minimal Common Oncology Data Elements (mCODE) Implementation Guide
2.1.0 - STU 2.1
minimal Common Oncology Data Elements (mCODE) Implementation Guide
2.1.0 - STU 2.1
This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v2.1.0: STU 2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions 
| Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-parent | Version: 2.1.0 | |||
| Active as of 2023-03-21 | Computable Name: ComorbiditiesParent | |||
General structure for capturing comorbid conditions with respect to a primary (‘index’) condition. The specific set of comorbidities of interest in a given context are defined by slicing the components array. The same general approach can be applied to any comorbidity category checklist.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Observation | 0..* | Observation | This is an abstract profile. Child profiles: Observation Measurements and simple assertions | |
  subject | 0..1 | Reference(Cancer Patient Profile) | Who and/or what the observation is about | |
| focus | 0..* | Reference(Condition) | The Index Condition | |
 bodySite | 0..1 | CodeableConcept | Not used in this profile | |
| specimen | 0..1 | Reference(Specimen) | Not used in this profile | |
| device | 0..1 | Reference(Device | DeviceMetric) | Not used in this profile | |
 component | 0..* | BackboneElement | Component results | |
  Slices for extension | 0..* | Extension | Extensions to capture specific conditions that fall into the given category. Slice: Unordered, Open by value:url | |
 conditionCode | 0..* | CodeableConcept | Comorbid Condition Code Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code | |
| conditionReference | 0..* | Reference(Condition) | Comorbid Condition Reference Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference | |
 modifierExtension | 0..0 | |||
| code | 1..1 | CodeableConcept | Code representing the comorbidity category | |
  value[x] | 0..1 | CodeableConcept | Actual component result | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | C | 0..* | Observation | This is an abstract profile. Child profiles: Observation Measurements and simple assertions |
 implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. |
| code | Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| subject | Σ | 0..1 | Reference(Cancer Patient Profile) | Who and/or what the observation is about |
| focus | Σ | 0..* | Reference(Condition) | The Index Condition |
| bodySite | 0..1 | CodeableConcept | Not used in this profile Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |
| specimen | 0..1 | Reference(Specimen) | Not used in this profile | |
| device | 0..1 | Reference(Device | DeviceMetric) | Not used in this profile | |
| component | Σ | 0..* | BackboneElement | Component results |
| Slices for extension | 0..* | Extension | Extensions to capture specific conditions that fall into the given category. Slice: Unordered, Open by value:url | |
| conditionCode | 0..* | CodeableConcept | Comorbid Condition Code Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code | |
| conditionReference | 0..* | Reference(Condition) | Comorbid Condition Reference Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference | |
| code | Σ | 1..1 | CodeableConcept | Code representing the comorbidity category Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| value[x] | Σ | 0..1 | CodeableConcept | Actual component result |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| Observation.status | required | ObservationStatus |
| Observation.code | example | LOINCCodes (a valid code from LOINC) |
| Observation.bodySite | example | SNOMEDCTBodyStructures |
| Observation.component.code | example | LOINCCodes (a valid code from LOINC) |
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Observation | C | 0..* | Observation | This is an abstract profile. Child profiles: Observation Measurements and simple assertions | ||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | Σ | 0..* | Identifier | Business Identifier for observation | ||||
| basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
| partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | ||||
| status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. | ||||
| category | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| code | Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| subject | Σ | 0..1 | Reference(Cancer Patient Profile) | Who and/or what the observation is about | ||||
| focus | Σ | 0..* | Reference(Condition) | The Index Condition | ||||
| encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made | ||||
  effective[x] | Σ | 0..1 | Clinically relevant time/time-period for observation | |||||
 effectiveDateTime | dateTime | |||||||
| effectivePeriod | Period | |||||||
| effectiveTiming | Timing | |||||||
| effectiveInstant | instant | |||||||
| issued | Σ | 0..1 | instant | Date/Time this version was made available | ||||
| performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation | ||||
| value[x] | ΣC | 0..1 | Actual result | |||||
| valueQuantity | Quantity | |||||||
| valueCodeableConcept | CodeableConcept | |||||||
| valueString | string | |||||||
| valueBoolean | boolean | |||||||
| valueInteger | integer | |||||||
| valueRange | Range | |||||||
| valueRatio | Ratio | |||||||
| valueSampledData | SampledData | |||||||
| valueTime | time | |||||||
| valueDateTime | dateTime | |||||||
| valuePeriod | Period | |||||||
| dataAbsentReason | C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| note | 0..* | Annotation | Comments about the observation | |||||
| bodySite | 0..1 | CodeableConcept | Not used in this profile Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
