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This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v4.0.0-ballot: STU4 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions

Extension: Radiotherapy Modality And Technique Extension

Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Version: 4.0.0-ballot
Active as of 2024-04-10 Maturity Level: 3 Computable Name: RadiotherapyModalityAndTechnique
Other Identifiers: OID:2.16.840.1.113883.4.642.40.15.42.45

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

Context of Use

This extension may be used on the following element(s):

  • Element ID DomainResource
  • Element ID Extension
  • Element ID Procedure
  • Element ID ServiceRequest

Usage

Extension capturing modality and technique of a given radiotherapy procedure. For definitions, see the Radiotherapy Glossary page.

Allowed combinations of modality and technique are shown here and enforced by invariants:

Treatment Type Modality Technique
All UNC (.text required) Not constrained
External Beam Radiotherapy Photons IMRT, VMAT, 3D, 2D, IORT, FLASH, UNC (.text required)
External Beam Radiotherapy Electrons 3D, 2D, IORT, FLASH, UNC (.text required)
External Beam Radiotherapy Neutrons 3D, NCT, UNC (.text required)
External Beam Radiotherapy Carbon Ions PPS, PSS, PS, UNC (.text required)
External Beam Radiotherapy Protons PPS, PSS, PS, FLASH, UNC (.text required)
Brachytherapy Internal radiotherapy – permanent seeds Interstitial, UNC (.text required)
Brachytherapy Low Dose Rate using temporary source Intracavitary, Interstitial, Surface, UNC (.text required)
Brachytherapy Pulsed Dose Rate Intracavitary, Interstitial, UNC (.text required)
Brachytherapy High Dose Rate Intracavitary, IMB, Interstitial, Intravascular, Intraluminal, IORT, Surface, UNC (.text required)
Brachytherapy High dose rate electronic Intracavitary, IMB, Interstitial, Intraluminal, IORT, Surface, UNC (.text required)
Brachytherapy Radiopharmaceutical Oral, Intravascular, Intracavitary, Interstitial, UNC (.text required)

It may not be possible to map modalities and techniques to the coded values defined here, since the system may have been configured with a local code system, or the values may have been recorded as text strings. In order to enable systems to produce mCODE-conformant data, an “un-encoded” value (HL7 Codesystem NullFlavor value UNC) is included in the value sets for both modality and technique. UNC means the original text or a local code has not been translated or encoded to the approved value set due to limitations of the sending system. If the UNC value is used, a text literal that specifies the source value SHALL be provided in the .text element of the CodeableConcept. This requirement is enforced by an invariant.

Technique Acronyms:

Acronym Meaning
IMB Intensity Modulated Brachytherapy
IMRT Intensity Modulated Radiation Therapy
VMAT Volumetric Modulated Arc Therapy
3D Three Dimensional Planning
2D Two Dimensional Planning
IORT Intraoperative Radiation Therapy
NCT Neutron Capture Therapy
PS Particle Scanning other than PSS
PPS Particle Spot Scanning
PSS Particle Passive Scattering
FLASH Ultra high dose rate radiotherapy
UNC “Un-encoded” value.

Conformance

Usage info

Usage:

Changes since version true:

  • No changes

    • Formal Views of Extension Content

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

    This structure is derived from Extension

    Summary

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

    • modality: CodeableConcept: Extension capturing a modality of external beam or brachytherapy radiation procedures.
    • technique: CodeableConcept: Extension capturing a technique of external beam or brachytherapy radiation procedures.

    Maturity: 3

    This structure is derived from Extension

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Extension C 0..* Extension Radiotherapy Modality And Technique Extension
    TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality
    TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality
    TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality
    TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality
    TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality
    TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds
    TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source
    TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate
    TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate
    TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic
    TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical
    ModalityTextRequiredForOther: Require a text literal for code other
    TechniqueTextRequiredForOther: Require a text literal for code other
    ... extension 1..* Extension Extension
    ... modality S 1..1 (Complex) Radiotherapy Modality Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
    .... value[x] 1..1 CodeableConcept Value of extension
    Binding: Radiotherapy Modality Value Set (required)
    ... technique S 0..* (Complex) Radiotherapy Technique Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
    .... value[x] 1..1 CodeableConcept Value of extension
    Binding: Radiotherapy Technique Value Set (required)
    ... value[x] 0..0

    doco Documentation for this format
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Extension C 0..* Extension Radiotherapy Modality And Technique Extension
    TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality
    TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality
    TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality
    TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality
    TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality
    TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds
    TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source
    TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate
    TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate
    TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic
    TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical
    ModalityTextRequiredForOther: Require a text literal for code other
    TechniqueTextRequiredForOther: Require a text literal for code other
    ... id 0..1 string Unique id for inter-element referencing
    ... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ... modality S 1..1 (Complex) Radiotherapy Modality Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..0
    .... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
    .... value[x] 1..1 CodeableConcept Value of extension
    Binding: Radiotherapy Modality Value Set (required)
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..0
    .... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
    .... value[x] 1..1 CodeableConcept Value of extension
    Binding: Radiotherapy Technique Value Set (required)
    ... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"

    doco Documentation for this format

    This structure is derived from Extension

    Summary

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

    • modality: CodeableConcept: Extension capturing a modality of external beam or brachytherapy radiation procedures.
    • technique: CodeableConcept: Extension capturing a technique of external beam or brachytherapy radiation procedures.

