StructureDefinition NHSEngland-BodyStructure-GenomicsmCODE

Only required where additional elements regarding the body site need to be captured, e.g. histology/morphology. If a simple SNOMED CT anatomical location code is sufficient, this SHOULD be captured in Specimen.bodySite.

For metastatic sites vs. primary, the Condition resource SHOULD be used instead, following guidance from the mCode FHIR IG

The Genomics BodyStructure is currently based on the Minimum Common Oncology Data Elements (mCODE) version of the resource as a profile for BodyStructure does not exist in UKCore.

Profile url FHIR Module Normative Status
https://fhir.nhs.uk/StructureDefinition/NHSEngland-BodyStructure-GenomicsmCODE NHS England Genomics trial-use

Usage

Use of this resource is meant to replace the Genomics extensions for topology and morphology on the Specimen profile

Canonical_URLStatusCurrent_VersionLast_UpdatedDescription
https://fhir.nhs.uk/StructureDefinition/NHSEngland-BodyStructure-GenomicsmCODEactive0.3.02026-04-16

This profile defines the Genomics constraints and extensions on the mCODE FHIR resource Tumour BodyStructure.


Tree View

idΣ0..1id
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
id0..1string
extensionC0..0Extension
url1..1uriFixed Value
valueReferenceReference(USCoreConditionProblemsHealthConcernsProfile)
modifierExtension?! C0..*Extension
bodyStructureIdentifierΣ1..*BodyStructureIdentifier
activeΣ ?!0..1boolean
morphologyS Σ0..1CodeableConceptBinding
locationS Σ1..1CodeableConceptBinding
locationQualifierS0..*CodeableConceptBinding
descriptionΣ0..1string
imageC0..*Attachment
patientS Σ C1..1Reference(CancerPatient | NHSEngland_Patient_Genomics)

Detailed Descriptions

BodyStructure
ShortSpecific and identified anatomical structure
Definition

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

Cardinality0..*
Aliasanatomical location
Constraints
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
  • dom-6: A resource should have narrative for robust management
    text.`div`.exists()
  • dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    contained.meta.security.empty()
Mappings
  • rim: Entity. Role, or Act
  • rim: ActSIte
  • openehr: Archetype ID openEHR-EHR-CLUSTER.anatomical_location.v1 Concept name Anatomical Location Concept description Record details about an anatomical location. Keywords location, site, anatomical Copyright © openEHR Foundation Purpose To record details about anatomical location. Misuse Not for specifiying unilateral/bilateral occurrence - this is related to an evaluation which perhaps includes multiple locations. Author Author name: Heather Leslie Organization: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10 Translator Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh Other contributors Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK References Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail.
BodyStructure.id
ShortLogical id of this artifact
Definition

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

Cardinality0..1
Typeid
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
BodyStructure.meta
ShortMetadata about the resource
Definition

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

Cardinality0..1
TypeMeta
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
BodyStructure.implicitRules
ShortA set of rules under which this content was created
Definition

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

Cardinality0..1
Typeuri
ModifierTrue
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
BodyStructure.language
ShortLanguage of the resource content
Definition

The base language in which the resource is written.

Cardinality0..1
Typecode
Binding

A human language.

CommonLanguages (preferred)

Binding extensions
maxValueSetAllLanguages
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
BodyStructure.text
ShortText summary of the resource, for human interpretation
Definition

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

Cardinality0..1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
BodyStructure.contained
ShortContained, inline Resources
Definition

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

Cardinality0..*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

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

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
BodyStructure.extension
ShortAdditional content defined by implementations
Definition

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

Cardinality0..*
TypeExtension
Must SupportTrue
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
BodyStructure.extension:relatedCondition
ShortReference to cancer condition associated with this tumor
Definition

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

Cardinality0..1
TypeExtension(CodeableConceptReference(Condition))
Must SupportTrue
Aliasextensions, user content
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
BodyStructure.extension:relatedCondition.id
ShortUnique id for inter-element referencing
Definition

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

Cardinality0..1
Typestring
Mappings
  • rim: n/a
BodyStructure.extension:relatedCondition.extension
ShortAdditional content defined by implementations
Definition

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

Cardinality0..0
TypeExtension
Aliasextensions, user content
Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
BodyStructure.extension:relatedCondition.url
Shortidentifies the meaning of the extension
Definition

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

Cardinality1..1
Typeuri
Comments

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

Fixed Value
http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition
Mappings
  • rim: N/A
BodyStructure.extension:relatedCondition.value[x]
ShortValue of extension
Definition

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

Cardinality1..1
TypeReference(USCoreConditionProblemsHealthConcernsProfile)
Must SupportTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
BodyStructure.modifierExtension
ShortExtensions that cannot be ignored
Definition

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

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

Cardinality0..*
TypeExtension
ModifierTrue
Aliasextensions, user content
Requirements

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

Comments

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

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
BodyStructure.identifier
ShortStable identifier(s) for this tumor
Definition

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

Cardinality1..*
TypeIdentifier
Must SupportTrue
SummaryTrue
Comments

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

Slicing

Unordered, Open, by type(Value)

Slice containing at least one tumor identifier

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • rim: .id
  • openehr: Specific location Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)
BodyStructure.identifier:bodyStructureIdentifier
ShortA persistent identifier of this tumor.
Definition

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

Cardinality1..*
TypeBodyStructureIdentifier
SummaryTrue
ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • w5: FiveWs.identifier
  • rim: .id
  • openehr: Specific location Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)
BodyStructure.active
ShortWhether this record is in active use
Definition

Whether this body site is in active use.

Cardinality0..1
Typeboolean
ModifierTrue
SummaryTrue
Requirements

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

Comments

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

Meaning when missing

This resource is generally assumed to be active if no value is provided for the active element

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.status
  • rim: statusCode
BodyStructure.morphology
ShortKind of Structure
Definition

SHALL be provided where relevant. SHOULD use SNOMED CT encoding. SHOULD use a code under the 14799000 | Neoplasm, metastatic (morphologic abnormality) concept if the sample has been collected from a metastatic site, as opposed to primary.

