CMS ACCESS Model API
0.9.0 - ci-build

CMS ACCESS Model API - Local Development build (v0.9.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: ACCESS Condition Profile ( Abstract )

Official URL: https://globalalliantinc.com/access/StructureDefinition/access-condition | Version: 0.9.0
Active as of 2026-02-05 | Computable Name: ACCESSCondition

This profile constrains the US Core Condition Problems and Health Concerns Profile to require ICD-10-CM codes for the ACCESS Model. This ensures consistent diagnosis coding across all ACCESS APIs. This profile also serves as the foundation for track-specific condition profiles:

- CKM Track: ACCESSCKMCondition - Adds extensible binding to CKM diagnoses
- eCKM Track: ACCESSeCKMCondition - Adds extensible binding to eCKM diagnoses
- MSK Track: ACCESSMSKCondition - Adds extensible binding to MSK diagnoses
- BH Track: ACCESSBHCondition - Adds extensible binding to BH diagnoses

For more information on value set binding strengths, see the Conformance page.

Usages:

- Derived from this Profile: ACCESS BH Condition Profile, ACCESS CKM Track Condition Profile, ACCESS Clinical Exclusion Condition, ACCESS eCKM Track Condition Profile and ACCESS MSK Track Condition Profile
- Use this Profile: ACCESS Alignment Request Parameters and ACCESS Check Eligibility Request Parameters