| method | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. | |||||
| specimen | 0..1 | Reference(Specimen) | Not used in this profile | |||||
| device | 0..1 | Reference(Device | DeviceMetric) | Not used in this profile | |||||
| referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| low | C | 0..1 | SimpleQuantity | Low Range, if relevant | ||||
| high | C | 0..1 | SimpleQuantity | High Range, if relevant | ||||
| type | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range. | |||||
| appliesTo | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to. | |||||
| age | 0..1 | Range | Applicable age range, if relevant | |||||
| text | 0..1 | string | Text based reference range in an observation | |||||
| hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group | ||||
| derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | ||||
| component | Σ | 0..* | BackboneElement | Component results | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension | 0..* | Extension | Extensions to capture specific conditions that fall into the given category. Slice: Unordered, Open by value:url | |||||
| conditionCode | 0..* | CodeableConcept | Comorbid Condition Code Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code | |||||
| conditionReference | 0..* | Reference(Condition) | Comorbid Condition Reference Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference | |||||
| code | Σ | 1..1 | CodeableConcept | Code representing the comorbidity category Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| value[x] | Σ | 0..1 | CodeableConcept | Actual component result | ||||
| dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | ||||
| Observation.language | preferred | CommonLanguages
| ||||
| Observation.status | required | ObservationStatus | ||||
| Observation.category | preferred | ObservationCategoryCodes | ||||
| Observation.code | example | LOINCCodes (a valid code from LOINC) | ||||
| Observation.dataAbsentReason | extensible | DataAbsentReason | ||||
| Observation.interpretation | extensible | ObservationInterpretationCodes | ||||
| Observation.bodySite | example | SNOMEDCTBodyStructures | ||||
| Observation.method | example | ObservationMethods | ||||
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes | ||||
| Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes | ||||
| Observation.component.code | example | LOINCCodes (a valid code from LOINC) | ||||
| Observation.component.dataAbsentReason | extensible | DataAbsentReason | ||||
| Observation.component.interpretation | extensible | ObservationInterpretationCodes |
This structure is derived from Observation
Differential View
This structure is derived from Observation
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | 0..* | Observation | This is an abstract profile. Child profiles: Observation Measurements and simple assertions | |
| subject | 0..1 | Reference(Cancer Patient Profile) | Who and/or what the observation is about | |
| focus | 0..* | Reference(Condition) | The Index Condition | |
| bodySite | 0..1 | CodeableConcept | Not used in this profile | |
| specimen | 0..1 | Reference(Specimen) | Not used in this profile | |
| device | 0..1 | Reference(Device | DeviceMetric) | Not used in this profile | |
| component | 0..* | BackboneElement | Component results | |
| Slices for extension | 0..* | Extension | Extensions to capture specific conditions that fall into the given category. Slice: Unordered, Open by value:url | |
| conditionCode | 0..* | CodeableConcept | Comorbid Condition Code Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code | |
| conditionReference | 0..* | Reference(Condition) | Comorbid Condition Reference Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference | |
| modifierExtension | 0..0 | |||
| code | 1..1 | CodeableConcept | Code representing the comorbidity category | |
| value[x] | 0..1 | CodeableConcept | Actual component result | |
| Documentation for this format | ||||
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Observation | C | 0..* | Observation | This is an abstract profile. Child profiles: Observation Measurements and simple assertions |
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created |
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored |
| status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. |
| code | Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| subject | Σ | 0..1 | Reference(Cancer Patient Profile) | Who and/or what the observation is about |
| focus | Σ | 0..* | Reference(Condition) | The Index Condition |
| bodySite | 0..1 | CodeableConcept | Not used in this profile Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |
| specimen | 0..1 | Reference(Specimen) | Not used in this profile | |
| device | 0..1 | Reference(Device | DeviceMetric) | Not used in this profile | |
| component | Σ | 0..* | BackboneElement | Component results |
| Slices for extension | 0..* | Extension | Extensions to capture specific conditions that fall into the given category. Slice: Unordered, Open by value:url | |
| conditionCode | 0..* | CodeableConcept | Comorbid Condition Code Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code | |
| conditionReference | 0..* | Reference(Condition) | Comorbid Condition Reference Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference | |
| code | Σ | 1..1 | CodeableConcept | Code representing the comorbidity category Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| value[x] | Σ | 0..1 | CodeableConcept | Actual component result |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| Observation.status | required | ObservationStatus |
