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. For a full list of available versions, see the Directory of published versions

Resource Profile: US Quality Core AllergyIntolerance

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

Profile of AllergyIntolerance 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:

  • code: (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance
  • onset[x]: (USCDI+ Quality) When allergy or intolerance was identified
  • recordedDate: (USCDI+ Quality) Date first version of the resource instance was recorded
  • lastOccurrence: (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
  • reaction: (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance

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

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
.. AllergyIntolerance C 0..* USCoreAllergyIntolerance(6.1.0) Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
Constraints: ait-1, ait-2
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... verificationStatus ?!SΣC 0..1 CodeableConcept (USCDI) unconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required)
... type Σ 0..1 code allergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
... category Σ 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
... criticality Σ 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance
Binding: Common substances for allergy and intolerance documentation including refutations . (extensible)
... patient SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who the sensitivity is for
... onset[x] 0..1 (USCDI+ Quality) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (USCDI+ Quality) Date first version of the resource instance was recorded
... lastOccurrence 0..1 dateTime (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
... reaction S 0..* BackboneElement (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... manifestation S 1..* CodeableConcept (USCDI) Clinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (extensible)
.... severity 0..1 code mild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
AllergyIntolerance.clinicalStatus Base required AllergyIntolerance Clinical Status Codes 📦4.0.1 FHIR Std.
AllergyIntolerance.verificationStatus Base required AllergyIntolerance Verification Status Codes 📦4.0.1 FHIR Std.
AllergyIntolerance.type Base required AllergyIntoleranceType 📍4.0.1 FHIR Std.
AllergyIntolerance.category Base required AllergyIntoleranceCategory 📍4.0.1 FHIR Std.
AllergyIntolerance.criticality Base required AllergyIntoleranceCriticality 📍4.0.1 FHIR Std.
AllergyIntolerance.code Base extensible Common substances for allergy and intolerance documentation including refutations . 📦20210622 VSAC v0.18
AllergyIntolerance.reaction.​manifestation Base extensible SNOMED CT Clinical Findings 📦4.0.1 FHIR Std.
AllergyIntolerance.reaction.​severity Base required AllergyIntoleranceSeverity 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ait-1 error AllergyIntolerance AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2 error AllergyIntolerance AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2 error AllergyIntolerance If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error AllergyIntolerance 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 AllergyIntolerance 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 AllergyIntolerance If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice AllergyIntolerance 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()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. AllergyIntolerance 0..* USCoreAllergyIntolerance(6.1.0) Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... Slices for extension Content/Rules for all slices
.... extension:resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... type 0..1 code allergy | intolerance - Underlying mechanism (if known)
... category 0..* code food | medication | environment | biologic
... code 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance
... patient 1..1 Reference(US Quality Core Patient) (USCDI) Who the sensitivity is for
... onset[x] 0..1 (USCDI+ Quality) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (USCDI+ Quality) Date first version of the resource instance was recorded
... lastOccurrence 0..1 dateTime (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
... reaction 0..* BackboneElement (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance
.... manifestation 1..* CodeableConcept (USCDI) Clinical symptoms/signs associated with the Event
.... severity 0..1 code mild | moderate | severe (of event as a whole)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. AllergyIntolerance C 0..* USCoreAllergyIntolerance(6.1.0) Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
Constraints: ait-1, ait-2
... 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
... 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
.... extension:resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External ids for this item
... clinicalStatus ?!SΣC 0..1 CodeableConcept (USCDI) active | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept (USCDI) unconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required)
... type Σ 0..1 code allergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
... category Σ 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
... criticality Σ 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance
Binding: Common substances for allergy and intolerance documentation including refutations . (extensible)
... patient SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who the sensitivity is for
... encounter 0..1 Reference(Encounter) Encounter when the allergy or intolerance was asserted
... onset[x] 0..1 (USCDI+ Quality) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (USCDI+ Quality) Date first version of the resource instance was recorded
... recorder 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Who recorded the sensitivity
... asserter Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Source of the information about the allergy
... lastOccurrence 0..1 dateTime (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
... note 0..* Annotation Additional text not captured in other fields
... reaction S 0..* BackboneElement (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance
.... 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
.... substance 0..1 CodeableConcept Specific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
.... manifestation S 1..* CodeableConcept (USCDI) Clinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (extensible)
.... description 0..1 string Description of the event as a whole
.... onset 0..1 dateTime Date(/time) when manifestations showed
.... severity 0..1 code mild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
.... exposureRoute 0..1 CodeableConcept How the subject was exposed to the substance
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... note 0..* Annotation Text about event not captured in other fields

