Onconova Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: Radiotherapy Summary Profile

A profile representing a summary of a course of radiotherapy delivered to a patient. It records the treatment intent, termination reason, modalities, techniques, number of sessions, and doses delivered to one or more body volumes. Whether the course has been fully delivered or stopped is indicated in the status element.

This profile extends the base mCODE RadiotherapyCourseSummary profile to include specific constraints and requirements for Onconova.

Conformance:

Procedure resources representing a radiotherapy in the scope of Onconova SHALL conform to this profile. Any resource intended to conform to this profile SHOULD populate meta.profile accordingly.

Usages:

• Refer to this Profile: Adverse Event Profile
• CapabilityStatements using this Profile: Onconova FHIR REST Server Capability Statement

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: us-core-7, termination-reason-code-invariant, termination-reason-invariant, mcode-reason-required, o-rad-req-1, o-rad-req-2, o-rad-req-3, o-rad-req-4
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:treatmentIntent	SO	1..1	(Complex)	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent"
value[x]		1..1	CodeableConcept	Value of extension Binding: Treatment Intents Value Set (required)
extension:terminationReason		0..1	CodeableConcept	Not used in this profile URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:modalityAndTechnique	SOC	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Constraints: TechniquesForNeutronBeamModality, TechniquesForPhotonBeamModality, TechniquesForElectronBeamModality, TechniquesForCarbonIonBeamModality, TechniquesForProtonBeamModality, TechniquesForInternalRadiotherapyPermanentSeeds, TechniquesForLowDoseRateUsingTempRadSource, TechniquesForPulsedDoseRate, TechniquesForHighDoseRate, TechniquesForHighDoseRateElectronic, TechniquesForRadioPharmaceutical, ModalityTextRequiredForOther, TechniqueTextRequiredForOther Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:actualNumberOfSessions	SO	1..1	unsignedInt	Radiotherapy Number of Sessions Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:doseDeliveredToVolume	SO	0..*	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:therapyLine	SO	0..1	Reference(Therapy Line Profile)	Reference to the therapy line associated with this treatment URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-therapy-line-reference Obligations Actor MAY:ignore Creator (Onconova) MAY:persist Consumer (Onconova)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Not used in this profile
instantiatesUri	Σ	0..*	uri	Not used in this profile
basedOn	Σ	0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	Not used in this profile
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Not used in this profile
status	?!SΣC	1..1	code	Not used in this profile Binding: EventStatus (required)
statusReason	SOΣ	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reasons Value Set (required) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
performed[x]	SOΣC	0..1	Period	The time period over which the radiotherapy course was performed Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
performer	Σ	0..*	BackboneElement	Not used in this profile
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
location	Σ	0..1	Reference(Location)	Not used in this profile
reasonCode	SΣ	0..*	CodeableConcept	Not used in this profile Binding: Cancer Disorder Value Set (extensible)
reasonReference	SOΣ	1..*	Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile)	The condition(s) that motivated the radiotherapy treatment Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite	SΣ	0..*	CodeableConcept	Not used in this profile Binding: Radiotherapy Treatment Location Value Set (extensible)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	CodeableConcept	General location qualifier (excluding laterality) for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier		0..1	CodeableConcept	Laterality qualifier for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required)
outcome	Σ	0..1	CodeableConcept	Not used in this profile Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Not used in this profile
complication		0..*	CodeableConcept	Not used in this profile Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	Not used in this profile
followUp		0..*	CodeableConcept	Not used in this profile Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Not used in this profile
focalDevice		0..*	BackboneElement	Not used in this profile
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Not used in this profile
usedCode		0..*	CodeableConcept	Not used in this profile Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.extension:treatmentIntent.​value[x]	Base	required	Treatment Intents Value Set	📦0.2.0	This IG
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	required	Treatment Termination Reasons Value Set	📦0.2.0	This IG
Procedure.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	extensible	Radiotherapy Treatment Location Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.outcome	Base	example	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📦4.0.1	FHIR Std.
Procedure.followUp	Base	example	Procedure Follow up Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.usedCode	Base	example	FHIR Device Types	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
ModalityTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
TechniqueTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
TechniquesForCarbonIonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Carbon Ion Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
TechniquesForElectronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Electron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
TechniquesForHighDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForHighDoseRateElectronic	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate Electronic	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForInternalRadiotherapyPermanentSeeds	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Internal Radiotherapy - Permanent Seeds	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
TechniquesForLowDoseRateUsingTempRadSource	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Low Dose Rate Using Temp Radiation Source	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
TechniquesForNeutronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Neutron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
TechniquesForPhotonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Photon Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
TechniquesForProtonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Proton Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
TechniquesForPulsedDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Pulsed Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
TechniquesForRadioPharmaceutical	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Radiopharmaceutical	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	error	Procedure	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	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mcode-reason-required	warning	Procedure	One of reasonCode or reasonReference SHALL be present	reasonCode.exists() or reasonReference.exists()
o-rad-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-rad-req-2	error	Procedure	The performedPeriod element is required and must be provided.	performedPeriod.exists()
o-rad-req-3	error	Procedure	The actualNumberOfSessions extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists()
o-rad-req-4	error	Procedure	The treatmentIntent extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()
termination-reason-code-invariant	error	Procedure	When status is stopped, only certain statusReason values are allowed	status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	Procedure	Certain statusReason values are allowed only when status is stopped	statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

