# MII PR Prozedur Procedure - MII Implementation Guide Core Dataset Base v2026.0.1

## Resource Profile: MII PR Prozedur Procedure 

 
A procedure that is or was performed on or for a patient. 

**Example Usage Scenarios:**

* Document procedures performed on patients using OPS (Operationen- und Prozedurenschlüssel) coding for billing and administrative purposes
* Record surgical interventions, diagnostic procedures, and therapeutic treatments in clinical care
* Support quality management and clinical research through standardized procedure documentation
* Enable procedure-based analyses and outcome research across healthcare facilities
* Represent procedures using SNOMED CT for semantic interoperability alongside OPS coding
* Link procedures to specific encounters for temporal and contextual documentation

### Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the MII Procedure (Prozedur) Profile.

#### Coding Requirements

**Mandatory Coding:**

* **`Procedure.code`**: [Mandatory](general-requirements.md) coding using either OPS or SNOMED CT
* At least one coded procedure **MUST** be present
* Additional codings from other terminologies are OPTIONAL

**OPS Coding:**

* **`Procedure.code:ops`**: OPS (Operationen- und Prozedurenschlüssel) is the primary coding system for procedures in Germany
* See [OPS Coding - German Base Profiles](https://ig.fhir.de/basisprofile-de/1.5.4/ig-markdown-Ressourcen-ProzedurenProcedure.html#ig-markdown-Ressourcen-Procedure-OPS) for detailed OPS coding requirements
* OPS codes include: 
* `Procedure.code:ops.coding.code`: Complete procedure code
* `Procedure.code:ops.coding.system`: Code system (`http://fhir.de/CodeSystem/bfarm/ops`)
* `Procedure.code:ops.coding.version`: OPS version year
* `Procedure.code:ops.extension:seitenlokalisation`: Laterality extension
 

**SNOMED CT Coding:**

* **`Procedure.code:sct`**: SNOMED CT coding
* Can be used as primary coding or alongside OPS

#### Category Classification

##### Best Practice - SNOMED CT Categorization

**Mandatory Categorization:** `Procedure.category` SNOMED CT categorization based on the procedure code.

**OPS Class Title Mapping:** When the procedure is coded using OPS, the category **SHOULD** be derived by mapping OPS chapter/class titles to SNOMED CT concepts. See the Terminologies section in this IG for OPS-to-SNOMED CT category mappings.

**Constraint proc-mii-1:** This requirement is only relevant when the procedure is coded using OPS.

**Purpose:** Category classification enables:

* High-level procedure grouping for epidemiological analyses
* Filtering and browsing procedures by broad clinical categories
* Semantic consistency across differently coded procedures

#### Temporal Information

**`Procedure.performed[x]`:**

* Documents when the procedure was performed
* **MAY** be specified as `performedDateTime` (single point in time) or `performedPeriod` (start and end times)
* Use `performedPeriod` when both start and end times are known (e.g., surgical procedures with documented start/end)
* Use `performedDateTime` for point-in-time procedures or when only a single timestamp is available

**`Procedure.extension:Dokumentationsdatum`:**

* MII-specific extension for documentation date
* Represents when the procedure was documented/recorded in the system
* Distinct from `performed[x]` which represents when the procedure actually occurred
* Useful for auditing and temporal ordering of documentation

#### Body Site Documentation

##### Best Practice - Body Site vs. Laterality

**Body Site Purpose:** `Procedure.bodySite` provides detailed anatomical location coding for the procedure using SNOMED CT.

**NOT for Laterality:** `Procedure.bodySite` **SHOULD NOT** be used to represent laterality (left/right/bilateral). Laterality is a property of the procedure code itself.

