minimal Common Oncology Data Elements (mCODE) Implementation Guide
2.1.0 - STU 2.1 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 (v2.1.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

mcode-receiver-cancer-conditions-then-patients

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.

mcode-receiver-patient-bundle

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.

mcode-receiver-patients-and-cancer-conditions

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.

mcode-receiver-patients-in-group

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.

mcode-receiver-patients-with-cancer-condition

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

mcode-sender-cancer-conditions-then-patients

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.

mcode-sender-patient-bundle

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

mcode-sender-patients-and-cancer-conditions

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.

mcode-sender-patients-in-group

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.

mcode-sender-patients-with-cancer-condition

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

Behavior: Operation Definitions

These are custom operations that can be supported by and/or invoked by systems conforming to this implementation guide.

mcode-patient-everything

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

Structures: Abstract Profiles

These are profiles on resources or data types that describe patterns used by other profiles, but cannot be instantiated directly. I.e. instances can conform to profiles based on these abstract profiles, but do not declare conformance to the abstract profiles themselves.

Comorbidities Parent Abstract Profile

General structure for capturing comorbid conditions with respect to a primary (‘index’) condition. The specific set of comorbidities of interest in a given context are defined by slicing the components array. The same general approach can be applied to any comorbidity category checklist.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Cancer Disease Status Profile

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.

Cancer Patient Profile

A patient who has been diagnosed with or is receiving medical treatment for a malignant growth or tumor. The is the most essential profile in mCODE, since it is referenced by many other profiles. The only difference between the mCODE Patient profile and the US Core Patient Profile is that Patient.deceased is a must-support element in mCODE.

Cancer-Related Medication Administration Profile

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.

Cancer-Related Medication Request Profile

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.

Cancer-Related Surgical Procedure Profile

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.

Cancer Stage Group Profile

The extent of the cancer in the body, according to a given cancer staging classification system, based on evidence such as physical examination, imaging, and/or biopsy or based on pathologic analysis of a specimen.

Comorbidities Elixhauser Profile

Comorbid condition checklist and optional risk score, using Elixhauser comorbidity categories as defined by the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (H-CUP).

ECOG Performance Status Profile

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)

Genomic Region Studied Profile

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

Genomic Specimen Profile

A small sample of blood, hair, skin, amniotic fluid (the fluid that surrounds a fetus during pregnancy), or other tissue which is excised from a subject for the purposes of genomics testing or analysis.

Genomic Variant Profile

An alteration in the most common DNA nucleotide 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.

Genomics Report Profile

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.

Karnofsky Performance Status Profile

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.

mCODE Patient Bundle Profile

A collection of data for an mCODE cancer patient.

mCODE Patient Group Profile

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

Primary Cancer Condition Profile

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

Radiotherapy Course Summary Profile

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.

Radiotherapy Volume Profile

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

Secondary Cancer Condition Profile

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).

TNM Distant Metastases Category Profile

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

TNM Primary Tumor Category Profile

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

TNM Regional Nodes Category Profile

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

Tumor Profile

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 TumorSpecimen to represent the tumor after removal from the body.

Tumor Marker Test Profile

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.

Tumor Size Profile

Records the dimensions of a tumor

Tumor Specimen Profile

Represents a tumor after it has been removed from the body. If there is a Tumor resource representing the tumor before it was removed from the body, use identifier to associate this TumorSpecimen with that Tumor resource.

Structures: Data Type Profiles

These define constraints on FHIR data types for systems conforming to this implementation guide.

Body Structure Identifier Data Type Profile

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

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Body Location Qualifier Extension

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

Cancer Disease Status Evidence Type Extension

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

Comorbid Condition Code Extension

An extension for representing a specific condition code corresponding to the comorbid condition category.

Comorbid Condition Reference Extension

An extension for representing a reference to a condition resource corresponding to the comorbid condition category.

Histology-Morphology-Behavior Extension

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

Laterality Qualifier Extension

Qualifier to specify laterality.

Procedure Intent Extension

The purpose of a treatment, medication, or procedure.

Radiotherapy Dose Delivered To Volume Extension

Dose delivered to a given radiotherapy volume.

Radiotherapy Modality Extension

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

Radiotherapy Modality And Technique 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.

Radiotherapy Number of Sessions Extension

The number of sessions in a course of radiotherapy.

Radiotherapy Technique Extension

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

Related Condition Extension

The resource has an unspecified relationship with a Condition.