| Observation.code | example | LOINCCodes (a valid code from LOINC) |
| Observation.bodySite | example | SNOMEDCTBodyStructures |
| Observation.component.code | example | LOINCCodes (a valid code from LOINC) |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints | ||||
|---|---|---|---|---|---|---|---|---|
| Observation | C | 0..* | Observation | This is an abstract profile. Child profiles: Observation Measurements and simple assertions | ||||
| id | Σ | 0..1 | id | Logical id of this artifact | ||||
| meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
| implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
| contained | 0..* | Resource | Contained, inline Resources | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier | Σ | 0..* | Identifier | Business Identifier for observation | ||||
| basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order | ||||
| partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event | ||||
| status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. | ||||
| category | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| code | Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| subject | Σ | 0..1 | Reference(Cancer Patient Profile) | Who and/or what the observation is about | ||||
| focus | Σ | 0..* | Reference(Condition) | The Index Condition | ||||
| encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made | ||||
| effective[x] | Σ | 0..1 | Clinically relevant time/time-period for observation | |||||
| effectiveDateTime | dateTime | |||||||
| effectivePeriod | Period | |||||||
| effectiveTiming | Timing | |||||||
| effectiveInstant | instant | |||||||
| issued | Σ | 0..1 | instant | Date/Time this version was made available | ||||
| performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation | ||||
| value[x] | ΣC | 0..1 | Actual result | |||||
| valueQuantity | Quantity | |||||||
| valueCodeableConcept | CodeableConcept | |||||||
| valueString | string | |||||||
| valueBoolean | boolean | |||||||
| valueInteger | integer | |||||||
| valueRange | Range | |||||||
| valueRatio | Ratio | |||||||
| valueSampledData | SampledData | |||||||
| valueTime | time | |||||||
| valueDateTime | dateTime | |||||||
| valuePeriod | Period | |||||||
| dataAbsentReason | C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| note | 0..* | Annotation | Comments about the observation | |||||
| bodySite | 0..1 | CodeableConcept | Not used in this profile Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
| method | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations. | |||||
| specimen | 0..1 | Reference(Specimen) | Not used in this profile | |||||
| device | 0..1 | Reference(Device | DeviceMetric) | Not used in this profile | |||||
| referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| extension | 0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| low | C | 0..1 | SimpleQuantity | Low Range, if relevant | ||||
| high | C | 0..1 | SimpleQuantity | High Range, if relevant | ||||
| type | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range. | |||||
| appliesTo | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to. | |||||
| age | 0..1 | Range | Applicable age range, if relevant | |||||
| text | 0..1 | string | Text based reference range in an observation | |||||
| hasMember | Σ | 0..* | Reference(Observation | QuestionnaireResponse | MolecularSequence) | Related resource that belongs to the Observation group | ||||
| derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from | ||||
| component | Σ | 0..* | BackboneElement | Component results | ||||
| id | 0..1 | string | Unique id for inter-element referencing | |||||
| Slices for extension | 0..* | Extension | Extensions to capture specific conditions that fall into the given category. Slice: Unordered, Open by value:url | |||||
| conditionCode | 0..* | CodeableConcept | Comorbid Condition Code Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-code | |||||
| conditionReference | 0..* | Reference(Condition) | Comorbid Condition Reference Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference | |||||
| code | Σ | 1..1 | CodeableConcept | Code representing the comorbidity category Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| value[x] | Σ | 0..1 | CodeableConcept | Actual component result | ||||
| dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| Documentation for this format | ||||||||
| Path | Conformance | ValueSet | ||||
| Observation.language | preferred | CommonLanguages
| ||||
| Observation.status | required | ObservationStatus | ||||
| Observation.category | preferred | ObservationCategoryCodes | ||||
| Observation.code | example | LOINCCodes (a valid code from LOINC) | ||||
| Observation.dataAbsentReason | extensible | DataAbsentReason | ||||
| Observation.interpretation | extensible | ObservationInterpretationCodes | ||||
| Observation.bodySite | example | SNOMEDCTBodyStructures | ||||
| Observation.method | example | ObservationMethods | ||||
| Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes | ||||
| Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes | ||||
| Observation.component.code | example | LOINCCodes (a valid code from LOINC) | ||||
| Observation.component.dataAbsentReason | extensible | DataAbsentReason | ||||
| Observation.component.interpretation | extensible | ObservationInterpretationCodes |
This structure is derived from Observation
Other representations of profile: CSV, Excel, Schematron
IG © 2022+ HL7 International Clinical Interoperability Council. Package hl7.fhir.us.mcode#2.1.0 based on FHIR 4.0.1. Generated 2023-03-21
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