HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU Ballot 1

HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU Ballot 1 - Local Development build (v0.9.1). See the Directory of published versions

PrimaryCancerCondition


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="onco-core-PrimaryCancerCondition"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
  <p><b>PrimaryCancerCondition Profile</b></p>
  <p>Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.

Cancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.

Conformance note: For the code attribute, to be compliant with [US Core Profiles](http://hl7.org/fhir/us/core/STU3/index.html), SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used.</p>
  <p><b>Mapping Summary</b></p>
  <p><pre>onco.core.PrimaryCancerCondition maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition:
  Language maps to language
  ImplicitRules maps to implicitRules
  Metadata.VersionId maps to meta.versionId
  Metadata.SourceSystem maps to meta.source
  Metadata.Profile maps to meta.profile
  Metadata.LastUpdated maps to meta.lastUpdated
  Metadata.SecurityLabel maps to meta.security
  Metadata.Tag maps to meta.tag
  Narrative maps to text
  Identifier maps to identifier
  ClinicalStatus maps to clinicalStatus
  Status maps to verificationStatus
  Category maps to category
  Severity maps to severity
  Code maps to code
  BodyLocation.Code maps to bodySite
  BodyLocation.Laterality maps to bodySite.extension
  BodyLocation.AnatomicalOrientation maps to bodySite.extension
  BodyLocation.RelationToLandmark maps to bodySite.extension
  SubjectOfRecord maps to subject
  CareContext maps to encounter
  Onset maps to onset[x]
  Abatement maps to abatement[x]
  StatementDateTime maps to recordedDate
  Author maps to recorder
  PractitionerInformationSource maps to asserter
  StageInformation maps to stage
  StageInformation.StageSummary maps to stage.summary
  StageInformation.StageDetail maps to stage.assessment
  StageInformation.Type maps to stage.type
  Evidence.Manifestation maps to evidence.code
  Evidence.Resource maps to evidence.detail
  Annotation maps to note
  DateOfDiagnosis maps to http://hl7.org/fhir/StructureDefinition/condition-assertedDate
</pre></p>
</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-PrimaryCancerCondition"/>
  <version value="0.9.1"/>
  <name value="PrimaryCancerCondition"/>
  <title value="onco-core-PrimaryCancerCondition"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2019-08-01T00:00:00-04:00"/>
  <publisher value="HL7 International Clinical Interoperability Council"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cic"/>
    </telecom>
  </contact>
  <description
               value="Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.

Cancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.

Conformance note: For the code attribute, to be compliant with [US Core Profiles](http://hl7.org/fhir/us/core/STU3/index.html), SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <fhirVersion value="4.0.0"/>
  <mapping>
    <identity value="argonaut-dq-dstu2"/>
    <uri value="http://unknown.org/Argonaut-DQ-DSTU2"/>
    <name value="Argonaut-DQ-DSTU2"/>
  </mapping>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Pattern"/>
  </mapping>
  <mapping>
    <identity value="sct-concept"/>
    <uri value="http://snomed.info/conceptdomain"/>
    <name value="SNOMED CT Concept Domain Binding"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <mapping>
    <identity value="sct-attr"/>
    <uri value="http://snomed.org/attributebinding"/>
    <name value="SNOMED CT Attribute Binding"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="Condition"/>
  <baseDefinition
                  value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition"/>
  <derivation value="constraint"/>
  <snapshot>
    <element id="Condition">
      <path value="Condition"/>
      <short value="onco-core-PrimaryCancerCondition"/>
      <definition
                  value="Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.

Cancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.