**Laterality Representation:**

* For OPS codes: Use `Procedure.code:ops.extension:seitenlokalisation`
* For SNOMED CT: Laterality is inherent in the procedure concept (e.g., "Appendectomy of right appendix")

**When to Use bodySite:**

* To provide additional anatomical detail beyond what the code specifies
* To specify precise anatomical structures using SNOMED CT anatomy concepts

#### Procedure Intent

**`Procedure.extension:Durchfuehrungsabsicht`:**

* MII-specific extension for procedure intent/purpose
* Uses SNOMED CT codes to classify the clinical intent: 
* Therapeutic procedures
* Diagnostic procedures
* Prophylactic procedures
* Palliative procedures
* etc.
 
* Provides clinical context for the procedure beyond the procedural code itself

#### Encounter Context

##### Best Practice - Procedure-Encounter Relationships

**Recommended Implementation:**

Use `Procedure.encounter` to reference from the Procedure to the Encounter of type **Abteilungskontakt (Department Contact)**. This approach establishes the general encounter context for the procedure, providing temporal and organizational context.

#### Status and Workflow

**`Procedure.status`:**

* No restrictions on status values (preparation, in-progress, on-hold, stopped, completed, entered-in-error, unknown)
* Most procedures in retrospective documentation will have `status='completed'`

#### Patient Reference

**`Procedure.subject`:**

* Reference to Patient **MUST** always be provided
* Procedures are inherently patient-specific and cannot exist without this reference

**Usages:**

* Examples for this Profile: [Procedure/mii-exa-prozedur-imaging](Procedure-mii-exa-prozedur-imaging.md), [Procedure/mii-exa-prozedur-procedure-2](Procedure-mii-exa-prozedur-procedure-2.md) and [Procedure/mii-exa-prozedur-procedure](Procedure-mii-exa-prozedur-procedure.md)
* CapabilityStatements using this Profile: [MII CPS Prozedur CapabilityStatement](CapabilityStatement-mii-cps-prozedur-capabilitystatement.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/de.medizininformatikinitiative.kerndatensatz.base|current/StructureDefinition/StructureDefinition-mii-pr-prozedur-procedure.json)

