Retrieves a Bundle of Condition resources with a code in mCODE’s cancer condition value set, and allows for associated Patient resources to be retrieved in a subsequent request. Use ONLY when reverse chaining AND _include are not available on the system.

Gets an mCODE Patient Bundle for a specific patient that contains all of that patient’s resources that conform to mCODE Profiles.

Uses _include to retrieve a Bundle of Condition resources with a code in mCODE’s cancer condition value set, along with the associated Patient resources. Use ONLY when reverse chaining is not available on the system.

Capabilities for an mCODE Data Receiver where not all cancer patients conform to mCODE. Retrieves a Group of references to Patient resources that conform to mCODE, and allows for the full Patient resources to be retrieved in a subsequent request.

Uses reverse chaining to retrieve a Bundle of Patient resources with a condition code in mCODE’s cancer condition value set.

Retrieves a Bundle of Condition resources with a code in mCODE’s cancer condition value set, and allows for associated Patient resources to be retrieved in a subsequent request. Use ONLY when reverse chaining AND _include are not available on the system.

Retrieves a Bundle of Condition resources with a code in mCODE’s cancer condition value set, and allows for associated Patient resources to be retrieved in a subsequent request. Use ONLY when reverse chaining AND _include are not available on the system.

Uses _include to retrieve a Bundle of Condition resources with a code in mCODE’s cancer condition value set, along with the associated Patient resources. Use ONLY when reverse chaining is not available on the system.

Capabilities for an mCODE Data Sender where not all cancer patients conform to mCODE. Retrieves a Group of references to Patient resources that conform to mCODE, and allows for the full Patient resources to be retrieved in a subsequent request.

Uses reverse chaining to retrieve a Bundle of Patient resources with a condition code in mCODE’s cancer condition value set.

Gets an mCODE Patient Bundle for a specific patient that contains all of that patient’s resources that conform to mCODE Profiles.

A clinician’s qualitative judgment on the current trend of the cancer, e.g., whether it is stable, worsening (progressing), or improving (responding). The judgment may be based a single type or multiple kinds of evidence, such as imaging data, assessment of symptoms, tumor markers, laboratory data, etc.

A patient who has been diagnosed with or is receiving medical treatment for a malignant growth or tumor. The only difference between CancerPatient and US Core Patient is that Patient.deceased is a must-support element in mCODE. Must-support is an instruction to implementers of FHIR clients and servers, rather than a constraint on data structure. Any Patient resource complying with US Core Patient Profile will also comply with CancerPatient.

An episode of medication administration for a patient whose condition is related to a primary or secondary cancer condition. In the context of chemotherapy drugs, the medication administration in most cases is performed and documented by the provider.

A record of a medication prescription or consumption associated with cancer treatment. The medication may reported by the prescriber, prescribing organization, or patient. It does not have to be directly observed.

A surgical action addressing a cancer condition. The scope of this profile has been narrowed to cancer-related procedures by constraining the reasonReference and reasonCode to cancer conditions, one of which is required.

An assessment of the extent of the cancer in the body, according to a given cancer staging classification system. This profile can be used with any staging system, but it is specifically targeted for non-TNM staging systems, since specialized TNM staging profiles are provided.

General structure for capturing comorbid conditions with respect to a primary (‘index’) condition. The user can use this profile in three ways: (1) free-form, listing any conditions they wish to highlight as significant comorbidities, (2) following a formal paradigm such as the Charlson Comorbidity Index or the NCI Comorbidity Index, or (3) use disease categories defined for registry reporting purposes, such as those defined by Center for International Blood and Marrow Transplant Research (CIBMTR).

The Eastern Cooperative Oncology Group (ECOG) Performance Status represents the patient’s functional status and is used to determine their ability to tolerate therapies in serious illness, specifically for chemotherapy. (Definition from: LOINC)

A subset of genes or genomic regions of interest in a targeted resequencing study.

Details about a set of changes in the tested sample compared to a reference sequence. The term variant can be used to describe an alteration that may be benign, pathogenic, or of unknown significance. The term variant is increasingly being used in place of the term mutation. Variants can be computed relative to reference sequence assembly from which it was identified.

