Content

This profile describes a diagnosis in oncology. It is based on the MII KDS module Diagnose.

The oBDS requires the diagnosis to be coded via ICD-10, as well as the coding of the topography of the primary tumour and of the histological morphology via ICD-O-3. In FHIR this combination can already be represented completely by the MII Diagnose profile:

• ICD-10-GM via Condition.code[icd10-gm] (inherited from MII Diagnose)
• ICD-O-3 morphology via Condition.extension[morphology-behavior-icdo3] (comparable to the mCODE extension)
• ICD-O-3 topography via Condition.bodySite.

Further histological examinations with deviating morphologies during the course of therapy SHOULD be recorded via the Histologie profile.

Relations to previous tumour diseases: two axes

An oncological diagnosis can be related to a previous tumour disease in two different ways — the profile deliberately separates these cases into two orthogonal extensions:

oBDS classification: occurredFollowing represents oBDS 5.9; dueTo and transformationVon are not part of the registry report — they are FHIR added value beyond the oBDS for structured linkage (hence without an oBDS mapping). Examples: mii-exa-onko-diagnose-taml-nach-chemo (t-AML 9920/3 dueTo a cyclophosphamide MedicationStatement) and mii-exa-onko-diagnose-angiosarkom-nach-radiatio (haemangiosarcoma 9120/3 dueTo a radiotherapy Procedure).

Why not simply use condition-dueTo for transformations? dueTo models causation — if transformations were represented through it, lineage transformation (MDS → AML) and external causation (t-AML after chemotherapy) would no longer be distinguishable. The three axes are deliberately kept apart; R5/R6 do not offer a core element for this either (the standard extensions live in the cross-version HL7 extensions pack).

Why the separation? A plain occurredFollowing would wrongly suggest an independent second disease in the case of a transformation; transformationVon makes the tumour lineage traceable in a structured way.

Clinical correctness vs. cancer registry requirements: transformationVon links two diagnosis resources and is therefore only to be used where the registry rule set actually keeps a new tumour entity (MDS → AML, CNS /0 → /3). The CUP resolution following the best-of rule (Manual ch. 6.2) is deliberately not a use case: there the same entity is changed — histology, localisation and ICD-10 are rewritten to the primary tumour that was found, while the tumour ID and the original diagnosis date are retained. In registry-conformant terms this is an update of the same Condition resource (FHIR versioning, possibly with Provenance); a second resource with transformationVon would only arise if a system deviates and keeps its own history of the former CUP version.

Note on modelling: transformationVon is deliberately a normal extension (not a modifierExtension): its absence does not make any statement of the resource wrong — the diagnosis remains true and can be processed safely, only the provenance context is missing. Where the WHO has made the transformation origin an entity of its own, the morphology code itself carries it anyway (e.g. 9895/3 AML-MRC); this is, however, not guaranteed (a secondary glioblastoma may simply be coded as 9440/3) — which is precisely why the extension provides the structured provenance link.

Both extensions can be combined (a transformation always also occurred temporally "afterwards"); example: mii-exa-onko-diagnose-aml-transformation (MDS → secondary AML).

Links to other resources

The oncological diagnosis is the central core element of the base data set. All case-related observations are linked to it directly or indirectly:

• all observations reference the primary diagnosis via Observation.focus
• the tumour board resource references the primary diagnosis via CarePlan.addresses
• all procedures (surgery, radiotherapy, systemic therapy) reference the primary diagnosis via reasonReference

Temporal assignment over the course of disease

In the oBDS, the assignment of observations as relevant for establishing the initial diagnosis is given by the fact that they are part of the diagnosis report. Later reports can then be made, for example, as follow-up, pathology or death reports.

Observations made after the initial diagnosis has been established reference, in the present profiling, a "Verlauf" (course) Observation resource with a date of its own. The observations that are known at the time the initial diagnosis is established are of particular interest for prognostic research questions. In order to identify these data points more easily, all observations from the oBDS diagnosis report SHOULD be referenced via evidence.detail in a FHIR list using the profile "Evidenz Erstdiagnose".

Conformance

The present profiling is compatible with the diagnosis profile of the ISiK base modules stage 4. https://simplifier.net/isik-basis-v4/isikdiagnose

