2026 US Quality Core Implementation Guide
0.5.0 - release United States of America flag

This page is part of the US Quality Core (v0.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: US Quality Core Service Not Requested

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-servicenotrequested Version: 0.5.0
Active as of 2026-06-05 Computable Name: USQualityCoreServiceNotRequested

Negation profile of ServiceRequest for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

USCDI+ Quality Element Support Expectations

Systems are expected to support this profile as part of implementing USCDI+ Quality V1 in FHIR and meeting the conformance requirements of this guide.

The following elements are specifically relevant to USCDI+ Quality V1 data classes and elements. Systems are expected to support these elements as applicable to their role in US Quality Core data exchange. See the Must Support section of this guide for more information. These elements are tagged as (USCDI+ Quality) in the formal profile views.

USCDI+ Quality Elements:

  • status: (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
  • code: (USCDI+ Quality) (USCDI) What is being requested/ordered
  • authoredOn: (USCDI+ Quality) (USCDI) Date request signed
  • reasonCode: (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
  • reasonReference: (USCDI+ Quality) (USCDI) Explanation/Justification for service or service

Because this profile is derived from US Core, systems are also expected to support Must Support requirements and (USCDI) tagged elements inherited from US Core. The Formal Views section also provides the formal summary, definitions, terminology requirements, and mandatory element requirements.

Profile Specific Implementation Guidance

This profile represents a service request that was intentionally not requested for a medical, patient, or system reason. To represent service requests that were requested, use the US Quality Core ServiceRequest profile.

Additional informational guidance for authoring CQL using this profile is provided in the CQL Authoring Usage (Informational) section of this page.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(6.1.0) A request for a service to be performed
Constraints: prr-1, snr-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:reasonRefused 1..1 CodeableConcept Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code (USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... Slices for category SΣ 0..* CodeableConcept (USCDI) Classification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
.... category:us-core SΣ 0..* CodeableConcept (USCDI) Classification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... doNotPerform ?!Σ 1..1 boolean True if service/procedure should not be performed
Fixed Value: true
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Individual or Entity the service is ordered for
... occurrence[x] SΣ 0..1 (USCDI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... occurrenceTiming Timing
... authoredOn SΣ 1..1 dateTime (USCDI+ Quality) (USCDI) Date request signed
... requester SΣ 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) (USCDI)
... reasonCode Σ 0..* CodeableConcept (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) (USCDI+ Quality) (USCDI) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📦4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦7.0.0 US Core v7.0
ServiceRequest.code Base extensible US Core Procedure Codes 📦7.0.0 US Core v7.0
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest 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 ServiceRequest 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 ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest 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()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
snr-1 error ServiceRequest to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(6.1.0) A request for a service to be performed
Constraints: snr-1
... Slices for extension Content/Rules for all slices
.... extension:reasonRefused 1..1 CodeableConcept Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... status 1..1 code (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
... doNotPerform 1..1 boolean True if service/procedure should not be performed
Fixed Value: true
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject 1..1 Reference(US Quality Core Patient) (USCDI) Individual or Entity the service is ordered for
... occurrence[x] 0..1 (USCDI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn 1..1 dateTime (USCDI+ Quality) (USCDI) Date request signed
... requester 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) (USCDI)
... reasonCode 0..* CodeableConcept (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) (USCDI+ Quality) (USCDI) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
snr-1 error ServiceRequest to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(6.1.0) A request for a service to be performed
Constraints: prr-1, snr-1
... 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 BindingsPurpose
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 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:reasonRefused 1..1 CodeableConcept Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Identifiers assigned to this order
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest | MedicationRequest) What request fulfills
... replaces Σ 0..* Reference(ServiceRequest) What request replaces
... requisition Σ 0..1 Identifier Composite Request ID
... status ?!SΣ 1..1 code (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... intent ?!SΣ 1..1 code (USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... Slices for category SΣ 0..* CodeableConcept (USCDI) Classification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
.... category:us-core SΣ 0..* CodeableConcept (USCDI) Classification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!Σ 1..1 boolean True if service/procedure should not be performed
Fixed Value: true
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) What is being requested/ordered
Binding: US Core Procedure Codes (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:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... orderDetail ΣC 0..* CodeableConcept Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
.... quantityRatio Ratio
.... quantityRange Range
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Individual or Entity the service is ordered for
... encounter Σ 0..1 Reference(Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (USCDI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... occurrenceTiming Timing
... asNeeded[x] Σ 0..1 Preconditions for service
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
.... asNeededBoolean boolean
.... asNeededCodeableConcept CodeableConcept
... authoredOn SΣ 1..1 dateTime (USCDI+ Quality) (USCDI) Date request signed
... requester SΣ 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) (USCDI)
... performerType Σ 0..1 CodeableConcept Performer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested performer
... locationCode Σ 0..* CodeableConcept Requested location
Binding: V3 Value SetServiceDeliveryLocationRoleType (example): A location type where services are delivered.
... locationReference Σ 0..* Reference(Location) Requested location
... reasonCode Σ 0..* CodeableConcept (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) (USCDI+ Quality) (USCDI) Explanation/Justification for service or service
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... specimen Σ 0..* Reference(Specimen) Procedure Samples
... bodySite Σ 0..* CodeableConcept Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... note 0..* Annotation Comments
... patientInstruction Σ 0..1 string Patient or consumer-oriented instructions
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📦4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦7.0.0 US Core v7.0
ServiceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
ServiceRequest.code Base extensible US Core Procedure Codes 📦7.0.0 US Core v7.0
ServiceRequest.orderDetail Base example Service Request Order Details Codes 📦4.0.1 FHIR Std.
ServiceRequest.asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
ServiceRequest.performerType Base example Participant Roles 📦4.0.1 FHIR Std.
ServiceRequest.locationCode Base example V3 Value SetServiceDeliveryLocationRoleType 📦2014-03-26 FHIR Std.
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0
ServiceRequest.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest 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 ServiceRequest 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 ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest 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()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
snr-1 error ServiceRequest to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