Genomic analysis summary report. The report may include one or more tests, with two distinct test types. The first type is a targeted mutation test, where a specific mutation on a specific gene is tested for. The result is either positive or negative for that mutation. The second type is a more general test for variants. This type of test returns the identity of variants found in a certain region of the genome.

A specimen taken from a Patient. The profile includes extensions to specify a more precise body site and an identifier of source body structure at that site (for example, a tumor identifier).

The Karnofsky Performance Status (KPS) is a tool used to measure a patient’s functional status. It can be used to compare the effectiveness of different therapies and to help assess the prognosis of certain patients, such as those with certain cancers. The KPS score ranges from 0 to 100 in intervals of 10. Higher scores are associated with better functional status, with 100 representing no symptoms or evidence of disease, and 0 representing death.

A collection of data for an mCODE cancer patient.

A group of patients included in the scope of mCODE, whose cancer-related resources conform to mCODE profiles.

Records the the primary cancer condition, the original or first neoplasm 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.

A summary of a course of radiotherapy delivered to a patient. It records the treatment intent, termination reason, modalities, techniques, number of sessions, and doses delivered to one or more body volumes. Whether the course has been fully delivered or stopped is indicated in the status element.

A volume of the body used in radiotherapy planning or treatment delivery.

Records the history of secondary neoplasms, including location(s) and the date of onset of metastases. A secondary cancer results from the spread (metastasization) of cancer from its original site (Definition from: NCI Dictionary of Cancer Terms).

Category describing the extent of a tumor metastasis in remote anatomical locations, based on evidence such as physical examination, imaging, and/or biopsy.

Category of the primary tumor, based on its size and extent, based on evidence such as physical examination, imaging, and/or biopsy.

Category of the presence or absence of metastases in regional lymph nodes, based on evidence such as physical examination, imaging, and/or biopsy.

The extent of cancer reprsented by the stage group, based on a TNM staging system.

Identifies a tumor that has not been removed from the body. Whenever possible, a single resource conforming to this profile will be used to track a tumor over time (as opposed to creating new Tumor-conforming BodyStructure resources each time that tumor is measured). Use HumanSpecimen to represent the tumor after removal from the body.

The result of a tumor marker test. Tumor marker tests are generally used to guide cancer treatment decisions and monitor treatment, as well as to predict the chance of recovery and cancer recurrence.

Records the dimensions of a tumor

An identifier that designates a body structure such as a tumor and can be used for tracking the structure over time.

Qualifier to refine an body location. These include qualifiers for relative location, directionality, number, and plane, and exclude qualifiers for laterality.

Categorization of the kind of evidence contributing to a clinical judgment on cancer disease progression.

An extension describing the morphologic and behavioral characteristics of the cancer.

Qualifier to specify laterality.

The purpose of a treatment, medication, or procedure.

Dose delivered to a given radiotherapy volume.

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

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

The number of sessions in a course of radiotherapy.

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

A condition that has a relationship with the resource.

A condition that is NOT present, related to the resource.

A code explaining the unplanned or premature termination, or normal completion, of a plan of treatment, course of medication, or research study.

Types of benign neoplasms and neoplasms of uncertain behavior of the brain and central nervous system, coded in SNOMED CT or ICD-10-CM.

Qualifiers to refine a body structure or location including qualifiers for relative location, directionality, number, plane, and laterality.

Qualifiers to refine a body structure or location including qualifiers for relative location, directionality, number, and plane, and excluding qualifiers for laterality.

Allowed techniques for brachytherapy modality High Dose Rate electronic

Allowed techniques for brachytherapy modality High Dose Rate

Allowed techniques for brachytherapy modality Low Dose Rate using temporary radiation source

Codes describing the modalities of brachytherapy procedures.

Allowed techniques for brachytherapy modality internal radiotherapy - permanent seeds

Allowed techniques for brachytherapy modality Pulsed Dose Rate

Allowed techniques for brachytherapy modality radiopharmaceutical

Codes describing the techniques of brachytherapy (internal or surface radiation) procedures.

Codes describing the location(s) of primary or secondary cancer. The value set includes all codes from the SNOMED CT body structure hierarchy (codes descending from 123037004 ‘Body Structure’). The cancer body location may also be expressed using ICD-O-3 topography codes, however, those codes are not included here due to intellectual property restrictions. These topography terms have four-character codes that run from C00.0 to C80.9 ref. Only SNOMED CT and ICD-O-3 are considered conformant.

