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()"/> <xpath value="not(exists(f:verificationStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-ver-status' and f:code/@value='entered-in-error'])) or not(exists(f:clinicalStatus))"/> <source value="Condition"/> </constraint> <constraint> <key value="con-4"/> <severity value="error"/> <human value="If condition is abated, then clinicalStatus must be either inactive, resolved, or remission"/> <expression value="abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()"/> <xpath value="not(exists(*[starts-with(local-name(.), 'abatement')])) or exists(f:clinicalStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-clinical' and f:code/@value=('resolved', 'remission', 'inactive')])"/> <source value="Condition"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation"> <valueMarkdown value="Most systems will expect a clinicalStatus to be valued for problem-list-items that are managed over time, but might not need a clinicalStatus for point in time encounter-diagnosis."/> </extension> <key value="con-3"/> <severity value="warning"/> <human value="Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item"/> <expression value="clinicalStatus.exists() or verificationStatus='entered-in-error' or category.select($this='problem-list-item').empty()"/> <xpath value="exists(f:clinicalStatus) or f:verificationStatus/@value='entered-in-error' or not(exists(category[@value='problem-list-item']))"/> <source value="Condition"/> </constraint> <constraint> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice"> <valueBoolean value="true"/> </extension> <key value="us-core-1"/> <severity value="warning"/> <human value="A code in Condition.category SHOULD be from US Core Condition Category Codes value set."/> <expression value="where(category in 'http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category').exists()"/> <xpath value="(no xpath equivalent)"/> </constraint> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Entity. Role, or Act"/> </mapping> <mapping> <identity value="workflow"/> <map value="Event"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)"/> </mapping> <mapping> <identity value="v2"/> <map value="PPR message"/> </mapping> <mapping> <identity value="rim"/> <map value="Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="Condition"/> </mapping> </element> <element id="Condition.id"> <path value="Condition.id"/> <short value="Logical id of this artifact"/> <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/> <comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="id"/> </type> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Condition.meta"> <path value="Condition.meta"/> <short value="Metadata about the resource"/> <definition value="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."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.meta"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Meta"/> </type> <isModifier value="false"/> <isSummary value="true"/> </element> <element id="Condition.implicitRules"> <path value="Condition.implicitRules"/> <short value="A set of rules under which this content was created"/> <definition value="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."/> <comment value="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."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.implicitRules"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/> <isSummary value="true"/> </element> <element id="Condition.language"> <path value="Condition.language"/> <short value="Language of the resource content"/> <definition value="The base language in which the resource is written."/> <comment value="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)."/> <min value="0"/> <max value="1"/> <base> <path value="Resource.language"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet"> <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="Language"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding"> <valueBoolean value="true"/> </extension> <strength value="preferred"/> <description value="A human language."/> <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> </binding> </element> <element id="Condition.text"> <path value="Condition.text"/> <short value="Text summary of the resource, for human interpretation"/> <definition value="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."/> <comment value="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."/> <alias value="narrative"/> <alias value="html"/> <alias value="xhtml"/> <alias value="display"/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Narrative"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="Act.text?"/> </mapping> </element> <element id="Condition.contained"> <path value="Condition.contained"/> <short value="Contained, inline Resources"/> <definition value="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."/> <comment value="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."/> <alias value="inline resources"/> <alias value="anonymous resources"/> <alias value="contained resources"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.contained"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Resource"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Condition.extension"> <path value="Condition.extension"/> <slicing id="1"> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Condition.extension:dateofdiagnosis"> <path value="Condition.extension"/> <sliceName value="dateofdiagnosis"/> <definition value="The date the disease was first clinically recognized with sufficient certainty, regardless of whether it was fully characterized at that time."/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/StructureDefinition/condition-assertedDate"/> </type> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.modifierExtension"> <path value="Condition.modifierExtension"/> <short value="Extensions that cannot be ignored"/> <definition value="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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="DomainResource.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Condition.identifier"> <path value="Condition.identifier"/> <short value="External Ids for this condition"/> <definition value="Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server."