minimal Common Oncology Data Elements (mCODE) Implementation Guide
1.16.0 - STU Release 2 (Ballot Version)

This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v1.16.0: STU 2 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

Resource Profile: Primary Cancer Condition

Defining URL:http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-primary-cancer-condition
Version:1.16.0
Name:PrimaryCancerCondition
Title:Primary Cancer Condition
Status:Active as of 2021-04-15T12:44:45+00:00
Definition:

Records the the primary cancer condition, the original or first tumor in the body (Definition from: NCI Dictionary of Cancer Terms). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.

Publisher:HL7 International Clinical Interoperability Council
Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-primary-cancer-condition

Usage

This profile captures the cancer diagnosis. More information on coding the diagnosis can be found on the page Content by Group -> Disease.

In mCODE, staging information MUST be captured in an Observation that conforms to the CancerStageGroup profile. The resulting stage group MAY appear in this profile, in stage.summary and stage.type, but mCODE Data Senders and Receivers MAY ignore it in favor of the CancerStageGroup Observation. If present, cancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the CancerStageGroup, which refer back to PrimaryCancerCondition.

Conformance

Condition resources associated with an mCODE patient with a Condition.code in the value set PrimaryOrUncertainBehaviorCancerDisorderVS MUST conform to this profile. Beyond this requirement, a producer of resources SHOULD ensure that any resource instance associated with an mCODE patient that would reasonably be expected to conform to this profile SHOULD be published in this form.

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreCondition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition S0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... extension S0..*ExtensionExtension
Slice: Unordered, Open by value:url
... condition-assertedDate S0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... mcode-histology-morphology-behavior S0..1CodeableConceptHistology-Morphology-Behavior
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
Binding: Histology Morphology Behavior Value Set (required)
... bodySite S0..*CodeableConceptAnatomical location, if relevant
Binding: Cancer Body Location Value Set (extensible)
.... mcode-location-qualifier S0..*CodeableConceptLocation Qualifier
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-location-qualifier
Binding: Location Qualifier Value Set (required)
... stage S0..*BackboneElementStage/grade, usually assessed formally
.... summary 0..1CodeableConceptMost recent Stage Group
.... assessment S0..*Reference(Cancer Stage Group)Formal record of assessment
.... type 0..1CodeableConceptStaging system used.
Binding: Observation Codes for Stage Group Category (required)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition SI0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension S0..*ExtensionExtension
Slice: Unordered, Open by value:url
... condition-assertedDate S0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... mcode-histology-morphology-behavior S0..1CodeableConceptHistology-Morphology-Behavior
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
Binding: Histology Morphology Behavior Value Set (required)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... category SI1..*CodeableConceptproblem-list-item | encounter-diagnosis | health-concern
Binding: US Core Condition Category Codes (extensible)
... severity 0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... code SΣI1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Primary or Uncertain Behavior Cancer Disorder Value Set (required)
primary-cancer-condition-code-invariant: If the code representing 'Other primary cancer condition, specify' is used, a second code from outside the original value set must be present. The second code MUST NOT represent a concept in or subsumed by any concept in the original value set.
... bodySite SΣ0..*CodeableConceptAnatomical location, if relevant
Binding: Cancer Body Location Value Set (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... mcode-location-qualifier S0..*CodeableConceptLocation Qualifier
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-location-qualifier
Binding: Location Qualifier Value Set (required)
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... onset[x] Σ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] I0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate Σ0..1dateTimeDate record was first recorded
... recorder Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Person who asserts this condition
... stage SI0..*BackboneElementStage/grade, usually assessed formally
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary I0..1CodeableConceptMost recent Stage Group
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment SI0..*Reference(Cancer Stage Group)Formal record of assessment
.... type 0..1CodeableConceptStaging system used.
Binding: Observation Codes for Stage Group Category (required)
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... extension 0..*ExtensionExtension
Slice: Unordered, Open by value:url
... condition-assertedDate 0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... mcode-histology-morphology-behavior 0..1CodeableConceptHistology-Morphology-Behavior
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
Binding: Histology Morphology Behavior Value Set (required)
... verificationStatus ?!ΣI0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... category I1..*CodeableConceptproblem-list-item | encounter-diagnosis | health-concern
Binding: US Core Condition Category Codes (extensible)
... code ΣI1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Primary or Uncertain Behavior Cancer Disorder Value Set (required)
primary-cancer-condition-code-invariant: If the code representing 'Other primary cancer condition, specify' is used, a second code from outside the original value set must be present. The second code MUST NOT represent a concept in or subsumed by any concept in the original value set.
... bodySite Σ0..*CodeableConceptAnatomical location, if relevant
Binding: Cancer Body Location Value Set (extensible)
.... mcode-location-qualifier 0..*CodeableConceptLocation Qualifier
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-location-qualifier
Binding: Location Qualifier Value Set (required)
... subject Σ1..1Reference(US Core Patient Profile)Who has the condition?
... stage I0..*BackboneElementStage/grade, usually assessed formally
.... assessment I0..*Reference(Cancer Stage Group)Formal record of assessment

