minimal Common Oncology Data Elements (mCODE) Implementation Guide
2.0.0 - STU 2

This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v2.0.0: 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

Resource Profile: ComorbiditiesElixhauser - Detailed Descriptions

Definitions for the mcode-comorbidities-elixhauser resource profile.

1. Observation
Definition

Measurements and simple assertions made about a patient, device or other subject.

Control0..*
Alternate NamesVital Signs, Measurement, Results, Tests
Comments

Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

InvariantsDefined on this element
dom-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())
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (: dataAbsentReason.empty() or value.empty())
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present (: value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
2. Observation.id
Definition

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

Control0..1
Typestring
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.

3. Observation.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.

Control0..1
TypeMeta
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. Observation.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.

Control0..1
Typeuri
Is Modifiertrue
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. Observation.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages
Max Binding: AllLanguages A human language.

Typecode
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Observation.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.

Control0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. Observation.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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained 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.

8. Observation.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
ele-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())
9. Observation.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).

Control0..*
TypeExtension
Is Modifiertrue
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
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.

InvariantsDefined on this element
ele-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())
10. Observation.identifier
Definition

A unique identifier assigned to this observation.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Allows observations to be distinguished and referenced.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
11. Observation.basedOn
Definition

A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

Control0..*
TypeReference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)
Requirements

Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

Alternate NamesFulfills
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Observation.partOf
Definition

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

Control0..*
TypeReference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)
Alternate NamesContainer
Comments

To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
13. Observation.status
Definition

The status of the result value.

Control1..1
BindingThe codes SHALL be taken from ObservationStatus Codes providing the status of an observation.

Typecode
Is Modifiertrue
Must Supporttrue
Requirements

Need to track the status of individual results. Some results are finalized before the whole report is finalized.

Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Observation.category
Definition

A code that classifies the general type of observation being made.

Control0..*
BindingThe codes SHOULD be taken from ObservationCategoryCodes Codes for high level observation categories.

TypeCodeableConcept
Requirements

Used for filtering what observations are retrieved and displayed.

Comments

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
15. Observation.code
Definition

Describes what was observed. Sometimes this is called the observation "name".

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Alternate NamesName
Comments

All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="comorbidities-elixhauser"/>
    <display value="Elixhauser Comorbidity Panel"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
16. Observation.subject
Definition

The patient whose comorbidities are recorded.

Control0..1
TypeReference(CancerPatient)
Must Supporttrue
Requirements

Observations have no value if you don't know who or what they're about.

Comments

One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
17. Observation.focus
Definition

A reference to the cancer condition that is the context for the current list of comorbid conditions.

Control0..*
TypeReference(PrimaryCancerCondition)
Must Supporttrue
Comments

Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. Observation.encounter
Definition

The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

Control0..1
TypeReference(Encounter)
Requirements

For some observations it may be important to know the link between an observation and a particular encounter.

Alternate NamesContext
Comments

This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. Observation.effective[x]
Definition

The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

Control0..1
TypeChoice of: dateTime, Period, Timing, instant
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Must Support TypesNo must-support rules about the choice of types/profiles
Requirements

Knowing when an observation was deemed true is important to its relevance as well as determining trends.

Alternate NamesOccurrence
Comments

At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. Observation.issued
Definition

The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

Control0..1
Typeinstant
Comments

For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. Observation.performer
Definition

Who was responsible for asserting the observed value as "true".

Control0..*
TypeReference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)
Requirements

May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Observation.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1 This element is affected by the following invariants: obs-7
Typeinteger
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. Observation.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Observation.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. Observation.note
Definition

Comments about the observation or the results.

Control0..*
TypeAnnotation
Requirements

Need to be able to provide free text additional information.

Comments

May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Observation.bodySite
Definition

Not used in this profile

Control0..1
BindingFor example codes, see SNOMEDCTBodyStructures Codes describing anatomical locations. May include laterality.

TypeCodeableConcept
Comments

Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Observation.method
Definition

Indicates the mechanism used to perform the observation.

Control0..1
BindingFor example codes, see ObservationMethods Methods for simple observations.

TypeCodeableConcept
Requirements

In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

Comments

Only used if not implicit in code for Observation.code.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. Observation.specimen
Definition

Not used in this profile

Control0..1
TypeReference(Specimen)
Comments

Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Observation.device
Definition

Not used in this profile

Control0..1
TypeReference(Device | DeviceMetric)
Comments

Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Observation.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

Control0..*
TypeBackboneElement
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
obs-3: Must have at least a low or a high or text (: low.exists() or high.exists() or text.exists())
31. Observation.referenceRange.id
Definition

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

Control0..1
Typestring
32. Observation.referenceRange.extension
Definition

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
ele-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())
33. Observation.referenceRange.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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).

Control0..*
TypeExtension
Is Modifiertrue
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, modifiers
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.

InvariantsDefined on this element
ele-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())
34. Observation.referenceRange.low
Definition

The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

Control0..1 This element is affected by the following invariants: obs-3
TypeQuantity(SimpleQuantity)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. Observation.referenceRange.high
Definition

The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

Control0..1 This element is affected by the following invariants: obs-3
TypeQuantity(SimpleQuantity)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. Observation.referenceRange.type
Definition

Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

Control0..1
BindingThe codes SHOULD be taken from ObservationReferenceRangeMeaningCodes Code for the meaning of a reference range.

TypeCodeableConcept
Requirements

Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

Comments

This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Observation.referenceRange.appliesTo
Definition

Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

Control0..*
BindingFor example codes, see ObservationReferenceRangeAppliesToCodes Codes identifying the population the reference range applies to.