Cardinality0..1
TypeCodeableConcept
Binding

Codes describing anatomic morphology.

TumorMorphologyCodeVS (extensible)

Binding extensions
maxValueSetTumorMorphologyCodeMaxVS
Must SupportTrue
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • v2: SPM-4/SPM-5
BodyStructure.location
ShortBody site
Definition

SHALL be provided where relevant. SHOULD use SNOMED CT encoding. Equivalent to Topography when used in conjunction with locationQualifier.

Cardinality1..1
TypeCodeableConcept
Binding

Codes describing anatomical locations. May include laterality.

CancerBodyLocationVS (extensible)

Must SupportTrue
SummaryTrue
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • v2: OBX-20/SPM-8/SPM-10
  • rim: .targetSiteCode
  • openehr: Name of location
BodyStructure.locationQualifier
ShortBody site modifier
Definition

SHALL be provided where relevant. SHOULD use SNOMED CT encoding.

Cardinality0..*
TypeCodeableConcept
Binding

Concepts modifying the anatomic location.

BodyLocationAndLateralityQualifierVS (required)

Must SupportTrue
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • w5: FiveWs.what[x]
  • v2: No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies./SPM-9
  • rim: .targetSiteCode
  • openehr: Combines Side, Numerical identifier, Anatomical plane,and Aspect
BodyStructure.description
ShortText description
Definition

A summary, characterization or explanation of the body structure.

Cardinality0..1
Typestring
SummaryTrue
Comments

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

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
Mappings
  • rim: n/a
  • w5: FiveWs.what[x]
  • v2: NTE
  • rim: .text
  • openehr: Description of anatomical location/Visual markings/orientation
BodyStructure.image
ShortAttached images
Definition

Image or images used to identify a location.

Cardinality0..*
TypeAttachment
Comments

When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent".

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • att-1: If the Attachment has data, it SHALL have a contentType
    data.empty() or contentType.exists()
Mappings
  • rim: n/a
  • v2: ED/RP
  • rim: ED
  • w5: FiveWs.what[x]
  • v2: OBX
  • rim: outboundRelationship[typeCode=COMP].target
  • openehr: Image
BodyStructure.patient
ShortWho this is about
Definition

The patient associated with this tumor.

Cardinality1..1
TypeReference(CancerPatient | NHSEngland_Patient_Genomics)
Must SupportTrue
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1
Constraints
  • ele-1: All FHIR elements must have a @value or children
    hasValue() or (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • w5: FiveWs.subject[x]
  • v2: PID-3
  • rim: .scoper or .scoper.playsRole
  • w5: FiveWs.subject

Table View

BodyStructure0..*
BodyStructure.idid0..1
BodyStructure.metaMeta0..1
BodyStructure.implicitRulesuri0..1
BodyStructure.languagecode0..1
BodyStructure.textNarrative0..1
BodyStructure.containedResource0..*
BodyStructure.extensionExtension0..*
BodyStructure.extension:relatedConditionExtension0..1
BodyStructure.extension:relatedCondition.idstring0..1
BodyStructure.extension:relatedCondition.extensionExtension0..0
BodyStructure.extension:relatedCondition.urluri1..1
BodyStructure.extension:relatedCondition.value[x]Reference(USCoreConditionProblemsHealthConcernsProfile)1..1
BodyStructure.modifierExtensionExtension0..*
BodyStructure.identifierIdentifier1..*
BodyStructure.identifier:bodyStructureIdentifierBodyStructureIdentifier1..*
BodyStructure.activeboolean0..1
BodyStructure.morphologyCodeableConcept0..1
BodyStructure.locationCodeableConcept1..1
BodyStructure.locationQualifierCodeableConcept0..*
BodyStructure.descriptionstring0..1
BodyStructure.imageAttachment0..*
BodyStructure.patientReference(CancerPatient | NHSEngland_Patient_Genomics)1..1

