R6 Ballot (1st Draft)

This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions

10.9 Resource BodyStructure - Content

Orders and Observations icon

Work Group

Maturity Level: 1

Trial Use

Security Category: Patient

Compartments: Patient

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.

10.9.1 Scope and Usage

The BodyStructure resource contains details about the anatomical location of a specimen or body part, including patient information, identifiers, as well as text descriptions and images.

When needed, it allows the the representation of complex body structures and/or locations using the included and excluded elements. Also, it provides for the addition of qualifiers such as laterality and directionality to the anatomic location for those use cases where pre-coordination of codes is not possible. The BodyStructure resource supports recording and tracking of an anatomic location or structure on a patient outside the context of another resource. For example it can be the target of a Procedure or Observation resource.

10.9.2 Boundaries and Relationships

The BodyStructure resource is not intended to substitute for precoordination of codes. If precoordination of codes is supported by an implementation the codeableConcept should be used. This resource is not intended for describing the type of anatomical location but rather a specific body site on a specific patient.

10.9.3 References to this Resource

Structure

Name	Flags	Card.	Type	Description & Constraints
BodyStructure	TU		DomainResource	Specific and identified anatomical structure Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Bodystructure identifier
active	?!Σ	0..1	boolean	Whether this record is in active use
morphology	Σ	0..1	CodeableConcept	Kind of Structure Binding: SNOMED CT Morphologic Abnormalities (Example)
includedStructure		1..*	BackboneElement	Included anatomic location(s)
structure	Σ	1..1	CodeableConcept	Code that represents the included structure Binding: SNOMED CT Body Structures (Example)
laterality		0..1	CodeableConcept	Code that represents the included structure laterality Binding: Bodystructure Location Qualifier (Example)
bodyLandmarkOrientation		0..*	BackboneElement	Landmark relative location
landmarkDescription		0..*	CodeableConcept	Body ]andmark description Binding: SNOMED CT Body Structures (Example)
clockFacePosition		0..*	CodeableConcept	Clockface orientation Binding: Bodystructure Body Landmark Clock Face Position (Example)
distanceFromLandmark		0..*	BackboneElement	Landmark relative location
device		0..*	CodeableReference(Device)	Measurement device Binding: Device Type (Example)
value		0..*	Quantity	Measured distance from body landmark
surfaceOrientation		0..*	CodeableConcept	Relative landmark surface orientation Binding: Bodystructure Location Qualifier (Preferred)
spatialReference		0..*	Reference(ImagingSelection)	Cartesian reference for structure
qualifier		0..*	CodeableConcept	Code that represents the included structure qualifier Binding: Bodystructure Location Qualifier (Example)
excludedStructure		0..*	see includedStructure	Excluded anatomic locations(s)
description	Σ	0..1	markdown	Text description
image		0..*	Attachment	Attached images
patient	Σ	1..1	Reference(Patient)	Who this is about
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<BodyStructure xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Bodystructure identifier --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this record is in active use -->
 <morphology><!-- 0..1 CodeableConcept Kind of Structure --></morphology>
 <includedStructure>  <!-- 1..* Included anatomic location(s) -->
  <structure><!-- 1..1 CodeableConcept Code that represents the included structure --></structure>
  <laterality><!-- 0..1 CodeableConcept Code that represents the included structure laterality --></laterality>
  <bodyLandmarkOrientation>  <!-- 0..* Landmark relative location -->
   <landmarkDescription><!-- 0..* CodeableConcept Body ]andmark description --></landmarkDescription>
   <clockFacePosition><!-- 0..* CodeableConcept Clockface orientation --></clockFacePosition>
   <distanceFromLandmark>  <!-- 0..* Landmark relative location -->
    <device><!-- 0..* CodeableReference(Device) Measurement device --></device>
    <value><!-- 0..* Quantity Measured distance from body landmark --></value>
   </distanceFromLandmark>
   <surfaceOrientation><!-- 0..* CodeableConcept Relative landmark surface orientation --></surfaceOrientation>
  </bodyLandmarkOrientation>
  <spatialReference><!-- 0..* Reference(ImagingSelection) Cartesian reference for structure --></spatialReference>
  <qualifier><!-- 0..* CodeableConcept Code that represents the included structure qualifier --></qualifier>
 </includedStructure>
 <excludedStructure><!-- 0..* Content as for BodyStructure.includedStructure Excluded anatomic locations(s) --></excludedStructure>
 <description value="[markdown]"/><!-- 0..1 Text description -->
 <image><!-- 0..* Attachment Attached images --></image>
 <patient><!-- 1..1 Reference(Patient) Who this is about --></patient>
</BodyStructure>