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile(6.1.0) | This is an abstract profile. Child profiles: ACCESSBHCondition, ACCESSCKMCondition, ACCESSClinicalExclusionCondition, ACCESSeCKMCondition, ACCESSMSKCondition Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | (USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 1..* | CodeableConcept | (USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | (USCDI) problem-list-item | health-concern Binding: USCoreProblemOrHealthConcern (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment | S | 0..* | CodeableConcept | (USCDI) USCDI Health Status/Assessments Data Class Binding: USCoreScreeningAssessmentConditionCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code | S Σ | 1..1 | CodeableConcept | Identification of the condition using ICD-10-CM codes Binding: USCoreConditionCodes (6.1.0) (extensible): Valueset to describe the actual problem experienced by the patient
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:icd10cm | S Σ | 1..1 | Coding | ICD-10-CM diagnosis code
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/sid/icd-10-cm
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 1..1 | Reference(US Core Patient Profile(6.1.0)) | (USCDI) Who has the condition?
onset[x] | S Σ | 0..1 |  | (USCDI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
abatement[x] | S C | 0..1 |  | (USCDI) When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | S Σ | 0..1 | dateTime | (USCDI) Date record was first recorded
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.category:us-core | Base | required | US Core Problem or Health Concern | 📍6.1.0 | US Core v6.1
Condition.category:screening-assessment | Base | required | US Core Screening Assessment Condition Category | 📍6.1.0 | US Core v6.1
Condition.code | Base | extensible | US Core Condition Codes | 📍6.1.0 | US Core v6.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 | Condition.implicitRules, Condition.extension:assertedDate, Condition.modifierExtension, Condition.clinicalStatus, Condition.verificationStatus, Condition.category, Condition.category:us-core, Condition.category:screening-assessment, Condition.code, Condition.code.coding, Condition.code.coding:icd10cm, Condition.code.coding:icd10cm.system, Condition.code.coding:icd10cm.code, Condition.subject, Condition.onset[x], Condition.abatement[x], Condition.recordedDate | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Condition.extension:assertedDate, Condition.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  |  | USCoreConditionProblemsHealthConcernsProfile(6.1.0) | This is an abstract profile. Child profiles: ACCESSBHCondition, ACCESSCKMCondition, ACCESSClinicalExclusionCondition, ACCESSeCKMCondition, ACCESSMSKCondition
code |  | 1..1 | CodeableConcept | Identification of the condition using ICD-10-CM codes
Slices for coding |  | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:icd10cm | S | 1..1 | Coding | ICD-10-CM diagnosis code
system | S | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/sid/icd-10-cm
code | S | 1..1 | code | Symbol in syntax defined by the system
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile(6.1.0) | This is an abstract profile. Child profiles: ACCESSBHCondition, ACCESSCKMCondition, ACCESSClinicalExclusionCondition, ACCESSeCKMCondition, ACCESSMSKCondition Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
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 |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:assertedDate | S | 0..1 | dateTime | (USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
identifier | Σ | 0..* | Identifier | External Ids for this condition
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 1..* | CodeableConcept | (USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | (USCDI) problem-list-item | health-concern Binding: USCoreProblemOrHealthConcern (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment | S | 0..* | CodeableConcept | (USCDI) USCDI Health Status/Assessments Data Class Binding: USCoreScreeningAssessmentConditionCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
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 | S Σ | 1..1 | CodeableConcept | Identification of the condition using ICD-10-CM codes Binding: USCoreConditionCodes (6.1.0) (extensible): Valueset to describe the actual problem experienced by the patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:icd10cm | S Σ | 1..1 | Coding | ICD-10-CM diagnosis 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 Constraints: ext-1
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/sid/icd-10-cm
version | Σ | 0..1 | string | Version of the system - if relevant
code | S 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 | Σ | 0..1 | string | Plain text representation of the concept
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject | S Σ | 1..1 | Reference(US Core Patient Profile(6.1.0)) | (USCDI) Who has the condition?
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
onset[x] | S Σ | 0..1 |  | (USCDI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
abatement[x] | S C | 0..1 |  | (USCDI) When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | S Σ | 0..1 | dateTime | (USCDI) Date record was first recorded
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 Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
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 | C | 0..* | BackboneElement | Supporting evidence Constraints: con-2
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
code | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.language | Base | preferred | Common Languages | 📍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.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.category:us-core | Base | required | US Core Problem or Health Concern | 📍6.1.0 | US Core v6.1
Condition.category:screening-assessment | Base | required | US Core Screening Assessment Condition Category | 📍6.1.0 | US Core v6.1
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📍4.0.1 | FHIR Std.
Condition.code | Base | extensible | US Core Condition Codes | 📍6.1.0 | US Core v6.1
Condition.bodySite | Base | example | SNOMED CT Body Structures | 📍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 | Condition.meta, Condition.implicitRules, Condition.language, Condition.text, Condition.extension, Condition.extension:assertedDate, Condition.modifierExtension, Condition.identifier, Condition.clinicalStatus, Condition.verificationStatus, Condition.category, Condition.category:us-core, Condition.category:screening-assessment, Condition.severity, Condition.code, Condition.code.extension, Condition.code.coding, Condition.code.coding:icd10cm, Condition.code.coding:icd10cm.extension, Condition.code.coding:icd10cm.system, Condition.code.coding:icd10cm.version, Condition.code.coding:icd10cm.code, Condition.code.coding:icd10cm.display, Condition.code.coding:icd10cm.userSelected, Condition.code.text, Condition.bodySite, Condition.subject, Condition.encounter, Condition.onset[x], Condition.abatement[x], Condition.recordedDate, Condition.recorder, Condition.asserter, Condition.stage, Condition.stage.extension, Condition.stage.modifierExtension, Condition.stage.summary, Condition.stage.assessment, Condition.stage.type, Condition.evidence, Condition.evidence.extension, Condition.evidence.modifierExtension, Condition.evidence.code, Condition.evidence.detail, Condition.note | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Condition.extension, Condition.extension:assertedDate, Condition.modifierExtension, Condition.code.extension, Condition.code.coding:icd10cm.extension, Condition.stage.extension, Condition.stage.modifierExtension, Condition.evidence.extension, Condition.evidence.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Mandatory: 4 elements
Must-Support: 3 elements
Fixed: 1 element

