This profile describes individual irradiations within radiotherapy in oncology. This profile describes radiotherapy in the narrower sense; brachytherapies and systemic nuclear medicine procedures are represented via the Nuclear Medicine Therapies profile. The radiotherapy profile for oncology is based on the MII procedure module.

Implementation recommendation

The points listed above result in the following coding recommendation for oBDS radiotherapy:

• Category as SNOMED code
  • Category for radiotherapy 1287742003 | Radiotherapy (procedure)
• Coding via OPS
  • Radiotherapy as OPS 8-52 Strahlentherapie or more specific if available

Conformance

The present profilings are compatible with the procedure profile of the ISiK base modules level 4. https://simplifier.net/isik-basis-v4/isikprozedur

Documentation guidance

Prophylactic irradiations (§65c resolution of 31.05.2022): Tumor-specific prophylactic irradiations — the main case being prophylactic whole-brain irradiation (PCI) in small cell lung carcinoma — MUST be documented: StellungZurOp = S (other), the Intention follows from the overall treatment concept (curative/palliative), target region e.g. 1.1 whole brain. Supportive irradiations without tumor specificity (e.g. nipple irradiation for gynecomastia prophylaxis under hormone therapy in prostate carcinoma) are not to be recorded. Example: mii-exa-onko-strahlentherapie-pci-sclc.

Permanent implants/seeds (oBDS 14.6): For seed implantations (typically interstitial LDR brachytherapy), the day of application MUST be documented as the end — performedPeriod.start = performedPeriod.end is then correct and valid. Deviations from this are a data quality signal (for DQ rules see GitHub #292).

Mapping of dataset to FHIR

The mapping of the dataset fields is documented in the logical model: MII LM Onkologie.

Mapping Einheitlicher onkologischer Basisdatensatz (oBDS) to FHIR

The oBDS mappings are recorded in the artefact view of this profile: MII PR Onkologie Strahlentherapie.