The type of evidence backing up the clinical determination of cancer progression.

A broad cancer-related value set containing both primary and secondary tumor types, with codes from ICD-10 and SNOMED CT, including both diagnosis and histology/morphology/behavior codes. ICD-O-3 morphology codes may also be used and are considered conformant to the specification. For SNOMED, the value set includes all codes descending from 363346000 ‘Malignant neoplastic disease (disorder)’ and 108369006 ‘Neoplasm (morphologic abnormality)’.

Includes surgical procedure codes from SNOMED CT, ICD-10-PCS and CPT. The value set may be a superset of cancer surgery codes, but narrowing the set further risks eliminating potentially useful and relevant codes.

The result of cancer staging, i.e., the stage or category of the cancer.

System or method used for staging cancers. The terms in this value set describe staging systems, not specific stages or descriptors used within those systems.

Identifying codes for the type of cancer staging performed. In terms of the SNOMED CT hierarchy, these codes represent observables.

Types of carcinoma in-situ, coded in SNOMED CT or ICD-10-CM.

How patient’s given disease, condition, or ability is trending.

Types of cytological evience of malignancy, coded in SNOMED CT or ICD-10-CM.

Codes representing the structure, arrangement, and behavioral characteristics of malignant neoplasms, and cancer cells. Inclusion criteria: in situ neoplasms and malignant neoplasms. Exclusion criteria: benign neoplasms and neoplasms of unspecified behavior. Note: ICD-O-3 morphology codes are referenced in the logical definition but not expanded in the value set for intellectual property reasons. For primary cancers, the ICD-O-3 behavior suffix should be /1, /2, or /3. For secondary cancers, the ICD-O-3 behavior suffix should be /6.

Specimen taken from a human subject. The values include the subset of codes in the HL7 Specimen Type code system (https://terminology.hl7.org/CodeSystem-v2-0487.html) representing body sites and body fluids likely to be used in tumor marker or genomic testing. The most specific term available should be used, for example, for arterial blood, use #BLDA not #BLD.

Types of hypereosinophilic syndrome, coded in SNOMED CT or ICD-10-CM.

Qualifiers to specify laterality.

Types of melanoma in-situ, coded in SNOMED CT or ICD-10-CM.

Types of primary malignant neoplastic disease, coded in SNOMED CT or ICD-10-CM.

Types of primary malignant neoplasms, coded in SNOMED CT or ICD-10-CM.

The purpose of a procedure.

Codes describing the modalities of external beam and brachytherapy radiation procedures, for use with radiotherapy summaries. This value set is the union of the teleradiotherapy and brachytherapy modality value sets.

Codes describing the techniques of external beam and brachytherapy radiation procedures, for use with radiotherapy summaries. This is the union of the EBRT and brachytherapy technique value sets.

Various modifiers that can be applied to body locations where radiotherapy treatments can be directed.

Codes describing the body locations where radiotherapy treatments can be directed. Based on TG263.

Codes describing the types of body volumes used in radiotherapy planning and treatment. The value set includes the most common codes from DICOM CID 9534 Radiotherapy Targets (UID 1.2.840.10008.6.1.1244) and adds a code for Organs at Risk (OAR).

Types of secondary malignant neoplastic disease, coded in SNOMED CT or ICD-10-CM.

Values for TNM distant metastases category must be selected from this value set, which includes all codes from AJCC and all codes from TNMDistantMetastasesCategoryVS.

Result values for M category. This value set contains SNOMED-CT equivalents of AJCC codes for the M category, according to TNM staging rules.

Identifying codes for the type of cancer staging performed, i.e., clinical, pathological, or other, for distant metastases (M) staging observation.

Values for TNM primary tumor category must be selected from this value set, which includes all codes from AJCC and all codes from TNMPrimaryTumorCategoryVS.

Result values for T category. This value set contains SNOMED-CT equivalents of AJCC codes for the T category, according to TNM staging rules.

Identifying codes for the type of cancer staging performed, i.e., clinical, pathological, or other, for primary tumor (T) staging observation.

Values for TNM regional nodes category must be selected from this value set, which includes all codes from AJCC and all codes from TNMRegionalNodesCategoryVS.