Conformance note: For the code attribute, to be compliant with [US Core Profiles](http://hl7.org/fhir/us/core/STU3/index.html), SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <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="DomainResource"/>
      </constraint>
      <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="DomainResource"/>
      </constraint>
      <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(((&#39;#&#39;+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists() or descendants().where(as(canonical) = &#39;#&#39;).exists()).not()).trace(&#39;unmatched&#39;, id).empty()"/>
        <xpath
               value="not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat(&#39;#&#39;, $contained/*/id/@value) or descendant::f:reference[@value=&#39;#&#39;])]))"/>
        <source value="DomainResource"/>
      </constraint>
      <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="DomainResource"/>
      </constraint>
      <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="DomainResource"/>
      </constraint>
      <constraint>
        <key value="con-5"/>
        <severity value="error"/>
        <human
               value="Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error"/>
        <expression
                    value="verificationStatus.coding.where(system=&#39;http://terminology.hl7.org/CodeSystem/condition-ver-status&#39; and code=&#39;entered-in-error&#39;).empty() or clinicalStatus.empty()"/>
        <xpath
               value="not(exists(f:verificationStatus/f:coding[f:system/@value=&#39;http://terminology.hl7.org/CodeSystem/condition-ver-status&#39; and f:code/@value=&#39;entered-in-error&#39;])) or not(exists(f:clinicalStatus))"/>
        <source value="Condition"/>
      </constraint>
      <constraint>
        <key value="con-4"/>
        <severity value="error"/>
        <human
               value="If condition is abated, then clinicalStatus must be either inactive, resolved, or remission"/>
        <expression
                    value="abatement.empty() or clinicalStatus.coding.where(system=&#39;http://terminology.hl7.org/CodeSystem/condition-clinical&#39; and (code=&#39;resolved&#39; or code=&#39;remission&#39; or code=&#39;inactive&#39;)).exists()"/>
        <xpath
               value="not(exists(*[starts-with(local-name(.), &#39;abatement&#39;)])) or exists(f:clinicalStatus/f:coding[f:system/@value=&#39;http://terminology.hl7.org/CodeSystem/condition-clinical&#39; and f:code/@value=(&#39;resolved&#39;, &#39;remission&#39;, &#39;inactive&#39;)])"/>
        <source value="Condition"/>
      </constraint>
      <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="Most systems will expect a clinicalStatus to be valued for problem-list-items that are managed over time, but might not need a clinicalStatus for point in time encounter-diagnosis."/>
        </extension>
        <key value="con-3"/>
        <severity value="warning"/>
        <human
               value="Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item"/>
        <expression
                    value="clinicalStatus.exists() or verificationStatus=&#39;entered-in-error&#39; or category.select($this=&#39;problem-list-item&#39;).empty()"/>
        <xpath
               value="exists(f:clinicalStatus) or f:verificationStatus/@value=&#39;entered-in-error&#39; or not(exists(category[@value=&#39;problem-list-item&#39;]))"/>
        <source value="Condition"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <key value="us-core-1"/>
        <severity value="warning"/>
        <human
               value="A code in Condition.category SHOULD be from US Core Condition Category Codes value set."/>
        <expression
                    value="where(category in &#39;http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category&#39;).exists()"/>
        <xpath value="(no xpath equivalent)"/>
      </constraint>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="sct-concept"/>
        <map
             value="&lt; 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( &lt; 404684003 |Clinical finding| MINUS ( &lt;&lt; 420134006 |Propensity to adverse reactions| OR &lt;&lt; 473010000 |Hypersensitivity condition| OR &lt;&lt; 79899007 |Drug interaction| OR &lt;&lt; 69449002 |Drug action| OR &lt;&lt; 441742003 |Evaluation finding| OR &lt;&lt; 307824009 |Administrative status| OR &lt;&lt; 385356007 |Tumor stage finding|)) OR &lt; 272379006 |Event|)"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PPR message"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value&lt;Diagnosis]"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition"/>
      </mapping>
    </element>
    <element id="Condition.id">
      <path value="Condition.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"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="id"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Condition.meta">
      <path value="Condition.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"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="Condition.implicitRules">
      <path value="Condition.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&#39;s narrative along with other profiles, value sets, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <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&#39;s meaning or interpretation"/>
      <isSummary value="true"/>
    </element>
    <element id="Condition.language">
      <path value="Condition.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"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <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>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding">
          <valueBoolean value="true"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages"/>
      </binding>
    </element>
    <element id="Condition.text">
      <path value="Condition.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 &quot;clinically safe&quot; 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 &quot;text blob&quot; 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"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="Condition.contained">
      <path value="Condition.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="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition.extension">
      <path value="Condition.extension"/>
      <slicing id="2">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <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="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition.extension:dateofdiagnosis">
      <path value="Condition.extension"/>
      <sliceName value="dateofdiagnosis"/>
      <definition
                  value="The date the disease was first clinically recognized with sufficient certainty, regardless of whether it was fully characterized at that time."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/condition-assertedDate"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.extension:histologymorphologybehavior">
      <path value="Condition.extension"/>
      <sliceName value="histologymorphologybehavior"/>
      <definition
                  value="A description of the morphologic and behavioral characteristics of the cancer."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-HistologyMorphologyBehavior-extension"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.modifierExtension">
      <path value="Condition.modifierExtension"/>
      <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&#39;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)."/>
      <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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition.identifier">
      <path value="Condition.identifier"/>
      <short value="External Ids for this condition"/>
      <definition
                  value="Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server."/>
      <comment
               value="This is a business identifier, not a resource identifier (see [discussion](http://hl7.org/fhir/R4/resource.html#identifiers)).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and a Person resource instance might share the same social insurance number."/>
      <requirements
                    value="Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".id"/>
      </mapping>
    </element>
    <element id="Condition.clinicalStatus">
      <path value="Condition.clinicalStatus"/>
      <short
             value="active | recurrence | relapse | inactive | remission | resolved"/>
      <definition value="The clinical status of the condition."/>
      <comment
               value="The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.clinicalStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-3"/>
      <condition value="con-4"/>
      <condition value="con-5"/>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because the status contains codes that mark the condition as no longer active."/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-clinical"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 303105007 |Disease phases|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Observation ACT
.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=&quot;clinicalStatus&quot;, moodCode=EVN].value"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.clinicalStatus"/>
      </mapping>
    </element>
    <element id="Condition.verificationStatus">
      <path value="Condition.verificationStatus"/>
      <short
             value="unconfirmed | provisional | differential | confirmed | refuted | entered-in-error"/>
