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: Surgical Procedure Profile

A profile representing a surgical procedure performed on a cancer patient, including details about the procedure, its intent, and relevant dates.

It extends the base mCODE CancerRelatedSurgicalProcedure profile to include specific constraints and requirements for Onconova.

Conformance:

Procedure resources representing a surgery 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..*	CancerRelatedSurgicalProcedure	An action that is being or was performed on a patient Constraints: us-core-7, mcode-reason-required, o-sur-req-1, o-sur-req-2, o-sur-req-3, o-sur-req-4
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	1..*	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: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
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	Σ	0..1	CodeableConcept	Not used in this profile Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
code	SOΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: Surgical Procedures Value Set (required) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
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)	Not used in this profile
performed[x]	SOΣC	0..1	dateTime S	The date on which the surgical procedure 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 surgical procedure Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite	SΣ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:locationQualifier	S	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	S	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	SOΣ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (required) Obligations Actor SHOULD:populate-if-available Creator (Onconova) MAY:persist Consumer (Onconova)
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.
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	example	Procedure Not Performed Reason (SNOMED-CT)	📦4.0.1	FHIR Std.
Procedure.code	Base	required	Surgical Procedures Value Set	📦0.2.0	This IG
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Procedure.outcome	Base	required	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
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-sur-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-sur-req-2	error	Procedure	The performedDateTime element is required and must be provided.	performedDateTime.exists() and performedDateTime.hasValue()
o-sur-req-3	error	Procedure	The code element is required and must be provided.	code.exists() and code.coding.exists()
o-sur-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()
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 CancerRelatedSurgicalProcedure

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	CancerRelatedSurgicalProcedure	An action that is being or was performed on a patient Constraints: o-sur-req-1, o-sur-req-2, o-sur-req-3, o-sur-req-4
extension		1..*	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: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)
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		0..1	CodeableConcept	Not used in this profile
code	O	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: Surgical Procedures Value Set (required) Obligations Actor SHALL:populate 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)
encounter		0..1	Reference(Encounter)	Not used in this profile
performed[x]	O	0..1	dateTime	The date on which the surgical procedure 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 surgical procedure Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
outcome	SO	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (required) Obligations Actor SHOULD:populate-if-available Creator (Onconova) MAY:persist Consumer (Onconova)
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
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.code	Base	required	Surgical Procedures Value Set	📦0.2.0	This IG
Procedure.outcome	Base	required	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
o-sur-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-sur-req-2	error	Procedure	The performedDateTime element is required and must be provided.	performedDateTime.exists() and performedDateTime.hasValue()
o-sur-req-3	error	Procedure	The code element is required and must be provided.	code.exists() and code.coding.exists()
o-sur-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..*	CancerRelatedSurgicalProcedure	An action that is being or was performed on a patient Constraints: us-core-7, mcode-reason-required, o-sur-req-1, o-sur-req-2, o-sur-req-3, o-sur-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	1..*	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: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)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
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	Σ	0..1	CodeableConcept	Not used in this profile Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
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	SOΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: Surgical Procedures Value Set (required) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
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)	Not used in this profile
performed[x]	SOΣC	0..1	dateTime S	The date on which the surgical procedure 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 surgical procedure Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite	SΣ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
id		0..1	string	Unique id for inter-element referencing
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:locationQualifier	S	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	S	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	SOΣ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (required) Obligations Actor SHOULD:populate-if-available Creator (Onconova) MAY:persist Consumer (Onconova)
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	Additional information about the procedure
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	example	Procedure Not Performed Reason (SNOMED-CT)	📦4.0.1	FHIR Std.
Procedure.category	Base	example	Procedure Category Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.code	Base	required	Surgical Procedures Value Set	📦0.2.0	This IG
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	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Procedure.outcome	Base	required	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
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-sur-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-sur-req-2	error	Procedure	The performedDateTime element is required and must be provided.	performedDateTime.exists() and performedDateTime.hasValue()
o-sur-req-3	error	Procedure	The code element is required and must be provided.	code.exists() and code.coding.exists()
o-sur-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()
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 CancerRelatedSurgicalProcedure