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Condition.code.coding

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile(6.1.0) | This is an abstract profile. Child profiles: ACCESSBHCondition, ACCESSCKMCondition, ACCESSClinicalExclusionCondition, ACCESSeCKMCondition, ACCESSMSKCondition Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:assertedDate | S | 0..1 | dateTime | (USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 1..* | CodeableConcept | (USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | (USCDI) problem-list-item | health-concern Binding: USCoreProblemOrHealthConcern (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment | S | 0..* | CodeableConcept | (USCDI) USCDI Health Status/Assessments Data Class Binding: USCoreScreeningAssessmentConditionCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code | S Σ | 1..1 | CodeableConcept | Identification of the condition using ICD-10-CM codes Binding: USCoreConditionCodes (6.1.0) (extensible): Valueset to describe the actual problem experienced by the patient
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:icd10cm | S Σ | 1..1 | Coding | ICD-10-CM diagnosis code
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/sid/icd-10-cm
code | S Σ | 1..1 | code | Symbol in syntax defined by the system
subject | S Σ | 1..1 | Reference(US Core Patient Profile(6.1.0)) | (USCDI) Who has the condition?
onset[x] | S Σ | 0..1 |  | (USCDI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
abatement[x] | S C | 0..1 |  | (USCDI) When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | S Σ | 0..1 | dateTime | (USCDI) Date record was first recorded
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.clinicalStatus | Base | required | Condition Clinical Status Codes | 📍4.0.1 | FHIR Std.
Condition.verificationStatus | Base | required | ConditionVerificationStatus | 📍4.0.1 | FHIR Std.
Condition.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.category:us-core | Base | required | US Core Problem or Health Concern | 📍6.1.0 | US Core v6.1
Condition.category:screening-assessment | Base | required | US Core Screening Assessment Condition Category | 📍6.1.0 | US Core v6.1
Condition.code | Base | extensible | US Core Condition Codes | 📍6.1.0 | US Core v6.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
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 | Condition.implicitRules, Condition.extension:assertedDate, Condition.modifierExtension, Condition.clinicalStatus, Condition.verificationStatus, Condition.category, Condition.category:us-core, Condition.category:screening-assessment, Condition.code, Condition.code.coding, Condition.code.coding:icd10cm, Condition.code.coding:icd10cm.system, Condition.code.coding:icd10cm.code, Condition.subject, Condition.onset[x], Condition.abatement[x], Condition.recordedDate | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Condition.extension:assertedDate, Condition.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition |  |  | USCoreConditionProblemsHealthConcernsProfile(6.1.0) | This is an abstract profile. Child profiles: ACCESSBHCondition, ACCESSCKMCondition, ACCESSClinicalExclusionCondition, ACCESSeCKMCondition, ACCESSMSKCondition
code |  | 1..1 | CodeableConcept | Identification of the condition using ICD-10-CM codes
Slices for coding |  | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:icd10cm | S | 1..1 | Coding | ICD-10-CM diagnosis code
system | S | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/sid/icd-10-cm
code | S | 1..1 | code | Symbol in syntax defined by the system
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Condition | C | 0..* | USCoreConditionProblemsHealthConcernsProfile(6.1.0) | This is an abstract profile. Child profiles: ACCESSBHCondition, ACCESSCKMCondition, ACCESSClinicalExclusionCondition, ACCESSeCKMCondition, ACCESSMSKCondition Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
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 |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ext-1
extension:assertedDate | S | 0..1 | dateTime | (USCDI) Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored Constraints: ext-1
identifier | Σ | 0..* | Identifier | External Ids for this condition
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required)
Slices for category | S | 1..* | CodeableConcept | (USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core | S | 1..* | CodeableConcept | (USCDI) problem-list-item | health-concern Binding: USCoreProblemOrHealthConcern (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment | S | 0..* | CodeableConcept | (USCDI) USCDI Health Status/Assessments Data Class Binding: USCoreScreeningAssessmentConditionCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