      <definition
                  value="The verification status to support the clinical status of the condition."/>
      <comment
               value="verificationStatus is not required.  For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status.
The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.verificationStatus"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-3"/>
      <condition value="con-5"/>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid."/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-ver-status"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 410514004 |Finding context value|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-13"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Observation ACT
.inboundRelationship[typeCode=COMP].source[classCode=OBS, code=&quot;verificationStatus&quot;, moodCode=EVN].value"/>
      </mapping>
      <mapping>
        <identity value="sct-attr"/>
        <map value="408729009"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.verificationStatus"/>
      </mapping>
    </element>
    <element id="Condition.category">
      <path value="Condition.category"/>
      <short value="problem-list-item | encounter-diagnosis"/>
      <definition value="A category assigned to the condition."/>
      <comment
               value="The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.category"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 404684003 |Clinical finding|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="&#39;problem&#39; if from PRB-3. &#39;diagnosis&#39; if from DG1 segment in PV1 message"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".code"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.category"/>
      </mapping>
    </element>
    <element id="Condition.category.id">
      <path value="Condition.category.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"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.category.extension">
      <path value="Condition.category.extension"/>
      <slicing>
        <discriminator>
          <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="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.category.coding">
      <path value="Condition.category.coding"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="code"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Code defined by a terminology system"/>
      <definition value="A reference to a code defined by a terminology system."/>
      <comment
               value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/>
      <requirements
                    value="Allows for alternative encodings within a code system, and translations to other code systems."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element id="Condition.category.coding:Fixed_64572001">
      <path value="Condition.category.coding"/>
      <sliceName value="Fixed_64572001"/>
      <short value="Disease"/>
      <definition value="Disease"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.id">
      <path value="Condition.category.coding.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"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.extension">
      <path value="Condition.category.coding.extension"/>
      <slicing>
        <discriminator>
          <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="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.system">
      <path value="Condition.category.coding.system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comment
               value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7&#39;s list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <fixedUri value="http://snomed.info/sct"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.version">
      <path value="Condition.category.coding.version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/>
      <comment
               value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.version"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.code">
      <path value="Condition.category.coding.code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/>
      <requirements value="Need to refer to a particular code in the system."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <fixedCode value="64572001"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="Condition.category.coding.display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.userSelected">
      <path value="Condition.category.coding.userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
      <comment
               value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly &#39;directly chosen&#39; implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/>
      <requirements
                    value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.userSelected"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
    </element>
    <element id="Condition.category.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="Condition.category.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/>
      <comment
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element id="Condition.severity">
      <path value="Condition.severity"/>
      <short value="Subjective severity of condition"/>
      <definition
                  value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
      <comment
               value="Coding of the severity with a terminology is preferred, where possible."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Condition.severity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConditionSeverity"/>
        </extension>
        <strength value="preferred"/>
        <description
                     value="A subjective assessment of the severity of the condition as evaluated by the clinician."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-severity"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.grade"/>
      </mapping>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 272141005 |Severities|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-26 / ABS-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="Can be pre/post-coordinated into value.  Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;severity&quot;].value"/>
      </mapping>
      <mapping>
        <identity value="sct-attr"/>
        <map value="246112005"/>
      </mapping>
    </element>
    <element id="Condition.code">
      <path value="Condition.code"/>
      <short value="Identification of the condition, problem or diagnosis"/>
      <definition value="Identification of the condition, problem or diagnosis."/>
      <requirements
                    value="0..1 to account for primarily narrative only resources."/>
      <alias value="type"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://hl7.org/fhir/us/mcode/ValueSet/onco-core-PrimaryOrUncertainBehaviorCancerDisorderVS"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.what[x]"/>
      </mapping>
      <mapping>
        <identity value="sct-concept"/>
        <map
             value="code 246090004 |Associated finding| (&lt; 404684003 |Clinical finding| MINUS
&lt;&lt; 420134006 |Propensity to adverse reactions| MINUS 
&lt;&lt; 473010000 |Hypersensitivity condition| MINUS 
&lt;&lt; 79899007 |Drug interaction| MINUS
&lt;&lt; 69449002 |Drug action| MINUS 
&lt;&lt; 441742003 |Evaluation finding| MINUS 
&lt;&lt; 307824009 |Administrative status| MINUS 
&lt;&lt; 385356007 |Tumor stage finding|) 
OR &lt; 413350009 |Finding with explicit context|
OR &lt; 272379006 |Event|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
      <mapping>
        <identity value="sct-attr"/>
        <map value="246090004"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.code"/>
      </mapping>
    </element>
    <element id="Condition.bodySite">
      <path value="Condition.bodySite"/>
      <short value="Anatomical location, if relevant"/>
      <definition
                  value="The anatomical location where this condition manifests itself."/>
      <comment
               value="Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [bodySite](http://hl7.org/fhir/R4/extension-bodysite.html).  May be a summary code, or a reference to a very precise definition of the location, or both."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.bodySite"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <valueSet
                  value="http://hl7.org/fhir/us/mcode/ValueSet/onco-core-CancerBodyLocationVS"/>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 442083009  |Anatomical or acquired body structure|"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".targetBodySiteCode"/>
      </mapping>
      <mapping>
        <identity value="sct-attr"/>
        <map value="363698007"/>
      </mapping>
    </element>
    <element id="Condition.bodySite.id">
      <path value="Condition.bodySite.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"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.bodySite.extension">
      <path value="Condition.bodySite.extension"/>
      <slicing>
        <discriminator>
          <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="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.bodySite.extension:laterality">
      <path value="Condition.bodySite.extension"/>
      <sliceName value="laterality"/>
      <definition
                  value="Body side of the body location, if needed to distinguish from a similar location on the other side of the body.