    Maturity: 3

    Differential View

    This structure is derived from Extension

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Extension C 0..* Extension Radiotherapy Modality And Technique Extension
    TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality
    TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality
    TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality
    TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality
    TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality
    TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds
    TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source
    TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate
    TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate
    TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic
    TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical
    ModalityTextRequiredForOther: Require a text literal for code other
    TechniqueTextRequiredForOther: Require a text literal for code other
    ... extension 1..* Extension Extension
    ... modality S 1..1 (Complex) Radiotherapy Modality Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
    .... value[x] 1..1 CodeableConcept Value of extension
    Binding: Radiotherapy Modality Value Set (required)
    ... technique S 0..* (Complex) Radiotherapy Technique Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique
    .... value[x] 1..1 CodeableConcept Value of extension
    Binding: Radiotherapy Technique Value Set (required)
    ... value[x] 0..0

    doco Documentation for this format

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Extension C 0..* Extension Radiotherapy Modality And Technique Extension
    TechniquesForNeutronBeamModality: Allowed Techniques for Neutron Beam Modality
    TechniquesForPhotonBeamModality: Allowed Techniques for Photon Beam Modality
    TechniquesForElectronBeamModality: Allowed Techniques for Electron Beam Modality
    TechniquesForCarbonIonBeamModality: Allowed Techniques for Carbon Ion Beam Modality
    TechniquesForProtonBeamModality: Allowed Techniques for Proton Beam Modality
    TechniquesForInternalRadiotherapyPermanentSeeds: Allowed Techniques for Internal Radiotherapy - Permanent Seeds
    TechniquesForLowDoseRateUsingTempRadSource: Allowed Techniques for Low Dose Rate Using Temp Radiation Source
    TechniquesForPulsedDoseRate: Allowed Techniques for Pulsed Dose Rate
    TechniquesForHighDoseRate: Allowed Techniques for High Dose Rate
    TechniquesForHighDoseRateElectronic: Allowed Techniques for High Dose Rate Electronic
    TechniquesForRadioPharmaceutical: Allowed Techniques for Radiopharmaceutical
    ModalityTextRequiredForOther: Require a text literal for code other
    TechniqueTextRequiredForOther: Require a text literal for code other
    ... id 0..1 string Unique id for inter-element referencing
    ... Slices for extension 1..* Extension Extension
    Slice: Unordered, Open by value:url
    ... modality S 1..1 (Complex) Radiotherapy Modality Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..0
    .... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality"
    .... value[x] 1..1 CodeableConcept Value of extension
    Binding: Radiotherapy Modality Value Set (required)
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..0
    .... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique"
    .... value[x] 1..1 CodeableConcept Value of extension
    Binding: Radiotherapy Technique Value Set (required)
    ... url 1..1 uri "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique"

    doco Documentation for this format

     

    Other representations of profile: CSV, Excel, Schematron

    Terminology Bindings

    PathConformanceValueSetURI
    Extension.extension:modality.value[x]requiredRadiotherapyModalityVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-modality-vs
    from this IG
    Extension.extension:technique.value[x]requiredRadiotherapyTechniqueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-radiotherapy-technique-vs
    from this IG

    Constraints

    IdGradePath(s)DetailsRequirements
    ModalityTextRequiredForOthererrorExtensionRequire a text literal for code other
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
    TechniqueTextRequiredForOthererrorExtensionRequire a text literal for code other
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
    TechniquesForCarbonIonBeamModalityerrorExtensionAllowed Techniques for Carbon Ion Beam Modality
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
    TechniquesForElectronBeamModalityerrorExtensionAllowed Techniques for Electron Beam Modality
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
    TechniquesForHighDoseRateerrorExtensionAllowed Techniques for High Dose Rate
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
    TechniquesForHighDoseRateElectronicerrorExtensionAllowed Techniques for High Dose Rate Electronic
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
    TechniquesForInternalRadiotherapyPermanentSeedserrorExtensionAllowed Techniques for Internal Radiotherapy - Permanent Seeds
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
    TechniquesForLowDoseRateUsingTempRadSourceerrorExtensionAllowed Techniques for Low Dose Rate Using Temp Radiation Source
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
    TechniquesForNeutronBeamModalityerrorExtensionAllowed Techniques for Neutron Beam Modality
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
    TechniquesForPhotonBeamModalityerrorExtensionAllowed Techniques for Photon Beam Modality
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
    TechniquesForProtonBeamModalityerrorExtensionAllowed Techniques for Proton Beam Modality
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
    TechniquesForPulsedDoseRateerrorExtensionAllowed Techniques for Pulsed Dose Rate
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
    TechniquesForRadioPharmaceuticalerrorExtensionAllowed Techniques for Radiopharmaceutical
    : extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')