### Formal Views of Profile Content

 [Description Differentials, Snapshots, and other representations](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](../StructureDefinition-mii-pr-prozedur-procedure.csv), [Excel](../StructureDefinition-mii-pr-prozedur-procedure.xlsx), [Schematron](../StructureDefinition-mii-pr-prozedur-procedure.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "mii-pr-prozedur-procedure",
  "meta" : {
    "extension" : [{
      "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-license",
      "valueCode" : "CC-BY-4.0"
    },
    {
      "extension" : [{
        "url" : "packageId",
        "valueId" : "de.medizininformatikinitiative.kerndatensatz.base"
      },
      {
        "url" : "version",
        "valueString" : "2026.0.1"
      },
      {
        "url" : "uri",
        "valueUri" : "https://www.medizininformatik-initiative.de/fhir/modul-base"
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/package-source"
    }],
    "profile" : ["http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablestructuredefinition",
    "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablestructuredefinition"]
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm",
    "valueCoding" : {
      "system" : "http://hl7.org/fhir/version-algorithm",
      "code" : "semver",
      "display" : "SemVer"
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability",
    "valueCode" : "shareable"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability",
    "valueCode" : "publishable"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-versionPolicy",
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/artifact-version-policy-codes",
        "code" : "package",
        "display" : "Package"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-usage",
    "valueMarkdown" : "Use this profile as the technical FHIR representation of the corresponding Medical Informatics Initiative logical model. The profile constrains a base FHIR resource for the MII module context by specifying how elements are used, which elements are required or not used, which extensions and terminology bindings apply, and how the resource maps to the module-specific content model. Implementers should produce and consume resource instances that conform to this profile when exchanging data for the corresponding MII module."
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/resource-approvalDate",
    "valueDate" : "2024-03-07"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/resource-effectivePeriod",
    "valuePeriod" : {
      "start" : "2026"
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-topic",
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl",
        "code" : "C25218"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-author",
    "valueContactDetail" : {
      "telecom" : [{
        "system" : "email",
        "value" : "julian.sass@charite.de"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-editor",
    "valueContactDetail" : {
      "name" : "Taskforce Core Data Set"
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-reviewer",
    "valueContactDetail" : {
      "name" : "Interoperability Working Group",
      "telecom" : [{
        "system" : "url",
        "value" : "https://www.medizininformatik-initiative.de/en/collaboration/interoperability-working-group"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-reviewer",
    "valueContactDetail" : {
      "name" : "National Steering Committee",
      "telecom" : [{
        "system" : "url",
        "value" : "https://www.medizininformatik-initiative.de/en/collaboration/national-steering-committee"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-endorser",
    "valueContactDetail" : {
      "name" : "Interoperability Working Group",
      "telecom" : [{
        "system" : "url",
        "value" : "https://www.medizininformatik-initiative.de/en/collaboration/interoperability-working-group"
      }]
    }
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/artifact-endorser",
    "valueContactDetail" : {
      "name" : "National Steering Committee",
      "telecom" : [{
        "system" : "url",
        "value" : "https://www.medizininformatik-initiative.de/en/collaboration/national-steering-committee"
      }]
    }
  }],
  "url" : "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Procedure",
  "version" : "2026.0.1",
  "name" : "MII_PR_Prozedur_Procedure",
  "title" : "MII PR Prozedur Procedure",
  "_title" : {
    "extension" : [{
      "extension" : [{
        "url" : "lang",
        "valueCode" : "de-DE"
      },
      {
        "url" : "content",
        "valueString" : "Prozedur"
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/translation"
    },
    {
      "extension" : [{
        "url" : "lang",
        "valueCode" : "en-US"
      },
      {
        "url" : "content",
        "valueString" : "Procedure"
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/translation"
    }]
  },
  "status" : "active",
  "experimental" : false,
  "date" : "2026-06-09",
  "publisher" : "Medical Informatics Initiative (MII)",
  "contact" : [{
    "name" : "Medical Informatics Initiative (MII)",
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.medizininformatik-initiative.de/en"
    }]
  }],
  "description" : "Dieses Profil beschreibt eine Prozedur in der Medizininformatik-Initiative.",
  "_description" : {
    "extension" : [{
      "extension" : [{
        "url" : "lang",
        "valueCode" : "de-DE"
      },
      {
        "url" : "content",
        "valueString" : "Eine Prozedur, die an oder für einen Patienten durchgeführt wird oder wurde."
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/translation"
    },
    {
      "extension" : [{
        "url" : "lang",
        "valueCode" : "en-US"
      },
      {
        "url" : "content",
        "valueString" : "A procedure that is or was performed on or for a patient."
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/translation"
    }]
  },
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "DE",
