minimal Common Oncology Data Elements (mCODE) Implementation Guide
4.0.0-ballot - STU4 Ballot United States of America flag

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

Resource Profile: Tumor - Detailed Descriptions

Active as of 2024-04-10 Maturity Level: 3

Definitions for the mcode-tumor resource profile.

Guidance on how to interpret the contents of this table can be found here

0. BodyStructure
2. BodyStructure.extension
Must Supporttrue
SlicingThis element introduces a set of slices on BodyStructure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 4. BodyStructure.extension:relatedCondition
    Slice NamerelatedCondition
    Definition

    Associates this tumor with a cancer condition. This could be a causal association (e.g., this is believed to be the primary tumor causing the cancer) or a different type of relationship (e.g., this tumor is a metastasis)

    ShortReference to cancer condition associated with this tumor
    Control0..1
    TypeExtension(Related Condition Extension) (Extension Type: Choice of: CodeableConcept, Reference(Condition))
    Must Supporttrue
    6. BodyStructure.extension:relatedCondition.value[x]
    TypeReference(US Core Condition Problems and Health Concerns Profile)
    [x] NoteSee Choice of Data Types for further information about how to use [x]
    Must Supporttrue
    8. BodyStructure.identifier
    Definition

    Stable identifier(s) for this specific tumor. The identifiers MUST be unique within the context of the referenced CancerPatient.

    ShortStable identifier(s) for this tumor
    Comments

    If applicable, an identifier should correspond to the physical tag inserted into the tumor during a procedure that is used for tracking the tumor by radiology and pathology.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..?
    Must Supporttrue
    SlicingThis element introduces a set of slices on BodyStructure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • pattern @ type
    • 10. BodyStructure.identifier:bodyStructureIdentifier
      Slice NamebodyStructureIdentifier
      Definition

      A persistent identifier used to identify and track the tumor over time. The identifier must be unique in the context of the patient.

      ShortA persistent identifier of this tumor.
      NoteThis is a business identifier, not a resource identifier (see discussion)
      Control1..*
      TypeIdentifier(Body Structure Identifier Profile)
      12. BodyStructure.morphology
      BindingUnless not suitable, these codes SHALL be taken from Tumor Morphology Code Value Set
      (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-tumor-morphology-code-vs)
      Additional BindingsPurpose
      Tumor Morphology Code Max Value SetMax Binding
      Must Supporttrue
      14. BodyStructure.location
      Control1..?
      BindingUnless not suitable, these codes SHALL be taken from Cancer Body Location Value Set
      (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
      Must Supporttrue
      16. BodyStructure.locationQualifier
      BindingThe codes SHALL be taken from Body Location and Laterality Qualifier Value Set
      (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-body-location-and-laterality-qualifier-vs)
      Must Supporttrue
      18. BodyStructure.patient
      Definition

      The patient associated with this tumor.

      TypeReference(Cancer Patient Profile)
      Must Supporttrue

      Guidance on how to interpret the contents of this table can be found here

      0. BodyStructure
      Definition

      Record details about an anatomical structure. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

      ShortSpecific and identified anatomical structure
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Alternate Namesanatomical location
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. BodyStructure.implicitRules
      Definition

      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.

      ShortA set of rules under which this content was created
      Comments

      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.

      Control0..1
      Typeuri
      Is Modifiertrue because 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
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. BodyStructure.extension
      Definition

      An Extension


      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.

      ShortExtensionAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on BodyStructure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. BodyStructure.extension:relatedCondition
        Slice NamerelatedCondition
        Definition

        Associates this tumor with a cancer condition. This could be a causal association (e.g., this is believed to be the primary tumor causing the cancer) or a different type of relationship (e.g., this tumor is a metastasis)

        ShortReference to cancer condition associated with this tumor
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Related Condition Extension) (Extension Type: Choice of: CodeableConcept, Reference(Condition))
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        8. BodyStructure.extension:relatedCondition.extension
        Definition

        An Extension


        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.

        ShortExtensionAdditional content defined by implementations
        Comments

        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.

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on BodyStructure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 10. BodyStructure.extension:relatedCondition.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
          12. BodyStructure.extension:relatedCondition.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          TypeReference(US Core Condition Problems and Health Concerns Profile), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSee Choice of Data Types for further information about how to use [x]
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          14. BodyStructure.modifierExtension
          Definition

          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).