TypeCodeableConcept
Requirements

Need to be able to identify the target population for proper interpretation.

Comments

This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. Observation.referenceRange.age
Definition

The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

Control0..1
TypeRange
Requirements

Some analytes vary greatly over age.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Observation.referenceRange.text
Definition

Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Observation.hasMember
Definition

This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

Control0..*
TypeReference(Observation | QuestionnaireResponse | MolecularSequence)
Comments

When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. Observation.derivedFrom
Definition

The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

Control0..*
TypeReference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)
Comments

All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. Observation.component
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..*
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on Observation.component. The slices are unordered and Closed, and can be differentiated using the following discriminators:
  • pattern @ code
43. Observation.component.id
Definition

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

Control0..1
Typestring
44. Observation.component.extension
Definition

If more detail about the comorbid condition is desired, elements in this extension can be populated with a specific condition code or a reference to a Condition resource. The extension elements SHALL be used only if the comorbidity category is present.

Control0..*
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
45. Observation.component.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
InvariantsDefined on this element
ele-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())
46. Observation.component.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
InvariantsDefined on this element
ele-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())
47. Observation.component.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
48. Observation.component.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Observation.component.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
BindingThe codes SHALL be taken from Present Absent Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Observation.component.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. Observation.component.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
52. Observation.component.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. Observation.component:aids
SliceNameaids
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. Observation.component:aids.id
Definition

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

Control0..1
Typestring
55. Observation.component:aids.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
56. Observation.component:aids.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
57. Observation.component:aids.extension:conditionCode.id
Definition

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

Control0..1
Typestring
58. Observation.component:aids.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
59. Observation.component:aids.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
60. Observation.component:aids.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser HIV-AIDS Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. Observation.component:aids.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
62. Observation.component:aids.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
63. Observation.component:aids.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="AIDS"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. Observation.component:aids.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
65. Observation.component:aids.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
66. Observation.component:aids.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
67. Observation.component:aids.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. Observation.component:alcoholAbuse
SliceNamealcoholAbuse
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. Observation.component:alcoholAbuse.id
Definition

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

Control0..1
Typestring
70. Observation.component:alcoholAbuse.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
71. Observation.component:alcoholAbuse.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
72. Observation.component:alcoholAbuse.extension:conditionCode.id
Definition

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

Control0..1
Typestring
73. Observation.component:alcoholAbuse.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
74. Observation.component:alcoholAbuse.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
75. Observation.component:alcoholAbuse.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Alcohol Abuse Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
76. Observation.component:alcoholAbuse.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
77. Observation.component:alcoholAbuse.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
78. Observation.component:alcoholAbuse.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="ALCOHOL"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. Observation.component:alcoholAbuse.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. Observation.component:alcoholAbuse.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
81. Observation.component:alcoholAbuse.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
82. Observation.component:alcoholAbuse.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
83. Observation.component:deficiencyAnemia
SliceNamedeficiencyAnemia
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
84. Observation.component:deficiencyAnemia.id
Definition

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

Control0..1
Typestring
85. Observation.component:deficiencyAnemia.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
86. Observation.component:deficiencyAnemia.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
87. Observation.component:deficiencyAnemia.extension:conditionCode.id
Definition

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

Control0..1
Typestring
88. Observation.component:deficiencyAnemia.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
89. Observation.component:deficiencyAnemia.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
90. Observation.component:deficiencyAnemia.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Deficiency Anemia Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
91. Observation.component:deficiencyAnemia.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
92. Observation.component:deficiencyAnemia.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
93. Observation.component:deficiencyAnemia.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="ANEMDF"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
94. Observation.component:deficiencyAnemia.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
95. Observation.component:deficiencyAnemia.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
96. Observation.component:deficiencyAnemia.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
97. Observation.component:deficiencyAnemia.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
98. Observation.component:arthropathy
SliceNamearthropathy
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
99. Observation.component:arthropathy.id
Definition

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

Control0..1
Typestring
100. Observation.component:arthropathy.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
101. Observation.component:arthropathy.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
102. Observation.component:arthropathy.extension:conditionCode.id
Definition

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

Control0..1
Typestring
103. Observation.component:arthropathy.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
104. Observation.component:arthropathy.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
105. Observation.component:arthropathy.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Rheumatoid Arthritis and Collagen Vascular Disease Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
106. Observation.component:arthropathy.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
107. Observation.component:arthropathy.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
108. Observation.component:arthropathy.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="ARTH"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
109. Observation.component:arthropathy.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
110. Observation.component:arthropathy.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
111. Observation.component:arthropathy.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
112. Observation.component:arthropathy.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
113. Observation.component:bloodLossAnemia
SliceNamebloodLossAnemia
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
114. Observation.component:bloodLossAnemia.id
Definition

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

Control0..1
Typestring
115. Observation.component:bloodLossAnemia.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
116. Observation.component:bloodLossAnemia.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
117. Observation.component:bloodLossAnemia.extension:conditionCode.id
Definition

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

Control0..1
Typestring
118. Observation.component:bloodLossAnemia.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
119. Observation.component:bloodLossAnemia.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
120. Observation.component:bloodLossAnemia.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Blood Loss Anemia Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
121. Observation.component:bloodLossAnemia.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
122. Observation.component:bloodLossAnemia.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
123. Observation.component:bloodLossAnemia.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="BLDLOSS"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
124. Observation.component:bloodLossAnemia.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
125. Observation.component:bloodLossAnemia.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
126. Observation.component:bloodLossAnemia.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
127. Observation.component:bloodLossAnemia.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
128. Observation.component:cancerLeukemia
SliceNamecancerLeukemia
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
129. Observation.component:cancerLeukemia.id
Definition