Examples

mii-exa-onko-diagnose

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	MII_PR_Diagnose_Condition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
source	SΣ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:ReferenzPrimaerdiagnose	S	0..1	(Complex)	Conditions associated with this condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
extension		0..0		Extension Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]	S	1..1	Reference(Condition)	Value of extension
extension:Feststellungsdatum	S	1..1	(Complex)	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
extension		0..0		Extension Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-assertedDate"
value[x]	S	1..1	dateTime	Value of extension
extension:morphology-behavior-icdo3	S	0..*	(Complex)	ICD-O-Morphologie URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-histology-morphology-behavior-icdo3
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-histology-morphology-behavior-icdo3"
value[x]		1..1	CodeableConcept	Value of extension Binding: MII VS Onkologie ICD-O-3 Morphologie (required)
text	SΣ	0..1	string	Plain text representation of the concept
extension:occurredFollowing	S	0..*	(Complex)	Frühere Tumorerkrankungen (zeitliche Abfolge) URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing"
Slices for value[x]		1..1		Value of extension Slice: Unordered, Open by type:$this Binding: ConditionPredecessorCodes (example): Codes that describe activities or observations that occurred prior to the condition.
valueCodeableConcept			CodeableConcept
valueReference			Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)
Slices for value[x]				Content/Rules for all slices
value[x]:valueReference		0..1	Reference(MII PR Onkologie Diagnose Primärtumor | MII PR Onkologie Frühere Tumorerkrankung)	Value of extension
extension:dueTo	S	0..*	(Complex)	Verursacht durch (therapieassoziierte Sekundärmalignome) URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-dueTo"
Slices for value[x]		1..1		Value of extension Slice: Unordered, Open by type:$this Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
valueCodeableConcept			CodeableConcept
valueReference			Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)
Slices for value[x]				Content/Rules for all slices
value[x]:valueReference		0..1	Reference(MII PR Onkologie Strahlentherapie | MII PR Onkologie Systemische Therapie | MII PR Onkologie Systemische Therapie Medikation | MII PR Onkologie Diagnose Primärtumor | MII PR Onkologie Frühere Tumorerkrankung)	Value of extension
extension:transformationVon	S	0..*	Reference(MII PR Onkologie Diagnose Primärtumor)	Transformation aus registriertem Primärtumor URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-transformation-von
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Tumor-ID (Tumoridentität)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	0..1	string	The value that is unique Example General: 123456
clinicalStatus	?!SΣC	0..1	CodeableConcept	Klinischer Status Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
coding	SΣ	0..*	Coding	Code defined by a terminology system
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
verificationStatus	?!SΣC	0..1	CodeableConcept	Verifizierungsstatus Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:All Slices				Content/Rules for all slices
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
coding:condition-ver-status	SΣ	0..1	Coding	Code defined by a terminology system Binding: ConditionVerificationStatus (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	SΣ	0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/condition-ver-status
code	SΣ	0..1	code	Symbol in syntax defined by the system
coding:primaertumorDiagnosesicherung	SΣ	0..1	Coding	Diagnosesicherung gemäß oBDS Binding: MII VS Onkologie Primärtumor Diagnosesicherung (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-primaertumor-diagnosesicherung
code	SΣ	1..1	code	Symbol in syntax defined by the system
Slices for category		1..*	CodeableConcept	problem-list-item | encounter-diagnosis Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:onkologie	S	1..1	CodeableConcept	Onkologie-Kennzeichnung Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55342001
display		1..1	string	Representation defined by the system Fixed Value: Neoplastic disease
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Code Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:icd10-gm	SΣC	0..1	CodingICD10GM	ICD-10-GM Code Binding: MII VS Diagnose ICD-10-GM (required) Constraints: onko-icd-meldepflicht Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
Slices for extension				Content/Rules for all slices
extension:Mehrfachcodierungs-Kennzeichen	S	0..1	(Complex)	Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-mehrfachcodierungs-kennzeichen
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/icd-10-gm-mehrfachcodierungs-kennzeichen"
value[x]	S	1..1	Coding	Value of extension Binding: Mehrfachkodierungs-Kennzeichen ICD10GM ValueSet (required)
system	SΣ	1..1	uri	Identity of the terminology system
code	SΣ	1..1	code	Symbol in syntax defined by the system
extension:Seitenlokalisation	S	0..1	(Complex)	Optional Extensions Element URL: http://fhir.de/StructureDefinition/seitenlokalisation
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/seitenlokalisation"