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 | S Σ | 1..1 | CodeableConcept | Identification of the condition using ICD-10-CM codes Binding: USCoreConditionCodes (6.1.0) (extensible): Valueset to describe the actual problem experienced by the patient
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url Constraints: ext-1
Slices for coding | Σ | 1..* | Coding | Code defined by a terminology system Slice: Unordered, Open by value:system
coding:icd10cm | S Σ | 1..1 | Coding | ICD-10-CM diagnosis 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 Constraints: ext-1
system | S Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/sid/icd-10-cm
version | Σ | 0..1 | string | Version of the system - if relevant
code | S 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 | Σ | 0..1 | string | Plain text representation of the concept
bodySite | Σ | 0..* | CodeableConcept | Anatomical location, if relevant Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
subject | S Σ | 1..1 | Reference(US Core Patient Profile(6.1.0)) | (USCDI) Who has the condition?
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
onset[x] | S Σ | 0..1 |  | (USCDI) Estimated or actual date, date-time, or age
onsetDateTime |  |  | dateTime S |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
abatement[x] | S C | 0..1 |  | (USCDI) When in resolution/remission
abatementDateTime |  |  | dateTime S |
abatementAge |  |  | Age |
abatementPeriod |  |  | Period |
abatementRange |  |  | Range |
abatementString |  |  | string |
recordedDate | S Σ | 0..1 | dateTime | (USCDI) Date record was first recorded
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 Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
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 | C | 0..* | BackboneElement | Supporting evidence Constraints: con-2
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Constraints: ext-1
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized Constraints: ext-1
code | Σ C | 0..* | CodeableConcept | Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail | Σ C | 0..* | Reference(Resource) | Supporting information found elsewhere
note |  | 0..* | Annotation | Additional information about the Condition
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Condition.language | Base | preferred | Common Languages | 📍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.category | Base | extensible | Condition Category Codes | 📍4.0.1 | FHIR Std.
Condition.category:us-core | Base | required | US Core Problem or Health Concern | 📍6.1.0 | US Core v6.1
Condition.category:screening-assessment | Base | required | US Core Screening Assessment Condition Category | 📍6.1.0 | US Core v6.1
Condition.severity | Base | preferred | Condition/Diagnosis Severity | 📍4.0.1 | FHIR Std.
Condition.code | Base | extensible | US Core Condition Codes | 📍6.1.0 | US Core v6.1
Condition.bodySite | Base | example | SNOMED CT Body Structures | 📍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 | Condition.meta, Condition.implicitRules, Condition.language, Condition.text, Condition.extension, Condition.extension:assertedDate, Condition.modifierExtension, Condition.identifier, Condition.clinicalStatus, Condition.verificationStatus, Condition.category, Condition.category:us-core, Condition.category:screening-assessment, Condition.severity, Condition.code, Condition.code.extension, Condition.code.coding, Condition.code.coding:icd10cm, Condition.code.coding:icd10cm.extension, Condition.code.coding:icd10cm.system, Condition.code.coding:icd10cm.version, Condition.code.coding:icd10cm.code, Condition.code.coding:icd10cm.display, Condition.code.coding:icd10cm.userSelected, Condition.code.text, Condition.bodySite, Condition.subject, Condition.encounter, Condition.onset[x], Condition.abatement[x], Condition.recordedDate, Condition.recorder, Condition.asserter, Condition.stage, Condition.stage.extension, Condition.stage.modifierExtension, Condition.stage.summary, Condition.stage.assessment, Condition.stage.type, Condition.evidence, Condition.evidence.extension, Condition.evidence.modifierExtension, Condition.evidence.code, Condition.evidence.detail, Condition.note | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Condition.extension, Condition.extension:assertedDate, Condition.modifierExtension, Condition.code.extension, Condition.code.coding:icd10cm.extension, Condition.stage.extension, Condition.stage.modifierExtension, Condition.evidence.extension, Condition.evidence.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from USCoreConditionProblemsHealthConcernsProfile

Summary

Mandatory: 4 elements
Must-Support: 3 elements
Fixed: 1 element

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Condition.code.coding

Other representations of profile: CSV, Excel, Schematron