<status value="draft" /> <experimental value="false" /> <date value="2023-11-06T01:23:00-08:00" /> <description value="This profile represents the constraints applied to the Procedure resource by the PS-CA project, which is informed by the constraints of the [Procedure IPS-UV profile](http://hl7.org/fhir/uv/ips/StructureDefinition-Procedure-uv-ips.html) and the [Canadian Baseline Profile](http://build.fhir.org/ig/HL7-Canada/ca-baseline/branches/master/StructureDefinition-profile-procedure.html) to allow for cross-border and cross-jurisdiction sharing of History of Procedure information." /> <copyright value="Copyright © 2021,2022 Canada Health Infoway. All rights reserved. [Terms of Use and License Agreements](https://ic.infoway-inforoute.ca/en/about/tou). [Privacy Policy](https://www.infoway-inforoute.ca/en/legal/privacy-policy)." /> <fhirVersion value="4.0.1" /> <kind value="resource" /> <abstract value="false" /> <type value="Procedure" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Procedure" /> <derivation value="constraint" /> <differential> <element id="Procedure.status"> <path value="Procedure.status" /> <mustSupport value="true" /> </element> <element id="Procedure.code"> <path value="Procedure.code" /> <definition value="Identification of the procedure or recording of "absence of relevant procedures" or of "procedures unknown"." /> <comment value="Many Canadian implementations use codes from either SNOMED CT and the SNOMED CT Canada Extension to describe this concept, while others may still be using localized code systems or text descriptions. The Procedures - IPS ValueSet contains codes that are subsumed within the SNOMED CT CA ProcedureCode ValueSet that is preferred for this element. Future releases of PS-CA may require use of coded entries. In this release, however, implementations that support codings are encouraged to send the codings for codeable concepts if they are available. Consistent with FHIR best practice, receivers should not produce failures or rejections if codings are received. Vendors should expect that some jurisdictions may further constrain support of this element within the context of their own jurisdictional content." /> <min value="1" /> <max value="1" /> <type> <code value="CodeableConcept" /> <profile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" /> </type> <mustSupport value="true" /> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="ProcedureCode" /> </extension> <extension url="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/additional-binding-test"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/CCI" /> </extension> <extension url="documentation"> <valueMarkdown value="While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology. Any code from CCI." /> </extension> </extension> <extension url="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/additional-binding-test"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="http://fhir.infoway-inforoute.ca/io/psca/ValueSet/ICD9CM" /> </extension> <extension url="documentation"> <valueMarkdown value="While not the preferred terminology for broader pan-Canadian exchange use cases, this additional binding is surfaced to socialize the value sets that may be more commonly in use. Where multiple codings can be supplied, it is encouraged to supply the original coding alongside the pan-Canadian preferred terminology. Any code from ICD-9 CM." /> </extension> <extension url="shortDoco"> <valueString value="ICD 9 CM Codes" /> </extension> </extension> <extension url="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/additional-binding-test"> <extension url="purpose"> <valueCode value="candidate" /> </extension> <extension url="valueSet"> <valueCanonical value="http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-procedures-uv-ips" /> </extension> <extension url="documentation"> <valueMarkdown value="Code to identify absent or unknown procedures." /> </extension> </extension> <strength value="preferred" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/procedurecode" /> </binding> </element> <element id="Procedure.subject"> <path value="Procedure.subject" /> <definition value="The person on which the procedure was performed." /> <type> <code value="Reference" /> <targetProfile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/patient-ca-ps" /> </type> <mustSupport value="true" /> </element> <element id="Procedure.subject.reference"> <path value="Procedure.subject.reference" /> <min value="1" /> <mustSupport value="true" /> </element> <element id="Procedure.performed[x]"> <path value="Procedure.performed[x]" /> <min value="1" /> <max value="1" /> <mustSupport value="true" /> </element> <element id="Procedure.performed[x].extension"> <path value="Procedure.performed[x].extension" /> <slicing> <discriminator> <type value="value" /> <path value="url" /> </discriminator> <rules value="open" /> </slicing> </element> <element id="Procedure.performed[x].extension:data-absent-reason"> <path value="Procedure.performed[x].extension" /> <sliceName value="data-absent-reason" /> <short value="performed[x] absence reason" /> <definition value="Provides a reason why the performed is missing." /> <comment value="Some Canadian implementations cannot guarantee that a procedure performed date will always be available in every instance of legacy data. Any implementers who do not require a performed date be available on every procedure need to be able to produce a dataAbsentReason extension in order to be conformant" /> <max value="1" /> <type> <code value="Extension" /> <profile value="http://hl7.org/fhir/StructureDefinition/data-absent-reason" /> </type> </element> <element id="Procedure.bodySite"> <path value="Procedure.bodySite" /> <comment value="IPS-UV no longer flags this as a Must Support Element. It is not currently flagged as Must Support in PS-CA, as stakeholders have indicated the element may not be supported by the majority of systems today. Systems that do support the element are encouraged to include it in generated Patient Summary documents, and support it when received." /> <type> <code value="CodeableConcept" /> <profile value="http://fhir.infoway-inforoute.ca/io/psca/StructureDefinition/CodeableConcept-ca-ps" /> </type> <binding> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName"> <valueString value="BodySite" /> </extension> <strength value="preferred" /> <valueSet value="https://fhir.infoway-inforoute.ca/ValueSet/anatomicaloracquiredbodystructurecode" /> </binding> </element> </differential> </StructureDefinition>