HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1
1.0.0 - STU1

This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

StructureDefinition: ComorbidCondition

A comorbidity refers to one or more diseases or conditions that occur along with another condition in the same person at the same time. Conditions considered comorbidities are often long-term or chronic conditions. Comorbidities are defined relative to an index disease and may be categorical, rather than described in full detail. The comorbid condition class provides comorbidity codes corresponding the Elixhauser Comorbidity Index. Conformance note: If an ICD-10-CM code is used for the code attribute, and a semantically equivalent SNOMED code is available, the resulting instance will not be compliant with US Core Profiles.

The official URL for this profile is: 

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

Formal Views of Profile Content

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

This structure is derived from USCoreCondition

Summary

Mandatory: 1 element

Extensions

This structure refers to these extensions:

This structure is derived from USCoreCondition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..*USCoreCondition
... verificationStatus 1..1CodeableConcept
... category 1..*CodeableConceptRequired Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 398192003
... code 1..1CodeableConceptBinding: Comorbid Condition Value Set (required)
.... mcode-laterality 0..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣI1..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... category SI1..*CodeableConceptproblem-list-item | encounter-diagnosis | health-concern
Binding: US Core Condition Category Codes (extensible)

Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 398192003
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... severity I0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred)
... code SΣI1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Comorbid Condition Value Set (required)
... bodySite ΣI0..*CodeableConceptAnatomical location, if relevant
Binding: SNOMEDCTBodyStructures (preferred)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... mcode-laterality I0..1CodeableConceptOptional Extensions Element
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality
.... coding ΣI0..*CodingCode defined by a terminology system
.... text ΣI0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(US Core Patient Profile)Who has the condition?
... encounter ΣI0..1Reference(Encounter)Encounter created as part of
... onset[x] ΣI0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] I0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate ΣI0..1dateTimeDate record was first recorded
... recorder ΣI0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter ΣI0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Person who asserts this condition
... stage I0..*BackboneElementStage/grade, usually assessed formally
con-1: Stage SHALL have summary or assessment
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary I0..1CodeableConceptSimple summary (disease specific)
Binding: ConditionStage (example)
.... assessment I0..*Reference(ClinicalImpression | DiagnosticReport | Observation)Formal record of assessment
.... type I0..1CodeableConceptKind of staging
Binding: ConditionStageType (example)
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example)
.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note I0..*AnnotationAdditional information about the Condition

doco Documentation for this format

This structure is derived from USCoreCondition

Summary

Mandatory: 1 element

Extensions

This structure refers to these extensions:

Differential View

This structure is derived from USCoreCondition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..*USCoreCondition
... verificationStatus 1..1CodeableConcept
... category 1..*CodeableConceptRequired Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 398192003
... code 1..1CodeableConceptBinding: Comorbid Condition Value Set (required)
.... mcode-laterality 0..1CodeableConceptExtension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*USCoreConditionDetailed information about conditions, problems or diagnoses
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI0..1CodeableConceptactive | recurrence | relapse | inactive | remission | resolved
Binding: ConditionClinicalStatusCodes (required)
... verificationStatus ?!SΣI1..1CodeableConceptunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
Binding: ConditionVerificationStatus (required)
... category SI1..*CodeableConceptproblem-list-item | encounter-diagnosis | health-concern
Binding: US Core Condition Category Codes (extensible)

Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 398192003
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... severity I0..1CodeableConceptSubjective severity of condition
Binding: Condition/DiagnosisSeverity (preferred)
... code SΣI1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Comorbid Condition Value Set (required)
... bodySite ΣI0..*CodeableConceptAnatomical location, if relevant
Binding: SNOMEDCTBodyStructures (preferred)
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... mcode-laterality I0..1CodeableConceptOptional Extensions Element
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality
.... coding ΣI0..*CodingCode defined by a terminology system
.... text ΣI0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(US Core Patient Profile)Who has the condition?
... encounter ΣI0..1Reference(Encounter)Encounter created as part of
... onset[x] ΣI0..1Estimated or actual date, date-time, or age
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... abatement[x] I0..1When in resolution/remission
.... abatementDateTimedateTime
.... abatementAgeAge
.... abatementPeriodPeriod
.... abatementRangeRange
.... abatementStringstring
... recordedDate ΣI0..1dateTimeDate record was first recorded
... recorder ΣI0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Who recorded the condition
... asserter ΣI0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)Person who asserts this condition
... stage I0..*BackboneElementStage/grade, usually assessed formally
con-1: Stage SHALL have summary or assessment
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... summary I0..1CodeableConceptSimple summary (disease specific)
Binding: ConditionStage (example)
.... assessment I0..*Reference(ClinicalImpression | DiagnosticReport | Observation)Formal record of assessment
.... type I0..1CodeableConceptKind of staging
Binding: ConditionStageType (example)
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: ManifestationAndSymptomCodes (example)
.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note I0..*AnnotationAdditional information about the Condition

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

Terminology Bindings

PathConformanceValueSet / Code
Condition.languagepreferredCommonLanguages
Max Binding: AllLanguages
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
Condition.verificationStatusrequiredConditionVerificationStatus
Condition.categoryextensiblePattern: SNOMED CT code 398192003
Condition.severitypreferredCondition/DiagnosisSeverity
Condition.coderequiredComorbidConditionVS
Condition.bodySitepreferredSNOMEDCTBodyStructures
Condition.stage.summaryexampleConditionStage
Condition.stage.typeexampleConditionStageType
Condition.evidence.codeexampleManifestationAndSymptomCodes

Constraints

Constraints

IdPathDetailsRequirements
con-1Condition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2Condition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()