XML View

<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="NHSEngland-BodyStructure-GenomicsmCODE" />
<url value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-BodyStructure-GenomicsmCODE" />
<version value="0.3.0" />
<name value="NHSEngland_BodyStructure_GenomicsmCODE" />
<title value="NHSEngland BodyStructure GenomicsmCODE" />
<status value="active" />
<date value="2026-04-16" />
<publisher value="NHS England" />
<name value="NHS England" />
<system value="email" />
<value value="interoperabilityteam@nhs.net" />
<use value="work" />
<rank value="1" />
</telecom>
</contact>
<description value="This profile defines the Genomics constraints and extensions on the mCODE FHIR resource [Tumour BodyStructure](http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor)." />
<purpose value="Only required where additional elements regarding the body site need to be captured, e.g. histology/morphology. If a simple SNOMED CT anatomical location code is sufficient, this SHOULD be captured in Specimen.bodySite.\n\nFor metastatic sites vs. primary, the Condition resource SHOULD be used instead, following guidance from the mCode FHIR IG" />
<copyright value="Copyright © 2026+ NHS England Licensed under the Apache License, Version 2.0 (the \\\"License\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\"AS IS\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html." />
<fhirVersion value="4.0.1" />
<kind value="resource" />
<abstract value="false" />
<type value="BodyStructure" />
<baseDefinition value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor" />
<derivation value="constraint" />
<element id="BodyStructure">
<path value="BodyStructure" />
<short value="Specific and identified anatomical structure" />
<definition value="Record details about an anatomical structure. This resource may be used when a coded concept does not provide the necessary detail needed for the use case." />
<alias value="anatomical location" />
<min value="0" />
<max value="*" />
<path value="BodyStructure" />
<min value="0" />
<max value="*" />
</base>
<key value="dom-2" />
<severity value="error" />
<human value="If the resource is contained in another resource, it SHALL NOT contain nested Resources" />
<expression value="contained.contained.empty()" />
<xpath value="not(parent::f:contained and f:contained)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-4" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated" />
<expression value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-3" />
<severity value="error" />
<human value="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" />
<expression value="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()" />
<xpath value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
<valueBoolean value="true" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
<valueMarkdown value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." />
</extension>
<key value="dom-6" />
<severity value="warning" />
<human value="A resource should have narrative for robust management" />
<expression value="text.`div`.exists()" />
<xpath value="exists(f:text/h:div)" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<key value="dom-5" />
<severity value="error" />
<human value="If a resource is contained in another resource, it SHALL NOT have a security label" />
<expression value="contained.meta.security.empty()" />
<xpath value="not(exists(f:contained/*/f:meta/f:security))" />
<source value="http://hl7.org/fhir/StructureDefinition/DomainResource" />
</constraint>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<identity value="rim" />
<map value="ActSIte" />
</mapping>
<identity value="openehr" />
<map value="Archetype ID openEHR-EHR-CLUSTER.anatomical_location.v1 Concept name Anatomical Location Concept description Record details about an anatomical location. Keywords location, site, anatomical Copyright © openEHR Foundation Purpose To record details about anatomical location. Misuse Not for specifiying unilateral/bilateral occurrence - this is related to an evaluation which perhaps includes multiple locations. Author Author name: Heather Leslie Organization: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10 Translator Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh Other contributors Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK References Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail." />
</mapping>
</element>
<element id="BodyStructure.id">
<path value="BodyStructure.id" />
<short value="Logical id of this artifact" />
<definition value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes." />
<comment value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation." />
<min value="0" />
<max value="1" />
<path value="Resource.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id" />
</extension>
<code value="id" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="BodyStructure.meta">
<path value="BodyStructure.meta" />
<short value="Metadata about the resource" />
<definition value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource." />
<min value="0" />
<max value="1" />
<path value="Resource.meta" />
<min value="0" />
<max value="1" />
</base>
<code value="Meta" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="BodyStructure.implicitRules">
<path value="BodyStructure.implicitRules" />
<short value="A set of rules under which this content was created" />
<definition value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc." />
<comment value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc." />
<min value="0" />
<max value="1" />
<path value="Resource.implicitRules" />
<min value="0" />
<max value="1" />
</base>
<code value="uri" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="BodyStructure.language">
<path value="BodyStructure.language" />
<short value="Language of the resource content" />
<definition value="The base language in which the resource is written." />
<comment value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)." />
<min value="0" />
<max value="1" />
<path value="Resource.language" />
<min value="0" />
<max value="1" />
</base>
<code value="code" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="Language" />
</extension>
<strength value="preferred" />
<description value="A human language." />
<valueSet value="http://hl7.org/fhir/ValueSet/languages" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="BodyStructure.text">
<path value="BodyStructure.text" />
<short value="Text summary of the resource, for human interpretation" />
<definition value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety." />
<comment value="Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later." />
<alias value="narrative" />
<alias value="html" />
<alias value="xhtml" />
<alias value="display" />
<min value="0" />
<max value="1" />
<path value="DomainResource.text" />
<min value="0" />
<max value="1" />
</base>
<code value="Narrative" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
<identity value="rim" />
<map value="Act.text?" />
</mapping>
</element>
<element id="BodyStructure.contained">
<path value="BodyStructure.contained" />
<short value="Contained, inline Resources" />
<definition value="These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope." />
<comment value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels." />
<alias value="inline resources" />
<alias value="anonymous resources" />
<alias value="contained resources" />
<min value="0" />
<max value="*" />
<path value="DomainResource.contained" />
<min value="0" />
<max value="*" />
</base>
<code value="Resource" />
</type>
<identity value="rim" />
<map value="Entity. Role, or Act" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="BodyStructure.extension">