value[x]	S	1..1	Coding	Value of extension Binding: KBV_VS_SFHIR_ICD_SEITENLOKALISATION (required)
system	SΣ	1..1	uri	Identity of the terminology system
code	SΣ	1..1	code	Symbol in syntax defined by the system
extension:Diagnosesicherheit	S	0..1	(Complex)	Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit"
value[x]	SC	1..1	Coding	Value of extension Binding: KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT (required) Constraints: icd-4, icd-5, icd-6, icd-7
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
system	SΣ	1..1	uri	Canonische CodeSystem URL für ICD-10-GM Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version	SΣ	1..1	string	Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code	SΣC	1..1	code	Der ICD-10-Code Constraints: icd-regex Example Einfacher ICD-Code: F17.4
coding:alpha-id	SΣ	0..1	CodingAlphaID	Alpha-ID Code Binding: MII VS Diagnose Alpha-ID (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	SΣ	1..1	uri	Canonische CodeSystem URL für Alpha-ID Fixed Value: http://fhir.de/CodeSystem/bfarm/alpha-id
version	SΣ	1..1	string	Die Jahresversion von Alpha-ID. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code	SΣ	1..1	code	Der Alpha-ID-Code
coding:sct	SΣ	0..1	Coding	SNOMED CT Code Binding: MII VS Diagnose Diagnose-Codes SNOMED (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	SΣ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
coding:orphanet	SΣ	0..1	Coding	ORPHAcode Binding: MII VS Diagnose Orphanet (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://www.orpha.net
code	SΣ	1..1	code	Symbol in syntax defined by the system
text	Σ	0..1	string	Plain text representation of the concept
bodySite	SΣ	0..*	CodeableConcept	Körperstelle Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
Slices for extension				Content/Rules for all slices
extension:bodySite		0..1	Reference(BodyStructure)	Target anatomic location or structure URL: http://hl7.org/fhir/StructureDefinition/bodySite
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:snomed-ct	SΣ	0..1	Coding	SNOMED CT Code Binding: MII VS Diagnose BodyStructure SNOMED (required)
system	SΣ	1..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
version	SΣ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
coding:primaertumorSeitenlokalisation	SΣ	0..1	Coding	Seitenlokalisation des Primärtumors gemäß oBDS Binding: MII VS Onkologie Primärtumor Seitenlokalisation (required)
system	SΣ	1..1	uri	Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-seitenlokalisation
code	SΣ	1..1	code	Symbol in syntax defined by the system
coding:icd-o-3	SΣ	0..1	Coding	ICD-O-Topographie Binding: MII VS Onkologie ICD-O-3 Topographie (required)
system	SΣ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/icd-o-3
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
subject	SΣ	1..1	Reference(Patient)	Who has the condition?
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
encounter	SΣ	0..1	Reference(Encounter)	Kontakt (Aufenthaltsbezug)
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
Slices for onset[x]	SΣ	0..1		Beginn Slice: Unordered, Open by type:$this
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onset[x]:onsetDateTime	SΣ	0..1	dateTime	Beginn Datum
onset[x]:onsetAge	SΣ	0..1	Age	Erkrankungsbeginn als Alter
Slices for extension				Content/Rules for all slices
extension:Lebensphase-Beginn		0..1	(Complex)	Lebensphase des Erkrankungsbeginns URL: http://fhir.de/StructureDefinition/lebensphase
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/lebensphase"
value[x]	S	1..1	CodeableConcept	Value of extension
coding	SΣ	1..1	Coding	Code defined by a terminology system Binding: LebensphaseDe ValueSet (required): Lebensphase
system	SΣ	1..1	uri	Identity of the terminology system
code	SΣ	1..1	code	Symbol in syntax defined by the system
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
Slices for abatement[x]	SC	0..1		Ende Slice: Unordered, Open by type:$this
abatementDateTime			dateTime
abatementAge			Age
abatementPeriod			Period
abatement[x]:abatementDateTime	SC	0..1	dateTime	Ende Datum
abatement[x]:abatementAge	SC	0..1	Age	Erkrankungsende als Alter
Slices for extension				Content/Rules for all slices
extension:Lebensphase-Ende		0..1	(Complex)	Lebensphase des Erkrankungsendes URL: http://fhir.de/StructureDefinition/lebensphase
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/lebensphase"
value[x]	S	1..1	CodeableConcept	Value of extension
coding	SΣ	1..1	Coding	Code defined by a terminology system Binding: LebensphaseDe ValueSet (required): Lebensphase
system	SΣ	1..1	uri	Identity of the terminology system
code	SΣ	1..1	code	Symbol in syntax defined by the system
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
recordedDate	SΣ	1..1	dateTime	Aufzeichnungsdatum
evidence	SC	0..1	BackboneElement	Supporting evidence Constraints: con-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	SΣC	0..*	Reference(MII PR Onkologie Evidenz Diagnose Primärtumor)	Evidenz für Erstdiagnose
note	S	0..*	Annotation	Hinweis
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:morphology-behavior-icdo3.​value[x]	Base	required	MII VS Onkologie ICD-O-3 Morphologie	📦2027.0.0-ballot.1	This IG
Condition.extension:occurredFollowing.​value[x]	Base	example	Condition Predecessor Codes	📦4.0.1	FHIR Std.
Condition.extension:dueTo.​value[x]	Base	example	Condition Cause Codes	📦4.0.1	FHIR Std.