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

Control0..1
Typestring
130. Observation.component:cancerLeukemia.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
131. Observation.component:cancerLeukemia.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
132. Observation.component:cancerLeukemia.extension:conditionCode.id
Definition

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

Control0..1
Typestring
133. Observation.component:cancerLeukemia.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
134. Observation.component:cancerLeukemia.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
135. Observation.component:cancerLeukemia.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Leukemia Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
136. Observation.component:cancerLeukemia.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
137. Observation.component:cancerLeukemia.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
138. Observation.component:cancerLeukemia.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="CANCER_LEUK"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
139. Observation.component:cancerLeukemia.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
140. Observation.component:cancerLeukemia.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
141. Observation.component:cancerLeukemia.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
142. Observation.component:cancerLeukemia.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
143. Observation.component:cancerLymphoma
SliceNamecancerLymphoma
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
144. Observation.component:cancerLymphoma.id
Definition

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

Control0..1
Typestring
145. Observation.component:cancerLymphoma.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
146. Observation.component:cancerLymphoma.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
147. Observation.component:cancerLymphoma.extension:conditionCode.id
Definition

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

Control0..1
Typestring
148. Observation.component:cancerLymphoma.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
149. Observation.component:cancerLymphoma.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
150. Observation.component:cancerLymphoma.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Lymphoma Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
151. Observation.component:cancerLymphoma.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
152. Observation.component:cancerLymphoma.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
153. Observation.component:cancerLymphoma.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="CANCER_LYMPH"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
154. Observation.component:cancerLymphoma.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
155. Observation.component:cancerLymphoma.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
156. Observation.component:cancerLymphoma.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
157. Observation.component:cancerLymphoma.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
158. Observation.component:cancerMetastatic
SliceNamecancerMetastatic
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
159. Observation.component:cancerMetastatic.id
Definition

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

Control0..1
Typestring
160. Observation.component:cancerMetastatic.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
161. Observation.component:cancerMetastatic.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
162. Observation.component:cancerMetastatic.extension:conditionCode.id
Definition

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

Control0..1
Typestring
163. Observation.component:cancerMetastatic.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
164. Observation.component:cancerMetastatic.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
165. Observation.component:cancerMetastatic.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Metastatic Cancer Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
166. Observation.component:cancerMetastatic.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
167. Observation.component:cancerMetastatic.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
168. Observation.component:cancerMetastatic.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="CANCER_METS"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
169. Observation.component:cancerMetastatic.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
170. Observation.component:cancerMetastatic.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
171. Observation.component:cancerMetastatic.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
172. Observation.component:cancerMetastatic.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
173. Observation.component:cancerSolidInSitu
SliceNamecancerSolidInSitu
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
174. Observation.component:cancerSolidInSitu.id
Definition

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

Control0..1
Typestring
175. Observation.component:cancerSolidInSitu.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
176. Observation.component:cancerSolidInSitu.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
177. Observation.component:cancerSolidInSitu.extension:conditionCode.id
Definition

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

Control0..1
Typestring
178. Observation.component:cancerSolidInSitu.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
179. Observation.component:cancerSolidInSitu.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
180. Observation.component:cancerSolidInSitu.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Malignant Solid Tumors In Situ Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
181. Observation.component:cancerSolidInSitu.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
182. Observation.component:cancerSolidInSitu.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
183. Observation.component:cancerSolidInSitu.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="CANCER_NSITU"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
184. Observation.component:cancerSolidInSitu.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
185. Observation.component:cancerSolidInSitu.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
186. Observation.component:cancerSolidInSitu.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
187. Observation.component:cancerSolidInSitu.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
188. Observation.component:cancerSolidMalignant
SliceNamecancerSolidMalignant
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
189. Observation.component:cancerSolidMalignant.id
Definition

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

Control0..1
Typestring
190. Observation.component:cancerSolidMalignant.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
191. Observation.component:cancerSolidMalignant.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
192. Observation.component:cancerSolidMalignant.extension:conditionCode.id
Definition

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

Control0..1
Typestring
193. Observation.component:cancerSolidMalignant.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
194. Observation.component:cancerSolidMalignant.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
195. Observation.component:cancerSolidMalignant.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Malignant Solid Tumors Without Metastases Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
196. Observation.component:cancerSolidMalignant.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
197. Observation.component:cancerSolidMalignant.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
198. Observation.component:cancerSolidMalignant.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="CANCER_SOLID"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
199. Observation.component:cancerSolidMalignant.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
200. Observation.component:cancerSolidMalignant.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
201. Observation.component:cancerSolidMalignant.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
202. Observation.component:cancerSolidMalignant.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
203. Observation.component:cerebrovascular
SliceNamecerebrovascular
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
204. Observation.component:cerebrovascular.id
Definition

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

Control0..1
Typestring
205. Observation.component:cerebrovascular.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
206. Observation.component:cerebrovascular.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
207. Observation.component:cerebrovascular.extension:conditionCode.id
Definition