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
AllergyIntolerance.language Base preferred Common Languages 📦4.0.1 FHIR Std.
AllergyIntolerance.clinicalStatus Base required AllergyIntolerance Clinical Status Codes 📦4.0.1 FHIR Std.
AllergyIntolerance.verificationStatus Base required AllergyIntolerance Verification Status Codes 📦4.0.1 FHIR Std.
AllergyIntolerance.type Base required AllergyIntoleranceType 📍4.0.1 FHIR Std.
AllergyIntolerance.category Base required AllergyIntoleranceCategory 📍4.0.1 FHIR Std.
AllergyIntolerance.criticality Base required AllergyIntoleranceCriticality 📍4.0.1 FHIR Std.
AllergyIntolerance.code Base extensible Common substances for allergy and intolerance documentation including refutations . 📦20210622 VSAC v0.18
AllergyIntolerance.reaction.​substance Base example Substance Code 📦4.0.1 FHIR Std.
AllergyIntolerance.reaction.​manifestation Base extensible SNOMED CT Clinical Findings 📦4.0.1 FHIR Std.
AllergyIntolerance.reaction.​severity Base required AllergyIntoleranceSeverity 📍4.0.1 FHIR Std.
AllergyIntolerance.reaction.​exposureRoute Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ait-1 error AllergyIntolerance AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2 error AllergyIntolerance AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2 error AllergyIntolerance If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error AllergyIntolerance 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 AllergyIntolerance 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 AllergyIntolerance If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice AllergyIntolerance 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()

Summary

Mandatory: 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
.. AllergyIntolerance C 0..* USCoreAllergyIntolerance(6.1.0) Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
Constraints: ait-1, ait-2
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension Content/Rules for all slices
.... extension:resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... verificationStatus ?!SΣC 0..1 CodeableConcept (USCDI) unconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required)
... type Σ 0..1 code allergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
... category Σ 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
... criticality Σ 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance
Binding: Common substances for allergy and intolerance documentation including refutations . (extensible)
... patient SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who the sensitivity is for
... onset[x] 0..1 (USCDI+ Quality) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (USCDI+ Quality) Date first version of the resource instance was recorded
... lastOccurrence 0..1 dateTime (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
... reaction S 0..* BackboneElement (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... manifestation S 1..* CodeableConcept (USCDI) Clinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (extensible)
.... severity 0..1 code mild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
AllergyIntolerance.clinicalStatus Base required AllergyIntolerance Clinical Status Codes 📦4.0.1 FHIR Std.
AllergyIntolerance.verificationStatus Base required AllergyIntolerance Verification Status Codes 📦4.0.1 FHIR Std.
AllergyIntolerance.type Base required AllergyIntoleranceType 📍4.0.1 FHIR Std.
AllergyIntolerance.category Base required AllergyIntoleranceCategory 📍4.0.1 FHIR Std.
AllergyIntolerance.criticality Base required AllergyIntoleranceCriticality 📍4.0.1 FHIR Std.
AllergyIntolerance.code Base extensible Common substances for allergy and intolerance documentation including refutations . 📦20210622 VSAC v0.18
AllergyIntolerance.reaction.​manifestation Base extensible SNOMED CT Clinical Findings 📦4.0.1 FHIR Std.
AllergyIntolerance.reaction.​severity Base required AllergyIntoleranceSeverity 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ait-1 error AllergyIntolerance AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2 error AllergyIntolerance AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2 error AllergyIntolerance If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error AllergyIntolerance 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 AllergyIntolerance 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 AllergyIntolerance If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice AllergyIntolerance 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()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. AllergyIntolerance 0..* USCoreAllergyIntolerance(6.1.0) Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
... Slices for extension Content/Rules for all slices
.... extension:resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... type 0..1 code allergy | intolerance - Underlying mechanism (if known)
... category 0..* code food | medication | environment | biologic
... code 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance
... patient 1..1 Reference(US Quality Core Patient) (USCDI) Who the sensitivity is for
... onset[x] 0..1 (USCDI+ Quality) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (USCDI+ Quality) Date first version of the resource instance was recorded
... lastOccurrence 0..1 dateTime (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
... reaction 0..* BackboneElement (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance
.... manifestation 1..* CodeableConcept (USCDI) Clinical symptoms/signs associated with the Event
.... severity 0..1 code mild | moderate | severe (of event as a whole)