<path value="BodyStructure.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<ordered value="false" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mustSupport value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="BodyStructure.extension:relatedCondition">
<path value="BodyStructure.extension" />
<sliceName value="relatedCondition" />
<short value="Reference to cancer condition associated with this tumor" />
<definition value="Associates this tumor with a cancer condition. This could be a causal association (e.g., this is believed to be the primary tumor causing the cancer) or a different type of relationship (e.g., this tumor is a metastasis)" />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="1" />
<path value="DomainResource.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
<profile value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<mustSupport value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="BodyStructure.extension:relatedCondition.id">
<path value="BodyStructure.extension.id" />
<representation value="xmlAttr" />
<short value="Unique id for inter-element referencing" />
<definition value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces." />
<min value="0" />
<max value="1" />
<path value="Element.id" />
<min value="0" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="string" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<identity value="rim" />
<map value="n/a" />
</mapping>
</element>
<element id="BodyStructure.extension:relatedCondition.extension">
<path value="BodyStructure.extension.extension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Additional content defined by implementations" />
<definition value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="0" />
<path value="Element.extension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="BodyStructure.extension:relatedCondition.url">
<path value="BodyStructure.extension.url" />
<representation value="xmlAttr" />
<short value="identifies the meaning of the extension" />
<definition value="Source of the definition for the extension code - a logical name or a URL." />
<comment value="The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension." />
<min value="1" />
<max value="1" />
<path value="Extension.url" />
<min value="1" />
<max value="1" />
</base>
<extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="uri" />
</extension>
<code value="http://hl7.org/fhirpath/System.String" />
</type>
<fixedUri value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition" />
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="BodyStructure.extension:relatedCondition.value[x]">
<path value="BodyStructure.extension.value[x]" />
<short value="Value of extension" />
<definition value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list)." />
<min value="1" />
<max value="1" />
<path value="Extension.value[x]" />
<min value="0" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="BodyStructure.modifierExtension">
<path value="BodyStructure.modifierExtension" />
<type value="value" />
<path value="url" />
</discriminator>
<description value="Extensions are always sliced by (at least) url" />
<rules value="open" />
</slicing>
<short value="Extensions that cannot be ignored" />
<definition value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)." />
<comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone." />
<requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension)." />
<alias value="extensions" />
<alias value="user content" />
<min value="0" />
<max value="*" />
<path value="DomainResource.modifierExtension" />
<min value="0" />
<max value="*" />
</base>
<code value="Extension" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ext-1" />
<severity value="error" />
<human value="Must have either extensions or value[x], not both" />
<expression value="extension.exists() != value.exists()" />
<xpath value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Extension" />
</constraint>
<isModifier value="true" />
<isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="N/A" />
</mapping>
</element>
<element id="BodyStructure.identifier">
<path value="BodyStructure.identifier" />
<type value="value" />
<path value="type" />
</discriminator>
<description value="Slice containing at least one tumor identifier" />
<rules value="open" />
</slicing>
<short value="Stable identifier(s) for this tumor" />
<definition value="Stable identifier(s) for this specific tumor. The identifiers MUST be unique within the context of the referenced `CancerPatient`." />
<comment value="If applicable, an identifier should correspond to the physical tag inserted into the tumor during a procedure that is used for tracking the tumor by radiology and pathology." />
<min value="1" />
<max value="*" />
<path value="BodyStructure.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="rim" />
<map value=".id" />
</mapping>
<identity value="openehr" />
<map value="Specific location Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)" />
</mapping>
</element>
<element id="BodyStructure.identifier:bodyStructureIdentifier">
<path value="BodyStructure.identifier" />
<sliceName value="bodyStructureIdentifier" />
<short value="A persistent identifier of this tumor." />
<definition value="A persistent identifier used to identify and track the tumor over time. The identifier must be unique in the context of the patient." />
<min value="1" />
<max value="*" />
<path value="BodyStructure.identifier" />
<min value="0" />
<max value="*" />
</base>
<code value="Identifier" />
<profile value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-structure-identifier" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CX / EI (occasionally, more often EI maps to a resource id or a URL)" />
</mapping>
<identity value="rim" />
<map value="II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]" />
</mapping>
<identity value="servd" />
<map value="Identifier" />
</mapping>
<identity value="w5" />
<map value="FiveWs.identifier" />
</mapping>
<identity value="rim" />
<map value=".id" />
</mapping>
<identity value="openehr" />
<map value="Specific location Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)" />
</mapping>
</element>
<element id="BodyStructure.active">
<path value="BodyStructure.active" />
<short value="Whether this record is in active use" />
<definition value="Whether this body site is in active use." />
<comment value="This element is labeled as a modifier because it may be used to mark that the resource was created in error." />
<requirements value="Need to be able to mark a body site entry as not to be used because it was created in error." />
<min value="0" />
<max value="1" />
<path value="BodyStructure.active" />
<min value="0" />
<max value="1" />
</base>
<code value="boolean" />
</type>
<meaningWhenMissing value="This resource is generally assumed to be active if no value is provided for the active element" />
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isModifier value="true" />
<isModifierReason value="This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="w5" />
<map value="FiveWs.status" />
</mapping>
<identity value="rim" />
<map value="statusCode" />
</mapping>
</element>
<element id="BodyStructure.morphology">
<path value="BodyStructure.morphology" />
<short value="Kind of Structure" />
<definition value="SHALL be provided where relevant. SHOULD use SNOMED CT encoding. SHOULD use a code under the `14799000 | Neoplasm, metastatic (morphologic abnormality)` concept if the sample has been collected from a metastatic site, as opposed to primary." />
<comment value="The minimum cardinality of 0 supports the use case of specifying a location without defining a morphology." />
<min value="0" />
<max value="1" />
<path value="BodyStructure.morphology" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="BodyStructureCode" />
