2026 US Quality Core Implementation Guide
0.5.0 - release

2026 US Quality Core Implementation Guide - Downloaded Version 0.5.0 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 | Highlight text changes?
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:

- Examples for this Profile: ServiceRequest/negation-example-code and ServiceRequest/negation-example
- CapabilityStatements using this Profile: US Quality Core Client CapabilityStatement and US Quality Core Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
status | ?!S Σ | 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 | ?!S Σ | 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 | S Σ | 0..* | CodeableConcept | (USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 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 | S Σ | 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 | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) Individual or Entity the service is ordered for
occurrence[x] | S Σ | 0..1 |  | (USCDI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
occurrenceTiming |  |  | Timing |
authoredOn | S Σ | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester | S Σ | 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
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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
code |  | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) What is being requested/ordered
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
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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 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 |  | 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 | ?!S Σ | 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 | ?!S Σ | 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 | S Σ | 0..* | CodeableConcept | (USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 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 | S Σ | 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 | Σ C | 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 | S Σ | 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] | S Σ | 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 | S Σ | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester | S Σ | 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
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:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Practitioner (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitioner)
- US Quality Core PractitionerRole (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitionerrole)
- US Quality Core Organization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization)
- US Quality Core RelatedPerson (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson)
- US Quality Core Device (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-device)
- US Core Implantable Device Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device|6.1.0)
- US Quality Core Condition Encounter Diagnosis (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis)
- US Quality Core Condition Problems Health Concerns (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
status | ?!S Σ | 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 | ?!S Σ | 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 | S Σ | 0..* | CodeableConcept | (USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 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 | S Σ | 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 | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) Individual or Entity the service is ordered for
occurrence[x] | S Σ | 0..1 |  | (USCDI) When service should occur
occurrenceDateTime |  |  | dateTime |
occurrencePeriod |  |  | Period S |
occurrenceTiming |  |  | Timing |
authoredOn | S Σ | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester | S Σ | 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
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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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
code |  | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) What is being requested/ordered
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
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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
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 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 |  | 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 | ?!S Σ | 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 | ?!S Σ | 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 | S Σ | 0..* | CodeableConcept | (USCDI) Classification of service Slice: Unordered, Open by pattern:$this Binding: ServiceRequestCategoryCodes (example): Classification of the requested service.
category:us-core | S Σ | 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 | S Σ | 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 | Σ C | 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 | S Σ | 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] | S Σ | 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 | S Σ | 1..1 | dateTime | (USCDI+ Quality) (USCDI) Date request signed
requester | S Σ | 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
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:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)
- US Quality Core Practitioner (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitioner)
- US Quality Core PractitionerRole (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-practitionerrole)
- US Quality Core Organization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization)
- US Quality Core RelatedPerson (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson)
- US Quality Core Device (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-device)
- US Core Implantable Device Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device|6.1.0)
- US Quality Core Condition Encounter Diagnosis (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis)
- US Quality Core Condition Problems Health Concerns (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-doNotPerformReason
- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-notDoneValueSet

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.