/> <comment value="This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)). 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."/> <requirements value="Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers."/> <min value="0"/> <max value="*"/> <base> <path value="Condition.identifier"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Identifier"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.identifier"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.identifier"/> </mapping> <mapping> <identity value="rim"/> <map value=".id"/> </mapping> </element> <element id="Condition.clinicalStatus"> <path value="Condition.clinicalStatus"/> <short value="active | recurrence | relapse | inactive | remission | resolved"/> <definition value="The clinical status of the condition."/> <comment value="The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.clinicalStatus"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="con-3"/> <condition value="con-4"/> <condition value="con-5"/> <mustSupport value="true"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the status contains codes that mark the condition as no longer active."/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="http://hl7.org/fhir/ValueSet/condition-clinical"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 303105007 |Disease phases|"/> </mapping> <mapping> <identity value="v2"/> <map value="PRB-14"/> </mapping> <mapping> <identity value="rim"/> <map value="Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="Condition.clinicalStatus"/> </mapping> </element> <element id="Condition.verificationStatus"> <path value="Condition.verificationStatus"/> <short value="unconfirmed | provisional | differential | confirmed | refuted | entered-in-error"/> <definition value="The verification status to support the clinical status of the condition."/> <comment value="verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity."/> <min value="1"/> <max value="1"/> <base> <path value="Condition.verificationStatus"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="con-3"/> <condition value="con-5"/> <mustSupport value="true"/> <isModifier value="true"/> <isModifierReason value="This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid."/> <isSummary value="true"/> <binding> <strength value="required"/> <valueSet value="http://hl7.org/fhir/ValueSet/condition-ver-status"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.status"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.status"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 410514004 |Finding context value|"/> </mapping> <mapping> <identity value="v2"/> <map value="PRB-13"/> </mapping> <mapping> <identity value="rim"/> <map value="Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="408729009"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="Condition.verificationStatus"/> </mapping> </element> <element id="Condition.category"> <path value="Condition.category"/> <short value="problem-list-item | encounter-diagnosis"/> <definition value="A category assigned to the condition."/> <comment value="The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts."/> <min value="1"/> <max value="1"/> <base> <path value="Condition.category"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="extensible"/> <valueSet value="http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.class"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 404684003 |Clinical finding|"/> </mapping> <mapping> <identity value="v2"/> <map value="'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message"/> </mapping> <mapping> <identity value="rim"/> <map value=".code"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="Condition.category"/> </mapping> </element> <element id="Condition.severity"> <path value="Condition.severity"/> <short value="Subjective severity of condition"/> <definition value="A subjective assessment of the severity of the condition as evaluated by the clinician."/> <comment value="Coding of the severity with a terminology is preferred, where possible."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.severity"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ConditionSeverity"/> </extension> <strength value="preferred"/> <description value="A subjective assessment of the severity of the condition as evaluated by the clinician."/> <valueSet value="http://hl7.org/fhir/ValueSet/condition-severity"/> </binding> <mapping> <identity value="w5"/> <map value="FiveWs.grade"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 272141005 |Severities|"/> </mapping> <mapping> <identity value="v2"/> <map value="PRB-26 / ABS-3"/> </mapping> <mapping> <identity value="rim"/> <map value="Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="246112005"/> </mapping> </element> <element id="Condition.code"> <path value="Condition.code"/> <short value="Identification of the condition, problem or diagnosis"/> <definition value="Identification of the condition, problem or diagnosis."/> <requirements value="0..1 to account for primarily narrative only resources."/> <alias value="type"/> <min value="1"/> <max value="1"/> <base> <path value="Condition.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="extensible"/> <description value="Valueset to describe the actual problem experienced by the patient"/> <valueSet value="http://hl7.org/fhir/us/core/ValueSet/us-core-problem"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.code"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.what[x]"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS << 420134006 |Propensity to adverse reactions| MINUS << 473010000 |Hypersensitivity condition| MINUS << 79899007 |Drug interaction| MINUS << 69449002 |Drug action| MINUS << 441742003 |Evaluation finding| MINUS << 307824009 |Administrative status| MINUS << 385356007 |Tumor stage finding|) OR < 413350009 |Finding with explicit context| OR < 272379006 |Event|"/> </mapping> <mapping> <identity value="v2"/> <map value="PRB-3"/> </mapping> <mapping> <identity value="rim"/> <map value=".value"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="246090004"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="Condition.code"/> </mapping> </element> <element id="Condition.bodySite"> <path value="Condition.bodySite"/> <short value="Anatomical location, if relevant"/> <definition value="The anatomical location where this condition manifests itself."