Condition.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.
Condition.verificationStatus.​coding:condition-ver-status	Base	required	ConditionVerificationStatus	📦4.0.1	FHIR Std.
Condition.verificationStatus.​coding:primaertumorDiagnosesicherung	Base	required	MII VS Onkologie Primärtumor Diagnosesicherung	📦2027.0.0-ballot.1	This IG
Condition.category	Base	extensible	Condition Category Codes	📍4.0.1	FHIR Std.
Condition.category:onkologie	Base	extensible	Condition Category Codes	📍4.0.1	FHIR Std.
Condition.code	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Condition.code.coding:icd10-gm	Base	required	MII VS Diagnose ICD-10-GM	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.code.coding:icd10-gm.​extension:Mehrfachcodierungs-Kennzeichen.​value[x]	Base	required	Mehrfachkodierungs-Kennzeichen ICD10GM ValueSet	📦1.6.0	de.basisprofil.r4 v1.6
Condition.code.coding:icd10-gm.​extension:Seitenlokalisation.​value[x]	Base	required	KBV_VS_SFHIR_ICD_SEITENLOKALISATION	⏿1.00	127.0.0.1
Condition.code.coding:icd10-gm.​extension:Diagnosesicherheit.​value[x]	Base	required	KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT	⏿1.00	127.0.0.1
Condition.code.coding:alpha-id	Base	required	MII VS Diagnose Alpha-ID	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.code.coding:sct	Base	required	MII VS Diagnose Diagnose-Codes SNOMED	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.code.coding:orphanet	Base	required	MII VS Diagnose Orphanet	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Condition.bodySite.coding:snomed-ct	Base	required	MII VS Diagnose BodyStructure SNOMED	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.bodySite.coding:primaertumorSeitenlokalisation	Base	required	MII VS Onkologie Primärtumor Seitenlokalisation	📦2027.0.0-ballot.1	This IG
Condition.bodySite.coding:icd-o-3	Base	required	MII VS Onkologie ICD-O-3 Topographie	📦2027.0.0-ballot.1	This IG
Condition.onset[x]:onsetAge.​extension:Lebensphase-Beginn.​value[x].coding	Base	required	LebensphaseDe ValueSet	📦1.6.0	de.basisprofil.r4 v1.6
Condition.onset[x]:onsetAge.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Condition.abatement[x]:abatementAge.​extension:Lebensphase-Ende.​value[x].coding	Base	required	LebensphaseDe ValueSet	📦1.6.0	de.basisprofil.r4 v1.6
Condition.abatement[x]:abatementAge.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
con-2	error	Condition.evidence	evidence SHALL have code or details	code.exists() or detail.exists()
con-3	best practice	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item	clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission	abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5	error	Condition	Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error	verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Condition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Condition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Condition	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Condition	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
icd-4	warning	Condition.code.coding:icd10-gm.extension:Diagnosesicherheit.value[x]	Wenn die Diagnosesicherheit "A (Ausschluss)" verwendet wird, dann muss clinicalStatus leer bleiben und verificationStaus auf "refuted" gesetzt werden.	code!='A' or (%resource.verificationStatus.coding.where(code='refuted').exists() and %resource.clinicalStatus.empty())
icd-5	warning	Condition.code.coding:icd10-gm.extension:Diagnosesicherheit.value[x]	Wenn die Diagnosesicherheit "G (Gesichert)" verwendet wird, dann muss clinicalStatus auf "active" und verificationStatus auf "confirmed" gesetzt werden.	code!='G' or (%resource.clinicalStatus.coding.where(code='active').exists() and %resource.verificationStatus.coding.where(code='confirmed').exists())
icd-6	warning	Condition.code.coding:icd10-gm.extension:Diagnosesicherheit.value[x]	Wenn die Diagnosesicherheit "V (Verdacht auf)" verwendet wird, dann muss clinicalStatus auf "active" und verificationStatus auf "provisional" oder "differential" gesetzt werden.	code!='V' or (%resource.clinicalStatus.coding.where(code='active').exists() and (%resource.verificationStatus.coding.where(code='provisional').exists() or %resource.verificationStatus.coding.where(code='differential').exists()))
icd-7	warning	Condition.code.coding:icd10-gm.extension:Diagnosesicherheit.value[x]	Wenn die Diagnosesicherheit "Z (Zustand nach)" verwendet wird, dann muss clinicalStatus auf "resolved" und verificationStatus auf "confirmed" gesetzt werden.	code!='Z' or (%resource.clinicalStatus.coding.where(code='resolved').exists() and %resource.verificationStatus.coding.where(code='confirmed').exists())
icd-regex	warning	Condition.code.coding:icd10-gm.code	In code sind nur gültige ICD-10-Codes ohne Zusätze erlaubt	matches('^[A-Z][0-9][A-Z0-9](\\.?[A-Z0-9]{0,4})?$')
onko-icd-meldepflicht	warning	Condition.code.coding:icd10-gm	Der ICD-10-GM-Code sollte aus der Menge der krebsregister-meldepflichtigen Neubildungen stammen (C00-C97, D00-D09, D32-D33, D35.2-D35.4, D37-D48). Andere Codes sind zulässig, aber untypisch für eine onkologische Primärdiagnose.	$this.memberOf('https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-icd10-meldepflichtige-tumoren')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition		0..*	MII_PR_Diagnose_Condition	Detailed information about conditions, problems or diagnoses