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

Control0..1
Typestring
208. Observation.component:cerebrovascular.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
209. Observation.component:cerebrovascular.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
210. Observation.component:cerebrovascular.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Cerebrovascular Disease Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
211. Observation.component:cerebrovascular.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
212. Observation.component:cerebrovascular.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
213. Observation.component:cerebrovascular.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="CBVD"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
214. Observation.component:cerebrovascular.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
215. Observation.component:cerebrovascular.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
216. Observation.component:cerebrovascular.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
217. Observation.component:cerebrovascular.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
218. Observation.component:congestiveHeartFailure
SliceNamecongestiveHeartFailure
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
219. Observation.component:congestiveHeartFailure.id
Definition

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

Control0..1
Typestring
220. Observation.component:congestiveHeartFailure.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
221. Observation.component:congestiveHeartFailure.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
222. Observation.component:congestiveHeartFailure.extension:conditionCode.id
Definition

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

Control0..1
Typestring
223. Observation.component:congestiveHeartFailure.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
224. Observation.component:congestiveHeartFailure.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
225. Observation.component:congestiveHeartFailure.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Congestive Heart Failure Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
226. Observation.component:congestiveHeartFailure.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
227. Observation.component:congestiveHeartFailure.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
228. Observation.component:congestiveHeartFailure.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="CHF"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
229. Observation.component:congestiveHeartFailure.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
230. Observation.component:congestiveHeartFailure.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
231. Observation.component:congestiveHeartFailure.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
232. Observation.component:congestiveHeartFailure.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
233. Observation.component:coagulopathy
SliceNamecoagulopathy
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
234. Observation.component:coagulopathy.id
Definition

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

Control0..1
Typestring
235. Observation.component:coagulopathy.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
236. Observation.component:coagulopathy.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
237. Observation.component:coagulopathy.extension:conditionCode.id
Definition

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

Control0..1
Typestring
238. Observation.component:coagulopathy.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
239. Observation.component:coagulopathy.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
240. Observation.component:coagulopathy.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Coagulation Deficiency Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
241. Observation.component:coagulopathy.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
242. Observation.component:coagulopathy.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
243. Observation.component:coagulopathy.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="COAG"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
244. Observation.component:coagulopathy.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
245. Observation.component:coagulopathy.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
246. Observation.component:coagulopathy.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
247. Observation.component:coagulopathy.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
248. Observation.component:dementia
SliceNamedementia
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
249. Observation.component:dementia.id
Definition

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

Control0..1
Typestring
250. Observation.component:dementia.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
251. Observation.component:dementia.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
252. Observation.component:dementia.extension:conditionCode.id
Definition

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

Control0..1
Typestring
253. Observation.component:dementia.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
254. Observation.component:dementia.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
255. Observation.component:dementia.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Dementia Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
256. Observation.component:dementia.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
257. Observation.component:dementia.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
258. Observation.component:dementia.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="DEMENTIA"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
259. Observation.component:dementia.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
260. Observation.component:dementia.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
261. Observation.component:dementia.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
262. Observation.component:dementia.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
263. Observation.component:depression
SliceNamedepression
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
264. Observation.component:depression.id
Definition

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

Control0..1
Typestring
265. Observation.component:depression.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
266. Observation.component:depression.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
267. Observation.component:depression.extension:conditionCode.id
Definition

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

Control0..1
Typestring
268. Observation.component:depression.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
269. Observation.component:depression.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
270. Observation.component:depression.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Depression Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
271. Observation.component:depression.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
272. Observation.component:depression.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
273. Observation.component:depression.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="DEPRESS"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
274. Observation.component:depression.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
275. Observation.component:depression.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
276. Observation.component:depression.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
277. Observation.component:depression.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
278. Observation.component:diabetesComplicated
SliceNamediabetesComplicated
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
279. Observation.component:diabetesComplicated.id
Definition

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

Control0..1
Typestring
280. Observation.component:diabetesComplicated.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
281. Observation.component:diabetesComplicated.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
282. Observation.component:diabetesComplicated.extension:conditionCode.id
Definition

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

Control0..1
Typestring
283. Observation.component:diabetesComplicated.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
284. Observation.component:diabetesComplicated.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
285. Observation.component:diabetesComplicated.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Diabetes With Chronic Complications Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
286. Observation.component:diabetesComplicated.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
287. Observation.component:diabetesComplicated.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
288. Observation.component:diabetesComplicated.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="DIAB_CX"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
289. Observation.component:diabetesComplicated.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
290. Observation.component:diabetesComplicated.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
291. Observation.component:diabetesComplicated.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
292. Observation.component:diabetesComplicated.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
293. Observation.component:diabetesUncomplicated
SliceNamediabetesUncomplicated
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
294. Observation.component:diabetesUncomplicated.id
Definition

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

Control0..1
Typestring
295. Observation.component:diabetesUncomplicated.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
296. Observation.component:diabetesUncomplicated.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
297. Observation.component:diabetesUncomplicated.extension:conditionCode.id
Definition

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

Control0..1
Typestring
298. Observation.component:diabetesUncomplicated.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
299. Observation.component:diabetesUncomplicated.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
300. Observation.component:diabetesUncomplicated.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Diabetes Without Chronic Complications Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
301. Observation.component:diabetesUncomplicated.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
302. Observation.component:diabetesUncomplicated.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
303. Observation.component:diabetesUncomplicated.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="DIAB_UNCX"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
304. Observation.component:diabetesUncomplicated.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
305. Observation.component:diabetesUncomplicated.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
306. Observation.component:diabetesUncomplicated.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
307. Observation.component:diabetesUncomplicated.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
308. Observation.component:drugAbuse
SliceNamedrugAbuse
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
309. Observation.component:drugAbuse.id
Definition