/> <comment value="Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html). May be a summary code, or a reference to a very precise definition of the location, or both."/> <min value="0"/> <max value="*"/> <base> <path value="Condition.bodySite"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="preferred"/> <valueSet value="http://hl7.org/fhir/us/mcode/ValueSet/obf-datatype-BodyLocationVS"/> </binding> <mapping> <identity value="sct-concept"/> <map value="< 442083009 |Anatomical or acquired body structure|"/> </mapping> <mapping> <identity value="rim"/> <map value=".targetBodySiteCode"/> </mapping> <mapping> <identity value="sct-attr"/> <map value="363698007"/> </mapping> </element> <element id="Condition.bodySite.id"> <path value="Condition.bodySite.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Condition.bodySite.extension"> <path value="Condition.bodySite.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional content defined by implementations"/> <definition value="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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Condition.bodySite.extension:laterality"> <path value="Condition.bodySite.extension"/> <sliceName value="laterality"/> <definition value="Body side of the body location, if needed to distinguish from a similar location on the other side of the body. The laterality element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases. * Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location. * Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation. * Relation to landmark: The location relative to a landmark is specified by: 1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and 2. Specifying the direction and distance from the landmark to the body location. Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5)."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-Laterality-extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.bodySite.extension:anatomicalorientation"> <path value="Condition.bodySite.extension"/> <sliceName value="anatomicalorientation"/> <definition value="AnatomicalOrientation of the body location, if needed to distinguish from a similar location in another orientation. The orientation element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases. * Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location. * Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation. * Relation to landmark: The location relative to a landmark is specified by: 1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and 2. Specifying the direction and distance from the landmark to the body location. Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5)."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-AnatomicalOrientation-extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.bodySite.extension:relationtolandmark"> <path value="Condition.bodySite.extension"/> <sliceName value="relationtolandmark"/> <definition value="The relationship between a landmark that helps determine a body location and the body location itself. The location relative to a landmark is specified by: * Specifying the location and type of landmark using a body site code and optional laterality/orientation, * Specifying the direction from the landmark to the body location, and * Specifying the distance from the landmark to the body location. The RelationToLandmark element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases. * Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location. * Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation. * Relation to landmark: The location relative to a landmark is specified by: 1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and 2. Specifying the direction and distance from the landmark to the body location. Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5)."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-RelationToLandmark-extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.bodySite.coding"> <path value="Condition.bodySite.coding"/> <short value="Code defined by a terminology system"/> <definition value="A reference to a code defined by a terminology system."/> <comment value="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."/> <requirements value="Allows for alternative encodings within a code system, and translations to other code systems."/> <min value="0"/> <max value="*"/> <base> <path value="CodeableConcept.coding"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1-8, C*E.10-22"/> </mapping> <mapping> <identity value="rim"/> <map value="union(., ./translation)"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/> </mapping> </element> <element id="Condition.bodySite.text"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="Condition.bodySite.text"/> <short value="Plain text representation of the concept"/> <definition value="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."/> <comment value="Very often the text is the same as a displayName of one of the codings."/> <requirements value="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."/> <min value="0"/> <max value="1"/> <base> <path value="CodeableConcept.text"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.9. But note many systems use C*E.2 for this"/> </mapping> <mapping> <identity value="rim"/> <map value="./originalText[mediaType/code="text/plain"]/data"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/> </mapping> </element> <element id="Condition.subject"> <path value="Condition.subject"/> <short value="Who has the condition?"/> <definition value="Indicates the patient or group who the condition record is associated with."/> <requirements value="Group is typically used for veterinary or public health use cases."