extension	S	1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:Feststellungsdatum		1..1	ConditionAssertedDate(5.3.0)	Date the condition was first asserted
extension:morphology-behavior-icdo3	S	0..*	(Complex)	ICD-O-Morphologie URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-histology-morphology-behavior-icdo3
value[x]
coding
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system
text		0..1	string	Plain text representation of the concept
extension:occurredFollowing	S	0..*	(Complex)	Frühere Tumorerkrankungen (zeitliche Abfolge) URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
Slices for value[x]		1..1	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Value of extension Slice: Unordered, Open by type:$this
Slices for value[x]				Content/Rules for all slices
value[x]:valueReference		0..1	Reference(MII PR Onkologie Diagnose Primärtumor | MII PR Onkologie Frühere Tumorerkrankung)	Value of extension
extension:dueTo	S	0..*	(Complex)	Verursacht durch (therapieassoziierte Sekundärmalignome) URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Slices for value[x]		1..1	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Value of extension Slice: Unordered, Open by type:$this
Slices for value[x]				Content/Rules for all slices
value[x]:valueReference		0..1	Reference(MII PR Onkologie Strahlentherapie | MII PR Onkologie Systemische Therapie | MII PR Onkologie Systemische Therapie Medikation | MII PR Onkologie Diagnose Primärtumor | MII PR Onkologie Frühere Tumorerkrankung)	Value of extension
extension:transformationVon	S	0..*	Reference(MII PR Onkologie Diagnose Primärtumor)	Transformation aus registriertem Primärtumor URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-transformation-von
identifier	S	0..*	Identifier	Tumor-ID (Tumoridentität)
system	S	0..1	uri	The namespace for the identifier value
value	S	0..1	string	The value that is unique
verificationStatus
Slices for coding		0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:condition-ver-status	S	0..1	Coding	Code defined by a terminology system Binding: ConditionVerificationStatus (required) Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/condition-ver-status
coding:primaertumorDiagnosesicherung	S	0..1	Coding	Diagnosesicherung gemäß oBDS Binding: MII VS Onkologie Primärtumor Diagnosesicherung (required) Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-primaertumor-diagnosesicherung
code		1..1	code	Symbol in syntax defined by the system
Slices for category		1..*	CodeableConcept	problem-list-item | encounter-diagnosis Slice: Unordered, Open by pattern:$this
category:onkologie	S	1..1	CodeableConcept	Onkologie-Kennzeichnung Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55342001
display		1..1	string	Representation defined by the system Fixed Value: Neoplastic disease
code
Slices for coding				Content/Rules for all slices
coding:icd10-gm	C	0..1	CodingICD10GM	ICD-10-GM Code Constraints: onko-icd-meldepflicht
version		1..1	string	Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code		1..1	code	Der ICD-10-Code
text		0..1	string	Plain text representation of the concept
bodySite
Slices for coding				Content/Rules for all slices
coding:primaertumorSeitenlokalisation	S	0..1	Coding	Seitenlokalisation des Primärtumors gemäß oBDS Binding: MII VS Onkologie Primärtumor Seitenlokalisation (required)
system	S	1..1	uri	Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-seitenlokalisation
code	S	1..1	code	Symbol in syntax defined by the system
coding:icd-o-3	S	0..1	Coding	ICD-O-Topographie Binding: MII VS Onkologie ICD-O-3 Topographie (required)
system	S	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/icd-o-3
version		0..1	string	Version of the system - if relevant
code	S	1..1	code	Symbol in syntax defined by the system
subject		1..1	Reference(Patient)	Who has the condition?
evidence	S	0..1	BackboneElement	Supporting evidence
detail	S	0..*	Reference(MII PR Onkologie Evidenz Diagnose Primärtumor)	Evidenz für Erstdiagnose
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Condition.verificationStatus.​coding:condition-ver-status	Base	required	ConditionVerificationStatus	📦4.0.1	FHIR Std.
Condition.verificationStatus.​coding:primaertumorDiagnosesicherung	Base	required	MII VS Onkologie Primärtumor Diagnosesicherung	📦2027.0.0-ballot.1	This IG
Condition.bodySite.coding:primaertumorSeitenlokalisation	Base	required	MII VS Onkologie Primärtumor Seitenlokalisation	📦2027.0.0-ballot.1	This IG
Condition.bodySite.coding:icd-o-3	Base	required	MII VS Onkologie ICD-O-3 Topographie	📦2027.0.0-ballot.1	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
onko-icd-meldepflicht	warning	Condition.code.coding:icd10-gm	Der ICD-10-GM-Code sollte aus der Menge der krebsregister-meldepflichtigen Neubildungen stammen (C00-C97, D00-D09, D32-D33, D35.2-D35.4, D37-D48). Andere Codes sind zulässig, aber untypisch für eine onkologische Primärdiagnose.	$this.memberOf('https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-icd10-meldepflichtige-tumoren')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	MII_PR_Diagnose_Condition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	SΣ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:ReferenzPrimaerdiagnose	S	0..1	(Complex)	Conditions associated with this condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]	S	1..1	Reference(Condition)	Value of extension