Summary

Mandatory: 3 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(6.1.0) A request for a service to be performed
Constraints: prr-1, snr-1
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:reasonRefused 1..1 CodeableConcept Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... intent ?!SΣ 1..1 code (USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... Slices for category SΣ 0..* CodeableConcept (USCDI) Classification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
.... category:us-core SΣ 0..* CodeableConcept (USCDI) Classification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... doNotPerform ?!Σ 1..1 boolean True if service/procedure should not be performed
Fixed Value: true
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) What is being requested/ordered
Binding: US Core Procedure Codes (extensible)
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Individual or Entity the service is ordered for
... occurrence[x] SΣ 0..1 (USCDI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... occurrenceTiming Timing
... authoredOn SΣ 1..1 dateTime (USCDI+ Quality) (USCDI) Date request signed
... requester SΣ 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) (USCDI)
... reasonCode Σ 0..* CodeableConcept (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) (USCDI+ Quality) (USCDI) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📦4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦7.0.0 US Core v7.0
ServiceRequest.code Base extensible US Core Procedure Codes 📦7.0.0 US Core v7.0
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest 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 ServiceRequest 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 ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest 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()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
snr-1 error ServiceRequest to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(6.1.0) A request for a service to be performed
Constraints: snr-1
... Slices for extension Content/Rules for all slices
.... extension:reasonRefused 1..1 CodeableConcept Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... status 1..1 code (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
... doNotPerform 1..1 boolean True if service/procedure should not be performed
Fixed Value: true
.... Slices for extension Content/Rules for all slices
..... extension:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
... subject 1..1 Reference(US Quality Core Patient) (USCDI) Individual or Entity the service is ordered for
... occurrence[x] 0..1 (USCDI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period
.... occurrenceTiming Timing
... authoredOn 1..1 dateTime (USCDI+ Quality) (USCDI) Date request signed
... requester 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) (USCDI)
... reasonCode 0..* CodeableConcept (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) (USCDI+ Quality) (USCDI) Explanation/Justification for service or service