JSON Template

{
  "resourceType" : "BodyStructure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Bodystructure identifier
  "active" : <boolean>, // Whether this record is in active use
  "morphology" : { CodeableConcept }, // Kind of Structure
  "includedStructure" : [{ // R!  Included anatomic location(s)
    "structure" : { CodeableConcept }, // R!  Code that represents the included structure
    "laterality" : { CodeableConcept }, // Code that represents the included structure laterality
    "bodyLandmarkOrientation" : [{ // Landmark relative location
      "landmarkDescription" : [{ CodeableConcept }], // Body ]andmark description
      "clockFacePosition" : [{ CodeableConcept }], // Clockface orientation
      "distanceFromLandmark" : [{ // Landmark relative location
        "device" : [{ CodeableReference(Device) }], // Measurement device
        "value" : [{ Quantity }] // Measured distance from body landmark
      }],
      "surfaceOrientation" : [{ CodeableConcept }] // Relative landmark surface orientation
    }],
    "spatialReference" : [{ Reference(ImagingSelection) }], // Cartesian reference for structure
    "qualifier" : [{ CodeableConcept }] // Code that represents the included structure qualifier
  }],
  "excludedStructure" : [{ Content as for BodyStructure.includedStructure }], // Excluded anatomic locations(s)
  "description" : "<markdown>", // Text description
  "image" : [{ Attachment }], // Attached images
  "patient" : { Reference(Patient) } // R!  Who this is about
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:BodyStructure;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Bodystructure identifier
  fhir:active [ boolean ] ; # 0..1 Whether this record is in active use
  fhir:morphology [ CodeableConcept ] ; # 0..1 Kind of Structure
  fhir:includedStructure ( [ # 1..* Included anatomic location(s)
    fhir:structure [ CodeableConcept ] ; # 1..1 Code that represents the included structure
    fhir:laterality [ CodeableConcept ] ; # 0..1 Code that represents the included structure laterality
    fhir:bodyLandmarkOrientation ( [ # 0..* Landmark relative location
      fhir:landmarkDescription  ( [ CodeableConcept ] ... ) ; # 0..* Body ]andmark description
      fhir:clockFacePosition  ( [ CodeableConcept ] ... ) ; # 0..* Clockface orientation
      fhir:distanceFromLandmark ( [ # 0..* Landmark relative location
        fhir:device  ( [ CodeableReference(Device) ] ... ) ; # 0..* Measurement device
        fhir:value  ( [ Quantity ] ... ) ; # 0..* Measured distance from body landmark
      ] ... ) ;
      fhir:surfaceOrientation  ( [ CodeableConcept ] ... ) ; # 0..* Relative landmark surface orientation
    ] ... ) ;
    fhir:spatialReference  ( [ Reference(ImagingSelection) ] ... ) ; # 0..* Cartesian reference for structure
    fhir:qualifier  ( [ CodeableConcept ] ... ) ; # 0..* Code that represents the included structure qualifier
  ] ... ) ;
  fhir:excludedStructure  ( [ See BodyStructure.includedStructure ] ... ) ; # 0..* Excluded anatomic locations(s)
  fhir:description [ markdown ] ; # 0..1 Text description
  fhir:image  ( [ Attachment ] ... ) ; # 0..* Attached images
  fhir:patient [ Reference(Patient) ] ; # 1..1 Who this is about
]