The laterality element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
* Relation to landmark: The location relative to a landmark is specified by:
1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
2. Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR&#39;s stand-alone BodySite (aka BodyStructure in r4) which &#39;is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient&#39; (FHIR 3.5)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-Laterality-extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.bodySite.extension:anatomicalorientation">
      <path value="Condition.bodySite.extension"/>
      <sliceName value="anatomicalorientation"/>
      <definition
                  value="AnatomicalOrientation of the body location, if needed to distinguish from a similar location in another orientation.
The orientation element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
* Relation to landmark: The location relative to a landmark is specified by:
1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
2. Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR&#39;s stand-alone BodySite (aka BodyStructure in r4) which &#39;is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient&#39; (FHIR 3.5)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-AnatomicalOrientation-extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.bodySite.extension:relationtolandmark">
      <path value="Condition.bodySite.extension"/>
      <sliceName value="relationtolandmark"/>
      <definition
                  value="The relationship between a landmark that helps determine a body location and the body location itself. The location relative to a landmark is specified by:
* Specifying the location and type of landmark using a body site code and optional laterality/orientation,
* Specifying the direction from the landmark to the body location, and
* Specifying the distance from the landmark to the body location.

The RelationToLandmark element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
* Relation to landmark: The location relative to a landmark is specified by:
1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
2. Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR&#39;s stand-alone BodySite (aka BodyStructure in r4) which &#39;is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient&#39; (FHIR 3.5)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-RelationToLandmark-extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.bodySite.coding">
      <path value="Condition.bodySite.coding"/>
      <short value="Code defined by a terminology system"/>
      <definition value="A reference to a code defined by a terminology system."/>
      <comment
               value="Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true."/>
      <requirements
                    value="Allows for alternative encodings within a code system, and translations to other code systems."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element id="Condition.bodySite.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="Condition.bodySite.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user."/>
      <comment
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element id="Condition.subject">
      <path value="Condition.subject"/>
      <short value="Who has the condition?"/>
      <definition
                  value="Indicates the patient or group who the condition record is associated with."/>
      <requirements
                    value="Group is typically used for veterinary or public health use cases."/>
      <alias value="patient"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Condition.subject"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=SBJ].role[classCode=PAT]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject"/>
      </mapping>
      <mapping>
        <identity value="argonaut-dq-dstu2"/>
        <map value="Condition.patient"/>
      </mapping>
    </element>
    <element id="Condition.encounter">
      <path value="Condition.encounter"/>
      <short value="Encounter created as part of"/>
      <definition
                  value="The Encounter during which this Condition was created or to which the creation of this record is tightly associated."/>
      <comment
               value="This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with.  In the case of a &quot;new&quot; diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first &quot;known&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.context"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.context"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19 (+PV1-54)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Condition.onset[x]">
      <path value="Condition.onset[x]"/>
      <short value="Estimated or actual date,  date-time, or age"/>
      <definition
                  value="Estimated or actual date or date-time  the condition began, in the opinion of the clinician."/>
      <comment
               value="Age is generally used when the patient reports an age at which the Condition began to occur."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.onset[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.init"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-16"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;age at onset&quot;].value"/>
      </mapping>
    </element>
    <element id="Condition.abatement[x]">
      <path value="Condition.abatement[x]"/>
      <short value="When in resolution/remission"/>
      <definition
                  value="The date or estimated date that the condition resolved or went into remission. This is called &quot;abatement&quot; because of the many overloaded connotations associated with &quot;remission&quot; or &quot;resolution&quot; - Conditions are never really resolved, but they can abate."/>
      <comment
               value="There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated.  If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.  When abatementString exists, it implies the condition is abated."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.abatement[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <type>
        <code value="Age"/>
      </type>
      <type>
        <code value="Period"/>
      </type>
      <type>
        <code value="Range"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <condition value="con-4"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.done[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;age at remission&quot;].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed"/>
      </mapping>
    </element>
    <element id="Condition.recordedDate">
      <path value="Condition.recordedDate"/>
      <short value="Date record was first recorded"/>
      <definition
                  value="The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.recordedDate"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.recorded"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="REL-11"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].time"/>
      </mapping>
    </element>
    <element id="Condition.recorder">
      <path value="Condition.recorder"/>
      <short value="Who recorded the condition"/>
      <definition
                  value="Individual who recorded the record and takes responsibility for its content."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.recorder"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.author"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=AUT].role"/>
      </mapping>
    </element>
    <element id="Condition.asserter">
      <path value="Condition.asserter"/>
      <short