doco Documentation for this format

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. AllergyIntolerance C 0..* USCoreAllergyIntolerance(6.1.0) Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
Constraints: ait-1, ait-2
... 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
... 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
.... extension:resolutionAge 0..1 Age Age that the allergy or intolerance resolved
URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External ids for this item
... clinicalStatus ?!SΣC 0..1 CodeableConcept (USCDI) active | inactive | resolved
Binding: AllergyIntoleranceClinicalStatusCodes (required)
... verificationStatus ?!SΣC 0..1 CodeableConcept (USCDI) unconfirmed | confirmed | refuted | entered-in-error
Binding: AllergyIntoleranceVerificationStatusCodes (required)
... type Σ 0..1 code allergy | intolerance - Underlying mechanism (if known)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
... category Σ 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
... criticality Σ 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
... code SΣ 1..1 CodeableConcept (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance
Binding: Common substances for allergy and intolerance documentation including refutations . (extensible)
... patient SΣ 1..1 Reference(US Quality Core Patient) (USCDI) Who the sensitivity is for
... encounter 0..1 Reference(Encounter) Encounter when the allergy or intolerance was asserted
... onset[x] 0..1 (USCDI+ Quality) When allergy or intolerance was identified
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
... recordedDate 0..1 dateTime (USCDI+ Quality) Date first version of the resource instance was recorded
... recorder 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Who recorded the sensitivity
... asserter Σ 0..1 Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) Source of the information about the allergy
... lastOccurrence 0..1 dateTime (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
... note 0..* Annotation Additional text not captured in other fields
... reaction S 0..* BackboneElement (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance
.... 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
.... substance 0..1 CodeableConcept Specific substance or pharmaceutical product considered to be responsible for event
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
.... manifestation S 1..* CodeableConcept (USCDI) Clinical symptoms/signs associated with the Event
Binding: SNOMEDCTClinicalFindings (extensible)
.... description 0..1 string Description of the event as a whole
.... onset 0..1 dateTime Date(/time) when manifestations showed
.... severity 0..1 code mild | moderate | severe (of event as a whole)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
.... exposureRoute 0..1 CodeableConcept How the subject was exposed to the substance
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
.... note 0..* Annotation Text about event not captured in other fields

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
AllergyIntolerance.language Base preferred Common Languages 📦4.0.1 FHIR Std.
AllergyIntolerance.clinicalStatus Base required AllergyIntolerance Clinical Status Codes 📦4.0.1 FHIR Std.
AllergyIntolerance.verificationStatus Base required AllergyIntolerance Verification Status Codes 📦4.0.1 FHIR Std.
AllergyIntolerance.type Base required AllergyIntoleranceType 📍4.0.1 FHIR Std.
AllergyIntolerance.category Base required AllergyIntoleranceCategory 📍4.0.1 FHIR Std.
AllergyIntolerance.criticality Base required AllergyIntoleranceCriticality 📍4.0.1 FHIR Std.
AllergyIntolerance.code Base extensible Common substances for allergy and intolerance documentation including refutations . 📦20210622 VSAC v0.18
AllergyIntolerance.reaction.​substance Base example Substance Code 📦4.0.1 FHIR Std.
AllergyIntolerance.reaction.​manifestation Base extensible SNOMED CT Clinical Findings 📦4.0.1 FHIR Std.
AllergyIntolerance.reaction.​severity Base required AllergyIntoleranceSeverity 📍4.0.1 FHIR Std.
AllergyIntolerance.reaction.​exposureRoute Base example SNOMED CT Route Codes 📦4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
ait-1 error AllergyIntolerance AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2 error AllergyIntolerance AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2 error AllergyIntolerance If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error AllergyIntolerance 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 AllergyIntolerance 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 AllergyIntolerance If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice AllergyIntolerance 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()

Summary

Mandatory: 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)

define "Statin Allergy Intolerance":
  ["AllergyIntolerance": "Statin Allergen"] StatinAllergyIntolerance
    where StatinAllergyIntolerance.clinicalStatus ~ "allergy-active"

This example represents a situation where the subject is currently experiencing, or is at risk of, a reaction to the identified substance.