</extension>
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
<valueCanonical value="http://hl7.org/fhir/us/mcode/ValueSet/mcode-tumor-morphology-code-max-vs" />
</extension>
<strength value="extensible" />
<description value="Codes describing anatomic morphology." />
<valueSet value="http://hl7.org/fhir/us/mcode/ValueSet/mcode-tumor-morphology-code-vs" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<identity value="v2" />
<map value="SPM-4/SPM-5" />
</mapping>
</element>
<element id="BodyStructure.location">
<path value="BodyStructure.location" />
<short value="Body site" />
<definition value="SHALL be provided where relevant. SHOULD use SNOMED CT encoding. Equivalent to Topography when used in conjunction with locationQualifier." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
<min value="1" />
<max value="1" />
<path value="BodyStructure.location" />
<min value="0" />
<max value="1" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="BodySite" />
</extension>
<strength value="extensible" />
<description value="Codes describing anatomical locations. May include laterality." />
<valueSet value="http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<identity value="v2" />
<map value="OBX-20/SPM-8/SPM-10" />
</mapping>
<identity value="rim" />
<map value=".targetSiteCode" />
</mapping>
<identity value="openehr" />
<map value="Name of location" />
</mapping>
</element>
<element id="BodyStructure.locationQualifier">
<path value="BodyStructure.locationQualifier" />
<short value="Body site modifier" />
<definition value="SHALL be provided where relevant. SHOULD use SNOMED CT encoding." />
<comment value="Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination." />
<min value="0" />
<max value="*" />
<path value="BodyStructure.locationQualifier" />
<min value="0" />
<max value="*" />
</base>
<code value="CodeableConcept" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<mustSupport value="true" />
<extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
<valueString value="BodyStructureQualifier" />
</extension>
<strength value="required" />
<description value="Concepts modifying the anatomic location." />
<valueSet value="http://hl7.org/fhir/us/mcode/ValueSet/mcode-body-location-and-laterality-qualifier-vs" />
</binding>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="CE/CNE/CWE" />
</mapping>
<identity value="rim" />
<map value="CD" />
</mapping>
<identity value="orim" />
<map value="fhir:CodeableConcept rdfs:subClassOf dt:CD" />
</mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<identity value="v2" />
<map value="No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies./SPM-9" />
</mapping>
<identity value="rim" />
<map value=".targetSiteCode" />
</mapping>
<identity value="openehr" />
<map value="Combines Side, Numerical identifier, Anatomical plane,and Aspect" />
</mapping>
</element>
<element id="BodyStructure.description">
<path value="BodyStructure.description" />
<short value="Text description" />
<definition value="A summary, characterization or explanation of the body structure." />
<comment value="This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings." />
<min value="0" />
<max value="1" />
<path value="BodyStructure.description" />
<min value="0" />
<max value="1" />
</base>
<code value="string" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<identity value="v2" />
<map value="NTE" />
</mapping>
<identity value="rim" />
<map value=".text" />
</mapping>
<identity value="openehr" />
<map value="Description of anatomical location/Visual markings/orientation" />
</mapping>
</element>
<element id="BodyStructure.image">
<path value="BodyStructure.image" />
<short value="Attached images" />
<definition value="Image or images used to identify a location." />
<comment value="When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as "Signed Procedure Consent"." />
<min value="0" />
<max value="*" />
<path value="BodyStructure.image" />
<min value="0" />
<max value="*" />
</base>
<code value="Attachment" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="att-1" />
<severity value="error" />
<human value="If the Attachment has data, it SHALL have a contentType" />
<expression value="data.empty() or contentType.exists()" />
<xpath value="not(exists(f:data)) or exists(f:contentType)" />
<source value="http://hl7.org/fhir/StructureDefinition/Attachment" />
</constraint>
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="v2" />
<map value="ED/RP" />
</mapping>
<identity value="rim" />
<map value="ED" />
</mapping>
<identity value="w5" />
<map value="FiveWs.what[x]" />
</mapping>
<identity value="v2" />
<map value="OBX" />
</mapping>
<identity value="rim" />
<map value="outboundRelationship[typeCode=COMP].target" />
</mapping>
<identity value="openehr" />
<map value="Image" />
</mapping>
</element>
<element id="BodyStructure.patient">
<path value="BodyStructure.patient" />
<short value="Who this is about" />
<definition value="The patient associated with this tumor." />
<comment value="References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository." />
<min value="1" />
<max value="1" />
<path value="BodyStructure.patient" />
<min value="1" />
<max value="1" />
</base>
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics" />
<targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
<condition value="ele-1" />
<key value="ele-1" />
<severity value="error" />
<human value="All FHIR elements must have a @value or children" />
<expression value="hasValue() or (children().count() > id.count())" />
<xpath value="@value|f:*|h:div" />
<source value="http://hl7.org/fhir/StructureDefinition/Element" />
</constraint>
<key value="ref-1" />
<severity value="error" />
<human value="SHALL have a contained resource if a local reference is provided" />
<expression value="reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))" />
<xpath value="not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])" />
<source value="http://hl7.org/fhir/StructureDefinition/Reference" />
</constraint>
<mustSupport value="true" />
<isSummary value="true" />
<identity value="rim" />
<map value="n/a" />
</mapping>
<identity value="rim" />
<map value="The target of a resource reference is a RIM entry point (Act, Role, or Entity)" />
</mapping>
<identity value="w5" />
<map value="FiveWs.subject[x]" />
</mapping>
<identity value="v2" />
<map value="PID-3" />
</mapping>
<identity value="rim" />
<map value=".scoper or .scoper.playsRole" />
</mapping>
<identity value="w5" />
<map value="FiveWs.subject" />
</mapping>
</element>
</snapshot>
<element id="BodyStructure.morphology">
<path value="BodyStructure.morphology" />
<definition value="SHALL be provided where relevant. SHOULD use SNOMED CT encoding. SHOULD use a code under the `14799000 | Neoplasm, metastatic (morphologic abnormality)` concept if the sample has been collected from a metastatic site, as opposed to primary." />
</element>
<element id="BodyStructure.location">
<path value="BodyStructure.location" />
<definition value="SHALL be provided where relevant. SHOULD use SNOMED CT encoding. Equivalent to Topography when used in conjunction with locationQualifier." />
</element>
<element id="BodyStructure.locationQualifier">
<path value="BodyStructure.locationQualifier" />
<definition value="SHALL be provided where relevant. SHOULD use SNOMED CT encoding." />
</element>
<element id="BodyStructure.patient">
<path value="BodyStructure.patient" />
<code value="Reference" />
<targetProfile value="https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics" />
<targetProfile value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient" />
<aggregation value="referenced" />
<aggregation value="bundled" />
</type>
</element>
</differential>
</StructureDefinition>