             value="The information comes from a practitioner who asserts the condition"/>
      <definition
                  value="The information comes from a practitioner who asserts the condition."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.asserter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.source"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="REL-7.1 identifier + REL-7.12 type code"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=INF].role"/>
      </mapping>
    </element>
    <element id="Condition.stage">
      <path value="Condition.stage"/>
      <short value="Stage/grade, usually assessed formally"/>
      <definition
                  value="Clinical stage or grade of a condition. May include formal severity assessments."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="con-1"/>
        <severity value="error"/>
        <human value="Stage SHALL have summary or assessment"/>
        <expression value="summary.exists() or assessment.exists()"/>
        <xpath value="exists(f:summary) or exists(f:assessment)"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;stage/grade&quot;]"/>
      </mapping>
    </element>
    <element id="Condition.stage.id">
      <path value="Condition.stage.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"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.stage.extension">
      <path value="Condition.stage.extension"/>
      <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="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.stage.modifierExtension">
      <path value="Condition.stage.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element&#39;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 can 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)."/>
      <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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition.stage.summary">
      <path value="Condition.stage.summary"/>
      <short value="Simple summary (disease specific)"/>
      <definition
                  value="A simple summary of the stage such as &quot;Stage 3&quot;. The determination of the stage is disease-specific."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage.summary"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-1"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConditionStage"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing condition stages (e.g. Cancer stages)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-stage"/>
      </binding>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 254291000 |Staging and scales|"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRB-14"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".value"/>
      </mapping>
    </element>
    <element id="Condition.stage.assessment">
      <path value="Condition.stage.assessment"/>
      <short value="Formal record of assessment"/>
      <definition
                  value="Reference to a formal record of the evidence on which the staging assessment is based."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage.assessment"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-CancerStageGroup"/>
      </type>
      <condition value="con-1"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value=".self"/>
      </mapping>
    </element>
    <element id="Condition.stage.type">
      <path value="Condition.stage.type"/>
      <short value="Kind of staging"/>
      <definition
                  value="The kind of staging, such as pathological or clinical staging."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Condition.stage.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConditionStageType"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Codes describing the kind of condition staging (e.g. clinical or pathological)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/condition-stage-type"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map
             value="./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;stage type&quot;]"/>
      </mapping>
    </element>
    <element id="Condition.evidence">
      <path value="Condition.evidence"/>
      <short value="Supporting evidence"/>
      <definition
                  value="Supporting evidence / manifestations that are the basis of the Condition&#39;s verification status, such as evidence that confirmed or refuted the condition."/>
      <comment
               value="The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="Element"/>
      </constraint>
      <constraint>
        <key value="con-2"/>
        <severity value="error"/>
        <human value="evidence SHALL have code or details"/>
        <expression value="code.exists() or detail.exists()"/>
        <xpath value="exists(f:code) or exists(f:detail)"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="Condition.evidence.id">
      <path value="Condition.evidence.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"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.evidence.extension">
      <path value="Condition.evidence.extension"/>
      <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="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="Condition.evidence.modifierExtension">
      <path value="Condition.evidence.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element&#39;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 can 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)."/>
      <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](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="Condition.evidence.code">
      <path value="Condition.evidence.code"/>
      <short value="Manifestation/symptom"/>
      <definition
                  value="A manifestation or symptom that led to the recording of this condition."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence.code"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="con-2"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="example"/>
        <valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.reasonCode"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="sct-concept"/>
        <map value="&lt; 404684003 |Clinical finding|"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="[code=&quot;diagnosis&quot;].value"/>
      </mapping>
    </element>
    <element id="Condition.evidence.detail">
      <path value="Condition.evidence.detail"/>
      <short value="Supporting information found elsewhere"/>
      <definition
                  value="Links to other relevant information, including pathology reports."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.evidence.detail"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/Resource"/>
      </type>
      <condition value="con-2"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.why[x]"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".self"/>
      </mapping>
    </element>
    <element id="Condition.note">
      <path value="Condition.note"/>
      <short value="Additional information about the Condition"/>
      <definition
                  value="Additional information about the Condition. This is a general notes/comments entry  for description of the Condition, its diagnosis and prognosis."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Condition.note"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.note"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="NTE child of PRB"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="Condition">
      <path value="Condition"/>
      <short value="onco-core-PrimaryCancerCondition"/>
      <definition
                  value="Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.

Cancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.

Conformance note: For the code attribute, to be compliant with [US Core Profiles](http://hl7.org/fhir/us/core/STU3/index.html), SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used."/>
      <mustSupport value="false"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.extension">
      <path value="Condition.extension"/>
      <slicing id="2">
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
    </element>
    <element id="Condition.extension:dateofdiagnosis">
      <path value="Condition.extension"/>
      <sliceName value="dateofdiagnosis"/>
      <definition
                  value="The date the disease was first clinically recognized with sufficient certainty, regardless of whether it was fully characterized at that time."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/condition-assertedDate"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.extension:histologymorphologybehavior">
      <path value="Condition.extension"/>
      <sliceName value="histologymorphologybehavior"/>
      <definition
                  value="A description of the morphologic and behavioral characteristics of the cancer."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-HistologyMorphologyBehavior-extension"/>
      </type>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.verificationStatus">
      <path value="Condition.verificationStatus"/>
      <min value="1"/>
      <max value="1"/>
    </element>
    <element id="Condition.category">
      <path value="Condition.category"/>
      <min value="1"/>
      <max value="1"/>
    </element>
    <element id="Condition.category.coding">
      <path value="Condition.category.coding"/>
      <slicing id="1">
        <discriminator>
          <type value="value"/>
          <path value="code"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <min value="1"/>
      <max value="*"/>
    </element>
    <element id="Condition.category.coding:Fixed_64572001">
      <path value="Condition.category.coding"/>
      <sliceName value="Fixed_64572001"/>
      <short value="Disease"/>
      <definition value="Disease"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <isSummary value="true"/>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.system">
      <path value="Condition.category.coding.system"/>
      <fixedUri value="http://snomed.info/sct"/>
    </element>
    <element id="Condition.category.coding:Fixed_64572001.code">
      <path value="Condition.category.coding.code"/>
      <fixedCode value="64572001"/>
    </element>
    <element id="Condition.severity">
      <path value="Condition.severity"/>
      <min value="0"/>
      <max value="0"/>
    </element>
    <element id="Condition.code">
      <path value="Condition.code"/>
      <binding>
        <strength value="extensible"/>
        <valueSet
                  value="http://hl7.org/fhir/us/mcode/ValueSet/onco-core-PrimaryOrUncertainBehaviorCancerDisorderVS"/>
      </binding>
    </element>
    <element id="Condition.bodySite">
      <path value="Condition.bodySite"/>
      <mustSupport value="true"/>
      <binding>
        <strength value="preferred"/>
        <valueSet
                  value="http://hl7.org/fhir/us/mcode/ValueSet/onco-core-CancerBodyLocationVS"/>
      </binding>
    </element>
    <element id="Condition.bodySite.extension:laterality">
      <path value="Condition.bodySite.extension"/>
      <sliceName value="laterality"/>
      <definition
                  value="Body side of the body location, if needed to distinguish from a similar location on the other side of the body.