      "display" : "Germany"
    }]
  }],
  "purpose" : "Constrain the FHIR Procedure resource for consistent exchange of procedures in the MII Procedure module.",
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Procedure",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Procedure",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Procedure",
      "path" : "Procedure",
      "constraint" : [{
        "key" : "proc-mii-1",
        "severity" : "error",
        "human" : "Falls die Prozedur per OPS kodiert wird, MUSS eine SNOMED-CT kodierte Category abgebildet werden",
        "expression" : "code.coding.where(system = 'http://fhir.de/CodeSystem/bfarm/ops').exists() implies category.coding.where(system = 'http://snomed.info/sct').exists()",
        "source" : "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Procedure"
      }]
    },
    {
      "id" : "Procedure.id",
      "path" : "Procedure.id",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.meta",
      "path" : "Procedure.meta",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.meta.source",
      "path" : "Procedure.meta.source",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.meta.profile",
      "path" : "Procedure.meta.profile",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension",
      "path" : "Procedure.extension",
      "slicing" : {
        "discriminator" : [{
          "type" : "value",
          "path" : "url"
        }],
        "rules" : "open"
      },
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension:Dokumentationsdatum",
      "path" : "Procedure.extension",
      "sliceName" : "Dokumentationsdatum",
      "short" : "Dokumentationsdatum",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Dokumentationsdatum"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Recorded date"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Dokumentationsdatum der Prozedur, falls abweichend vom Durchführungsdatum",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Dokumentationsdatum der Prozedur, falls abweichend vom Durchführungsdatum"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "The date the procedure was documented, if different from the performed date"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.de/StructureDefinition/ProzedurDokumentationsdatum"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension:Dokumentationsdatum.url",
      "path" : "Procedure.extension.url",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension:Dokumentationsdatum.value[x]",
      "path" : "Procedure.extension.value[x]",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension:durchfuehrungsabsicht",
      "path" : "Procedure.extension",
      "sliceName" : "durchfuehrungsabsicht",
      "short" : "Durchführungsabsicht",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Durchführungsabsicht"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Intention"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "therapeutisch | palliativ | diagnostisch | präventiv | rehabilitativ | andere",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "therapeutisch | palliativ | diagnostisch | präventiv | rehabilitativ | andere"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "therapeutic | palliative | diagnostic | preventive | rehabilitative | other"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Durchfuehrungsabsicht"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension:durchfuehrungsabsicht.url",
      "path" : "Procedure.extension.url",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension:durchfuehrungsabsicht.value[x]",
      "path" : "Procedure.extension.value[x]",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension:durchfuehrungsabsicht.value[x].system",
      "path" : "Procedure.extension.value[x].system",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.extension:durchfuehrungsabsicht.value[x].code",
      "path" : "Procedure.extension.value[x].code",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.status",
      "path" : "Procedure.status",
      "short" : "Status",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Status"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Status"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Vorbereitung | in Arbeit | nicht durchgeführt | pausiert | abgebrochen | abgeschlossen | Eingabe fehlerhaft | unbekannt",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Vorbereitung | in Arbeit | nicht durchgeführt | pausiert | abgebrochen | abgeschlossen | Eingabe fehlerhaft | unbekannt"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "mustSupport" : true
    },
    {
      "id" : "Procedure.category",
      "path" : "Procedure.category",
      "short" : "Kategorie",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Kategorie"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Category"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Diagnostische Maßnahmen | Bildgebende Diagnostik | Operationen | Medikamente | Nichtoperative therapeutische Maßnahmen | Ergänzende Maßnahmen",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Diagnostische Maßnahmen | Bildgebende Diagnostik | Operationen | Medikamente | Nichtoperative therapeutische Maßnahmen | Ergänzende Maßnahmen"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Diagnostic procedures | Imaging procedures | Operations | Medications | Non-operative therapeutic procedures | Other procedures"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "mustSupport" : true
    },
    {
      "id" : "Procedure.category.coding",
      "path" : "Procedure.category.coding",
      "slicing" : {
        "discriminator" : [{
          "type" : "pattern",
          "path" : "$this"
        }],
        "rules" : "open"
      },
      "mustSupport" : true
    },
    {
      "id" : "Procedure.category.coding:sct",
      "path" : "Procedure.category.coding",
      "sliceName" : "sct",