Examples

mii-exa-onko-strahlentherapie-strahlentherapie-1

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	MII_PR_Prozedur_Procedure	An action that is being or was performed on a patient Constraints: proc-mii-1
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	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Dokumentationsdatum	S	0..1	(Complex)	Dokumentationsdatum URL: http://fhir.de/StructureDefinition/ProzedurDokumentationsdatum
extension		0..0		Additional content defined by implementations Slice: Unordered, Open by value:url
url	S	1..1	uri	"http://fhir.de/StructureDefinition/ProzedurDokumentationsdatum"
value[x]	S	1..1	dateTime	Value of extension
extension:durchfuehrungsabsicht	S	0..1	(Complex)	Durchführungsabsicht URL: https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Durchfuehrungsabsicht
extension		0..0		Extension Slice: Unordered, Open by value:url
url	S	1..1	uri	"https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Durchfuehrungsabsicht"
value[x]	S	1..1	Coding	Value of extension Binding: MII VS Prozedur Durchführungsabsicht [SNOMED CT] (required)
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	SΣ	1..1	code	Symbol in syntax defined by the system
extension:Gesamtdosis	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Gesamtdosis URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-gesamtdosis
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-strahlentherapie-bestrahlung-gesamtdosis"
extension:Einzeldosis	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Einzeldosis URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-einzeldosis
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-strahlentherapie-bestrahlung-einzeldosis"
extension:Boost	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Boost URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-boost
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-strahlentherapie-bestrahlung-boost"
extension:Applikationsart	S	0..1	(Complex)	Applikationsart URL: http://hl7.org/fhir/StructureDefinition/procedure-method
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/procedure-method"
value[x]		1..1	CodeableConcept	Value of extension Binding: MII VS Onkologie Strahlentherapie Applikationsart (extensible)
coding	Σ	0..*	Coding	Code defined by a terminology system
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-strahlentherapie-applikationsart
code	SΣ	1..1	code	Symbol in syntax defined by the system
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn	SΣ	0..*	Reference(CarePlan)	A request for this procedure
partOf	SΣ	0..*	Reference(Procedure | Observation)	Part of referenced event
status	?!SΣ	1..1	code	Status Binding: EventStatus (required): A code specifying the state of the procedure.
category	SΣ	0..1	CodeableConcept	Kategorie Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
text		0..1	string	Plain text representation of the concept
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy (procedure)
userSelected		0..1	boolean	If this coding was chosen directly by the user
coding:sct	SΣ	0..1	Coding	SNOMED CT Code Binding: MII VS Prozedur OPS Kategorien [SNOMED CT] (preferred) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
version		0..1	string	Version of the system - if relevant
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: 1287742003
code	SΣC	1..1	CodeableConcept	Code Binding: MII VS Onkologie OPS Strahlentherapie (extensible) Constraints: sct-ops-1
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:ops	SΣ	0..1	CodingOPS	Operationen- und Prozedurenschlüssel (OPS) Code Binding: MII VS Prozedur OPS (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
Slices for extension				Content/Rules for all slices
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
system	SΣ	1..1	uri	Canonische CodeSystem URL für OPS Fixed Value: http://fhir.de/CodeSystem/bfarm/ops
version	SΣ	1..1	string	Die Jahresversion des OPS Kataloges. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code	SΣC	1..1	code	Der OPS-Code Constraints: ops-regex Example Einfacher OPS-Code: 5-470
coding:sct	SΣ	0..1	Coding	SNOMED CT Code Binding: MII VS Prozedur Prozeduren [SNOMED CT] (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://snomed.info/sct
code	SΣ	1..1	code	Symbol in syntax defined by the system
subject	SΣ	1..1	Reference(Patient)	Who the procedure was performed on
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 performed[x]	SΣ	1..1	Period	Durchführungsdatum Slice: Unordered, Closed by type:$this
performed[x]:All Slices				Content/Rules for all slices
start	ΣC	0..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
performed[x]:performedPeriod	SΣ	0..1	Period	Durchführungszeitraum
start	SΣC	1..1	dateTime	Start der Strahlentherapie
end	SΣC	0..1	dateTime	Ende der Strahlentherapie
performed[x]:performedDateTime	SΣ	0..1	dateTime	When the procedure was performed