JSON View

{
"resourceType": "StructureDefinition",
"id": "NHSEngland-BodyStructure-GenomicsmCODE",
"url": "https://fhir.nhs.uk/StructureDefinition/NHSEngland-BodyStructure-GenomicsmCODE",
"version": "0.3.0",
"name": "NHSEngland_BodyStructure_GenomicsmCODE",
"title": "NHSEngland BodyStructure GenomicsmCODE",
"status": "active",
"date": "2026-04-16",
"publisher": "NHS England",
"contact": [
{
"name": "NHS England",
"telecom": [
{
"system": "email",
"value": "interoperabilityteam@nhs.net",
"use": "work",
"rank": 1
}
]
}
],
"description": "This profile defines the Genomics constraints and extensions on the mCODE FHIR resource [Tumour BodyStructure](http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor).",
"purpose": "Only required where additional elements regarding the body site need to be captured, e.g. histology/morphology. If a simple SNOMED CT anatomical location code is sufficient, this SHOULD be captured in Specimen.bodySite.\n\nFor metastatic sites vs. primary, the Condition resource SHOULD be used instead, following guidance from the mCode FHIR IG",
"copyright": "Copyright © 2026+ NHS England Licensed under the Apache License, Version 2.0 (the \\\\\\\"License\\\\\\\"); you may not use this file except in compliance with the License. You may obtain a copy of the License at http://www.apache.org/licenses/LICENSE-2.0 Unless required by applicable law or agreed to in writing, software distributed under the License is distributed on an \\\\\\\"AS IS\\\\\\\" BASIS, WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied. See the License for the specific language governing permissions and limitations under the License. HL7® FHIR® standard Copyright © 2011+ HL7 The HL7® FHIR® standard is used under the FHIR license. You may obtain a copy of the FHIR license at https://www.hl7.org/fhir/license.html.",
"fhirVersion": "4.0.1",
"kind": "resource",
"abstract": false,
"type": "BodyStructure",
"baseDefinition": "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor",
"derivation": "constraint",
"element": [
{
"id": "BodyStructure",
"path": "BodyStructure",
"short": "Specific and identified anatomical structure",
"definition": "Record details about an anatomical structure. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.",
"alias": [
"anatomical location"
],
"min": 0,
"max": "*",
"base": {
"path": "BodyStructure",
"min": 0,
"max": "*"
},
{
"key": "dom-2",
"severity": "error",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"expression": "contained.contained.empty()",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-4",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-3",
"severity": "error",
"human": "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",
"expression": "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()",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
}
],
"key": "dom-6",
"severity": "warning",
"human": "A resource should have narrative for robust management",
"expression": "text.`div`.exists()",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
},
{
"key": "dom-5",
"severity": "error",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"expression": "contained.meta.security.empty()",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "ActSIte"
},
{
"identity": "openehr",
"map": "Archetype ID openEHR-EHR-CLUSTER.anatomical_location.v1 Concept name Anatomical Location Concept description Record details about an anatomical location. Keywords location, site, anatomical Copyright © openEHR Foundation Purpose To record details about anatomical location. Misuse Not for specifiying unilateral/bilateral occurrence - this is related to an evaluation which perhaps includes multiple locations. Author Author name: Heather Leslie Organization: Ocean Informatics Email: heather.leslie@oceaninformatics.com Date of Origination: 2008-11-10 Translator Norwegian Bokmål: Lars Bitsch-Larsen, Haukeland University Hospital of Bergen, Norway, MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine. Arabic (Syria): Mona Saleh Other contributors Heather Leslie, Ocean Informatics, Australia (Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (Editor) Dunmail Hodkinson, Black Pear Software Ltd, UK References Use cases: - 5LICS, midclavicular line - L forearm, 2cm anterior to the cubital fossa - Right iliac fossa - 5 cm below L tibial tuberosity - 2 cm medial to R nipple - 4 cm below R costal margin in midclavicular line - R femur - midline nose - medial aspect of R great toe nail."
}
]
},
{
"id": "BodyStructure.id",
"path": "BodyStructure.id",
"short": "Logical id of this artifact",
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "id"
}
],
"code": "id"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "BodyStructure.meta",
"path": "BodyStructure.meta",
"short": "Metadata about the resource",
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.meta",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Meta"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "BodyStructure.implicitRules",
"path": "BodyStructure.implicitRules",
"short": "A set of rules under which this content was created",
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"min": 0,
"max": "1",
"base": {
"path": "Resource.implicitRules",
"min": 0,
"max": "1"
},
"type": [
{
"code": "uri"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "BodyStructure.language",
"path": "BodyStructure.language",
"short": "Language of the resource content",
"definition": "The base language in which the resource is written.",
"comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
"min": 0,
"max": "1",
"base": {
"path": "Resource.language",
"min": 0,
"max": "1"
},
"type": [
{
"code": "code"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}
],
"strength": "preferred",
"description": "A human language.",
"valueSet": "http://hl7.org/fhir/ValueSet/languages"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "BodyStructure.text",
"path": "BodyStructure.text",
"short": "Text summary of the resource, for human interpretation",
"definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
"comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
"alias": [
"narrative",
"html",
"xhtml",
"display"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.text",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Narrative"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
},
{
"identity": "rim",
"map": "Act.text?"
}
]
},
{
"id": "BodyStructure.contained",
"path": "BodyStructure.contained",
"short": "Contained, inline Resources",
"definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
"comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"alias": [
"inline resources",
"anonymous resources",
"contained resources"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.contained",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Resource"
}
],
"mapping": [
{
"identity": "rim",
"map": "Entity. Role, or Act"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "BodyStructure.extension",
"path": "BodyStructure.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"ordered": false,
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mustSupport": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "BodyStructure.extension:relatedCondition",