/> <alias value="patient"/> <min value="1"/> <max value="1"/> <base> <path value="Condition.subject"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/> </type> <mustSupport value="true"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.subject"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject[x]"/> </mapping> <mapping> <identity value="v2"/> <map value="PID-3"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.subject"/> </mapping> <mapping> <identity value="argonaut-dq-dstu2"/> <map value="Condition.patient"/> </mapping> </element> <element id="Condition.encounter"> <path value="Condition.encounter"/> <short value="Encounter created as part of"/> <definition value="The Encounter during which this Condition was created or to which the creation of this record is tightly associated."/> <comment value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known"."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.context"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.context"/> </mapping> <mapping> <identity value="v2"/> <map value="PV1-19 (+PV1-54)"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/> </mapping> </element> <element id="Condition.onset[x]"> <path value="Condition.onset[x]"/> <short value="Estimated or actual date, date-time, or age"/> <definition value="Estimated or actual date or date-time the condition began, in the opinion of the clinician."/> <comment value="Age is generally used when the patient reports an age at which the Condition began to occur."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.onset[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="Age"/> </type> <type> <code value="Period"/> </type> <type> <code value="Range"/> </type> <type> <code value="string"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="workflow"/> <map value="Event.occurrence[x]"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.init"/> </mapping> <mapping> <identity value="v2"/> <map value="PRB-16"/> </mapping> <mapping> <identity value="rim"/> <map value=".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value"/> </mapping> </element> <element id="Condition.abatement[x]"> <path value="Condition.abatement[x]"/> <short value="When in resolution/remission"/> <definition value="The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate."/> <comment value="There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.abatement[x]"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="Age"/> </type> <type> <code value="Period"/> </type> <type> <code value="Range"/> </type> <type> <code value="string"/> </type> <condition value="con-4"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="w5"/> <map value="FiveWs.done[x]"/> </mapping> <mapping> <identity value="rim"/> <map value=".effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed"/> </mapping> </element> <element id="Condition.recordedDate"> <path value="Condition.recordedDate"/> <short value="Date record was first recorded"/> <definition value="The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.recordedDate"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.recorded"/> </mapping> <mapping> <identity value="v2"/> <map value="REL-11"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].time"/> </mapping> </element> <element id="Condition.recorder"> <path value="Condition.recorder"/> <short value="Who recorded the condition"/> <definition value="Individual who recorded the record and takes responsibility for its content."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.recorder"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.author"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=AUT].role"/> </mapping> </element> <element id="Condition.asserter"> <path value="Condition.asserter"/> <short value="Person who asserts this condition"/> <definition value="Individual who is making the condition statement."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.asserter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> </type> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.source"/> </mapping> <mapping> <identity value="v2"/> <map value="REL-7.1 identifier + REL-7.12 type code"/> </mapping> <mapping> <identity value="rim"/> <map value=".participation[typeCode=INF].role"/> </mapping> </element> <element id="Condition.stage"> <path value="Condition.stage"/> <short value="Stage/grade, usually assessed formally"/> <definition value="Clinical stage or grade of a condition. May include formal severity assessments."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.stage"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="Element"/> </constraint> <constraint> <key value="con-1"/> <severity value="error"/> <human value="Stage SHALL have summary or assessment"/> <expression value="summary.exists() or assessment.exists()"/> <xpath value="exists(f:summary) or exists(f:assessment)"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]"/> </mapping> </element> <element id="Condition.stage.id"> <path value="Condition.stage.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Condition.stage.extension"> <path value="Condition.stage.extension"/> <short value="Additional content defined by implementations"/> <definition value="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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Condition.stage.modifierExtension"> <path value="Condition.stage.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Condition.stage.summary"> <path value="Condition.stage.summary"/> <short value="Simple summary (disease specific)"/> <definition value="A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.stage.summary"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="con-1"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ConditionStage"/> </extension> <strength value="example"/> <description value="Codes describing condition stages (e.g. Cancer stages)."/> <valueSet value="http://hl7.org/fhir/ValueSet/condition-stage"/> </binding> <mapping> <identity value="sct-concept"/> <map value="< 254291000 |Staging and scales|"/> </mapping> <mapping> <identity value="v2"/> <map value="PRB-14"/> </mapping> <mapping> <identity value="rim"/> <map value=".value"/> </mapping> </element> <element id="Condition.stage.assessment"> <path value="Condition.stage.assessment"/> <short value="Formal record of assessment"/> <definition value="Reference to a formal record of the evidence on which the staging assessment is based."