Result values for N category. This value set contains SNOMED-CT equivalents of AJCC codes for the N category, according to TNM staging rules.

Identifying codes for the type of cancer staging performed, i.e., clinical, pathological, or other, for regional nodes (N) staging observation.

Values for TNM stage group must be selected from this value set, which includes all codes from AJCC and all codes from TNMStageGroupVS.

Identifying codes for the type of cancer staging performed, i.e., clinical, pathological, or other, for the stage group observation.

Result values for cancer stage group using TNM staging. This value set contains SNOMED-CT equivalents of AJCC codes for Stage Group, according to TNM staging rules.

Method used for TNM staging, e.g., AJCC 6th, 7th, or 8th edition.

Allowed techniques for carbon ion beam modality

Allowed techniques for electron beam modality

Codes describing the modalities of teleradiotherapy (external beam) procedures.

Allowed techniques for neutron beam modality

Allowed techniques for photon beam modality

Allowed techniques for proton beam modality

Codes describing the techniques of teleradiotherapy (external beam) procedures.

Values used to describe the reasons for stopping a treatment or episode of care. Includes code for ‘treatment completed’ as well as codes for unplanned (early) stoppage. Applies to medications and other treatments that take place over a period of time, such as radiation treatments.

Codes representing tests for tumor markers. This value set of LOINC codes is not comprehensive and can be extended. Other vocabularies can be used only if the test of interest is not covered by LOINC. Tumor marker tests differ from genetic tests in that they measure levels of protein or other substances produced downstream from RNA protein synthesis.

Code for methods of measuring tumor size, including physical examination, pathology, and imaging.

Acceptable units for measuring tumor size

Codes requested from SNOMED by mCODE, to be issued at a later date. Where numeric codes are given, these correspond to the expected SNOMED CT codes. Terms beginning with ‘USCRS-‘ (for United States Content Request Service) represent request identifiers with no SNOMED code yet approved or assigned.

A mapping between TG263 Concepts and FHIR TG263 Value Set

This SearchParameter enables query of conditions by code with the in modifier.

This SearchParameter enables query of patients by _id with mutlipleOr enabled.

Example of a non-TNM Stage Group (Binet staging for CLL)

Extended example: example of body height vital sign

Extended example: example of body weight vital sign

Extended example: body weight vital sign at the time of chemotherapy administration

Example of Cancer Disease Status

Extended example: example showing disease status (patient’s condition improved)

Example of Patient

Example of Patient

Extended example: example cancer patient

Example of Patient

mCODE Example for Cancer-Related Comorbidities

Example of Cancer-Related Comorbidities

Extended example: example showing chemotherapy medication

Extended example: example showing chemotherapy medication

Extended example: example showing chemotherapy medication

Extended example: example showing chemotherapy medication

Example of CancerRelatedMedicationRequest - Chemo Infusion

Extended example: example showing chemotherapy medication

Extended example: example showing chemotherapy medication

Example of CancerRelatedMedicationRequest

Extended example: example showing chemotherapy medication

Extended example: example showing partial mastectomy surgical procedure

Example of Cancer Related Surgical Procedure

Example of ECOG Performance Status

Extended example: example showing ECOG performance status

Extended example: example showing family member history of cancer

Extended example: example showing family member history of cancer

Extended example: example showing family member history of cancer

Extended example: example showing which regions were included in the genomics panel

mCODE Example for Genomic Region Studied

mCODE Example for Genomic Variant gene fusion event

mCODE Example for Genomic Variant

Extended example: example showing genomic variant found by breast cancer genomics panel

mCODE Example for Genomic Variant

Extended example: example of gene panel report

mCODE Example for Genomics Report

Example of a Group identifying in-scope patients

GenomeX Example of NGS Patient

Extended genomics example conformant with an mCODE Bundle.