Summary

Mandatory: 3 elements
Must-Support: 1 element

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..*	CancerRelatedSurgicalProcedure	An action that is being or was performed on a patient Constraints: us-core-7, mcode-reason-required, o-sur-req-1, o-sur-req-2, o-sur-req-3, o-sur-req-4
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	1..*	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: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
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	Σ	0..1	CodeableConcept	Not used in this profile Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
code	SOΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: Surgical Procedures Value Set (required) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
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)	Not used in this profile
performed[x]	SOΣC	0..1	dateTime S	The date on which the surgical procedure 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 surgical procedure Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite	SΣ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:locationQualifier	S	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	S	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	SOΣ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (required) Obligations Actor SHOULD:populate-if-available Creator (Onconova) MAY:persist Consumer (Onconova)
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.
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	example	Procedure Not Performed Reason (SNOMED-CT)	📦4.0.1	FHIR Std.
Procedure.code	Base	required	Surgical Procedures Value Set	📦0.2.0	This IG
Procedure.reasonCode	Base	extensible	Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Procedure.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Procedure.outcome	Base	required	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
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-sur-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-sur-req-2	error	Procedure	The performedDateTime element is required and must be provided.	performedDateTime.exists() and performedDateTime.hasValue()
o-sur-req-3	error	Procedure	The code element is required and must be provided.	code.exists() and code.coding.exists()
o-sur-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()
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 CancerRelatedSurgicalProcedure

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	CancerRelatedSurgicalProcedure	An action that is being or was performed on a patient Constraints: o-sur-req-1, o-sur-req-2, o-sur-req-3, o-sur-req-4
extension		1..*	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: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)
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		0..1	CodeableConcept	Not used in this profile
code	O	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: Surgical Procedures Value Set (required) Obligations Actor SHALL:populate 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)
encounter		0..1	Reference(Encounter)	Not used in this profile
performed[x]	O	0..1	dateTime	The date on which the surgical procedure 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 surgical procedure Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
outcome	SO	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (required) Obligations Actor SHOULD:populate-if-available Creator (Onconova) MAY:persist Consumer (Onconova)
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
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.code	Base	required	Surgical Procedures Value Set	📦0.2.0	This IG
Procedure.outcome	Base	required	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
o-sur-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-sur-req-2	error	Procedure	The performedDateTime element is required and must be provided.	performedDateTime.exists() and performedDateTime.hasValue()
o-sur-req-3	error	Procedure	The code element is required and must be provided.	code.exists() and code.coding.exists()
o-sur-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..*	CancerRelatedSurgicalProcedure	An action that is being or was performed on a patient Constraints: us-core-7, mcode-reason-required, o-sur-req-1, o-sur-req-2, o-sur-req-3, o-sur-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	1..*	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: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)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
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	Σ	0..1	CodeableConcept	Not used in this profile Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
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	SOΣ	1..1	CodeableConcept	(USCDI) Identification of the procedure Binding: Surgical Procedures Value Set (required) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
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)	Not used in this profile
performed[x]	SOΣC	0..1	dateTime S	The date on which the surgical procedure 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 surgical procedure Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
bodySite	SΣ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
id		0..1	string	Unique id for inter-element referencing
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:locationQualifier	S	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	S	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	SOΣ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (required) Obligations Actor SHOULD:populate-if-available Creator (Onconova) MAY:persist Consumer (Onconova)
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	Additional information about the procedure
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	example	Procedure Not Performed Reason (SNOMED-CT)	📦4.0.1	FHIR Std.
Procedure.category	Base	example	Procedure Category Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.code	Base	required	Surgical Procedures Value Set	📦0.2.0	This IG
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	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Procedure.outcome	Base	required	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
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-sur-req-1	error	Procedure	The subject element is required and must be provided.	subject.exists()
o-sur-req-2	error	Procedure	The performedDateTime element is required and must be provided.	performedDateTime.exists() and performedDateTime.hasValue()
o-sur-req-3	error	Procedure	The code element is required and must be provided.	code.exists() and code.coding.exists()
o-sur-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()
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 CancerRelatedSurgicalProcedure

Summary

Mandatory: 3 elements
Must-Support: 1 element

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

Other representations of profile: CSV, Excel, Schematron