"path": "BodyStructure.extension",
"sliceName": "relatedCondition",
"short": "Reference to cancer condition associated with this tumor",
"definition": "Associates this tumor with a cancer condition. This could be a causal association (e.g., this is believed to be the primary tumor causing the cancer) or a different type of relationship (e.g., this tumor is a metastasis)",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "1",
"base": {
"path": "DomainResource.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension",
"profile": [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mustSupport": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "BodyStructure.extension:relatedCondition.id",
"path": "BodyStructure.extension.id",
"xmlAttr"
],
"short": "Unique id for inter-element referencing",
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"min": 0,
"max": "1",
"base": {
"path": "Element.id",
"min": 0,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
}
]
},
{
"id": "BodyStructure.extension:relatedCondition.extension",
"path": "BodyStructure.extension.extension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Additional content defined by implementations",
"definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "0",
"base": {
"path": "Element.extension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "BodyStructure.extension:relatedCondition.url",
"path": "BodyStructure.extension.url",
"xmlAttr"
],
"short": "identifies the meaning of the extension",
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
"min": 1,
"max": "1",
"base": {
"path": "Extension.url",
"min": 1,
"max": "1"
},
"type": [
{
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
}
],
"code": "http://hl7.org/fhirpath/System.String"
}
],
"fixedUri": "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition",
"mapping": [
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "BodyStructure.extension:relatedCondition.value[x]",
"path": "BodyStructure.extension.value[x]",
"short": "Value of extension",
"definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
"min": 1,
"max": "1",
"base": {
"path": "Extension.value[x]",
"min": 0,
"max": "1"
},
"type": [
{
"code": "Reference",
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition-problems-health-concerns"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "BodyStructure.modifierExtension",
"path": "BodyStructure.modifierExtension",
"slicing": {
{
"type": "value",
"path": "url"
}
],
"description": "Extensions are always sliced by (at least) url",
"rules": "open"
},
"short": "Extensions that cannot be ignored",
"definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"alias": [
"extensions",
"user content"
],
"min": 0,
"max": "*",
"base": {
"path": "DomainResource.modifierExtension",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Extension"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ext-1",
"severity": "error",
"human": "Must have either extensions or value[x], not both",
"expression": "extension.exists() != value.exists()",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension"
}
],
"isModifier": true,
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "N/A"
}
]
},
{
"id": "BodyStructure.identifier",
"path": "BodyStructure.identifier",
"slicing": {
{
"type": "value",
"path": "type"
}
],
"description": "Slice containing at least one tumor identifier",
"rules": "open"
},
"short": "Stable identifier(s) for this tumor",
"definition": "Stable identifier(s) for this specific tumor. The identifiers MUST be unique within the context of the referenced `CancerPatient`.",
"comment": "If applicable, an identifier should correspond to the physical tag inserted into the tumor during a procedure that is used for tracking the tumor by radiology and pathology.",
"min": 1,
"max": "*",
"base": {
"path": "BodyStructure.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".id"
},
{
"identity": "openehr",
"map": "Specific location Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)"
}
]
},
{
"id": "BodyStructure.identifier:bodyStructureIdentifier",
"path": "BodyStructure.identifier",
"sliceName": "bodyStructureIdentifier",
"short": "A persistent identifier of this tumor.",
"definition": "A persistent identifier used to identify and track the tumor over time. The identifier must be unique in the context of the patient.",
"min": 1,
"max": "*",
"base": {
"path": "BodyStructure.identifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Identifier",
"profile": [
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-structure-identifier"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)"
},
{
"identity": "rim",
"map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]"
},
{
"identity": "servd",
"map": "Identifier"
},
{
"identity": "w5",
"map": "FiveWs.identifier"
},
{
"identity": "rim",
"map": ".id"
},
{
"identity": "openehr",
"map": "Specific location Cluster Optional (0..1) Cardinality: Mandatory, repeating, unordered (1..*)"
}
]
},
{
"id": "BodyStructure.active",
"path": "BodyStructure.active",
"short": "Whether this record is in active use",
"definition": "Whether this body site is in active use.",
"comment": "This element is labeled as a modifier because it may be used to mark that the resource was created in error.",
"requirements": "Need to be able to mark a body site entry as not to be used because it was created in error.",
"min": 0,
"max": "1",
"base": {
"path": "BodyStructure.active",
"min": 0,
"max": "1"
},
"type": [
{
"code": "boolean"
}
],
"meaningWhenMissing": "This resource is generally assumed to be active if no value is provided for the active element",
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isModifier": true,
"isModifierReason": "This element is labelled as a modifier because it is a status element that can indicate that a record should not be treated as valid",
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "w5",
"map": "FiveWs.status"
},
{
"identity": "rim",
"map": "statusCode"
}
]
},
{
"id": "BodyStructure.morphology",
"path": "BodyStructure.morphology",
"short": "Kind of Structure",
"definition": "SHALL be provided where relevant. SHOULD use SNOMED CT encoding. SHOULD use a code under the `14799000 | Neoplasm, metastatic (morphologic abnormality)` concept if the sample has been collected from a metastatic site, as opposed to primary.",
"comment": "The minimum cardinality of 0 supports the use case of specifying a location without defining a morphology.",
"min": 0,
"max": "1",
"base": {
"path": "BodyStructure.morphology",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodyStructureCode"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/us/mcode/ValueSet/mcode-tumor-morphology-code-max-vs"
}
],
"strength": "extensible",
"description": "Codes describing anatomic morphology.",
"valueSet": "http://hl7.org/fhir/us/mcode/ValueSet/mcode-tumor-morphology-code-vs"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "SPM-4/SPM-5"
}
]
},
{
"id": "BodyStructure.location",
"path": "BodyStructure.location",
"short": "Body site",
"definition": "SHALL be provided where relevant. SHOULD use SNOMED CT encoding. Equivalent to Topography when used in conjunction with locationQualifier.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"min": 1,