      "short" : "SNOMED CT Code",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "SNOMED CT Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "SNOMED CT code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Ein Verweis auf einen von SNOMED CT definierten Code",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Ein Verweis auf einen von SNOMED CT definierten Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "A reference to a code defined by SNOMED CT"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 0,
      "max" : "1",
      "patternCoding" : {
        "system" : "http://snomed.info/sct"
      },
      "mustSupport" : true,
      "binding" : {
        "strength" : "preferred",
        "valueSet" : "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/ValueSet/procedures-category-sct"
      }
    },
    {
      "id" : "Procedure.category.coding:sct.system",
      "path" : "Procedure.category.coding.system",
      "min" : 1,
      "mustSupport" : true
    },
    {
      "id" : "Procedure.category.coding:sct.code",
      "path" : "Procedure.category.coding.code",
      "min" : 1,
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code",
      "path" : "Procedure.code",
      "short" : "Code",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Code aus OPS - Operationen- und Prozedurenschlüssel, SNOMED CT oder andere.",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Code aus OPS - Operationen- und Prozedurenschlüssel, SNOMED CT oder andere."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Code from OPS - Operationen- und Prozedurenschlüssel, SNOMED CT or other."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 1,
      "constraint" : [{
        "key" : "sct-ops-1",
        "severity" : "error",
        "human" : "Eine Prozedur MUSS mit OPS oder SNOMED-CT kodiert werden.",
        "expression" : "coding.where(system = 'http://snomed.info/sct').exists() or coding.where(system = 'http://fhir.de/CodeSystem/bfarm/ops').exists()",
        "source" : "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Procedure"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding",
      "path" : "Procedure.code.coding",
      "slicing" : {
        "discriminator" : [{
          "type" : "pattern",
          "path" : "$this"
        }],
        "rules" : "open"
      },
      "min" : 1,
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:ops",
      "path" : "Procedure.code.coding",
      "sliceName" : "ops",
      "short" : "Operationen- und Prozedurenschlüssel (OPS) Code",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "OPS Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "OPS code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Ein Verweis auf einen vom Operationen- und Prozedurenschlüssel (OPS) definierten Code",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Ein Verweis auf einen vom Operationen- und Prozedurenschlüssel definierten Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "A reference to a code defined by the German Procedure Classification OPS"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Coding",
        "profile" : ["http://fhir.de/StructureDefinition/CodingOPS"]
      }],
      "patternCoding" : {
        "system" : "http://fhir.de/CodeSystem/bfarm/ops"
      },
      "mustSupport" : true,
      "binding" : {
        "strength" : "required",
        "valueSet" : "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/ValueSet/mii-vs-prozedur-ops"
      }
    },
    {
      "id" : "Procedure.code.coding:ops.extension:Seitenlokalisation",
      "path" : "Procedure.code.coding.extension",
      "sliceName" : "Seitenlokalisation",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:ops.extension:Seitenlokalisation.url",
      "path" : "Procedure.code.coding.extension.url",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:ops.extension:Seitenlokalisation.value[x]",
      "path" : "Procedure.code.coding.extension.value[x]",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:ops.extension:Seitenlokalisation.value[x].system",
      "path" : "Procedure.code.coding.extension.value[x].system",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:ops.extension:Seitenlokalisation.value[x].code",
      "path" : "Procedure.code.coding.extension.value[x].code",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:ops.system",
      "path" : "Procedure.code.coding.system",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:ops.version",
      "path" : "Procedure.code.coding.version",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:ops.code",
      "path" : "Procedure.code.coding.code",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:sct",
      "path" : "Procedure.code.coding",
      "sliceName" : "sct",
      "short" : "SNOMED CT Code",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "SNOMED CT Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "SNOMED CT code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Ein Verweis auf einen von SNOMED CT definierten Code",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Ein Verweis auf einen von SNOMED CT definierten Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "A reference to a code defined by SNOMED CT"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 0,
      "max" : "1",
      "patternCoding" : {
        "system" : "http://snomed.info/sct"
      },
      "mustSupport" : true,
      "binding" : {
        "strength" : "required",
        "valueSet" : "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/ValueSet/procedures-sct"
      }
    },
    {
      "id" : "Procedure.code.coding:sct.system",
      "path" : "Procedure.code.coding.system",
      "min" : 1,
      "mustSupport" : true
    },
    {
      "id" : "Procedure.code.coding:sct.code",
      "path" : "Procedure.code.coding.code",
      "min" : 1,
      "mustSupport" : true
    },
    {
      "id" : "Procedure.subject",
      "path" : "Procedure.subject",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.subject.reference",
      "path" : "Procedure.subject.reference",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.encounter",
      "path" : "Procedure.encounter",