extension:Feststellungsdatum	S	1..1	(Complex)	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-assertedDate"
value[x]	S	1..1	dateTime	Value of extension
extension:morphology-behavior-icdo3	S	0..*	(Complex)	ICD-O-Morphologie URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-histology-morphology-behavior-icdo3
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-histology-morphology-behavior-icdo3"
value[x]		1..1	CodeableConcept	Value of extension Binding: MII VS Onkologie ICD-O-3 Morphologie (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/icd-o-3
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept
extension:occurredFollowing	S	0..*	(Complex)	Frühere Tumorerkrankungen (zeitliche Abfolge) URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing"
Slices for value[x]		1..1		Value of extension Slice: Unordered, Open by type:$this Binding: ConditionPredecessorCodes (example): Codes that describe activities or observations that occurred prior to the condition.
valueCodeableConcept			CodeableConcept
valueReference			Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)
Slices for value[x]				Content/Rules for all slices
value[x]:valueReference		0..1	Reference(MII PR Onkologie Diagnose Primärtumor | MII PR Onkologie Frühere Tumorerkrankung)	Value of extension
extension:dueTo	S	0..*	(Complex)	Verursacht durch (therapieassoziierte Sekundärmalignome) URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-dueTo"
Slices for value[x]		1..1		Value of extension Slice: Unordered, Open by type:$this Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
valueCodeableConcept			CodeableConcept
valueReference			Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)
Slices for value[x]				Content/Rules for all slices
value[x]:valueReference		0..1	Reference(MII PR Onkologie Strahlentherapie | MII PR Onkologie Systemische Therapie | MII PR Onkologie Systemische Therapie Medikation | MII PR Onkologie Diagnose Primärtumor | MII PR Onkologie Frühere Tumorerkrankung)	Value of extension
extension:transformationVon	S	0..*	Reference(MII PR Onkologie Diagnose Primärtumor)	Transformation aus registriertem Primärtumor URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-transformation-von
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	0..*	Identifier	Tumor-ID (Tumoridentität)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
clinicalStatus	?!SΣC	0..1	CodeableConcept	Klinischer Status Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
verificationStatus	?!SΣC	0..1	CodeableConcept	Verifizierungsstatus Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:condition-ver-status	SΣ	0..1	Coding	Code defined by a terminology system Binding: ConditionVerificationStatus (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/condition-ver-status
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:primaertumorDiagnosesicherung	SΣ	0..1	Coding	Diagnosesicherung gemäß oBDS Binding: MII VS Onkologie Primärtumor Diagnosesicherung (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-primaertumor-diagnosesicherung
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
Slices for category		1..*	CodeableConcept	problem-list-item | encounter-diagnosis Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:onkologie	S	1..1	CodeableConcept	Onkologie-Kennzeichnung Binding: ConditionCategoryCodes (extensible): A category assigned to the condition. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 55342001
display		1..1	string	Representation defined by the system Fixed Value: Neoplastic disease
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
severity		0..1	CodeableConcept	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	Code Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:icd10-gm	SΣC	0..1	CodingICD10GM	ICD-10-GM Code Binding: MII VS Diagnose ICD-10-GM (required) Constraints: onko-icd-meldepflicht Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:Mehrfachcodierungs-Kennzeichen	S	0..1	(Complex)	Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-mehrfachcodierungs-kennzeichen
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/icd-10-gm-mehrfachcodierungs-kennzeichen"
value[x]	S	1..1	Coding	Value of extension Binding: Mehrfachkodierungs-Kennzeichen ICD10GM ValueSet (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
extension:Seitenlokalisation	S	0..1	(Complex)	Optional Extensions Element URL: http://fhir.de/StructureDefinition/seitenlokalisation
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/seitenlokalisation"
value[x]	S	1..1	Coding	Value of extension Binding: KBV_VS_SFHIR_ICD_SEITENLOKALISATION (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
extension:Diagnosesicherheit	S	0..1	(Complex)	Optional Extensions Element URL: http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit"
value[x]	SC	1..1	Coding	Value of extension Binding: KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT (required) Constraints: icd-4, icd-5, icd-6, icd-7
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
system	SΣ	1..1	uri	Canonische CodeSystem URL für ICD-10-GM Fixed Value: http://fhir.de/CodeSystem/bfarm/icd-10-gm
version	SΣ	1..1	string	Die Jahresversion von ICD-10-GM. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code	SΣC	1..1	code	Der ICD-10-Code Constraints: icd-regex Example Einfacher ICD-Code: F17.4