Treatment Termination Reason Extension

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

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Benign Neoplasm of Brain and CNS Disorder Value Set

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

Body Location and Laterality Qualifier Value Set

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

Body Location Qualifier Value Set

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

Brachytherapy High Dose Rate Electronic Technique Value Set

Allowed techniques for brachytherapy modality High Dose Rate electronic

Brachytherapy High Dose Rate Technique Value Set

Allowed techniques for brachytherapy modality High Dose Rate

Brachytherapy Low Dose Rate Temporary Radation Technique Value Set

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

Brachytherapy Modality Value Set

Codes describing the modalities of brachytherapy procedures.

Brachytherapy Permanent Seeds Technique Value Set

Allowed techniques for brachytherapy modality internal radiotherapy - permanent seeds

Brachytherapy Pulsed Dose Rate Technique Value Set

Allowed techniques for brachytherapy modality Pulsed Dose Rate

Brachytherapy Radiopharmaceutical Technique Value Set

Allowed techniques for brachytherapy modality radiopharmaceutical

Brachytherapy Technique Value Set

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

Cancer Body Location Value Set

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.

Cancer Disease Status Evidence Type Value Set

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

Cancer Disorder Value Set

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)’.

Cancer-Related Surgical Procedure Value Set

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.

Cancer Stage Group Value Set

This value set is intended to contain allowable values for Stage Group, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

Cancer Staging System Value Set

System used for staging.

Carcinoma In-Situ Disorder Value Set

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

ClinVar Value Set

Value set of human genomic variants, drawn from ClinVar. The codes in this value set refer to the ClinVar Variation ID, or the identifier for the variant or set of variants that were interpreted. Source: NCBI ClinVar Data Dictionary

Condition Status Trend Value Set

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

Cytologic Evidence of Malignancy Value Set

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

DNA Change Type Value Set

DNA Change Type of a variant

Elixhauser HIV-AIDS Value Set

Elixhauser Comorbid Condition Value Set for HIV-AIDS. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Alcohol Abuse Value Set

Elixhauser Comorbid Condition Value Set for Alcohol Abuse. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Blood Loss Anemia Value Set

Elixhauser Comorbid Condition Value Set for Blood Loss Anemia. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Leukemia Value Set

Elixhauser Comorbid Condition Value Set for Leukemia. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Lymphoma Value Set

Elixhauser Comorbid Condition Value Set for Lymphoma. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Metastatic Cancer Value Set

Elixhauser Comorbid Condition Value Set for Metastatic cancer. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Malignant Solid Tumors In Situ Value Set

Elixhauser Comorbid Condition Value Set for malignant solid tumors in situ. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Malignant Solid Tumors Without Metastases Value Set

Elixhauser Comorbid Condition Value Set for malignant solid tumors without metastases. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Cerebrovascular Disease Value Set

Elixhauser Comorbid Condition Value Set for cerebrovascular disease. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Chronic Pulmonary Disease Value Set

Elixhauser Comorbid Condition Value Set for Chronic Pulmonary Disease. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Coagulation Deficiency Value Set

Elixhauser Comorbid Condition Value Set for Coagulation Deficiency. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Congestive Heart Failure Value Set

Elixhauser Comorbid Condition Value Set for CongestiveHeartFailure. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Deficiency Anemia Value Set

Elixhauser Comorbid Condition Value Set for Deficiency Anemia. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Dementia Value Set

Elixhauser Comorbid Condition Value Set for Dementia. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Depression Value Set

Elixhauser Comorbid Condition Value Set for Depression. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Diabetes With Chronic Complications Value Set

Elixhauser Comorbid Condition Value Set for diabetes with chronic complications. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Diabetes Without Chronic Complications Value Set

Elixhauser Comorbid Condition Value Set for diabetes without chronic complications. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Drug Abuse Value Set

Elixhauser Comorbid Condition Value Set for drug abuse. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Hypertension, Complicated Value Set

Elixhauser Comorbid Condition Value Set for Hypertension, Complicated. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Hypertension, Uncomplicated Value Set

Elixhauser Comorbid Condition Value Set for Hypertension, Uncomplicated. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Hypothyroidism Value Set

Elixhauser Comorbid Condition Value Set for Hypothyroidism. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Mild Liver Disease Value Set

Elixhauser Comorbid Condition Value Set for Mild Liver Disease. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Moderate To Severe Liver Disease Value Set

Elixhauser Comorbid Condition Value Set for Moderate to Severe Liver Disease. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Neurological Movement Disorder Value Set

Elixhauser Comorbid Condition Value Set for Neurological Movement Disorders. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Neurological Seizure Disorder Value Set