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

Control0..1
Typestring
310. Observation.component:drugAbuse.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
311. Observation.component:drugAbuse.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
312. Observation.component:drugAbuse.extension:conditionCode.id
Definition

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

Control0..1
Typestring
313. Observation.component:drugAbuse.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
314. Observation.component:drugAbuse.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
315. Observation.component:drugAbuse.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Drug Abuse Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
316. Observation.component:drugAbuse.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
317. Observation.component:drugAbuse.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
318. Observation.component:drugAbuse.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="DRUG_ABUSE"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
319. Observation.component:drugAbuse.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
320. Observation.component:drugAbuse.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
321. Observation.component:drugAbuse.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
322. Observation.component:drugAbuse.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
323. Observation.component:hypertensionComplicated
SliceNamehypertensionComplicated
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
324. Observation.component:hypertensionComplicated.id
Definition

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

Control0..1
Typestring
325. Observation.component:hypertensionComplicated.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
326. Observation.component:hypertensionComplicated.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
327. Observation.component:hypertensionComplicated.extension:conditionCode.id
Definition

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

Control0..1
Typestring
328. Observation.component:hypertensionComplicated.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
329. Observation.component:hypertensionComplicated.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
330. Observation.component:hypertensionComplicated.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Hypertension, Complicated Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
331. Observation.component:hypertensionComplicated.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
332. Observation.component:hypertensionComplicated.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
333. Observation.component:hypertensionComplicated.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="HTN_CX"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
334. Observation.component:hypertensionComplicated.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
335. Observation.component:hypertensionComplicated.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
336. Observation.component:hypertensionComplicated.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
337. Observation.component:hypertensionComplicated.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
338. Observation.component:hypertensionUncomplicated
SliceNamehypertensionUncomplicated
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
339. Observation.component:hypertensionUncomplicated.id
Definition

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

Control0..1
Typestring
340. Observation.component:hypertensionUncomplicated.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
341. Observation.component:hypertensionUncomplicated.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
342. Observation.component:hypertensionUncomplicated.extension:conditionCode.id
Definition

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

Control0..1
Typestring
343. Observation.component:hypertensionUncomplicated.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
344. Observation.component:hypertensionUncomplicated.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
345. Observation.component:hypertensionUncomplicated.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Hypertension, Uncomplicated Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
346. Observation.component:hypertensionUncomplicated.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
347. Observation.component:hypertensionUncomplicated.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
348. Observation.component:hypertensionUncomplicated.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="HTN_UNCX"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
349. Observation.component:hypertensionUncomplicated.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
350. Observation.component:hypertensionUncomplicated.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
351. Observation.component:hypertensionUncomplicated.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
352. Observation.component:hypertensionUncomplicated.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
353. Observation.component:liverDiseaseMild
SliceNameliverDiseaseMild
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
354. Observation.component:liverDiseaseMild.id
Definition

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

Control0..1
Typestring
355. Observation.component:liverDiseaseMild.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
356. Observation.component:liverDiseaseMild.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
357. Observation.component:liverDiseaseMild.extension:conditionCode.id
Definition

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

Control0..1
Typestring
358. Observation.component:liverDiseaseMild.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
359. Observation.component:liverDiseaseMild.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
360. Observation.component:liverDiseaseMild.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Mild Liver Disease Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
361. Observation.component:liverDiseaseMild.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
362. Observation.component:liverDiseaseMild.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
363. Observation.component:liverDiseaseMild.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="LIVER_MLD"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
364. Observation.component:liverDiseaseMild.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
365. Observation.component:liverDiseaseMild.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
366. Observation.component:liverDiseaseMild.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
367. Observation.component:liverDiseaseMild.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
368. Observation.component:liverDiseaseSevere
SliceNameliverDiseaseSevere
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
369. Observation.component:liverDiseaseSevere.id
Definition

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

Control0..1
Typestring
370. Observation.component:liverDiseaseSevere.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
371. Observation.component:liverDiseaseSevere.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
372. Observation.component:liverDiseaseSevere.extension:conditionCode.id
Definition

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

Control0..1
Typestring
373. Observation.component:liverDiseaseSevere.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
374. Observation.component:liverDiseaseSevere.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
375. Observation.component:liverDiseaseSevere.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Moderate To Severe Liver Disease Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
376. Observation.component:liverDiseaseSevere.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
377. Observation.component:liverDiseaseSevere.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
378. Observation.component:liverDiseaseSevere.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="LIVER_SEV"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
379. Observation.component:liverDiseaseSevere.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
380. Observation.component:liverDiseaseSevere.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
381. Observation.component:liverDiseaseSevere.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
382. Observation.component:liverDiseaseSevere.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
383. Observation.component:chronicPulmonaryDisease
SliceNamechronicPulmonaryDisease
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
384. Observation.component:chronicPulmonaryDisease.id
Definition

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

Control0..1
Typestring
385. Observation.component:chronicPulmonaryDisease.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
386. Observation.component:chronicPulmonaryDisease.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
387. Observation.component:chronicPulmonaryDisease.extension:conditionCode.id
Definition