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:alpha-id	SΣ	0..1	CodingAlphaID	Alpha-ID Code Binding: MII VS Diagnose Alpha-ID (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Canonische CodeSystem URL für Alpha-ID Fixed Value: http://fhir.de/CodeSystem/bfarm/alpha-id
version	SΣ	1..1	string	Die Jahresversion von Alpha-ID. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code	SΣ	1..1	code	Der Alpha-ID-Code
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:sct	SΣ	0..1	Coding	SNOMED CT Code Binding: MII VS Diagnose Diagnose-Codes SNOMED (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	SΣ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:orphanet	SΣ	0..1	Coding	ORPHAcode Binding: MII VS Diagnose Orphanet (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://www.orpha.net
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
bodySite	SΣ	0..*	CodeableConcept	Körperstelle Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:bodySite		0..1	Reference(BodyStructure)	Target anatomic location or structure URL: http://hl7.org/fhir/StructureDefinition/bodySite
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:system
coding:snomed-ct	SΣ	0..1	Coding	SNOMED CT Code Binding: MII VS Diagnose BodyStructure SNOMED (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Required Pattern: http://snomed.info/sct
version	SΣ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:primaertumorSeitenlokalisation	SΣ	0..1	Coding	Seitenlokalisation des Primärtumors gemäß oBDS Binding: MII VS Onkologie Primärtumor Seitenlokalisation (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-seitenlokalisation
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:icd-o-3	SΣ	0..1	Coding	ICD-O-Topographie Binding: MII VS Onkologie ICD-O-3 Topographie (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/icd-o-3
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	Who has the condition?
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
encounter	SΣ	0..1	Reference(Encounter)	Kontakt (Aufenthaltsbezug)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Slices for onset[x]	SΣ	0..1		Beginn Slice: Unordered, Open by type:$this
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onset[x]:onsetDateTime	SΣ	0..1	dateTime	Beginn Datum
onset[x]:onsetAge	SΣ	0..1	Age	Erkrankungsbeginn als Alter
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:Lebensphase-Beginn		0..1	(Complex)	Lebensphase des Erkrankungsbeginns URL: http://fhir.de/StructureDefinition/lebensphase
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/lebensphase"
value[x]	S	1..1	CodeableConcept	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system Binding: LebensphaseDe ValueSet (required): Lebensphase
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
Slices for abatement[x]	SC	0..1		Ende Slice: Unordered, Open by type:$this
abatementDateTime			dateTime
abatementAge			Age
abatementPeriod			Period
abatement[x]:abatementDateTime	SC	0..1	dateTime	Ende Datum
abatement[x]:abatementAge	SC	0..1	Age	Erkrankungsende als Alter
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:Lebensphase-Ende		0..1	(Complex)	Lebensphase des Erkrankungsendes URL: http://fhir.de/StructureDefinition/lebensphase
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/lebensphase"
value[x]	S	1..1	CodeableConcept	Value of extension
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	1..1	Coding	Code defined by a terminology system Binding: LebensphaseDe ValueSet (required): Lebensphase
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
recordedDate	SΣ	1..1	dateTime	Aufzeichnungsdatum
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Who recorded the condition
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally Constraints: con-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	C	0..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	SC	0..1	BackboneElement	Supporting evidence Constraints: con-2
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	SΣC	0..*	Reference(MII PR Onkologie Evidenz Diagnose Primärtumor)	Evidenz für Erstdiagnose
note	S	0..*	Annotation	Hinweis
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.meta.security	Base	extensible	SecurityLabels	📍4.0.1	FHIR Std.
Condition.meta.tag	Base	example	Common Tags	📍4.0.1	FHIR Std.
Condition.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Condition.extension:morphology-behavior-icdo3.​value[x]	Base	required	MII VS Onkologie ICD-O-3 Morphologie	📦2027.0.0-ballot.1	This IG
Condition.extension:occurredFollowing.​value[x]	Base	example	Condition Predecessor Codes	📦4.0.1	FHIR Std.
Condition.extension:dueTo.​value[x]	Base	example	Condition Cause Codes	📦4.0.1	FHIR Std.
Condition.identifier.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Condition.identifier.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.
Condition.verificationStatus.​coding:condition-ver-status	Base	required	ConditionVerificationStatus	📦4.0.1	FHIR Std.
Condition.verificationStatus.​coding:primaertumorDiagnosesicherung	Base	required	MII VS Onkologie Primärtumor Diagnosesicherung	📦2027.0.0-ballot.1	This IG
Condition.category	Base	extensible	Condition Category Codes	📍4.0.1	FHIR Std.
Condition.category:onkologie	Base	extensible	Condition Category Codes	📍4.0.1	FHIR Std.