Elixhauser Comorbid Condition Value Set for Neurological Seizure Disorders. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Obesity Value Set

Elixhauser Comorbid Condition Value Set for Obesity. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Other Neurological Disorder Value Set

Elixhauser Comorbid Condition Value Set for Other Neurological Disorders. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Other Thyroid Disorder Value Set

Elixhauser Comorbid Condition Value Set for Other Thyroid Disorder. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Paralysis Value Set

Elixhauser Comorbid Condition Value Set for Paralysis. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Peripheral Vascular Disease Value Set

Elixhauser Comorbid Condition Value Set for Peripheral vascular disease. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Psychosis Value Set

Elixhauser Comorbid Condition Value Set for Psychosis. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Pulmonary Circulation Disorder Value Set

Elixhauser Comorbid Condition Value Set for Pulmonary circulation disorders. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Moderate Renal Failure Value Set

Elixhauser Comorbid Condition Value Set for Moderate Renal Failure. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Severe Renal Failure Value Set

Elixhauser Comorbid Condition Value Set for Severe Renal Failure. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Rheumatoid Arthritis and Collagen Vascular Disease Value Set

Elixhauser Comorbid Condition Value Set for Rheumatoid Arthritis and collagen vascular diseases. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Chronic Peptic Ulcer Disease Value Set

Elixhauser Comorbid Condition Value Set for Chronic peptic ulcer disease. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Valvular Disease Value Set

Elixhauser Comorbid Condition Value Set for Valvular disease. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Elixhauser Weight Loss Value Set

Elixhauser Comorbid Condition Value Set for Weight loss. ICD-10 codes are drawn from https://www.hcup-us.ahrq.gov/toolssoftware/comorbidityicd10/comorbidity_icd10.jsp, version 2021.1

Genomic Molecular Consequence Value Set

Changes in a structural features of a sequence due to the observed variant.

Genomic Specimen Type Value Set

The type of specimen analyzed in a genomic test. The values include the subset of codes in the HL7 Specimen Type code system (https://terminology.hl7.org/2.1.0/CodeSystem-v2-0487.html) representing body sites and body fluids likely to be used in genomic testing. The most specific term available should be used.

HUGO Gene Nomenclature Committee Gene Names Value Set

HUGO Gene Nomenclature Committee Gene Names Value Set

Human Genome Variation Society Sequence Variant Nomenclature Value Set

HGVS nomenclature is used to report and exchange information regarding variants found in DNA, RNA, and protein sequences.

Histology Morphology Behavior Value Set

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.

Specific Diagnosis of Cancer Value Set

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

Laterality Qualifier Value Set

Qualifiers to specify laterality.

Melanoma In-Situ Disorder Value Set

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

Staging Type Value Set (for Distant Metastases Category)

Identifying codes based on the timing of classification for distant metastases (M) staging observations.

Staging Type for Primary Tumor Category Value Set

Identifying codes based on the timing of classification for primary tumor (T) staging observations.

Staging Type for Regional Node Category Value Set

Identifying codes based on the timing of classification for regional node (N) staging observations.

Staging Type for Stage Group Value Set

Identifying codes based on the timing of classification for stage group observations.

Present Absent Value Set

Value set used in association with phenomena that can be observed as being present or absent, such as a finding, organism, or physical object.

Primary Cancer Disorder Value Set

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

Primary Malignant Neoplasm Disorder Value Set

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

Procedure Intent Value Set

The purpose of a procedure.

Radiotherapy Modality Value Set

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.

Radiotherapy Technique Value Set

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.

Radiotherapy Treatment Location Qualifier Value Set

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

Radiotherapy Treatment Location Value Set

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

Radiotherapy Volume Type Value Set

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).

Secondary Cancer Disorder Value Set

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

TNM Distant Metastases Category Value Set

This value set is intended to contain allowable values for the M category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

TNM Primary Tumor Category Value Set

This value set is intended to contain allowable values for the T category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

TNM Regional Nodes Category Value Set

This value set is intended to contain allowable values for the N category, according to TNM staging rules. AJCC codes (preferably, version 8 for current cancers) SHOULD be used.

Carbon Ion Beam Technique Value Set

Allowed techniques for carbon ion beam modality

Electron Beam Technique Value Set

Allowed techniques for electron beam modality

Teleradiotherapy Modality Value Set

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

Neutron Beam Technique Value Set

Allowed techniques for neutron beam modality

Photon Beam Technique Value Set

Allowed techniques for photon beam modality

Proton Beam Technique Value Set

Allowed techniques for proton beam modality

Teleradiotherapy Technique Value Set

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

Treatment Termination Reason Value Set

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.