reasonReference	SΣ	0..*	Reference(MII PR Onkologie Diagnose Primärtumor | Condition)	The justification that the procedure was performed
bodySite	SΣ	0..1	CodeableConcept	Körperstelle Binding: MII VS Onkologie Strahlentherapie Zielgebiet (extensible)
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
extension:Seitenlokalisation	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Seitenlokalisation URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-seitenlokalisation
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-strahlentherapie-bestrahlung-seitenlokalisation"
Slices for coding	SΣ	0..*	Coding	Zielgebiet Slice: Unordered, Open by pattern:system
coding:All Slices				Content/Rules for all slices
code	Σ	0..1	code	Symbol in syntax defined by the system
coding:snomed-ct	SΣ	0..1	Coding	SNOMED CT Code
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
note	S	0..*	Annotation	Hinweis
Slices for usedCode	S	0..*	CodeableConcept	Coded items used during the procedure Slice: Unordered, Open by pattern:coding.system Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
usedCode:Strahlenart	S	0..1	CodeableConcept	Strahlenart Binding: MII VS Onkologie Strahlentherapie Strahlenart (extensible)
coding	Σ	0..*	Coding	Code defined by a terminology system
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-strahlentherapie-strahlenart
code	SΣ	1..1	code	Symbol in syntax defined by the system
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.extension:durchfuehrungsabsicht.​value[x]	Base	required	MII VS Prozedur Durchführungsabsicht [SNOMED CT]	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Procedure.extension:Applikationsart.​value[x]	Base	extensible	MII VS Onkologie Strahlentherapie Applikationsart	📦2027.0.0-ballot.1	This IG
Procedure.status	Base	required	EventStatus	📍4.0.1	FHIR Std.
Procedure.category	Base	example	Procedure Category Codes (SNOMED CT)	📍4.0.1	FHIR Std.
Procedure.category.coding:sct	Base	preferred	MII VS Prozedur OPS Kategorien [SNOMED CT]	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Procedure.code	Base	extensible	MII VS Onkologie OPS Strahlentherapie	📦2027.0.0-ballot.1	This IG
Procedure.code.coding:ops	Base	required	MII VS Prozedur OPS	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Procedure.code.coding:ops.​extension:Seitenlokalisation.​value[x]	Base	required	KBV_VS_SFHIR_ICD_SEITENLOKALISATION	⏿1.00	127.0.0.1
Procedure.code.coding:sct	Base	required	MII VS Prozedur Prozeduren [SNOMED CT]	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Procedure.bodySite	Base	extensible	MII VS Onkologie Strahlentherapie Zielgebiet	📦2027.0.0-ballot.1	This IG
Procedure.usedCode	Base	example	FHIR Device Types	📍4.0.1	FHIR Std.
Procedure.usedCode:Strahlenart	Base	extensible	MII VS Onkologie Strahlentherapie Strahlenart	📦2027.0.0-ballot.1	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	Procedure	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	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	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()
ops-regex	warning	Procedure.code.coding:ops.code	In code sind nur gültige OPS-Codes ohne Zusätze erlaubt	matches('^[1|3|5|6|8|9]-[a-zA-Z0-9]{3}([.][a-zA-Z0-9]{1,2})?$')
proc-mii-1	error	Procedure	Falls die Prozedur per OPS kodiert wird, MUSS eine SNOMED-CT kodierte Category abgebildet werden	code.coding.where(system = 'http://fhir.de/CodeSystem/bfarm/ops').exists() implies category.coding.where(system = 'http://snomed.info/sct').exists()
sct-ops-1	error	Procedure.code	Eine Prozedur MUSS mit OPS oder SNOMED-CT kodiert werden.	coding.where(system = 'http://snomed.info/sct').exists() or coding.where(system = 'http://fhir.de/CodeSystem/bfarm/ops').exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure		0..*	MII_PR_Prozedur_Procedure	An action that is being or was performed on a patient
Slices for extension				Content/Rules for all slices
extension:Gesamtdosis	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Gesamtdosis URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-gesamtdosis
value[x]
value		0..1	decimal	Numerical value (with implicit precision)
unit		0..1	string	Unit representation
extension:Einzeldosis	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Einzeldosis URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-einzeldosis
value[x]
value		0..1	decimal	Numerical value (with implicit precision)
unit		0..1	string	Unit representation
extension:Boost	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Boost URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-boost
value[x]
coding
code		0..1	code	Symbol in syntax defined by the system
extension:Applikationsart	S	0..1	(Complex)	Applikationsart URL: http://hl7.org/fhir/StructureDefinition/procedure-method
value[x]		1..1	CodeableConcept	Value of extension Binding: MII VS Onkologie Strahlentherapie Applikationsart (extensible)