Changes from both R4 and R4B

BodyStructure

BodyStructure.includedStructure

Added Mandatory Element

BodyStructure.includedStructure.structure

Added Mandatory Element

BodyStructure.includedStructure.laterality

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.landmarkDescription

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.clockFacePosition

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.device

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.value

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.surfaceOrientation

Added Element

BodyStructure.includedStructure.spatialReference

Added Element

BodyStructure.includedStructure.qualifier

Added Element

BodyStructure.excludedStructure

Added Element

BodyStructure.description

Type changed from string to markdown

BodyStructure.location

Deleted

BodyStructure.locationQualifier

Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Structure

Name	Flags	Card.	Type	Description & Constraints
BodyStructure	TU		DomainResource	Specific and identified anatomical structure Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
identifier	Σ	0..*	Identifier	Bodystructure identifier
active	?!Σ	0..1	boolean	Whether this record is in active use
morphology	Σ	0..1	CodeableConcept	Kind of Structure Binding: SNOMED CT Morphologic Abnormalities (Example)
includedStructure		1..*	BackboneElement	Included anatomic location(s)
structure	Σ	1..1	CodeableConcept	Code that represents the included structure Binding: SNOMED CT Body Structures (Example)
laterality		0..1	CodeableConcept	Code that represents the included structure laterality Binding: Bodystructure Location Qualifier (Example)
bodyLandmarkOrientation		0..*	BackboneElement	Landmark relative location
landmarkDescription		0..*	CodeableConcept	Body ]andmark description Binding: SNOMED CT Body Structures (Example)
clockFacePosition		0..*	CodeableConcept	Clockface orientation Binding: Bodystructure Body Landmark Clock Face Position (Example)
distanceFromLandmark		0..*	BackboneElement	Landmark relative location
device		0..*	CodeableReference(Device)	Measurement device Binding: Device Type (Example)
value		0..*	Quantity	Measured distance from body landmark
surfaceOrientation		0..*	CodeableConcept	Relative landmark surface orientation Binding: Bodystructure Location Qualifier (Preferred)
spatialReference		0..*	Reference(ImagingSelection)	Cartesian reference for structure
qualifier		0..*	CodeableConcept	Code that represents the included structure qualifier Binding: Bodystructure Location Qualifier (Example)
excludedStructure		0..*	see includedStructure	Excluded anatomic locations(s)
description	Σ	0..1	markdown	Text description
image		0..*	Attachment	Attached images
patient	Σ	1..1	Reference(Patient)	Who this is about
Documentation for this format

See the Extensions for this resource

UML Diagram (Legend)

XML Template

<BodyStructure xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Bodystructure identifier --></identifier>
 <active value="[boolean]"/><!-- 0..1 Whether this record is in active use -->
 <morphology><!-- 0..1 CodeableConcept Kind of Structure --></morphology>
 <includedStructure>  <!-- 1..* Included anatomic location(s) -->
  <structure><!-- 1..1 CodeableConcept Code that represents the included structure --></structure>
  <laterality><!-- 0..1 CodeableConcept Code that represents the included structure laterality --></laterality>
  <bodyLandmarkOrientation>  <!-- 0..* Landmark relative location -->
   <landmarkDescription><!-- 0..* CodeableConcept Body ]andmark description --></landmarkDescription>
   <clockFacePosition><!-- 0..* CodeableConcept Clockface orientation --></clockFacePosition>
   <distanceFromLandmark>  <!-- 0..* Landmark relative location -->
    <device><!-- 0..* CodeableReference(Device) Measurement device --></device>
    <value><!-- 0..* Quantity Measured distance from body landmark --></value>
   </distanceFromLandmark>
   <surfaceOrientation><!-- 0..* CodeableConcept Relative landmark surface orientation --></surfaceOrientation>
  </bodyLandmarkOrientation>
  <spatialReference><!-- 0..* Reference(ImagingSelection) Cartesian reference for structure --></spatialReference>
  <qualifier><!-- 0..* CodeableConcept Code that represents the included structure qualifier --></qualifier>
 </includedStructure>
 <excludedStructure><!-- 0..* Content as for BodyStructure.includedStructure Excluded anatomic locations(s) --></excludedStructure>
 <description value="[markdown]"/><!-- 0..1 Text description -->
 <image><!-- 0..* Attachment Attached images --></image>
 <patient><!-- 1..1 Reference(Patient) Who this is about --></patient>
</BodyStructure>