Tumor Marker Test Value Set

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.

Tumor Size Method Value Set

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

Tumor Size Units Value Set

Acceptable units for measuring tumor size

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Requested LOINC Codes Code System

Codes requested from LOINC, but not yet approved or assigned. Codes related to comorbidities use the categories originally defined by Elixhauser, and updated by the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (H-CUP) Elixhauser Comorbidity Software Refined for ICD-10-CM v2021.1. Each comorbidity category is associated with a specific ICD-10-CM value set. For example, the category #CHF (congestive heart failure) refers to the patient having a diagnosis within the Elixhauser Comorbid Condition Value Set for Congestive Heart Failure.

Requested SNOMED Codes Code System

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.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Search by code:in in Conditions

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

Search by _id in Patients with multipleOr

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

binet-stage-group-A

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

bodyheight-jenny-m-2018-03-06

Extended example: example of body height vital sign

bodyweight-jenny-m-2018-03-16

Extended example: example of body weight vital sign

bodyweight-jenny-m-2018-04-22

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

cancer-disease-status-improved

Example of Cancer Disease Status

cancer-disease-status-jenny-m

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

cancer-patient-adam-everyman

Example of Patient

cancer-patient-eve-anyperson

Example of Patient

cancer-patient-jenny-m

Extended example: example cancer patient

cancer-patient-john-anyperson

Example of Patient

cancer-related-mcode-comorbidities-elixhauser-jenny-m

mCODE Example for Cancer-Related Comorbidities

cancer-related-mcode-comorbidities-elixhauser-john-anyperson

Example of Cancer-Related Comorbidities

cancer-related-medication-admin-cyclophosphamide-jenny-m

Extended example: example showing chemotherapy medication

cancer-related-medication-admin-doxorubicin-jenny-m

Extended example: example showing chemotherapy medication

cancer-related-medication-admin-paclitaxel-jenny-m

Extended example: example showing chemotherapy medication

cancer-related-medication-request-anastrozole-jenny-m

Extended example: example showing chemotherapy medication

cancer-related-medication-request-cisplatin

Example of CancerRelatedMedicationRequest - Chemo Infusion

cancer-related-medication-request-cyclophosphamide-jenny-m

Extended example: example showing chemotherapy medication

cancer-related-medication-request-doxorubicin-jenny-m

Extended example: example showing chemotherapy medication

cancer-related-medication-request-gefitinib

Example of CancerRelatedMedicationRequest

cancer-related-medication-request-paclitaxel-jenny-m

Extended example: example showing chemotherapy medication

cancer-related-surgical-procedure-jenny-m

Extended example: example showing partial mastectomy surgical procedure

cancer-related-surgical-procedure-lobectomy

Example of Cancer Related Surgical Procedure

ecog-performance-status-fully-active

Example of ECOG Performance Status

ecog-performance-status-jenny-m

Extended example: example showing ECOG performance status

family-member-history-aunt-jenny-m

Extended example: example showing family member history of cancer

family-member-history-sister-jenny-m

Extended example: example showing family member history of cancer

family-member-history-uncle-jenny-m

Extended example: example showing family member history of cancer

genomic-region-studied-jenny-m

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

genomic-region-studied-stk11

mCODE Example for Genomic Region Studied

genomic-specimen-left-breast-jenny-m

Extended example: example showing genomic specimen for sequencing

genomic-specimen-lung

mCODE Example for Genomic Specimen

genomic-variant-fusion

mCODE Example for Genomic Variant gene fusion event

genomic-variant-germline-deletion

mCODE Example for Genomic Variant

genomic-variant-jenny-m

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

genomic-variant-somatic-single-nucleotide

mCODE Example for Genomic Variant

genomics-report-jenny-m

Extended example: example of gene panel report

genomics-report-john-anyperson

mCODE Example for Genomics Report

mCODE Patient Group Example

Example of a Group identifying in-scope patients

jenny-m-chest-wall-lymph-nodes-treatment-volume

Anatomic volume 2 for Jenny M’s teleradiotherapy.

jenny-m-chest-wall-treatment-volume

Anatomic volume 1 for Jenny M’s teleradiotherapy.

john-anyperson-treatment-volume

Anatomic volume for John Anyperson’s brachytherapy.