This structure is derived from RadiotherapyCourseSummary

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: o-rad-req-1, o-rad-req-2, o-rad-req-3, o-rad-req-4
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:treatmentIntent	O	1..1	ProcedureIntent	Procedure Intent Extension Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
value[x]		1..1	CodeableConcept	Value of extension Binding: Treatment Intents Value Set (required)
extension:terminationReason		0..1	TreatmentTerminationReason	Not used in this profile
extension:modalityAndTechnique	O	0..*	RadiotherapyModalityAndTechnique	Radiotherapy Modality And Technique Extension Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:actualNumberOfSessions	O	1..1	RadiotherapySessions	Radiotherapy Number of Sessions Extension Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:doseDeliveredToVolume	O	0..*	RadiotherapyDoseDeliveredToVolume	Radiotherapy Dose Delivered To Volume Extension Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:therapyLine	O	0..1	Reference(Therapy Line Profile)	Reference to the therapy line associated with this treatment URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-therapy-line-reference Obligations Actor MAY:ignore Creator (Onconova) MAY:persist Consumer (Onconova)
instantiatesCanonical		0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Not used in this profile
instantiatesUri		0..*	uri	Not used in this profile
basedOn		0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	Not used in this profile
partOf		0..*	Reference(Procedure | Observation | MedicationAdministration)	Not used in this profile
status		1..1	code	Not used in this profile
statusReason	O	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reasons Value Set (required) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
subject	O	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
performed[x]	O	0..1	Period	The time period over which the radiotherapy course was performed Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
recorder		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
asserter		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
performer		0..*	BackboneElement	Not used in this profile
location		0..1	Reference(Location)	Not used in this profile
reasonCode		0..*	CodeableConcept	Not used in this profile
reasonReference	O	1..*	Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile)	The condition(s) that motivated the radiotherapy treatment Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite		0..*	CodeableConcept	Not used in this profile
outcome		0..1	CodeableConcept	Not used in this profile
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Not used in this profile
complication		0..*	CodeableConcept	Not used in this profile
complicationDetail		0..*	Reference(Condition)	Not used in this profile
followUp		0..*	CodeableConcept	Not used in this profile
note		0..*	Annotation	Not used in this profile
focalDevice		0..*	BackboneElement	Not used in this profile
usedReference		0..*	Reference(Device | Medication | Substance)	Not used in this profile
usedCode		0..*	CodeableConcept	Not used in this profile
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Procedure.extension:treatmentIntent.​value[x]	Base	required	Treatment Intents Value Set	📦0.2.0	This IG
Procedure.statusReason	Base	required	Treatment Termination Reasons Value Set	📦0.2.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
o-rad-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-rad-req-2	error	Procedure	The performedPeriod element is required and must be provided.	performedPeriod.exists()
o-rad-req-3	error	Procedure	The actualNumberOfSessions extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists()
o-rad-req-4	error	Procedure	The treatmentIntent extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: us-core-7, termination-reason-code-invariant, termination-reason-invariant, mcode-reason-required, o-rad-req-1, o-rad-req-2, o-rad-req-3, o-rad-req-4
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. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension	S	2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:treatmentIntent	SO	1..1	(Complex)	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent"
value[x]		1..1	CodeableConcept	Value of extension Binding: Treatment Intents Value Set (required)
extension:terminationReason		0..1	CodeableConcept	Not used in this profile URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:modalityAndTechnique	SOC	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Constraints: TechniquesForNeutronBeamModality, TechniquesForPhotonBeamModality, TechniquesForElectronBeamModality, TechniquesForCarbonIonBeamModality, TechniquesForProtonBeamModality, TechniquesForInternalRadiotherapyPermanentSeeds, TechniquesForLowDoseRateUsingTempRadSource, TechniquesForPulsedDoseRate, TechniquesForHighDoseRate, TechniquesForHighDoseRateElectronic, TechniquesForRadioPharmaceutical, ModalityTextRequiredForOther, TechniqueTextRequiredForOther Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:actualNumberOfSessions	SO	1..1	unsignedInt	Radiotherapy Number of Sessions Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:doseDeliveredToVolume	SO	0..*	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:therapyLine	SO	0..1	Reference(Therapy Line Profile)	Reference to the therapy line associated with this treatment URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-therapy-line-reference Obligations Actor MAY:ignore Creator (Onconova) MAY:persist Consumer (Onconova)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Not used in this profile
instantiatesUri	Σ	0..*	uri	Not used in this profile