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0

Constraints

Id Grade Path(s) Description Expression
snr-1 error ServiceRequest to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ServiceRequest C 0..* USCoreServiceRequestProfile(6.1.0) A request for a service to be performed
Constraints: prr-1, snr-1
... 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 BindingsPurpose
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 1..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:reasonRefused 1..1 CodeableConcept Extension
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
Binding: USQualityCore Negation Reason Codes (extensible): The reason the event did not occur or was not performed
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Identifiers assigned to this order
... instantiatesCanonical Σ 0..* canonical(ActivityDefinition | PlanDefinition) Instantiates FHIR protocol or definition
... instantiatesUri Σ 0..* uri Instantiates external protocol or definition
... basedOn Σ 0..* Reference(CarePlan | ServiceRequest | MedicationRequest) What request fulfills
... replaces Σ 0..* Reference(ServiceRequest) What request replaces
... requisition Σ 0..1 Identifier Composite Request ID
... status ?!SΣ 1..1 code (USCDI+ Quality) (USCDI) draft | active | on-hold | revoked | completed | entered-in-error | unknown
Binding: RequestStatus (required): The status of a service order.
... intent ?!SΣ 1..1 code (USCDI) proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
Binding: RequestIntent (required): The kind of service request.
... Slices for category SΣ 0..* CodeableConcept (USCDI) Classification of service
Slice: Unordered, Open by pattern:$this
Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
.... category:us-core SΣ 0..* CodeableConcept (USCDI) Classification of service
Binding: US Core ServiceRequest Category Codes (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... priority Σ 0..1 code routine | urgent | asap | stat
Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
... doNotPerform ?!Σ 1..1 boolean True if service/procedure should not be performed
Fixed Value: true
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) What is being requested/ordered
Binding: US Core Procedure Codes (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:notDoneValueSet C 0..1 canonical(ValueSet) What was not requested
URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... orderDetail ΣC 0..* CodeableConcept Additional order information
Binding: ServiceRequestOrderDetailsCodes (example): Codified order entry details which are based on order context.
... quantity[x] Σ 0..1 Service amount
.... quantityQuantity Quantity
.... quantityRatio Ratio
.... quantityRange Range
... subject SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Individual or Entity the service is ordered for
... encounter Σ 0..1 Reference(Encounter) Encounter in which the request was created
... occurrence[x] SΣ 0..1 (USCDI) When service should occur
.... occurrenceDateTime dateTime
.... occurrencePeriod Period S
.... occurrenceTiming Timing
... asNeeded[x] Σ 0..1 Preconditions for service
Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.
.... asNeededBoolean boolean
.... asNeededCodeableConcept CodeableConcept
... authoredOn SΣ 1..1 dateTime (USCDI+ Quality) (USCDI) Date request signed
... requester SΣ 0..1 Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization | US Quality Core Patient | US Quality Core RelatedPerson | US Quality Core Device | US Core Implantable Device Profile(6.1.0)) (USCDI)
... performerType Σ 0..1 CodeableConcept Performer role
Binding: ParticipantRoles (example): Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | HealthcareService | Patient | Device | RelatedPerson) Requested performer
... locationCode Σ 0..* CodeableConcept Requested location
Binding: V3 Value SetServiceDeliveryLocationRoleType (example): A location type where services are delivered.
... locationReference Σ 0..* Reference(Location) Requested location
... reasonCode Σ 0..* CodeableConcept (USCDI+ Quality) (USCDI) Explanation/Justification for procedure or service
Binding: US Core Condition Codes (extensible)
... reasonReference Σ 0..* Reference(US Quality Core Condition Encounter Diagnosis | US Quality Core Condition Problems Health Concerns) (USCDI+ Quality) (USCDI) Explanation/Justification for service or service
... insurance 0..* Reference(Coverage | ClaimResponse) Associated insurance coverage
... supportingInfo 0..* Reference(Resource) Additional clinical information
... specimen Σ 0..* Reference(Specimen) Procedure Samples
... bodySite Σ 0..* CodeableConcept Location on Body
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... note 0..* Annotation Comments
... patientInstruction Σ 0..1 string Patient or consumer-oriented instructions
... relevantHistory 0..* Reference(Provenance) Request provenance

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ServiceRequest.language Base preferred Common Languages 📦4.0.1 FHIR Std.
ServiceRequest.status Base required RequestStatus 📍4.0.1 FHIR Std.
ServiceRequest.intent Base required RequestIntent 📍4.0.1 FHIR Std.
ServiceRequest.category Base example Service Request Category Codes 📦4.0.1 FHIR Std.
ServiceRequest.category:us-core Base required US Core ServiceRequest Category Codes 📦7.0.0 US Core v7.0
ServiceRequest.priority Base required Request priority 📍4.0.1 FHIR Std.
ServiceRequest.code Base extensible US Core Procedure Codes 📦7.0.0 US Core v7.0
ServiceRequest.orderDetail Base example Service Request Order Details Codes 📦4.0.1 FHIR Std.
ServiceRequest.asNeeded[x] Base example SNOMED CT Medication As Needed Reason Codes 📦4.0.1 FHIR Std.
ServiceRequest.performerType Base example Participant Roles 📦4.0.1 FHIR Std.
ServiceRequest.locationCode Base example V3 Value SetServiceDeliveryLocationRoleType 📦2014-03-26 FHIR Std.
ServiceRequest.reasonCode Base extensible US Core Condition Codes 📦7.0.0 US Core v7.0
ServiceRequest.bodySite Base example SNOMED CT Body Structures 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ServiceRequest If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ServiceRequest 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 ServiceRequest 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 ServiceRequest If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ServiceRequest 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()
prr-1 error ServiceRequest orderDetail SHALL only be present if code is present orderDetail.empty() or code.exists()
snr-1 error ServiceRequest to indicate what service was not performed, either at least one coding in the code or a notDoneValueSet extension shall be provided code.extension('http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet').exists() xor code.coding.exists()

Summary

Mandatory: 3 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

 

Other representations of profile: CSV, Excel, Schematron

Notes:

CQL Authoring Usage (Informational)

The ServiceRequest and ServiceNotRequested profiles represent the positive and negative statements for a service request.

The following illustrative CQL shows an exclusion pattern for services not requested:

define "Intermittent Pneumatic Compression Devices Not Ordered":
  ["ServiceNotRequested": "Application of intermittent pneumatic compression devices (IPC)"] DeviceNotOrdered
    where (DeviceNotOrdered.reasonRefused() in "Medical Reason"
      or DeviceNotOrdered.reasonRefused() in "Patient Refusal")
      and DeviceNotOrdered.status in { 'active', 'completed', 'on-hold' }

For a more complete discussion of representation of negation within US Quality Core and quality improvement artifacts, see the Negation in US Quality Core topic.