The laterality element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
* Relation to landmark: The location relative to a landmark is specified by:
1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
2. Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR&#39;s stand-alone BodySite (aka BodyStructure in r4) which &#39;is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient&#39; (FHIR 3.5)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-Laterality-extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.bodySite.extension:anatomicalorientation">
      <path value="Condition.bodySite.extension"/>
      <sliceName value="anatomicalorientation"/>
      <definition
                  value="AnatomicalOrientation of the body location, if needed to distinguish from a similar location in another orientation.
The orientation element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
* Relation to landmark: The location relative to a landmark is specified by:
1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
2. Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR&#39;s stand-alone BodySite (aka BodyStructure in r4) which &#39;is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient&#39; (FHIR 3.5)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-AnatomicalOrientation-extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.bodySite.extension:relationtolandmark">
      <path value="Condition.bodySite.extension"/>
      <sliceName value="relationtolandmark"/>
      <definition
                  value="The relationship between a landmark that helps determine a body location and the body location itself. The location relative to a landmark is specified by:
* Specifying the location and type of landmark using a body site code and optional laterality/orientation,
* Specifying the direction from the landmark to the body location, and
* Specifying the distance from the landmark to the body location.

The RelationToLandmark element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

* Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
* Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
* Relation to landmark: The location relative to a landmark is specified by:
1. Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
2. Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR&#39;s stand-alone BodySite (aka BodyStructure in r4) which &#39;is not ... intended for describing the type of anatomical location but rather a specific body site on a specific patient&#39; (FHIR 3.5)."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-datatype-RelationToLandmark-extension"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="Condition.subject">
      <path value="Condition.subject"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/>
      </type>
    </element>
    <element id="Condition.encounter">
      <path value="Condition.encounter"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/>
      </type>
    </element>
    <element id="Condition.recorder">
      <path value="Condition.recorder"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/obf-Patient"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson"/>
      </type>
    </element>
    <element id="Condition.asserter">
      <path value="Condition.asserter"/>
      <short
             value="The information comes from a practitioner who asserts the condition"/>
      <definition
                  value="The information comes from a practitioner who asserts the condition."/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
      </type>
    </element>
    <element id="Condition.stage">
      <path value="Condition.stage"/>
      <min value="0"/>
      <max value="1"/>
    </element>
    <element id="Condition.stage.assessment">
      <path value="Condition.stage.assessment"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/us/mcode/StructureDefinition/onco-core-CancerStageGroup"/>
      </type>
    </element>
    <element id="Condition.evidence">
      <path value="Condition.evidence"/>
    </element>
    <element id="Condition.evidence.code">
      <path value="Condition.evidence.code"/>
      <binding>
        <strength value="example"/>
        <valueSet value="http://hl7.org/fhir/ValueSet/clinical-findings"/>
      </binding>
    </element>
  </differential>
</StructureDefinition>