basedOn	Σ	0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	Not used in this profile
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Not used in this profile
status	?!SΣC	1..1	code	Not used in this profile Binding: EventStatus (required)
statusReason	SOΣ	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reasons Value Set (required) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
performed[x]	SOΣC	0..1	Period	The time period over which the radiotherapy course was performed Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
performer	Σ	0..*	BackboneElement	Not used in this profile
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Not used in this profile
reasonCode	SΣ	0..*	CodeableConcept	Not used in this profile Binding: Cancer Disorder Value Set (extensible)
reasonReference	SOΣ	1..*	Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile)	The condition(s) that motivated the radiotherapy treatment Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite	SΣ	0..*	CodeableConcept	Not used in this profile Binding: Radiotherapy Treatment Location Value Set (extensible)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:locationQualifier		0..*	CodeableConcept	General location qualifier (excluding laterality) for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier		0..1	CodeableConcept	Laterality qualifier for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	Not used in this profile Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Not used in this profile
complication		0..*	CodeableConcept	Not used in this profile Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	Not used in this profile
followUp		0..*	CodeableConcept	Not used in this profile Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Not used in this profile
focalDevice		0..*	BackboneElement	Not used in this profile
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
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Not used in this profile
usedCode		0..*	CodeableConcept	Not used in this profile Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Procedure.extension:treatmentIntent.​value[x]	Base	required	Treatment Intents Value Set	📦0.2.0	This IG
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	required	Treatment Termination Reasons Value Set	📦0.2.0	This IG
Procedure.category	Base	example	Procedure Category Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
Procedure.performer.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	extensible	Radiotherapy Treatment Location Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.outcome	Base	example	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📦4.0.1	FHIR Std.
Procedure.followUp	Base	example	Procedure Follow up Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.focalDevice.​action	Base	preferred	Procedure Device Action Codes	📦4.0.1	FHIR Std.
Procedure.usedCode	Base	example	FHIR Device Types	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
ModalityTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
TechniqueTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
TechniquesForCarbonIonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Carbon Ion Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
TechniquesForElectronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Electron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
TechniquesForHighDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForHighDoseRateElectronic	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate Electronic	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForInternalRadiotherapyPermanentSeeds	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Internal Radiotherapy - Permanent Seeds	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
TechniquesForLowDoseRateUsingTempRadSource	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Low Dose Rate Using Temp Radiation Source	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
TechniquesForNeutronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Neutron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
TechniquesForPhotonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Photon Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
TechniquesForProtonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Proton Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
TechniquesForPulsedDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Pulsed Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
TechniquesForRadioPharmaceutical	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Radiopharmaceutical	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	error	Procedure	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	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mcode-reason-required	warning	Procedure	One of reasonCode or reasonReference SHALL be present	reasonCode.exists() or reasonReference.exists()
o-rad-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-rad-req-2	error	Procedure	The performedPeriod element is required and must be provided.	performedPeriod.exists()
o-rad-req-3	error	Procedure	The actualNumberOfSessions extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists()
o-rad-req-4	error	Procedure	The treatmentIntent extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()
termination-reason-code-invariant	error	Procedure	When status is stopped, only certain statusReason values are allowed	status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	Procedure	Certain statusReason values are allowed only when status is stopped	statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