JSON Template

{
  "resourceType" : "BodyStructure",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Bodystructure identifier
  "active" : <boolean>, // Whether this record is in active use
  "morphology" : { CodeableConcept }, // Kind of Structure
  "includedStructure" : [{ // R!  Included anatomic location(s)
    "structure" : { CodeableConcept }, // R!  Code that represents the included structure
    "laterality" : { CodeableConcept }, // Code that represents the included structure laterality
    "bodyLandmarkOrientation" : [{ // Landmark relative location
      "landmarkDescription" : [{ CodeableConcept }], // Body ]andmark description
      "clockFacePosition" : [{ CodeableConcept }], // Clockface orientation
      "distanceFromLandmark" : [{ // Landmark relative location
        "device" : [{ CodeableReference(Device) }], // Measurement device
        "value" : [{ Quantity }] // Measured distance from body landmark
      }],
      "surfaceOrientation" : [{ CodeableConcept }] // Relative landmark surface orientation
    }],
    "spatialReference" : [{ Reference(ImagingSelection) }], // Cartesian reference for structure
    "qualifier" : [{ CodeableConcept }] // Code that represents the included structure qualifier
  }],
  "excludedStructure" : [{ Content as for BodyStructure.includedStructure }], // Excluded anatomic locations(s)
  "description" : "<markdown>", // Text description
  "image" : [{ Attachment }], // Attached images
  "patient" : { Reference(Patient) } // R!  Who this is about
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:BodyStructure;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Bodystructure identifier
  fhir:active [ boolean ] ; # 0..1 Whether this record is in active use
  fhir:morphology [ CodeableConcept ] ; # 0..1 Kind of Structure
  fhir:includedStructure ( [ # 1..* Included anatomic location(s)
    fhir:structure [ CodeableConcept ] ; # 1..1 Code that represents the included structure
    fhir:laterality [ CodeableConcept ] ; # 0..1 Code that represents the included structure laterality
    fhir:bodyLandmarkOrientation ( [ # 0..* Landmark relative location
      fhir:landmarkDescription  ( [ CodeableConcept ] ... ) ; # 0..* Body ]andmark description
      fhir:clockFacePosition  ( [ CodeableConcept ] ... ) ; # 0..* Clockface orientation
      fhir:distanceFromLandmark ( [ # 0..* Landmark relative location
        fhir:device  ( [ CodeableReference(Device) ] ... ) ; # 0..* Measurement device
        fhir:value  ( [ Quantity ] ... ) ; # 0..* Measured distance from body landmark
      ] ... ) ;
      fhir:surfaceOrientation  ( [ CodeableConcept ] ... ) ; # 0..* Relative landmark surface orientation
    ] ... ) ;
    fhir:spatialReference  ( [ Reference(ImagingSelection) ] ... ) ; # 0..* Cartesian reference for structure
    fhir:qualifier  ( [ CodeableConcept ] ... ) ; # 0..* Code that represents the included structure qualifier
  ] ... ) ;
  fhir:excludedStructure  ( [ See BodyStructure.includedStructure ] ... ) ; # 0..* Excluded anatomic locations(s)
  fhir:description [ markdown ] ; # 0..1 Text description
  fhir:image  ( [ Attachment ] ... ) ; # 0..* Attached images
  fhir:patient [ Reference(Patient) ] ; # 1..1 Who this is about
]

Changes from both R4 and R4B

BodyStructure

BodyStructure.includedStructure

Added Mandatory Element

BodyStructure.includedStructure.structure

Added Mandatory Element

BodyStructure.includedStructure.laterality

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.landmarkDescription

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.clockFacePosition

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.device

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.value

Added Element

BodyStructure.includedStructure.bodyLandmarkOrientation.surfaceOrientation

Added Element

BodyStructure.includedStructure.spatialReference

Added Element

BodyStructure.includedStructure.qualifier

Added Element

BodyStructure.excludedStructure

Added Element

BodyStructure.description

Type changed from string to markdown

BodyStructure.location

Deleted

BodyStructure.locationQualifier

Deleted

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON.