karnofsky-performance-status-normal-activity

Example of Karnofsky Performance Status

lab-result-observation-hemoglobin

Hemoglobin lab result to support CancerStageGroup example

mcode-patient-bundle-jenny-m

Extended example as a mCODE Patient Bundle

observation-smoking-pack-years-jenny-m

Extended example: example showing smoking history

primary-cancer-condition-breast

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

primary-cancer-condition-cll

Example of Primary Cancer Condition - hematologic cancer

primary-cancer-condition-jenny-m

Extended example: example showing primary cancer condition

primary-cancer-condition-nsclc

Example of Primary Cancer Condition

radiotherapy-treatment-summary-chest-wall-jenny-m

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

secondary-cancer-condition-brain-mets

Example of Secondary Cancer Condition

tnm-clinical-distant-metastases-category-cM0

Example of TNM Clinical Distant Metastases Category

tnm-clinical-distant-metastases-category-jenny-m

Extended example: example showing TNM staging (M)

tnm-clinical-primary-tumor-category-cT3

Example of TNM Clinical Primary Tumor Category

tnm-clinical-primary-tumor-category-jenny-m

Extended example: example showing TNM staging (T)

tnm-clinical-regional-nodes-category-cN3

Example of TNM Clinical Regional Nodes Category

tnm-clinical-regional-nodes-category-jenny-m

Extended example: example showing TNM staging (N)

tnm-clinical-stage-group-3c

Example of TNM Clinical Stage Group

tnm-clinical-stage-group-jenny-m

Extended example: example showing TNM staging (stage group)

tnm-pathologic-distant-metastases-category-jenny-m

Extended example: example showing TNM staging (M)

tnm-pathologic-primary-tumor-category-jenny-m

Extended example: example showing TNM staging (T)

tnm-pathologic-regional-nodes-category-jenny-m

Extended example: example showing TNM staging (N)

tnm-pathologic-stage-group-jenny-m

Extended example: example showing TNM staging (stage group)

tumor-lobular-carcinoma-left-breast

Example of a resource conforming to the tumor profile.

tumor-marker-test-egf

mCODE Example for Tumor Marker Test

tumor-marker-test-er-jenny-m

Extended example: example showing ER status

tumor-marker-test-her2-jenny-m

Extended example: example showing HER2 status

tumor-marker-test-oncotype-dx-jenny-m

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.

tumor-marker-test-pr-jenny-m

Extended example: example showing PR status

tumor-size-jenny-m

Extended example: example showing tumor size

tumor-size-pathology

Example of a resource conforming to the tumor size profile.

tumor-specimen-left-breast-jenny-m

Extended example: example tumor specimen

tumor-specimen-lobular-carcinoma-left-breast

Example of a TumorSpecimen linked to this Tumor via identifier.

us-core-condition-anxiety-jenny-m

Extended example: example showing comorbid condition (anxiety)

us-core-condition-depression-jenny-m

Extended example: example showing comorbid condition (depression)

us-core-condition-hypertension-jenny-m

Extended example: example showing comorbid condition (hypertension)

us-core-diagnosticreport-lab-jenny-m

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

us-core-observation-lab-neutrophils-jenny-m

Extended example: neutrophils lab test

us-core-observation-lab-sentinel-nodes-jenny-m

Extended example: example showing 3 sentinel lymph nodes were examined

us-core-observation-lab-tumor-dcis-jenny-m

Extended example: example showing DCIS diagnosis

us-core-observation-lab-tumor-grade-jenny-m

Extended example: example showing DCIS diagnosis

us-core-observation-lab-tumor-invasion-jenny-m

Extended example: example showing negative invasion for the removed tumor

us-core-observation-lab-tumor-margins-jenny-m

Extended example: example showing negative margins for the removed tumor

us-core-organization-bedrock-medicine

Example of US Core Organization

us-core-organization-physician-services-inc

Extended example: example organization

us-core-practitioner-jane-radiotech

Extended example: example PCP practitioner

us-core-practitioner-kyle-anydoc

Example of Practitioner

us-core-practitioner-mary-obgyn

Extended example: example PCP practitioner

us-core-practitioner-nancy-oncology-nurse

Extended example: example RN practitioner

us-core-practitioner-owen-oncologist

Extended example: example practitioner

us-core-practitioner-peter-pathologist

Extended example: example practitioner (pathologist)

us-core-procedure-biopsy-jenny-m

Extended example: example biopsy procedure

us-core-procedure-mammogram-jenny-m

Extended example: example mammogram

us-core-smokingstatus-jenny-m

Extended example: example showing smoking status