"max": "1",
"base": {
"path": "BodyStructure.location",
"min": 0,
"max": "1"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"isSummary": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodySite"
}
],
"strength": "extensible",
"description": "Codes describing anatomical locations. May include laterality.",
"valueSet": "http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "OBX-20/SPM-8/SPM-10"
},
{
"identity": "rim",
"map": ".targetSiteCode"
},
{
"identity": "openehr",
"map": "Name of location"
}
]
},
{
"id": "BodyStructure.locationQualifier",
"path": "BodyStructure.locationQualifier",
"short": "Body site modifier",
"definition": "SHALL be provided where relevant. SHOULD use SNOMED CT encoding.",
"comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
"min": 0,
"max": "*",
"base": {
"path": "BodyStructure.locationQualifier",
"min": 0,
"max": "*"
},
"type": [
{
"code": "CodeableConcept"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"mustSupport": true,
"binding": {
{
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "BodyStructureQualifier"
}
],
"strength": "required",
"description": "Concepts modifying the anatomic location.",
"valueSet": "http://hl7.org/fhir/us/mcode/ValueSet/mcode-body-location-and-laterality-qualifier-vs"
},
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "CE/CNE/CWE"
},
{
"identity": "rim",
"map": "CD"
},
{
"identity": "orim",
"map": "fhir:CodeableConcept rdfs:subClassOf dt:CD"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "No distinct element defined in V2.x. The IHE Radiology Technical Framework directs the use of OBR-15-specimen source to contain laterality for imaging studies./SPM-9"
},
{
"identity": "rim",
"map": ".targetSiteCode"
},
{
"identity": "openehr",
"map": "Combines Side, Numerical identifier, Anatomical plane,and Aspect"
}
]
},
{
"id": "BodyStructure.description",
"path": "BodyStructure.description",
"short": "Text description",
"definition": "A summary, characterization or explanation of the body structure.",
"comment": "This description could include any visual markings used to orientate the viewer e.g. external reference points, special sutures, ink markings.",
"min": 0,
"max": "1",
"base": {
"path": "BodyStructure.description",
"min": 0,
"max": "1"
},
"type": [
{
"code": "string"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
}
],
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "NTE"
},
{
"identity": "rim",
"map": ".text"
},
{
"identity": "openehr",
"map": "Description of anatomical location/Visual markings/orientation"
}
]
},
{
"id": "BodyStructure.image",
"path": "BodyStructure.image",
"short": "Attached images",
"definition": "Image or images used to identify a location.",
"comment": "When providing a summary view (for example with Observation.value[x]) Attachment should be represented with a brief display text such as \"Signed Procedure Consent\".",
"min": 0,
"max": "*",
"base": {
"path": "BodyStructure.image",
"min": 0,
"max": "*"
},
"type": [
{
"code": "Attachment"
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "att-1",
"severity": "error",
"human": "If the Attachment has data, it SHALL have a contentType",
"expression": "data.empty() or contentType.exists()",
"xpath": "not(exists(f:data)) or exists(f:contentType)",
"source": "http://hl7.org/fhir/StructureDefinition/Attachment"
}
],
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "v2",
"map": "ED/RP"
},
{
"identity": "rim",
"map": "ED"
},
{
"identity": "w5",
"map": "FiveWs.what[x]"
},
{
"identity": "v2",
"map": "OBX"
},
{
"identity": "rim",
"map": "outboundRelationship[typeCode=COMP].target"
},
{
"identity": "openehr",
"map": "Image"
}
]
},
{
"id": "BodyStructure.patient",
"path": "BodyStructure.patient",
"short": "Who this is about",
"definition": "The patient associated with this tumor.",
"comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
"min": 1,
"max": "1",
"base": {
"path": "BodyStructure.patient",
"min": 1,
"max": "1"
},
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics",
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient"
],
"referenced",
"bundled"
]
}
],
"ele-1"
],
{
"key": "ele-1",
"severity": "error",
"human": "All FHIR elements must have a @value or children",
"expression": "hasValue() or (children().count() > id.count())",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element"
},
{
"key": "ref-1",
"severity": "error",
"human": "SHALL have a contained resource if a local reference is provided",
"expression": "reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))",
"xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
"source": "http://hl7.org/fhir/StructureDefinition/Reference"
}
],
"mustSupport": true,
"isSummary": true,
"mapping": [
{
"identity": "rim",
"map": "n/a"
},
{
"identity": "rim",
"map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)"
},
{
"identity": "w5",
"map": "FiveWs.subject[x]"
},
{
"identity": "v2",
"map": "PID-3"
},
{
"identity": "rim",
"map": ".scoper or .scoper.playsRole"
},
{
"identity": "w5",
"map": "FiveWs.subject"
}
]
}
]
},
"element": [
{
"id": "BodyStructure.morphology",
"path": "BodyStructure.morphology",
"definition": "SHALL be provided where relevant. SHOULD use SNOMED CT encoding. SHOULD use a code under the `14799000 | Neoplasm, metastatic (morphologic abnormality)` concept if the sample has been collected from a metastatic site, as opposed to primary."
},
{
"id": "BodyStructure.location",
"path": "BodyStructure.location",
"definition": "SHALL be provided where relevant. SHOULD use SNOMED CT encoding. Equivalent to Topography when used in conjunction with locationQualifier."
},
{
"id": "BodyStructure.locationQualifier",
"path": "BodyStructure.locationQualifier",
"definition": "SHALL be provided where relevant. SHOULD use SNOMED CT encoding."
},
{
"id": "BodyStructure.patient",
"path": "BodyStructure.patient",
"type": [
{
"code": "Reference",
"https://fhir.nhs.uk/StructureDefinition/NHSEngland-Patient-Genomics",
"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient"
],
"referenced",
"bundled"
]
}
]
}
]
}
}


FHIRMDSHL7v2
BodyStructure.morphologyPS-17 - Primary Sample - Solid tumour morphologyAdditional SPM-4/5 qualifiers
BodyStructure.locationPS-18 - Primary Sample - Solid tumour histological type (topography)SPM-8


Additional Guidance

morphology

SHALL be provided where relevant. SHOULD use SNOMED CT encoding. SHOULD use a code under the `14799000 | Neoplasm, metastatic (morphologic abnormality)` concept if the sample has been collected from a metastatic site, as opposed to primary.
"morphology": {
  "coding": [
    {
      "system": "http://snomed.info/sct",
      "code": "53618008",
      "display": "Pancreatoblastoma"
    }
  ]
},

location

SHALL be provided where relevant. SHOULD use SNOMED CT encoding. Equivalent to Topography when used in conjunction with locationQualifier.
"location": {
  "coding": [
    {
      "system": "http://snomed.info/sct",
      "code": "15776009",
      "display": "Pancreatic structure"
    }
  ]
},

locationQualifier

SHALL be provided where relevant. SHOULD use SNOMED CT encoding.
"locationQualifier": [
  {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "261183002",
        "display": "Upper"
      }
    ]
  }
],