{ "resourceType": "StructureDefinition", "id": "NHSEngland-Condition-GenomicsmCODE", "url": "https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-GenomicsmCODE", "version": "0.3.0", "name": "NHSEngland_Condition_GenomicsmCODE", "title": "NHSEngland Condition 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 [Primary Cancer Condition](http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-primary-cancer-condition).", "purpose": "For detailing any Condition related information about the proband/consultands within a test order.\r\n\r\nIt is expected that the information used to populate this resource SHOULD be sourced from the requesters EHR system. As such, there is no limit on the amount of detail that can be provided, though at a minimum the code and subject fields SHOULD be populated.\r\n\r\nIt is also highly preferred if the verificationStatus, onsetDateTime, recordedDate, recorded and abatementDateTime are populated if applicable/known.\r\n\r\nThe primary condition, being tested for SHOULD be referenced via ServiceRequest.reasonReference, additional relevant conditions SHOULD be referenced via ServiceRequest.supportingInfo.\r\n\r\nWhere worflows do not require any additional condition related information apart from the clinical indication/test package code, the Condition resource is not required to be included.\r\n\r\nFor representing metastatic sites vs. primary sites, the mCODE guidance SHOULD be followed, whereby the metastatic site SHOULD be referenced using an additional Condition resource, related to the primary condition using the Condition-related extension", "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": "Condition", "baseDefinition": "http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-primary-cancer-condition", "derivation": "constraint", "differential": { "element": [ { "id": "Condition.extension:conditionRelated", "path": "Condition.extension", "sliceName": "conditionRelated", "type": [ { "code": "Extension", "profile": [ "http://hl7.org/fhir/StructureDefinition/condition-related" ] } ], "isModifier": false }, { "id": "Condition.extension:conditionRelated.value[x]", "path": "Condition.extension.value[x]", "definition": "Extension developed by mCODE to relate a Condition representing a metastatic site with a primary Condition.", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.nhs.uk/StructureDefinition/NHSEngland-Condition-mCODE", "http://hl7.org/fhir/StructureDefinition/Condition" ], "aggregation": [ "referenced", "bundled" ] } ] }, { "id": "Condition.clinicalStatus", "path": "Condition.clinicalStatus", "min": 1 }, { "id": "Condition.verificationStatus", "path": "Condition.verificationStatus", "min": 1 }, { "id": "Condition.category:ukcoreCategory", "path": "Condition.category", "sliceName": "ukcoreCategory", "binding": { "strength": "extensible", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCategory" } }, { "id": "Condition.code", "path": "Condition.code", "definition": "SHOULD be present. SNOMED CT coding is preferred, though alternative codings MAY be provided where the code is not present in SNOMED CT, e.g. more specific test directory Test Package codes MAY be used." }, { "id": "Condition.code.coding", "path": "Condition.code.coding", "slicing": { "discriminator": [ { "type": "pattern", "path": "$this" } ], "rules": "open" } }, { "id": "Condition.code.coding:codingSnomedCT", "path": "Condition.code.coding", "sliceName": "codingSnomedCT", "binding": { "strength": "preferred", "description": "A code from the SNOMED Clinical Terminology UK with the expression (<404684003 |Clinical finding| OR <413350009 |Finding with explicit context| OR <272379006 |Event|).", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-ConditionCode" } }, { "id": "Condition.code.coding:codingSnomedCT.system", "path": "Condition.code.coding.system", "fixedUri": "http://snomed.info/sct" }, { "id": "Condition.code.coding:codingDGTS", "path": "Condition.code.coding", "sliceName": "codingDGTS" }, { "id": "Condition.code.coding:codingDGTS.system", "path": "Condition.code.coding.system", "fixedUri": "https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory" }, { "id": "Condition.bodySite.extension:bodyStructureReference", "path": "Condition.bodySite.extension", "sliceName": "bodyStructureReference", "definition": "Within the bodySite element, if topography and morphology information is required, user SHOULD use the bodySite extension to reference a BodyStructure resource. For collection of body structure information for primary and secondary tumours separately, these should be referenced from conditions associated with the primary and secondary tumour respectively.", "type": [ { "code": "Extension", "profile": [ "http://hl7.org/fhir/StructureDefinition/bodySite" ] } ], "isModifier": false }, { "id": "Condition.subject", "path": "Condition.subject", "definition": "SHALL be present. Reference to the associated Patient. This MAY be through a resource reference if the ID on the central service is known (or provided within the transaction bundle) or through NHS number where this is known and has been traced through PDS" }, { "id": "Condition.recorder", "path": "Condition.recorder", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ], "aggregation": [ "referenced", "bundled" ] } ] }, { "id": "Condition.asserter", "path": "Condition.asserter", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.nhs.uk/StructureDefinition/NHSEngland-PractitionerRole-Genomics", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ], "aggregation": [ "referenced", "bundled" ] } ] }, { "id": "Condition.note", "path": "Condition.note", "definition": "For recording additional information regarding the condition where this does not fit into the structured fields or cannot be structured due to the way this information has been recorded in source systems." } ] } }