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

Control0..1
Typestring
388. Observation.component:chronicPulmonaryDisease.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
389. Observation.component:chronicPulmonaryDisease.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
390. Observation.component:chronicPulmonaryDisease.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Chronic Pulmonary Disease Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
391. Observation.component:chronicPulmonaryDisease.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
392. Observation.component:chronicPulmonaryDisease.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
393. Observation.component:chronicPulmonaryDisease.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="LUNG_CHRONIC"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
394. Observation.component:chronicPulmonaryDisease.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
395. Observation.component:chronicPulmonaryDisease.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
396. Observation.component:chronicPulmonaryDisease.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
397. Observation.component:chronicPulmonaryDisease.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
398. Observation.component:neurologicalMovement
SliceNameneurologicalMovement
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
399. Observation.component:neurologicalMovement.id
Definition

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

Control0..1
Typestring
400. Observation.component:neurologicalMovement.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
401. Observation.component:neurologicalMovement.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
402. Observation.component:neurologicalMovement.extension:conditionCode.id
Definition

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

Control0..1
Typestring
403. Observation.component:neurologicalMovement.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
404. Observation.component:neurologicalMovement.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
405. Observation.component:neurologicalMovement.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Neurological Movement Disorder Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
406. Observation.component:neurologicalMovement.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
407. Observation.component:neurologicalMovement.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
408. Observation.component:neurologicalMovement.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="NEURO_MOVT"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
409. Observation.component:neurologicalMovement.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
410. Observation.component:neurologicalMovement.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
411. Observation.component:neurologicalMovement.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
412. Observation.component:neurologicalMovement.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
413. Observation.component:neurologicalOther
SliceNameneurologicalOther
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
414. Observation.component:neurologicalOther.id
Definition

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

Control0..1
Typestring
415. Observation.component:neurologicalOther.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
416. Observation.component:neurologicalOther.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
417. Observation.component:neurologicalOther.extension:conditionCode.id
Definition

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

Control0..1
Typestring
418. Observation.component:neurologicalOther.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
419. Observation.component:neurologicalOther.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
420. Observation.component:neurologicalOther.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Other Neurological Disorder Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
421. Observation.component:neurologicalOther.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
422. Observation.component:neurologicalOther.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
423. Observation.component:neurologicalOther.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="NEURO_OTH"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
424. Observation.component:neurologicalOther.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
425. Observation.component:neurologicalOther.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
426. Observation.component:neurologicalOther.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
427. Observation.component:neurologicalOther.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
428. Observation.component:neurologicalSeizure
SliceNameneurologicalSeizure
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
429. Observation.component:neurologicalSeizure.id
Definition

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

Control0..1
Typestring
430. Observation.component:neurologicalSeizure.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
431. Observation.component:neurologicalSeizure.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
432. Observation.component:neurologicalSeizure.extension:conditionCode.id
Definition

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

Control0..1
Typestring
433. Observation.component:neurologicalSeizure.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
434. Observation.component:neurologicalSeizure.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
435. Observation.component:neurologicalSeizure.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Neurological Seizure Disorder Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
436. Observation.component:neurologicalSeizure.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
437. Observation.component:neurologicalSeizure.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
438. Observation.component:neurologicalSeizure.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="NEURO_SEIZ"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
439. Observation.component:neurologicalSeizure.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
440. Observation.component:neurologicalSeizure.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
441. Observation.component:neurologicalSeizure.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
442. Observation.component:neurologicalSeizure.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
443. Observation.component:obesity
SliceNameobesity
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
444. Observation.component:obesity.id
Definition

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

Control0..1
Typestring
445. Observation.component:obesity.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
446. Observation.component:obesity.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
447. Observation.component:obesity.extension:conditionCode.id
Definition

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

Control0..1
Typestring
448. Observation.component:obesity.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
449. Observation.component:obesity.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
450. Observation.component:obesity.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Obesity Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
451. Observation.component:obesity.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
452. Observation.component:obesity.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
453. Observation.component:obesity.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="OBESE"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
454. Observation.component:obesity.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
455. Observation.component:obesity.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
456. Observation.component:obesity.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
457. Observation.component:obesity.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
458. Observation.component:paralysis
SliceNameparalysis
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
459. Observation.component:paralysis.id
Definition

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

Control0..1
Typestring
460. Observation.component:paralysis.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
461. Observation.component:paralysis.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
462. Observation.component:paralysis.extension:conditionCode.id
Definition

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

Control0..1
Typestring
463. Observation.component:paralysis.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
464. Observation.component:paralysis.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
465. Observation.component:paralysis.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Paralysis Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
466. Observation.component:paralysis.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
467. Observation.component:paralysis.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
468. Observation.component:paralysis.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="PARALYSIS"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
469. Observation.component:paralysis.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
470. Observation.component:paralysis.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
471. Observation.component:paralysis.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
472. Observation.component:paralysis.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
473. Observation.component:peripheralVascularDisease
SliceNameperipheralVascularDisease
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
474. Observation.component:peripheralVascularDisease.id
Definition

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

Control0..1
Typestring
475. Observation.component:peripheralVascularDisease.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
476. Observation.component:peripheralVascularDisease.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
477. Observation.component:peripheralVascularDisease.extension:conditionCode.id
Definition

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

Control0..1
Typestring
478. Observation.component:peripheralVascularDisease.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
479. Observation.component:peripheralVascularDisease.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
480. Observation.component:peripheralVascularDisease.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Peripheral Vascular Disease Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
481. Observation.component:peripheralVascularDisease.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
482. Observation.component:peripheralVascularDisease.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
483. Observation.component:peripheralVascularDisease.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="PERIVASC"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
484. Observation.component:peripheralVascularDisease.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
485. Observation.component:peripheralVascularDisease.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
486. Observation.component:peripheralVascularDisease.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
487. Observation.component:peripheralVascularDisease.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
488. Observation.component:psychosis
SliceNamepsychosis
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
489. Observation.component:psychosis.id
Definition