See R4 <--> R5 Conversion Maps (status = See Conversions Summary.)

Additional definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions, the spreadsheet version & the dependency analysis

10.9.4.1 Terminology Bindings

Path	ValueSet	Type	Documentation
BodyStructure.morphology	SNOMEDCTMorphologicAbnormalities	Example	This value set includes all codes from SNOMED CT where concept is-a 442083009 (Anatomical or acquired body site (body structure)).
BodyStructure.includedStructure.structure	SNOMEDCTBodyStructures	Example	This value set includes all codes from SNOMED CT where concept is-a 442083009 (Anatomical or acquired body site (body structure)).
BodyStructure.includedStructure.laterality	BodystructureLocationQualifier	Example	SNOMED-CT concepts modifying the anatomic location
BodyStructure.includedStructure.bodyLandmarkOrientation.landmarkDescription	SNOMEDCTBodyStructures	Example	This value set includes all codes from SNOMED CT where concept is-a 442083009 (Anatomical or acquired body site (body structure)).
BodyStructure.includedStructure.bodyLandmarkOrientation.clockFacePosition	BodystructureBodyLandmarkClockFacePosition	Example	Select SNOMED CT codes. A set of codes that describe a things orientation based on a hourly positions of a clock face.
BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.device	DeviceType	Example	Codes used to identify medical devices. Includes concepts from SNOMED CT (http://www.snomed.org/) where concept is-a 49062001 (Device) and is provided as a suggestive example.
BodyStructure.includedStructure.bodyLandmarkOrientation.surfaceOrientation	BodystructureLocationQualifier	Preferred	SNOMED-CT concepts modifying the anatomic location
BodyStructure.includedStructure.qualifier	BodystructureLocationQualifier	Example	SNOMED-CT concepts modifying the anatomic location

Path

ValueSet

Type

Documentation

BodyStructure.morphology

SNOMEDCTMorphologicAbnormalities

Example

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).

BodyStructure.includedStructure.structure

SNOMEDCTBodyStructures

Example

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).

BodyStructure.includedStructure.laterality

BodystructureLocationQualifier

Example

SNOMED-CT concepts modifying the anatomic location

BodyStructure.includedStructure.bodyLandmarkOrientation.landmarkDescription

SNOMEDCTBodyStructures

Example

This value set includes all codes from SNOMED CT icon where concept is-a 442083009 (Anatomical or acquired body site (body structure)).

BodyStructure.includedStructure.bodyLandmarkOrientation.clockFacePosition

BodystructureBodyLandmarkClockFacePosition

Example

Select SNOMED CT codes. A set of codes that describe a things orientation based on a hourly positions of a clock face.

BodyStructure.includedStructure.bodyLandmarkOrientation.distanceFromLandmark.device

DeviceType

Example

Codes used to identify medical devices. Includes concepts from SNOMED CT (http://www.snomed.org/) where concept is-a 49062001 (Device) and is provided as a suggestive example.

BodyStructure.includedStructure.bodyLandmarkOrientation.surfaceOrientation

BodystructureLocationQualifier

Preferred

SNOMED-CT concepts modifying the anatomic location

BodyStructure.includedStructure.qualifier

BodystructureLocationQualifier

Example

SNOMED-CT concepts modifying the anatomic location

10.9.5 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource, and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name	Type	Description	Expression	In Common
excluded_structure	token	Body site excludedStructure structure	BodyStructure.excludedStructure.structure
identifier	token	Bodystructure identifier	BodyStructure.identifier	65 Resources
included_structure	token	Body site includedStructure structure	BodyStructure.includedStructure.structure
morphology	token	Kind of Structure	BodyStructure.morphology
patient	reference	Who this is about	BodyStructure.patient (Patient)	66 Resources