This structure is derived from RadiotherapyCourseSummary

Summary

Mandatory: 3 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-cancer-patient)
• Primary Cancer Condition Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-primary-cancer-condition)
• Secondary Cancer Condition Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-secondary-cancer-condition)

Extensions

This structure refers to these extensions:

• http://onconova.github.io/fhir/StructureDefinition/onconova-ext-therapy-line-reference

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: us-core-7, termination-reason-code-invariant, termination-reason-invariant, mcode-reason-required, o-rad-req-1, o-rad-req-2, o-rad-req-3, o-rad-req-4
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:treatmentIntent	SO	1..1	(Complex)	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent"
value[x]		1..1	CodeableConcept	Value of extension Binding: Treatment Intents Value Set (required)
extension:terminationReason		0..1	CodeableConcept	Not used in this profile URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:modalityAndTechnique	SOC	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Constraints: TechniquesForNeutronBeamModality, TechniquesForPhotonBeamModality, TechniquesForElectronBeamModality, TechniquesForCarbonIonBeamModality, TechniquesForProtonBeamModality, TechniquesForInternalRadiotherapyPermanentSeeds, TechniquesForLowDoseRateUsingTempRadSource, TechniquesForPulsedDoseRate, TechniquesForHighDoseRate, TechniquesForHighDoseRateElectronic, TechniquesForRadioPharmaceutical, ModalityTextRequiredForOther, TechniqueTextRequiredForOther Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:actualNumberOfSessions	SO	1..1	unsignedInt	Radiotherapy Number of Sessions Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:doseDeliveredToVolume	SO	0..*	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:therapyLine	SO	0..1	Reference(Therapy Line Profile)	Reference to the therapy line associated with this treatment URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-therapy-line-reference Obligations Actor MAY:ignore Creator (Onconova) MAY:persist Consumer (Onconova)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Not used in this profile
instantiatesUri	Σ	0..*	uri	Not used in this profile
basedOn	Σ	0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	Not used in this profile
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Not used in this profile
status	?!SΣC	1..1	code	Not used in this profile Binding: EventStatus (required)
statusReason	SOΣ	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reasons Value Set (required) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
performed[x]	SOΣC	0..1	Period	The time period over which the radiotherapy course was performed Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
performer	Σ	0..*	BackboneElement	Not used in this profile
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
location	Σ	0..1	Reference(Location)	Not used in this profile
reasonCode	SΣ	0..*	CodeableConcept	Not used in this profile Binding: Cancer Disorder Value Set (extensible)
reasonReference	SOΣ	1..*	Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile)	The condition(s) that motivated the radiotherapy treatment Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite	SΣ	0..*	CodeableConcept	Not used in this profile Binding: Radiotherapy Treatment Location Value Set (extensible)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	CodeableConcept	General location qualifier (excluding laterality) for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier		0..1	CodeableConcept	Laterality qualifier for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required)
outcome	Σ	0..1	CodeableConcept	Not used in this profile Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Not used in this profile
complication		0..*	CodeableConcept	Not used in this profile Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	Not used in this profile
followUp		0..*	CodeableConcept	Not used in this profile Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Not used in this profile
focalDevice		0..*	BackboneElement	Not used in this profile
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Not used in this profile
usedCode		0..*	CodeableConcept	Not used in this profile Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.extension:treatmentIntent.​value[x]	Base	required	Treatment Intents Value Set	📦0.2.0	This IG
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	required	Treatment Termination Reasons Value Set	📦0.2.0	This IG
Procedure.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	extensible	Radiotherapy Treatment Location Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.outcome	Base	example	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📦4.0.1	FHIR Std.
Procedure.followUp	Base	example	Procedure Follow up Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.usedCode	Base	example	FHIR Device Types	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
ModalityTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
TechniqueTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
TechniquesForCarbonIonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Carbon Ion Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
TechniquesForElectronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Electron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
TechniquesForHighDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForHighDoseRateElectronic	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate Electronic	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForInternalRadiotherapyPermanentSeeds	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Internal Radiotherapy - Permanent Seeds	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
TechniquesForLowDoseRateUsingTempRadSource	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Low Dose Rate Using Temp Radiation Source	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
TechniquesForNeutronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Neutron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
TechniquesForPhotonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Photon Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
TechniquesForProtonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Proton Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
TechniquesForPulsedDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Pulsed Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
TechniquesForRadioPharmaceutical	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Radiopharmaceutical	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	error	Procedure	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	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mcode-reason-required	warning	Procedure	One of reasonCode or reasonReference SHALL be present	reasonCode.exists() or reasonReference.exists()
o-rad-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-rad-req-2	error	Procedure	The performedPeriod element is required and must be provided.	performedPeriod.exists()
o-rad-req-3	error	Procedure	The actualNumberOfSessions extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists()
o-rad-req-4	error	Procedure	The treatmentIntent extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()
termination-reason-code-invariant	error	Procedure	When status is stopped, only certain statusReason values are allowed	status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	Procedure	Certain statusReason values are allowed only when status is stopped	statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