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.stage.assessment"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Observation"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-DiagnosticReport"/> </type> <condition value="con-1"/> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".self"/> </mapping> </element> <element id="Condition.stage.type"> <path value="Condition.stage.type"/> <short value="Kind of staging"/> <definition value="The kind of staging, such as pathological or clinical staging."/> <min value="0"/> <max value="1"/> <base> <path value="Condition.stage.type"/> <min value="0"/> <max value="1"/> </base> <type> <code value="CodeableConcept"/> </type> <isModifier value="false"/> <isSummary value="false"/> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ConditionStageType"/> </extension> <strength value="example"/> <description value="Codes describing the kind of condition staging (e.g. clinical or pathological)."/> <valueSet value="http://hl7.org/fhir/ValueSet/condition-stage-type"/> </binding> <mapping> <identity value="rim"/> <map value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage type"]"/> </mapping> </element> <element id="Condition.evidence"> <path value="Condition.evidence"/> <short value="Supporting evidence"/> <definition value="Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition."/> <comment value="The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both."/> <min value="0"/> <max value="*"/> <base> <path value="Condition.evidence"/> <min value="0"/> <max value="*"/> </base> <type> <code value="BackboneElement"/> </type> <constraint> <key value="ele-1"/> <severity value="error"/> <human value="All FHIR elements must have a @value or children"/> <expression value="hasValue() or (children().count() > id.count())"/> <xpath value="@value|f:*|h:div"/> <source value="Element"/> </constraint> <constraint> <key value="con-2"/> <severity value="error"/> <human value="evidence SHALL have code or details"/> <expression value="code.exists() or detail.exists()"/> <xpath value="exists(f:code) or exists(f:detail)"/> </constraint> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value=".outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]"/> </mapping> </element> <element id="Condition.evidence.id"> <path value="Condition.evidence.id"/> <representation value="xmlAttr"/> <short value="Unique id for inter-element referencing"/> <definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Condition.evidence.extension"> <path value="Condition.evidence.extension"/> <short value="Additional content defined by implementations"/> <definition value="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."/> <comment value="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."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="Condition.evidence.modifierExtension"> <path value="Condition.evidence.modifierExtension"/> <short value="Extensions that cannot be ignored even if unrecognized"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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)."/> <comment value="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."/> <requirements value="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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/> <alias value="extensions"/> <alias value="user content"/> <alias value="modifiers"/> <min value="0"/> <max value="*"/> <base> <path value="BackboneElement.modifierExtension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <isModifier value="true"/> <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/> <isSummary value="true"/> <mapping> <identity value="rim"/> <map value="N/A"/> </mapping> </element> <element id="Condition.evidence.code"> <path value="Condition.evidence.code"/> <short value="Manifestation/symptom"/> <definition value="A manifestation or symptom that led to the recording of this condition."/> <min value="0"/> <max value="*"/> <base> <path value="Condition.evidence.code"/> <min value="0"/> <max value="*"/> </base> <type> <code value="CodeableConcept"/> </type> <condition value="con-2"/> <isModifier value="false"/> <isSummary value="true"/> <binding> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings"/> </binding> <mapping> <identity value="workflow"/> <map value="Event.reasonCode"/> </mapping> <mapping> <identity value="w5"/> <map value="FiveWs.why[x]"/> </mapping> <mapping> <identity value="sct-concept"/> <map value="< 404684003 |Clinical finding|"/> </mapping> <mapping> <identity value="rim"/> <map value="[code="diagnosis"].value"/> </mapping> </element> <element id="Condition.evidence.detail"> <path value="Condition.evidence.detail"/> <short value="Supporting information found elsewhere"/> <definition value="Links to other relevant information, including pathology reports."/> <min value="0"/> <max value="*"/> <base> <path value="Condition.evidence.detail"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/> </type> <condition value="con-2"/> <isModifier value="false"/> <isSummary value="true"/> <mapping> <identity value="w5"/> <map value="FiveWs.why[x]"/> </mapping> <mapping> <identity value="rim"/> <map value=".self"/> </mapping> </element> <element id="Condition.note"> <path value="Condition.note"/> <short value="Additional information about the Condition"/> <definition value="Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis."/> <min value="0"/> <max value="*"/> <base> <path value="Condition.note"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Annotation"/> </type> <isModifier value="false"/> <isSummary value="false"/> <mapping> <identity value="workflow"/> <map value="Event.note"/> </mapping> <mapping> <identity value="v2"/> <map value="NTE child of PRB"/> </mapping> <mapping> <identity value="rim"/> <map value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value"/> </mapping> </element> </snapshot> <differential> <element id="Condition"> <path value="Condition"/> <short value="obf-Condition"/> <definition value="A condition that is or may be present in a subject. 