          ShortExtensions that cannot be ignored
          Comments

          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.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Summaryfalse
          Requirements

          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.

          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          16. BodyStructure.identifier
          Definition

          Stable identifier(s) for this specific tumor. The identifiers MUST be unique within the context of the referenced CancerPatient.


          Identifier for this instance of the anatomical structure.

          ShortStable identifier(s) for this tumorBodystructure identifier
          Comments

          If applicable, an identifier should correspond to the physical tag inserted into the tumor during a procedure that is used for tracking the tumor by radiology and pathology.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control10..*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on BodyStructure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • pattern @ type
          • 18. BodyStructure.identifier:bodyStructureIdentifier
            Slice NamebodyStructureIdentifier
            Definition

            A persistent identifier used to identify and track the tumor over time. The identifier must be unique in the context of the patient.


            Identifier for this instance of the anatomical structure.

            ShortA persistent identifier of this tumor.Bodystructure identifier
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control10..*
            This element is affected by the following invariants: ele-1
            TypeIdentifier(Body Structure Identifier Profile)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. BodyStructure.active
            Definition

            Whether this body site is in active use.

            ShortWhether this record is in active use
            Comments

            This element is labeled as a modifier because it may be used to mark that the resource was created in error.

            Control0..1
            Typeboolean
            Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            Need to be able to mark a body site entry as not to be used because it was created in error.

            Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. BodyStructure.morphology
            Definition

            The kind of structure being represented by the body structure at BodyStructure.location. This can define both normal and abnormal morphologies.

            ShortKind of Structure
            Comments

            The minimum cardinality of 0 supports the use case of specifying a location without defining a morphology.

            Control0..1
            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Tumor Morphology Code Value Sethttp://hl7.org/fhir/ValueSet/bodystructure-code
            (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-tumor-morphology-code-vs)
            Additional BindingsPurpose
            Tumor Morphology Code Max Value SetMax Binding
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            24. BodyStructure.location
            Definition

            The anatomical location or region of the specimen, lesion, or body structure.

            ShortBody site
            Control10..1
            BindingUnless not suitable, these codes SHALL be taken from For example codes, see Cancer Body Location Value Sethttp://hl7.org/fhir/ValueSet/body-site
            (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. BodyStructure.locationQualifier
            Definition

            Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

            ShortBody site modifier
            Control0..*
            BindingThe codes SHALL be taken from For example codes, see Body Location and Laterality Qualifier Value Sethttp://hl7.org/fhir/ValueSet/bodystructure-relative-location
            (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-body-location-and-laterality-qualifier-vs)
            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. BodyStructure.patient
            Definition

            The patient associated with this tumor.


            The person to which the body site belongs.

            ShortWho this is about
            Control1..1
            TypeReference(Cancer Patient Profile, Patient)
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

            Guidance on how to interpret the contents of this table can be found here

            0. BodyStructure
            Definition

            Record details about an anatomical structure. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

            ShortSpecific and identified anatomical structure
            Control0..*
            Is Modifierfalse
            Summaryfalse
            Alternate Namesanatomical location
            Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
            dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
            dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
            dom-6: A resource should have narrative for robust management (text.`div`.exists())
            2. BodyStructure.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Is Modifierfalse
            Summarytrue
            4. BodyStructure.meta
            Definition

            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.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. BodyStructure.implicitRules
            Definition

            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.

            ShortA set of rules under which this content was created
            Comments

            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.

            Control0..1
            Typeuri
            Is Modifiertrue because 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
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            8. BodyStructure.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            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).

            Control0..1
            BindingThe codes SHOULD be taken from CommonLanguages
            (preferred to http://hl7.org/fhir/ValueSet/languages)

            A human language.

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            10. BodyStructure.text
            Definition

            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.

            ShortText summary of the resource, for human interpretation
            Comments

            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.

            Control0..1
            TypeNarrative
            Is Modifierfalse
            Summaryfalse
            Alternate Namesnarrative, html, xhtml, display
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. BodyStructure.contained
            Definition

            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.

            ShortContained, inline Resources
            Comments

            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.