Differential View

This structure is derived from RadiotherapyCourseSummary

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: o-rad-req-1, o-rad-req-2, o-rad-req-3, o-rad-req-4
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:treatmentIntent	O	1..1	ProcedureIntent	Procedure Intent Extension Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
value[x]		1..1	CodeableConcept	Value of extension Binding: Treatment Intents Value Set (required)
extension:terminationReason		0..1	TreatmentTerminationReason	Not used in this profile
extension:modalityAndTechnique	O	0..*	RadiotherapyModalityAndTechnique	Radiotherapy Modality And Technique Extension Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:actualNumberOfSessions	O	1..1	RadiotherapySessions	Radiotherapy Number of Sessions Extension Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:doseDeliveredToVolume	O	0..*	RadiotherapyDoseDeliveredToVolume	Radiotherapy Dose Delivered To Volume Extension Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:therapyLine	O	0..1	Reference(Therapy Line Profile)	Reference to the therapy line associated with this treatment URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-therapy-line-reference Obligations Actor MAY:ignore Creator (Onconova) MAY:persist Consumer (Onconova)
instantiatesCanonical		0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Not used in this profile
instantiatesUri		0..*	uri	Not used in this profile
basedOn		0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	Not used in this profile
partOf		0..*	Reference(Procedure | Observation | MedicationAdministration)	Not used in this profile
status		1..1	code	Not used in this profile
statusReason	O	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reasons Value Set (required) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
subject	O	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
performed[x]	O	0..1	Period	The time period over which the radiotherapy course was performed Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
recorder		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
asserter		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
performer		0..*	BackboneElement	Not used in this profile
location		0..1	Reference(Location)	Not used in this profile
reasonCode		0..*	CodeableConcept	Not used in this profile
reasonReference	O	1..*	Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile)	The condition(s) that motivated the radiotherapy treatment Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite		0..*	CodeableConcept	Not used in this profile
outcome		0..1	CodeableConcept	Not used in this profile
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Not used in this profile
complication		0..*	CodeableConcept	Not used in this profile
complicationDetail		0..*	Reference(Condition)	Not used in this profile
followUp		0..*	CodeableConcept	Not used in this profile
note		0..*	Annotation	Not used in this profile
focalDevice		0..*	BackboneElement	Not used in this profile
usedReference		0..*	Reference(Device | Medication | Substance)	Not used in this profile
usedCode		0..*	CodeableConcept	Not used in this profile
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Procedure.extension:treatmentIntent.​value[x]	Base	required	Treatment Intents Value Set	📦0.2.0	This IG
Procedure.statusReason	Base	required	Treatment Termination Reasons Value Set	📦0.2.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
o-rad-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-rad-req-2	error	Procedure	The performedPeriod element is required and must be provided.	performedPeriod.exists()
o-rad-req-3	error	Procedure	The actualNumberOfSessions extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists()
o-rad-req-4	error	Procedure	The treatmentIntent extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	RadiotherapyCourseSummary	An action that is being or was performed on a patient Constraints: us-core-7, termination-reason-code-invariant, termination-reason-invariant, mcode-reason-required, o-rad-req-1, o-rad-req-2, o-rad-req-3, o-rad-req-4
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. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension	S	2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:treatmentIntent	SO	1..1	(Complex)	Procedure Intent Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent"
value[x]		1..1	CodeableConcept	Value of extension Binding: Treatment Intents Value Set (required)
extension:terminationReason		0..1	CodeableConcept	Not used in this profile URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-termination-reason Binding: Treatment Termination Reason Value Set (extensible)