'Condition' is interpreted broadly and could be a disorder, abnormality, problem, injury, complaint, functionality, illness, disease, ailment, sickness, affliction, upset, difficulty, disorder, symptom, worry, or trouble. The Observation-based class, ConditionAbsent, should be used to describe conditions that are not present or negative findings. This profiled Condition uses the BodyLocation structure that includes not only a code, but optional laterality, direction, and relation to landmark(s)."/> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.extension"> <path value="Condition.extension"/> <slicing id="1"> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <ordered value="false"/> <rules value="open"/> </slicing> </element> <element id="Condition.extension:dateofdiagnosis"> <path value="Condition.extension"/> <sliceName value="dateofdiagnosis"/> <definition value="The date the disease was first clinically recognized with sufficient certainty, regardless of whether it was fully characterized at that time."/> <min value="0"/> <max value="1"/> <base> <path value="DomainResource.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/StructureDefinition/condition-assertedDate"/> </type> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.verificationStatus"> <path value="Condition.verificationStatus"/> <min value="1"/> <max value="1"/> </element> <element id="Condition.category"> <path value="Condition.category"/> <min value="1"/> <max value="1"/> </element> <element id="Condition.bodySite"> <path value="Condition.bodySite"/> <binding> <strength value="preferred"/> <valueSet value="http://hl7.org/fhir/us/mcode/ValueSet/obf-datatype-BodyLocationVS"/> </binding> </element> <element id="Condition.bodySite.extension:laterality"> <path value="Condition.bodySite.extension"/> <sliceName value="laterality"/> <definition value="Body side of the body location, if needed to distinguish from a similar location on the other side of the body. The laterality element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases. * Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location. * Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation. * Relation to landmark: The location relative to a landmark is specified by: 1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and 2. Specifying the direction and distance from the landmark to the body location. Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5)."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-Laterality-extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.bodySite.extension:anatomicalorientation"> <path value="Condition.bodySite.extension"/> <sliceName value="anatomicalorientation"/> <definition value="AnatomicalOrientation of the body location, if needed to distinguish from a similar location in another orientation. The orientation element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases. * Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location. * Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation. * Relation to landmark: The location relative to a landmark is specified by: 1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and 2. Specifying the direction and distance from the landmark to the body location. Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5)."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-AnatomicalOrientation-extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.bodySite.extension:relationtolandmark"> <path value="Condition.bodySite.extension"/> <sliceName value="relationtolandmark"/> <definition value="The relationship between a landmark that helps determine a body location and the body location itself. The location relative to a landmark is specified by: * Specifying the location and type of landmark using a body site code and optional laterality/orientation, * Specifying the direction from the landmark to the body location, and * Specifying the distance from the landmark to the body location. The RelationToLandmark element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases. * Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location. * Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation. * Relation to landmark: The location relative to a landmark is specified by: 1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and 2. Specifying the direction and distance from the landmark to the body location. Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR's stand-alone BodySite (aka BodyStructure in r4) which 'is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient' (FHIR 3.5)."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> <profile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-RelationToLandmark-extension"/> </type> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="Condition.subject"> <path value="Condition.subject"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/> </type> </element> <element id="Condition.encounter"> <path value="Condition.encounter"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/> </type> </element> <element id="Condition.recorder"> <path value="Condition.recorder"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> </type> </element> <element id="Condition.asserter"> <path value="Condition.asserter"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/> <targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/> <targetProfile value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/> </type> </element> <element id="Condition.stage"> <path value="Condition.stage"/> <min value="0"/> <max value="1"/> </element> <element id="Condition.stage.assessment"> <path value="Condition.stage.assessment"/> <min value="0"/> <max value="1"/> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Observation"/> <targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-DiagnosticReport"/> </type> </element> <element id="Condition.evidence"> <path value="Condition.evidence"/> </element> <element id="Condition.evidence.code"> <path value="Condition.evidence.code"/> <binding> <strength value="example"/> <valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings"/> </binding> </element> </differential> </StructureDefinition>