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📍4.0.1	FHIR Std.
Condition.code	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Condition.code.coding:icd10-gm	Base	required	MII VS Diagnose ICD-10-GM	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.code.coding:icd10-gm.​extension:Mehrfachcodierungs-Kennzeichen.​value[x]	Base	required	Mehrfachkodierungs-Kennzeichen ICD10GM ValueSet	📦1.6.0	de.basisprofil.r4 v1.6
Condition.code.coding:icd10-gm.​extension:Seitenlokalisation.​value[x]	Base	required	KBV_VS_SFHIR_ICD_SEITENLOKALISATION	⏿1.00	127.0.0.1
Condition.code.coding:icd10-gm.​extension:Diagnosesicherheit.​value[x]	Base	required	KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT	⏿1.00	127.0.0.1
Condition.code.coding:alpha-id	Base	required	MII VS Diagnose Alpha-ID	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.code.coding:sct	Base	required	MII VS Diagnose Diagnose-Codes SNOMED	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.code.coding:orphanet	Base	required	MII VS Diagnose Orphanet	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Condition.bodySite.coding:snomed-ct	Base	required	MII VS Diagnose BodyStructure SNOMED	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Condition.bodySite.coding:primaertumorSeitenlokalisation	Base	required	MII VS Onkologie Primärtumor Seitenlokalisation	📦2027.0.0-ballot.1	This IG
Condition.bodySite.coding:icd-o-3	Base	required	MII VS Onkologie ICD-O-3 Topographie	📦2027.0.0-ballot.1	This IG
Condition.subject.type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Condition.encounter.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Condition.onset[x]:onsetAge.​extension:Lebensphase-Beginn.​value[x].coding	Base	required	LebensphaseDe ValueSet	📦1.6.0	de.basisprofil.r4 v1.6
Condition.onset[x]:onsetAge.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Condition.abatement[x]:abatementAge.​extension:Lebensphase-Ende.​value[x].coding	Base	required	LebensphaseDe ValueSet	📦1.6.0	de.basisprofil.r4 v1.6
Condition.abatement[x]:abatementAge.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Condition.stage.summary	Base	example	Condition Stage	📍4.0.1	FHIR Std.
Condition.stage.type	Base	example	Condition Stage Type	📍4.0.1	FHIR Std.
Condition.evidence.code	Base	example	Manifestation and Symptom Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
con-1	error	Condition.stage	Stage SHALL have summary or assessment	summary.exists() or assessment.exists()
con-2	error	Condition.evidence	evidence SHALL have code or details	code.exists() or detail.exists()
con-3	best practice	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item	clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission	abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5	error	Condition	Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error	verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Condition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Condition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Condition	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Condition	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
icd-4	warning	Condition.code.coding:icd10-gm.extension:Diagnosesicherheit.value[x]	Wenn die Diagnosesicherheit "A (Ausschluss)" verwendet wird, dann muss clinicalStatus leer bleiben und verificationStaus auf "refuted" gesetzt werden.	code!='A' or (%resource.verificationStatus.coding.where(code='refuted').exists() and %resource.clinicalStatus.empty())
icd-5	warning	Condition.code.coding:icd10-gm.extension:Diagnosesicherheit.value[x]	Wenn die Diagnosesicherheit "G (Gesichert)" verwendet wird, dann muss clinicalStatus auf "active" und verificationStatus auf "confirmed" gesetzt werden.	code!='G' or (%resource.clinicalStatus.coding.where(code='active').exists() and %resource.verificationStatus.coding.where(code='confirmed').exists())
icd-6	warning	Condition.code.coding:icd10-gm.extension:Diagnosesicherheit.value[x]	Wenn die Diagnosesicherheit "V (Verdacht auf)" verwendet wird, dann muss clinicalStatus auf "active" und verificationStatus auf "provisional" oder "differential" gesetzt werden.	code!='V' or (%resource.clinicalStatus.coding.where(code='active').exists() and (%resource.verificationStatus.coding.where(code='provisional').exists() or %resource.verificationStatus.coding.where(code='differential').exists()))
icd-7	warning	Condition.code.coding:icd10-gm.extension:Diagnosesicherheit.value[x]	Wenn die Diagnosesicherheit "Z (Zustand nach)" verwendet wird, dann muss clinicalStatus auf "resolved" und verificationStatus auf "confirmed" gesetzt werden.	code!='Z' or (%resource.clinicalStatus.coding.where(code='resolved').exists() and %resource.verificationStatus.coding.where(code='confirmed').exists())
icd-regex	warning	Condition.code.coding:icd10-gm.code	In code sind nur gültige ICD-10-Codes ohne Zusätze erlaubt	matches('^[A-Z][0-9][A-Z0-9](\\.?[A-Z0-9]{0,4})?$')
onko-icd-meldepflicht	warning	Condition.code.coding:icd10-gm	Der ICD-10-GM-Code sollte aus der Menge der krebsregister-meldepflichtigen Neubildungen stammen (C00-C97, D00-D09, D32-D33, D35.2-D35.4, D37-D48). Andere Codes sind zulässig, aber untypisch für eine onkologische Primärdiagnose.	$this.memberOf('https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-icd10-meldepflichtige-tumoren')