extension:modalityAndTechnique	SOC	0..*	(Complex)	Radiotherapy Modality And Technique Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality-and-technique Constraints: TechniquesForNeutronBeamModality, TechniquesForPhotonBeamModality, TechniquesForElectronBeamModality, TechniquesForCarbonIonBeamModality, TechniquesForProtonBeamModality, TechniquesForInternalRadiotherapyPermanentSeeds, TechniquesForLowDoseRateUsingTempRadSource, TechniquesForPulsedDoseRate, TechniquesForHighDoseRate, TechniquesForHighDoseRateElectronic, TechniquesForRadioPharmaceutical, ModalityTextRequiredForOther, TechniqueTextRequiredForOther Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:actualNumberOfSessions	SO	1..1	unsignedInt	Radiotherapy Number of Sessions Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:doseDeliveredToVolume	SO	0..*	(Complex)	Radiotherapy Dose Delivered To Volume Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:therapyLine	SO	0..1	Reference(Therapy Line Profile)	Reference to the therapy line associated with this treatment URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-therapy-line-reference Obligations Actor MAY:ignore Creator (Onconova) MAY:persist Consumer (Onconova)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Not used in this profile
instantiatesUri	Σ	0..*	uri	Not used in this profile
basedOn	Σ	0..*	Reference(US Core CarePlan Profile | US Core ServiceRequest Profile)	Not used in this profile
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Not used in this profile
status	?!SΣC	1..1	code	Not used in this profile Binding: EventStatus (required)
statusReason	SOΣ	0..1	CodeableConcept	Reason for current status Binding: Treatment Termination Reasons Value Set (required) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1217123003
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who the procedure was performed on Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Encounter created as part of
performed[x]	SOΣC	0..1	Period	The time period over which the radiotherapy course was performed Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Not used in this profile
performer	Σ	0..*	BackboneElement	Not used in this profile
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Not used in this profile
reasonCode	SΣ	0..*	CodeableConcept	Not used in this profile Binding: Cancer Disorder Value Set (extensible)
reasonReference	SOΣ	1..*	Reference(Primary Cancer Condition Profile | Secondary Cancer Condition Profile)	The condition(s) that motivated the radiotherapy treatment Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite	SΣ	0..*	CodeableConcept	Not used in this profile Binding: Radiotherapy Treatment Location Value Set (extensible)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:locationQualifier		0..*	CodeableConcept	General location qualifier (excluding laterality) for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier		0..1	CodeableConcept	Laterality qualifier for this bodySite URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	Not used in this profile Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Not used in this profile
complication		0..*	CodeableConcept	Not used in this profile Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	Not used in this profile
followUp		0..*	CodeableConcept	Not used in this profile Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note		0..*	Annotation	Not used in this profile
focalDevice		0..*	BackboneElement	Not used in this profile
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
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Not used in this profile
usedCode		0..*	CodeableConcept	Not used in this profile Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Procedure.extension:treatmentIntent.​value[x]	Base	required	Treatment Intents Value Set	📦0.2.0	This IG
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	required	Treatment Termination Reasons Value Set	📦0.2.0	This IG
Procedure.category	Base	example	Procedure Category Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.code	Base	extensible	US Core Procedure Codes	📦6.1.0	US Core v6.1
Procedure.performer.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	extensible	Radiotherapy Treatment Location Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.outcome	Base	example	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📦4.0.1	FHIR Std.
Procedure.followUp	Base	example	Procedure Follow up Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.focalDevice.​action	Base	preferred	Procedure Device Action Codes	📦4.0.1	FHIR Std.
Procedure.usedCode	Base	example	FHIR Device Types	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
ModalityTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.text.exists()
TechniqueTextRequiredForOther	error	Procedure.extension:modalityAndTechnique	Require a text literal for code other	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(system = 'http://terminology.hl7.org/CodeSystem/v3-NullFlavor' and code = 'UNC') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.text.exists()
TechniquesForCarbonIonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Carbon Ion Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156505006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code='1204242009')
TechniquesForElectronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Electron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '45643008') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1163157007')
TechniquesForHighDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '394902000') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = ' 1156383000' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForHighDoseRateElectronic	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for High Dose Rate Electronic	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '438629002') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '1156382005' or code = '113120007' or code = '384691004' or code = '168524008' or code = '14473006')
TechniquesForInternalRadiotherapyPermanentSeeds	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Internal Radiotherapy - Permanent Seeds	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '169359004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '113120007')
TechniquesForLowDoseRateUsingTempRadSource	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Low Dose Rate Using Temp Radiation Source	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156708005') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007' or code = '14473006')
TechniquesForNeutronBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Neutron Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '80347004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '169317000' or code = '1162782007')
TechniquesForPhotonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Photon Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156506007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '441799006' or code = '1156530009' or code = '1162782007' or code = '1156526006' or code = '168524008' or code = '1156530009' or code = '1163157007')
TechniquesForProtonBeamModality	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Proton Beam Modality	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '10611004') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '1156529004' or code = '1156528007' or code = '1204242009' or code = '1163157007')
TechniquesForPulsedDoseRate	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Pulsed Dose Rate	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '1156384006') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '384692006' or code = '113120007')
TechniquesForRadioPharmaceutical	error	Procedure.extension:modalityAndTechnique	Allowed Techniques for Radiopharmaceutical	extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality').value.coding.exists(system = 'http://snomed.info/sct' and code = '440252007') implies extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.exists() and extension.where(url = 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique').value.coding.exists(code = 'UNC' or code = '16560241000119104' or code = '1156383000' or code = '384692006' or code = '113120007')
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	error	Procedure	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	error	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mcode-reason-required	warning	Procedure	One of reasonCode or reasonReference SHALL be present	reasonCode.exists() or reasonReference.exists()
o-rad-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-rad-req-2	error	Procedure	The performedPeriod element is required and must be provided.	performedPeriod.exists()
o-rad-req-3	error	Procedure	The actualNumberOfSessions extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions').exists()
o-rad-req-4	error	Procedure	The treatmentIntent extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-procedure-intent').exists()
termination-reason-code-invariant	error	Procedure	When status is stopped, only certain statusReason values are allowed	status = 'stopped' and statusReason.exists() and statusReason.coding.exists() implies statusReason.coding.exists(system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006'))
termination-reason-invariant	error	Procedure	Certain statusReason values are allowed only when status is stopped	statusReason.exists() and statusReason.coding.exists( system = 'http://snomed.info/sct' and (code = '182992009' or code = '266721009' or code = '407563006' or code = '160932005' or code = '105480006' or code = '184081006' or code = '309846006' or code = '399307001' or code = '419620001' or code = '7058009' or code = '443729008' or code = '77386006')) implies status = 'stopped'
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

This structure is derived from RadiotherapyCourseSummary

Summary

Mandatory: 3 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-cancer-patient)
• Primary Cancer Condition Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-primary-cancer-condition)
• Secondary Cancer Condition Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-secondary-cancer-condition)

Extensions

This structure refers to these extensions:

• http://onconova.github.io/fhir/StructureDefinition/onconova-ext-therapy-line-reference