      "short" : "Kontakt (Aufenthaltsbezug)",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Kontakt"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Encounter"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Kontakt, während dem die Prozedur durchgeführt wurde oder mit dem die Prozedur in Zusammenhang steht.",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Kontakt, während dem die Prozedur durchgeführt wurde oder mit dem die Prozedur in Zusammenhang steht."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "The Encounter during which this Procedure was performed or to which the creation of this record is tightly associated."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "mustSupport" : true
    },
    {
      "id" : "Procedure.encounter.reference",
      "path" : "Procedure.encounter.reference",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.performed[x]",
      "path" : "Procedure.performed[x]",
      "slicing" : {
        "discriminator" : [{
          "type" : "type",
          "path" : "$this"
        }],
        "ordered" : false,
        "rules" : "open"
      },
      "short" : "Durchführungsdatum",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Durchführungsdatum"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Performed date"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Durchführungsdatum oder -zeitraum der Prozedur.",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Durchführungsdatum oder -zeitraum der Prozedur."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "The date or period of time the procedure was performed."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 1,
      "type" : [{
        "code" : "dateTime"
      },
      {
        "code" : "Period"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Procedure.performed[x]:performedDateTime",
      "path" : "Procedure.performed[x]",
      "sliceName" : "performedDateTime",
      "definition" : "Durchführungsdatum der Prozedur.",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Durchführungsdatum der Prozedur."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "The date the procedure was performed."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "dateTime"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Procedure.performed[x]:performedPeriod",
      "path" : "Procedure.performed[x]",
      "sliceName" : "performedPeriod",
      "short" : "Durchführungszeitraum",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Durchführungszeitraum"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Performed period"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Zeitraum, in dem die Prozedur durchgeführt wurde.",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Zeitraum, in dem die Prozedur durchgeführt wurde."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "The period of time the procedure was performed."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Period"
      }],
      "mustSupport" : true
    },
    {
      "id" : "Procedure.bodySite",
      "path" : "Procedure.bodySite",
      "short" : "Körperstelle",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Körperstelle"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Body site"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Körperstelle der Prozedur mittels SNOMED CT inklusive Lateralität.",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Körperstelle der Prozedur mittels SNOMED CT inklusive Lateralität."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "The body site of the procedure using SNOMED CT including laterality."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "mustSupport" : true
    },
    {
      "id" : "Procedure.bodySite.coding",
      "path" : "Procedure.bodySite.coding",
      "slicing" : {
        "discriminator" : [{
          "type" : "pattern",
          "path" : "system"
        }],
        "rules" : "open"
      },
      "mustSupport" : true
    },
    {
      "id" : "Procedure.bodySite.coding:snomed-ct",
      "path" : "Procedure.bodySite.coding",
      "sliceName" : "snomed-ct",
      "short" : "SNOMED CT Code",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "SNOMED CT Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "SNOMED CT code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Ein Verweis auf einen von SNOMED CT definierten Code",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Ein Verweis auf einen von SNOMED CT definierten Code"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "A reference to a code defined by SNOMED CT"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "min" : 0,
      "max" : "1",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.bodySite.coding:snomed-ct.system",
      "path" : "Procedure.bodySite.coding.system",
      "min" : 1,
      "patternUri" : "http://snomed.info/sct",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.bodySite.coding:snomed-ct.version",
      "path" : "Procedure.bodySite.coding.version",
      "mustSupport" : true
    },
    {
      "id" : "Procedure.bodySite.coding:snomed-ct.code",
      "path" : "Procedure.bodySite.coding.code",
      "min" : 1,
      "mustSupport" : true
    },
    {
      "id" : "Procedure.note",
      "path" : "Procedure.note",
      "short" : "Hinweis",
      "_short" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Hinweis"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Note"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "definition" : "Zusätzliche Informationen zur Prozedur als Freitext.",
      "_definition" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "de-DE"
          },
          {
            "url" : "content",
            "valueString" : "Zusätzliche Informationen zur Prozedur als Freitext."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        },
        {
          "extension" : [{
            "url" : "lang",
            "valueCode" : "en-US"
          },
          {
            "url" : "content",
            "valueString" : "Additional information about the procedure as free text."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      },
      "mustSupport" : true
    }]
  }
}

```