coding
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-strahlentherapie-applikationsart
code	S	1..1	code	Symbol in syntax defined by the system
basedOn	S	0..*	Reference(CarePlan)	A request for this procedure
partOf	S	0..*	Reference(Procedure | Observation)	Part of referenced event
category		0..1	CodeableConcept	Kategorie 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: 1287742003
display		1..1	string	Representation defined by the system Fixed Value: Radiotherapy (procedure)
code		1..1	CodeableConcept	Code Binding: MII VS Onkologie OPS Strahlentherapie (extensible)
subject		1..1	Reference(Patient)	Who the procedure was performed on
performed[x]		1..1	Period	Durchführungsdatum
start		0..1	dateTime	Starting time with inclusive boundary
end		0..1	dateTime	End time with inclusive boundary, if not ongoing
Slices for performed[x]				Content/Rules for all slices
performed[x]:performedPeriod		0..1	Period	Durchführungszeitraum
start	S	1..1	dateTime	Start der Strahlentherapie
end	S	0..1	dateTime	Ende der Strahlentherapie
reasonReference	S	0..*	Reference(MII PR Onkologie Diagnose Primärtumor | Condition)	The justification that the procedure was performed
bodySite		0..1	CodeableConcept	Körperstelle Binding: MII VS Onkologie Strahlentherapie Zielgebiet (extensible)
Slices for extension				Content/Rules for all slices
extension:Seitenlokalisation	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Seitenlokalisation URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-seitenlokalisation
value[x]
coding		0..*	Coding	Zielgebiet Lateralität
code		0..1	code	Symbol in syntax defined by the system
coding		0..*	Coding	Zielgebiet
code		0..1	code	Symbol in syntax defined by the system
Slices for usedCode	S	0..*	CodeableConcept	Coded items used during the procedure Slice: Unordered, Open by pattern:coding.system
usedCode:Strahlenart	S	0..1	CodeableConcept	Strahlenart Binding: MII VS Onkologie Strahlentherapie Strahlenart (extensible)
coding
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-strahlentherapie-strahlenart
code	S	1..1	code	Symbol in syntax defined by the system
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Procedure.extension:Applikationsart.​value[x]	Base	extensible	MII VS Onkologie Strahlentherapie Applikationsart	📦2027.0.0-ballot.1	This IG
Procedure.code	Base	extensible	MII VS Onkologie OPS Strahlentherapie	📦2027.0.0-ballot.1	This IG
Procedure.bodySite	Base	extensible	MII VS Onkologie Strahlentherapie Zielgebiet	📦2027.0.0-ballot.1	This IG
Procedure.usedCode:Strahlenart	Base	extensible	MII VS Onkologie Strahlentherapie Strahlenart	📦2027.0.0-ballot.1	This IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	MII_PR_Prozedur_Procedure	An action that is being or was performed on a patient Constraints: proc-mii-1
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	0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Dokumentationsdatum	S	0..1	(Complex)	Dokumentationsdatum URL: http://fhir.de/StructureDefinition/ProzedurDokumentationsdatum
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/ProzedurDokumentationsdatum"
value[x]	S	1..1	dateTime	Value of extension
extension:durchfuehrungsabsicht	S	0..1	(Complex)	Durchführungsabsicht URL: https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Durchfuehrungsabsicht
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	"https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Durchfuehrungsabsicht"
value[x]	S	1..1	Coding	Value of extension Binding: MII VS Prozedur Durchführungsabsicht [SNOMED CT] (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 Fixed Value: http://snomed.info/sct
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:Gesamtdosis	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Gesamtdosis URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-gesamtdosis
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-strahlentherapie-bestrahlung-gesamtdosis"
value[x]		0..1	Quantity	Strahlentherapie Gesamtdosis (Dosis) Binding: MII VS Onkologie Strahlentherapie Strahlungseinheit (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
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 Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit
extension:Einzeldosis	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Einzeldosis URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-einzeldosis
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-strahlentherapie-bestrahlung-einzeldosis"
value[x]		0..1	Quantity	Strahlentherapie Einzeldosis pro Tag (Dosis) Binding: MII VS Onkologie Strahlentherapie Strahlungseinheit (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
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 Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit
extension:Boost	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Boost URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-boost
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-strahlentherapie-bestrahlung-boost"
value[x]		0..1	CodeableConcept	Strahlentherapie Boost Binding: MII VS Onkologie Strahlentherapie Boost (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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	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
extension:Applikationsart	S	0..1	(Complex)	Applikationsart URL: http://hl7.org/fhir/StructureDefinition/procedure-method
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/procedure-method"
value[x]		1..1	CodeableConcept	Value of extension Binding: MII VS Onkologie Strahlentherapie Applikationsart (extensible)
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	SΣ	1..1	uri	Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-strahlentherapie-applikationsart
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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	SΣ	0..*	Reference(CarePlan)	A request for this procedure
partOf	SΣ	0..*	Reference(Procedure | Observation)	Part of referenced event
status	?!SΣ	1..1	code	Status Binding: EventStatus (required): A code specifying the state of the procedure.
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	SΣ	0..1	CodeableConcept	Kategorie Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes. 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
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this Fixed Value: (Complex)
coding:sct	SΣ	0..1	Coding	SNOMED CT Code Binding: MII VS Prozedur OPS Kategorien [SNOMED CT] (preferred) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: 1287742003
display	Σ	0..1	string	Representation defined by the system Fixed Value: Radiotherapy (procedure)
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣC	1..1	CodeableConcept	Code Binding: MII VS Onkologie OPS Strahlentherapie (extensible) Constraints: sct-ops-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:ops	SΣ	0..1	CodingOPS	Operationen- und Prozedurenschlüssel (OPS) Code Binding: MII VS Prozedur OPS (required) 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: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
system	SΣ	1..1	uri	Canonische CodeSystem URL für OPS Fixed Value: http://fhir.de/CodeSystem/bfarm/ops
version	SΣ	1..1	string	Die Jahresversion des OPS Kataloges. Angegeben wird immer die vierstellige Jahreszahl (z.B. "2017")
code	SΣC	1..1	code	Der OPS-Code Constraints: ops-regex Example Einfacher OPS-Code: 5-470
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 Prozedur Prozeduren [SNOMED CT] (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	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 the procedure was performed on
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 performed[x]	SΣ	1..1	Period	Durchführungsdatum Slice: Unordered, Closed by type:$this
performed[x]: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
start	ΣC	0..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
performed[x]:performedPeriod	SΣ	0..1	Period	Durchführungszeitraum
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Start der Strahlentherapie
end	SΣC	0..1	dateTime	Ende der Strahlentherapie
performed[x]:performedDateTime	SΣ	0..1	dateTime	When the procedure was performed
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
performer	Σ	0..*	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	Σ	0..1	Reference(Location)	Where the procedure happened
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference	SΣ	0..*	Reference(MII PR Onkologie Diagnose Primärtumor | Condition)	The justification that the procedure was performed
bodySite	SΣ	0..1	CodeableConcept	Körperstelle Binding: MII VS Onkologie Strahlentherapie Zielgebiet (extensible)
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
extension:Seitenlokalisation	S	0..1	(Complex)	MII EX Onko Strahlentherapie Bestrahlung Seitenlokalisation URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-strahlentherapie-bestrahlung-seitenlokalisation
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-strahlentherapie-bestrahlung-seitenlokalisation"
value[x]		0..1	CodeableConcept	Seitenlokalisation im Zielgebiet 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
coding	Σ	0..*	Coding	Zielgebiet Lateralität
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	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
Slices for coding	SΣ	0..*	Coding	Zielgebiet Slice: Unordered, Open by pattern:system
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	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	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:snomed-ct	SΣ	0..1	Coding	SNOMED CT Code
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
text	Σ	0..1	string	Plain text representation of the concept