GenomeX mCODE Example for functional effect (loss of function) - BAP1

GenomeX mCODE Example for Clinical Significance of VUS - POF1B

GenomeX mCODE Example for Clinical Significance of VUS - POF1B

Example for Microsatellite Instability

GenomeX mCODE Example for Genomic Specimen - Tumor specimen of the TumorNormal test

GenomeX mCODE Example for Genomic Specimen - Tumor specimen of the TumorNormal test

Example of how Genomics Reporting IG Therapeutic Implications fits with mCODE

Example of how Genomics Reporting IG Therapeutic Implications fits with mCODE

Example of how Genomics Reporting IG Therapeutic Implications fits with mCODE

Example of how Genomics Reporting IG Therapeutic Implications fits with mCODE

Example of how Genomics Reporting IG Therapeutic Implications fits with mCODE

Example for Tumor Mutation Burden

mCODE Example for Genomic Variant gene fusion event

GenomeX mCODE Example for the absence of a notable variant - KIT and BRAF

GenomeX mCODE Example for Genomic Variant - BAP1

GenomeX mCODE Example for Genomic Variant - CDKN2A

GenomeX mCODE Example for Genomic Variant - CDKN2B

GenomeX mCODE Example for Genomic Variant - KDM5D

GenomeX mCODE Example for Genomic Variant - MTAP

GenomeX mCODE Example for Genomic Variant - MYCN

GenomeX mCODE Example for Genomic Variant - POF1B

GenomeX mCODE Example for Genomic Variant - POLRMT

GenomeX Example for Genomics Report

GenomeX example: Order information

GenomeX mCODE example: results interpreter of the NGS test.

GenomeX example: example organization

GenomeX example: example organization

Extended example: example showing human specimen for genomic sequencing

mCODE Example of human specimen

Anatomic volume 2 for Jenny M’s teleradiotherapy.

Anatomic volume 1 for Jenny M’s teleradiotherapy.

Example of comorbid condition (congestive heart failure) present

Anatomic volume for John Anyperson’s brachytherapy.

Example of Karnofsky Performance Status

Hemoglobin lab result to support TNMStageGroup example

Extended example as a mCODE Patient Bundle

Extended example: example showing smoking history

mCODE Example for Primary Cancer Condition (breast). The example shows post-coordinated coding using SNOMED CT, with separate codes for morphology and bodySite.

Example of Primary Cancer Condition - hematologic cancer

Extended example: example showing primary cancer condition

Example of Primary Cancer Condition

Example of radiotherapy treatment summary involving external beam radiation to chest wall and regional node radiation with a chest wall boost

Example of Secondary Cancer Condition

Example of TNM Clinical Distant Metastases Category

Extended example: example showing TNM staging (M)

Example of TNM Clinical Primary Tumor Category

Extended example: example showing TNM staging (T)

Example of TNM Clinical Regional Nodes Category

Extended example: example showing TNM staging (N)

Example of TNM Clinical Stage Group

Extended example: example showing TNM staging (stage group)

Extended example: example showing TNM staging (M)

Extended example: example showing TNM staging (T)

Extended example: example showing TNM staging (N)

Extended example: example showing TNM staging (stage group)

Example of a resource conforming to the tumor profile.

mCODE Example for Tumor Marker Test

Extended example: example showing ER status

Extended example: example showing HER2 status

Extended example: example showing Oncotype DX breast recurrence score. Note that this test has no assigned LOINC code, so GTR is being used as a backup. Only the score from the Oncotype DX panel (as opposed to variant data from the genes in the panel) is represented here.

Extended example: example showing PR status

Extended example: example showing tumor size

Example of a resource conforming to the tumor size profile.

Extended example: example tumor specimen

Example of a tumor specimen, linked to this Tumor via identifier.

Extended example: example showing comorbid condition (anxiety)

Extended example: example showing comorbid condition (depression)

Extended example: example showing comorbid condition (hypertension)

Extended example: example of pathology findings represented as a DiagnosticReport resource.

Extended example: neutrophils lab test

Extended example: example showing 3 sentinel lymph nodes were examined

Extended example: example showing DCIS diagnosis

Extended example: example showing DCIS diagnosis

Extended example: example showing negative invasion for the removed tumor

Extended example: example showing negative margins for the removed tumor

Example of US Core Organization

Extended example: example organization

Extended example: example PCP practitioner

Example of Practitioner

Extended example: example PCP practitioner

Extended example: example RN practitioner

Extended example: example practitioner

Extended example: example practitioner (pathologist)

Extended example: example biopsy procedure

Extended example: example mammogram

Extended example: example showing smoking status