minimal Common Oncology Data Elements (mCODE) Implementation Guide
3.0.0 - STU3 Release United States of America flag

This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v3.0.0: STU 3) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: Tumor - Detailed Descriptions

Draft as of 2023-10-26 Maturity Level: 3

Definitions for the mcode-tumor resource profile.

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

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

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

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

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

ShortStable identifier(s) for this tumor
Comments

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

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

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

ShortA persistent identifier of this tumor.
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
TypeIdentifier(Body Structure Identifier Profile)
12. BodyStructure.morphology
BindingUnless not suitable, these codes SHALL be taken from Tumor Morphology Code Value Set
Additional BindingsPurpose
Tumor Morphology Code Max Value SetMax Binding
Must Supporttrue
14. BodyStructure.location
Control1..?
BindingUnless not suitable, these codes SHALL be taken from Cancer Body Location Value Set
Must Supporttrue
16. BodyStructure.locationQualifier
BindingThe codes SHALL be taken from Body Location and Laterality Qualifier Value Set
Must Supporttrue
18. BodyStructure.patient
Definition

The patient associated with this tumor.

TypeReference(Cancer Patient Profile)
Must Supporttrue

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

0. BodyStructure
Definition

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

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

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. BodyStructure.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

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

An Extension


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

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

Shortidentifies the meaning of the extension
Comments

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

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

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

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

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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


Identifier for this instance of the anatomical structure.

ShortStable identifier(s) for this tumorBodystructure identifier
Comments

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

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

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


Identifier for this instance of the anatomical structure.

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

Whether this body site is in active use.

ShortWhether this record is in active use
Comments

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

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

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

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

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

ShortKind of Structure
Comments

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

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

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

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

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

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

The patient associated with this tumor.


The person to which the body site belongs.

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

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

0. BodyStructure
Definition

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

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

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

ShortLogical id of this artifact
Comments

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

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

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

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

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. BodyStructure.language
Definition

The base language in which the resource is written.

ShortLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages: A human language.
Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. BodyStructure.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

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

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

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

An Extension

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

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

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

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

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

An Extension

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

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

Shortidentifies the meaning of the extension
Comments

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

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

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

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

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

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

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

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

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

ShortStable identifier(s) for this tumor
Comments

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

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

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

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

Whether this body site is in active use.

ShortWhether this record is in active use
Comments

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

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

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

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

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

ShortKind of Structure
Comments

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

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Tumor Morphology Code Value Set
Additional BindingsPurpose
Tumor Morphology Code Max Value SetMax Binding
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. BodyStructure.location
Definition

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

ShortBody site
Control1..1
BindingUnless not suitable, these codes SHALL be taken from Cancer Body Location Value Set
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. BodyStructure.locationQualifier
Definition

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

ShortBody site modifier
Control0..*
BindingThe codes SHALL be taken from Body Location and Laterality Qualifier Value Set
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. BodyStructure.description
Definition

A summary, characterization or explanation of the body structure.

ShortText description
Comments

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

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

Image or images used to identify a location.

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

The patient associated with this tumor.

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