            Control0..*
            TypeResource
            Is Modifierfalse
            Summaryfalse
            Alternate Namesinline resources, anonymous resources, contained resources
            14. BodyStructure.extension
            Definition

            An Extension

            ShortExtension
            Control0..*
            TypeExtension
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on BodyStructure.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 16. BodyStructure.extension:relatedCondition
              Slice NamerelatedCondition
              Definition

              Associates this tumor with a cancer condition. This could be a causal association (e.g., this is believed to be the primary tumor causing the cancer) or a different type of relationship (e.g., this tumor is a metastasis)

              ShortReference to cancer condition associated with this tumor
              Control0..1
              This element is affected by the following invariants: ele-1
              TypeExtension(Related Condition Extension) (Extension Type: Choice of: CodeableConcept, Reference(Condition))
              Is Modifierfalse
              Must Supporttrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              18. BodyStructure.extension:relatedCondition.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              20. BodyStructure.extension:relatedCondition.extension
              Definition

              An Extension

              ShortExtension
              Control0..0
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on BodyStructure.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 22. BodyStructure.extension:relatedCondition.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
                24. BodyStructure.extension:relatedCondition.value[x]
                Definition

                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                ShortValue of extension
                Control1..1
                TypeReference(US Core Condition Problems and Health Concerns Profile)
                [x] NoteSee Choice of Data Types for further information about how to use [x]
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                26. BodyStructure.modifierExtension
                Definition

                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).

                ShortExtensions that cannot be ignored
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                Summaryfalse
                Requirements

                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.

                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                28. BodyStructure.identifier
                Definition

                Stable identifier(s) for this specific tumor. The identifiers MUST be unique within the context of the referenced CancerPatient.

                ShortStable identifier(s) for this tumor
                Comments

                If applicable, an identifier should correspond to the physical tag inserted into the tumor during a procedure that is used for tracking the tumor by radiology and pathology.

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control1..*
                TypeIdentifier
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on BodyStructure.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • pattern @ type
                • 30. BodyStructure.identifier:bodyStructureIdentifier
                  Slice NamebodyStructureIdentifier
                  Definition

                  A persistent identifier used to identify and track the tumor over time. The identifier must be unique in the context of the patient.

                  ShortA persistent identifier of this tumor.
                  NoteThis is a business identifier, not a resource identifier (see discussion)
                  Control1..*
                  This element is affected by the following invariants: ele-1
                  TypeIdentifier(Body Structure Identifier Profile)
                  Is Modifierfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  32. BodyStructure.active
                  Definition

                  Whether this body site is in active use.

                  ShortWhether this record is in active use
                  Comments

                  This element is labeled as a modifier because it may be used to mark that the resource was created in error.

                  Control0..1
                  Typeboolean
                  Is Modifiertrue because This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  Need to be able to mark a body site entry as not to be used because it was created in error.

                  Meaning if MissingThis resource is generally assumed to be active if no value is provided for the active element
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  34. BodyStructure.morphology
                  Definition

                  The kind of structure being represented by the body structure at BodyStructure.location. This can define both normal and abnormal morphologies.

                  ShortKind of Structure
                  Comments

                  The minimum cardinality of 0 supports the use case of specifying a location without defining a morphology.

                  Control0..1
                  BindingUnless not suitable, these codes SHALL be taken from Tumor Morphology Code Value Set
                  (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-tumor-morphology-code-vs)
                  Additional BindingsPurpose
                  Tumor Morphology Code Max Value SetMax Binding
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  36. BodyStructure.location
                  Definition

                  The anatomical location or region of the specimen, lesion, or body structure.

                  ShortBody site
                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from Cancer Body Location Value Set
                  (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  38. BodyStructure.locationQualifier
                  Definition

                  Qualifier to refine the anatomical location. These include qualifiers for laterality, relative location, directionality, number, and plane.

                  ShortBody site modifier
                  Control0..*
                  BindingThe codes SHALL be taken from Body Location and Laterality Qualifier Value Set
                  (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-body-location-and-laterality-qualifier-vs)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  40. BodyStructure.description
                  Definition

                  A summary, characterization or explanation of the body structure.

                  ShortText description
                  Comments

                  This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  42. BodyStructure.image
                  Definition

                  Image or images used to identify a location.

                  ShortAttached images
                  Control0..*
                  TypeAttachment
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  44. BodyStructure.patient
                  Definition

                  The patient associated with this tumor.

                  ShortWho this is about
                  Control1..1
                  TypeReference(Cancer Patient Profile)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))