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

Control0..1
Typestring
490. Observation.component:psychosis.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
491. Observation.component:psychosis.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
492. Observation.component:psychosis.extension:conditionCode.id
Definition

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

Control0..1
Typestring
493. Observation.component:psychosis.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
494. Observation.component:psychosis.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
495. Observation.component:psychosis.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Psychosis Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
496. Observation.component:psychosis.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
497. Observation.component:psychosis.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
498. Observation.component:psychosis.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="PSYCHOSIS"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
499. Observation.component:psychosis.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
500. Observation.component:psychosis.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
501. Observation.component:psychosis.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
502. Observation.component:psychosis.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
503. Observation.component:pulmonaryCirculationDisorder
SliceNamepulmonaryCirculationDisorder
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
504. Observation.component:pulmonaryCirculationDisorder.id
Definition

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

Control0..1
Typestring
505. Observation.component:pulmonaryCirculationDisorder.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
506. Observation.component:pulmonaryCirculationDisorder.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
507. Observation.component:pulmonaryCirculationDisorder.extension:conditionCode.id
Definition

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

Control0..1
Typestring
508. Observation.component:pulmonaryCirculationDisorder.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
509. Observation.component:pulmonaryCirculationDisorder.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
510. Observation.component:pulmonaryCirculationDisorder.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Pulmonary Circulation Disorder Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
511. Observation.component:pulmonaryCirculationDisorder.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
512. Observation.component:pulmonaryCirculationDisorder.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
513. Observation.component:pulmonaryCirculationDisorder.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="PULMCIRC"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
514. Observation.component:pulmonaryCirculationDisorder.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
515. Observation.component:pulmonaryCirculationDisorder.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
516. Observation.component:pulmonaryCirculationDisorder.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
517. Observation.component:pulmonaryCirculationDisorder.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
518. Observation.component:renalFailureModerate
SliceNamerenalFailureModerate
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
519. Observation.component:renalFailureModerate.id
Definition

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

Control0..1
Typestring
520. Observation.component:renalFailureModerate.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
521. Observation.component:renalFailureModerate.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
522. Observation.component:renalFailureModerate.extension:conditionCode.id
Definition

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

Control0..1
Typestring
523. Observation.component:renalFailureModerate.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
524. Observation.component:renalFailureModerate.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
525. Observation.component:renalFailureModerate.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Moderate Renal Failure Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
526. Observation.component:renalFailureModerate.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
527. Observation.component:renalFailureModerate.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
528. Observation.component:renalFailureModerate.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="RENLFL_MOD"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
529. Observation.component:renalFailureModerate.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
530. Observation.component:renalFailureModerate.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
531. Observation.component:renalFailureModerate.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
532. Observation.component:renalFailureModerate.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
533. Observation.component:renalFailureSevere
SliceNamerenalFailureSevere
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
534. Observation.component:renalFailureSevere.id
Definition

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

Control0..1
Typestring
535. Observation.component:renalFailureSevere.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
536. Observation.component:renalFailureSevere.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
537. Observation.component:renalFailureSevere.extension:conditionCode.id
Definition

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

Control0..1
Typestring
538. Observation.component:renalFailureSevere.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
539. Observation.component:renalFailureSevere.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
540. Observation.component:renalFailureSevere.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Severe Renal Failure Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
541. Observation.component:renalFailureSevere.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
542. Observation.component:renalFailureSevere.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
543. Observation.component:renalFailureSevere.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="RENLFL_SEV"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
544. Observation.component:renalFailureSevere.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
545. Observation.component:renalFailureSevere.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
546. Observation.component:renalFailureSevere.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
547. Observation.component:renalFailureSevere.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
548. Observation.component:hypothyroidism
SliceNamehypothyroidism
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
549. Observation.component:hypothyroidism.id
Definition

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

Control0..1
Typestring
550. Observation.component:hypothyroidism.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
551. Observation.component:hypothyroidism.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
552. Observation.component:hypothyroidism.extension:conditionCode.id
Definition

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

Control0..1
Typestring
553. Observation.component:hypothyroidism.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
554. Observation.component:hypothyroidism.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
555. Observation.component:hypothyroidism.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Hypothyroidism Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
556. Observation.component:hypothyroidism.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
557. Observation.component:hypothyroidism.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
558. Observation.component:hypothyroidism.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="THYROID_HYPO"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
559. Observation.component:hypothyroidism.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
560. Observation.component:hypothyroidism.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
561. Observation.component:hypothyroidism.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
562. Observation.component:hypothyroidism.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
563. Observation.component:thyroidOther
SliceNamethyroidOther
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
564. Observation.component:thyroidOther.id
Definition

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

Control0..1
Typestring
565. Observation.component:thyroidOther.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
566. Observation.component:thyroidOther.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
567. Observation.component:thyroidOther.extension:conditionCode.id
Definition

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

Control0..1
Typestring
568. Observation.component:thyroidOther.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
569. Observation.component:thyroidOther.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
570. Observation.component:thyroidOther.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Other Thyroid Disorder Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
571. Observation.component:thyroidOther.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
572. Observation.component:thyroidOther.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
573. Observation.component:thyroidOther.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="THYROID_OTH"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
574. Observation.component:thyroidOther.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
575. Observation.component:thyroidOther.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
576. Observation.component:thyroidOther.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
577. Observation.component:thyroidOther.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
578. Observation.component:ulcer
SliceNameulcer
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
579. Observation.component:ulcer.id
Definition