doco Documentation for this format

Differential View

This structure is derived from USCoreCondition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition S0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... extension S0..*ExtensionExtension
Slice: Unordered, Open by value:url
... condition-assertedDate S0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... mcode-histology-morphology-behavior S0..1CodeableConceptHistology-Morphology-Behavior
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
Binding: Histology Morphology Behavior Value Set (required)
... bodySite S0..*CodeableConceptAnatomical location, if relevant
Binding: Cancer Body Location Value Set (extensible)
.... mcode-location-qualifier S0..*CodeableConceptLocation Qualifier
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-location-qualifier
Binding: Location Qualifier Value Set (required)
... stage S0..*BackboneElementStage/grade, usually assessed formally
.... summary 0..1CodeableConceptMost recent Stage Group
.... assessment S0..*Reference(Cancer Stage Group)Formal record of assessment
.... type 0..1CodeableConceptStaging system used.
Binding: Observation Codes for Stage Group Category (required)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition SI0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages: A human language.

... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension S0..*ExtensionExtension
Slice: Unordered, Open by value:url
... condition-assertedDate S0..1dateTimeDate the condition was first asserted
URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
... mcode-histology-morphology-behavior S0..1CodeableConceptHistology-Morphology-Behavior
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
Binding: Histology Morphology Behavior Value Set (required)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣI0..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... category SI1..*CodeableConceptproblem-list-item | encounter-diagnosis | health-concern
Binding: US Core Condition Category Codes (extensible)
... severity 0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.

... code SΣI1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Primary or Uncertain Behavior Cancer Disorder Value Set (required)
primary-cancer-condition-code-invariant: If the code representing 'Other primary cancer condition, specify' is used, a second code from outside the original value set must be present. The second code MUST NOT represent a concept in or subsumed by any concept in the original value set.
... bodySite SΣ0..*CodeableConceptAnatomical location, if relevant
Binding: Cancer Body Location Value Set (extensible)
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... mcode-location-qualifier S0..*CodeableConceptLocation Qualifier
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-location-qualifier
Binding: Location Qualifier Value Set (required)
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... onset[x] Σ0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] I0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate Σ0..1dateTimeDate record was first recorded
... recorder Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter Σ0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Person who asserts this condition
... stage SI0..*BackboneElementStage/grade, usually assessed formally
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary I0..1CodeableConceptMost recent Stage Group
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment SI0..*Reference(Cancer Stage Group)Formal record of assessment
.... type 0..1CodeableConceptStaging system used.
Binding: Observation Codes for Stage Group Category (required)
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet
Condition.languagepreferredCommonLanguages
Max Binding: AllLanguages
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensibleUSCoreConditionCategoryCodes
Condition.severitypreferredCondition/DiagnosisSeverity
Condition.coderequiredPrimaryOrUncertainBehaviorCancerDisorderVS
Condition.bodySiteextensibleCancerBodyLocationVS
Condition.stage.summaryexampleConditionStage
Condition.stage.typerequiredObservationCodesStageGroupVS
Condition.evidence.codeexampleManifestationAndSymptomCodes

Constraints

IdPathDetailsRequirements
primary-cancer-condition-code-invariantCondition.codeIf the code representing 'Other primary cancer condition, specify' is used, a second code from outside the original value set must be present. The second code MUST NOT represent a concept in or subsumed by any concept in the original value set.
: coding.where(code = 'PCC-OTHER').exists() implies coding.where(code != 'PCC-OTHER' and $this.memberOf('http://hl7.org/fhir/us/mcode/ValueSet/mcode-primary-or-uncertain-behavior-cancer-disorder-vs').not()).exists()
con-2Condition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()