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
complicationDetail		0..*	Reference(Condition)	A condition that is a result of the procedure
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note	S	0..*	Annotation	Hinweis
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
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
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Items used during procedure
Slices for usedCode	S	0..*	CodeableConcept	Coded items used during the procedure Slice: Unordered, Open by pattern:coding.system Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
usedCode:Strahlenart	S	0..1	CodeableConcept	Strahlenart Binding: MII VS Onkologie Strahlentherapie Strahlenart (extensible)
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	SΣ	1..1	uri	Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-strahlentherapie-strahlenart
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
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.meta.security	Base	extensible	SecurityLabels	📍4.0.1	FHIR Std.
Procedure.meta.tag	Base	example	Common Tags	📍4.0.1	FHIR Std.
Procedure.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Procedure.extension:durchfuehrungsabsicht.​value[x]	Base	required	MII VS Prozedur Durchführungsabsicht [SNOMED CT]	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Procedure.extension:Gesamtdosis.​value[x]	Base	required	MII VS Onkologie Strahlentherapie Strahlungseinheit	📦2027.0.0-ballot.1	This IG
Procedure.extension:Gesamtdosis.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Procedure.extension:Einzeldosis.​value[x]	Base	required	MII VS Onkologie Strahlentherapie Strahlungseinheit	📦2027.0.0-ballot.1	This IG
Procedure.extension:Einzeldosis.​value[x].comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Procedure.extension:Boost.​value[x]	Base	required	MII VS Onkologie Strahlentherapie Boost	📦2027.0.0-ballot.1	This IG
Procedure.extension:Applikationsart.​value[x]	Base	extensible	MII VS Onkologie Strahlentherapie Applikationsart	📦2027.0.0-ballot.1	This IG
Procedure.status	Base	required	EventStatus	📍4.0.1	FHIR Std.
Procedure.statusReason	Base	example	Procedure Not Performed Reason (SNOMED-CT)	📍4.0.1	FHIR Std.
Procedure.category	Base	example	Procedure Category Codes (SNOMED CT)	📍4.0.1	FHIR Std.
Procedure.category.coding:sct	Base	preferred	MII VS Prozedur OPS Kategorien [SNOMED CT]	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Procedure.code	Base	extensible	MII VS Onkologie OPS Strahlentherapie	📦2027.0.0-ballot.1	This IG
Procedure.code.coding:ops	Base	required	MII VS Prozedur OPS	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Procedure.code.coding:ops.​extension:Seitenlokalisation.​value[x]	Base	required	KBV_VS_SFHIR_ICD_SEITENLOKALISATION	⏿1.00	127.0.0.1
Procedure.code.coding:sct	Base	required	MII VS Prozedur Prozeduren [SNOMED CT]	📦2027.0.0-ballot	MII Implementation Guide Core Dataset Base v2027.0
Procedure.subject.type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Procedure.encounter.​type	Base	extensible	ResourceType	📍4.0.1	FHIR Std.
Procedure.performer.​function	Base	example	Procedure Performer Role Codes	📍4.0.1	FHIR Std.
Procedure.reasonCode	Base	example	Procedure Reason Codes	📍4.0.1	FHIR Std.
Procedure.bodySite	Base	extensible	MII VS Onkologie Strahlentherapie Zielgebiet	📦2027.0.0-ballot.1	This IG
Procedure.bodySite.extension:Seitenlokalisation.​value[x]	Base	required	MII VS Onkologie Primärtumor Seitenlokalisation	📦2027.0.0-ballot.1	This IG
Procedure.outcome	Base	example	Procedure Outcome Codes (SNOMED CT)	📍4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Procedure.followUp	Base	example	Procedure Follow up Codes (SNOMED CT)	📍4.0.1	FHIR Std.
Procedure.focalDevice.​action	Base	preferred	Procedure Device Action Codes	📍4.0.1	FHIR Std.
Procedure.usedCode	Base	example	FHIR Device Types	📍4.0.1	FHIR Std.
Procedure.usedCode:Strahlenart	Base	extensible	MII VS Onkologie Strahlentherapie Strahlenart	📦2027.0.0-ballot.1	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	Procedure	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	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	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()
ops-regex	warning	Procedure.code.coding:ops.code	In code sind nur gültige OPS-Codes ohne Zusätze erlaubt	matches('^[1|3|5|6|8|9]-[a-zA-Z0-9]{3}([.][a-zA-Z0-9]{1,2})?$')
proc-mii-1	error	Procedure	Falls die Prozedur per OPS kodiert wird, MUSS eine SNOMED-CT kodierte Category abgebildet werden	code.coding.where(system = 'http://fhir.de/CodeSystem/bfarm/ops').exists() implies category.coding.where(system = 'http://snomed.info/sct').exists()
sct-ops-1	error	Procedure.code	Eine Prozedur MUSS mit OPS oder SNOMED-CT kodiert werden.	coding.where(system = 'http://snomed.info/sct').exists() or coding.where(system = 'http://fhir.de/CodeSystem/bfarm/ops').exists()