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

Control0..1
Typestring
580. Observation.component:ulcer.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
581. Observation.component:ulcer.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
582. Observation.component:ulcer.extension:conditionCode.id
Definition

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

Control0..1
Typestring
583. Observation.component:ulcer.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
584. Observation.component:ulcer.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
585. Observation.component:ulcer.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Chronic Peptic Ulcer Disease Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
586. Observation.component:ulcer.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
587. Observation.component:ulcer.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
588. Observation.component:ulcer.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="ULCER_PEPTIC"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
589. Observation.component:ulcer.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
590. Observation.component:ulcer.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
591. Observation.component:ulcer.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
592. Observation.component:ulcer.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
593. Observation.component:valvularDisease
SliceNamevalvularDisease
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
594. Observation.component:valvularDisease.id
Definition

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

Control0..1
Typestring
595. Observation.component:valvularDisease.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
596. Observation.component:valvularDisease.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
597. Observation.component:valvularDisease.extension:conditionCode.id
Definition

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

Control0..1
Typestring
598. Observation.component:valvularDisease.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
599. Observation.component:valvularDisease.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
600. Observation.component:valvularDisease.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Valvular Disease Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
601. Observation.component:valvularDisease.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
602. Observation.component:valvularDisease.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
603. Observation.component:valvularDisease.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="VALVE"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
604. Observation.component:valvularDisease.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
605. Observation.component:valvularDisease.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
606. Observation.component:valvularDisease.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
607. Observation.component:valvularDisease.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
608. Observation.component:weightLoss
SliceNameweightLoss
Definition

Component representing the presence or absence of the named comorbidity, with optional condition code(s) or reference to the actual condition(s).

Control0..1
TypeBackboneElement
Must Supporttrue
Requirements

Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

Comments

For a discussion on the ways Observations can be assembled in groups together see Notes below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
609. Observation.component:weightLoss.id
Definition

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

Control0..1
Typestring
610. Observation.component:weightLoss.extension
Definition

The patient's specific condition within this comorbidity class.

Control0..*
TypeExtension
Must Supporttrue
InvariantsDefined on this element
ele-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 Observation.component.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
611. Observation.component:weightLoss.extension:conditionCode
SliceNameconditionCode
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionCode) (Extension Type: CodeableConcept)
Must Supporttrue
InvariantsDefined on this element
ele-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())
612. Observation.component:weightLoss.extension:conditionCode.id
Definition

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

Control0..1
Typestring
613. Observation.component:weightLoss.extension:conditionCode.extension
Definition

An Extension

Control0..0
TypeExtension
InvariantsDefined on this element
ele-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 Observation.component.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
614. Observation.component:weightLoss.extension:conditionCode.url
Definition

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

Control1..1
Typeuri
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.

Fixed Valuehttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code
615. Observation.component:weightLoss.extension:conditionCode.value[x]
Definition

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

Control1..1
BindingThe codes SHALL be taken from Elixhauser Weight Loss Value Set
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
616. Observation.component:weightLoss.extension:conditionReference
SliceNameconditionReference
Definition

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

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(ComorbidConditionReference) (Extension Type: Reference(Condition))
Must Supporttrue
InvariantsDefined on this element
ele-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())
617. Observation.component:weightLoss.modifierExtension
Definition

An Extension

Control0..0
TypeExtension
Is Modifiertrue
InvariantsDefined on this element
ele-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())
618. Observation.component:weightLoss.code
Definition

The code identifying category of comorbidity, for example, congestive heart failure or severe renal disease. The category typically represents a set of specific diagnosis codes.

Control1..1
BindingFor example codes, see LOINCCodes Codes identifying names of simple observations.

TypeCodeableConcept
Must Supporttrue
Requirements

Knowing what kind of observation is being made is essential to understanding the observation.

Comments

All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

Pattern Value<valueCodeableConcept xmlns="http://hl7.org/fhir">
  <coding>
    <system value="http://hl7.org/fhir/us/mcode/CodeSystem/loinc-requested-cs"/>
    <code value="WGHTLOSS"/>
  </coding>
</valueCodeableConcept>
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
619. Observation.component:weightLoss.value[x]
Definition

The information determined as a result of making the observation, if the information has a simple value.

Control0..1
TypeCodeableConcept
[x] NoteSee Choice of Data Types for further information about how to use [x]
Must Supporttrue
Requirements

An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

Comments

Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
620. Observation.component:weightLoss.dataAbsentReason
Definition

Provides a reason why the expected value in the element Observation.component.value[x] is missing.

Control0..1 This element is affected by the following invariants: obs-6
BindingThe codes SHALL be taken from DataAbsentReason; other codes may be used where these codes are not suitable Codes specifying why the result (Observation.value[x]) is missing.

TypeCodeableConcept
Requirements

For many results it is necessary to handle exceptional values in measurements.

Comments

"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
621. Observation.component:weightLoss.interpretation
Definition

A categorical assessment of an observation value. For example, high, low, normal.

Control0..*
BindingThe codes SHALL be taken from ObservationInterpretationCodes; other codes may be used where these codes are not suitable Codes identifying interpretations of observations.

TypeCodeableConcept
Requirements

For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

Alternate NamesAbnormal Flag
Comments

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
622. Observation.component:weightLoss.referenceRange
Definition

Guidance on how to interpret the value by comparison to a normal or recommended range.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Requirements

Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

Comments

Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))