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 DiagnosticReport Profile for Laboratory Results Reporting

Official URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-diagnosticreport-lab | Version: 0.5.0 | Highlight text changes?
Active as of 2026-06-05 | Computable Name: USQualityCoreDiagnosticReportLab

Profile of DiagnosticReport for laboratory results 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) registered | partial | preliminary | final +
- category: (USCDI+ Quality) (USCDI) Service category
- category:LaboratorySlice: (USCDI+ Quality) (USCDI) Service category
- code: (USCDI+ Quality) (USCDI) US Core Laboratory Report Order Code
- effective[x]: (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of specimen collection)
- result: (USCDI+ Quality) (USCDI) Observations

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.

Usages:

- Examples for this Profile: DiagnosticReport/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
--- | --- | --- | --- | ---
DiagnosticReport | C | 0..* | USCoreDiagnosticReportProfileLaboratoryReporting(6.1.0) | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports Constraints: us-core-8, us-core-9
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
basedOn |  | 0..* | Reference(US Quality Core CarePlan | US Quality Core ImmunizationRecommendation | US Quality Core MedicationRequest | US Quality Core NutritionOrder | US Quality Core ServiceRequest) | What was requested
status | ?!S Σ C | 1..1 | code | (USCDI+ Quality) (USCDI) registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
Slices for category | S Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
category:LaboratorySlice | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) US Core Laboratory Report Order Code Binding: US Core Laboratory Test Codes (extensible): LOINC codes
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) The subject of the report - usually, but not always, the patient
effective[x] | S Σ C | 0..1 |  | (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of specimen collection)
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
issued | S Σ C | 0..1 | instant | (USCDI) When the report was released
performer | S Σ | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization) | (USCDI) Responsible Diagnostic Service
result | S | 0..* | Reference(US Quality Core Laboratory Result Observation) | (USCDI+ Quality) (USCDI) Observations
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.
DiagnosticReport.category | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.category:LaboratorySlice | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.code | Base | extensible | US Core Laboratory Test Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | 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 | DiagnosticReport | 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 | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | 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()`
us-core-8 | error | DiagnosticReport | effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | `(status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()`
us-core-9 | error | DiagnosticReport | issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | `(status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | USCoreDiagnosticReportProfileLaboratoryReporting(6.1.0) | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
basedOn |  | 0..* | Reference(US Quality Core CarePlan | US Quality Core ImmunizationRecommendation | US Quality Core MedicationRequest | US Quality Core NutritionOrder | US Quality Core ServiceRequest) | What was requested
status |  | 1..1 | code | (USCDI+ Quality) (USCDI) registered | partial | preliminary | final +
Slices for category | Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
category:LaboratorySlice | Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections. Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
code |  | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) US Core Laboratory Report Order Code
subject |  | 1..1 | Reference(US Quality Core Patient) | (USCDI) The subject of the report - usually, but not always, the patient
effective[x] | Σ | 0..1 |  | (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of specimen collection)
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer |  | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization) | (USCDI) Responsible Diagnostic Service
result |  | 0..* | Reference(US Quality Core Laboratory Result Observation) | (USCDI+ Quality) (USCDI) Observations
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.category | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.category:LaboratorySlice | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport | C | 0..* | USCoreDiagnosticReportProfileLaboratoryReporting(6.1.0) | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports Constraints: us-core-8, us-core-9
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business identifier for report
basedOn |  | 0..* | Reference(US Quality Core CarePlan | US Quality Core ImmunizationRecommendation | US Quality Core MedicationRequest | US Quality Core NutritionOrder | US Quality Core ServiceRequest) | What was requested
status | ?!S Σ C | 1..1 | code | (USCDI+ Quality) (USCDI) registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
Slices for category | S Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
category:LaboratorySlice | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) US Core Laboratory Report Order Code Binding: US Core Laboratory Test Codes (extensible): LOINC codes
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(Encounter) | Health care event when test ordered
effective[x] | S Σ C | 0..1 |  | (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of specimen collection)
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
issued | S Σ C | 0..1 | instant | (USCDI) When the report was released
performer | S Σ | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization) | (USCDI) Responsible Diagnostic Service
resultsInterpreter | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter
specimen |  | 0..* | Reference(Specimen) | Specimens this report is based on
result | S | 0..* | Reference(US Quality Core Laboratory Result Observation) | (USCDI+ Quality) (USCDI) Observations
imagingStudy |  | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report
media | Σ | 0..* | BackboneElement | Key images associated with this report
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
comment |  | 0..1 | string | Comment about the image (e.g. explanation)
link | Σ | 1..1 | Reference(Media) | Reference to the image source
conclusion |  | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode |  | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm |  | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.
DiagnosticReport.category | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.category:LaboratorySlice | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.code | Base | extensible | US Core Laboratory Test Codes | 📦7.0.0 | US Core v7.0
DiagnosticReport.conclusionCode | Base | example | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | 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 | DiagnosticReport | 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 | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | 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()`
us-core-8 | error | DiagnosticReport | effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | `(status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()`
us-core-9 | error | DiagnosticReport | issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | `(status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()`

Summary

Structures

This structure refers to these other structures:

- US Quality Core CarePlan (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-careplan)
- US Quality Core ImmunizationRecommendation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunizationrecommendation)
- US Quality Core MedicationRequest (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationrequest)
- US Quality Core NutritionOrder (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-nutritionorder)
- US Quality Core ServiceRequest (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-servicerequest)
- 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 Laboratory Result Observation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-observation-lab)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DiagnosticReport.category

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport | C | 0..* | USCoreDiagnosticReportProfileLaboratoryReporting(6.1.0) | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports Constraints: us-core-8, us-core-9
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
basedOn |  | 0..* | Reference(US Quality Core CarePlan | US Quality Core ImmunizationRecommendation | US Quality Core MedicationRequest | US Quality Core NutritionOrder | US Quality Core ServiceRequest) | What was requested
status | ?!S Σ C | 1..1 | code | (USCDI+ Quality) (USCDI) registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
Slices for category | S Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
category:LaboratorySlice | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) US Core Laboratory Report Order Code Binding: US Core Laboratory Test Codes (extensible): LOINC codes
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) The subject of the report - usually, but not always, the patient
effective[x] | S Σ C | 0..1 |  | (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of specimen collection)
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
issued | S Σ C | 0..1 | instant | (USCDI) When the report was released
performer | S Σ | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization) | (USCDI) Responsible Diagnostic Service
result | S | 0..* | Reference(US Quality Core Laboratory Result Observation) | (USCDI+ Quality) (USCDI) Observations
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.
DiagnosticReport.category | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.category:LaboratorySlice | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.code | Base | extensible | US Core Laboratory Test Codes | 📦7.0.0 | US Core v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | 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 | DiagnosticReport | 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 | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | 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()`
us-core-8 | error | DiagnosticReport | effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | `(status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()`
us-core-9 | error | DiagnosticReport | issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | `(status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport |  | 0..* | USCoreDiagnosticReportProfileLaboratoryReporting(6.1.0) | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports
basedOn |  | 0..* | Reference(US Quality Core CarePlan | US Quality Core ImmunizationRecommendation | US Quality Core MedicationRequest | US Quality Core NutritionOrder | US Quality Core ServiceRequest) | What was requested
status |  | 1..1 | code | (USCDI+ Quality) (USCDI) registered | partial | preliminary | final +
Slices for category | Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
category:LaboratorySlice | Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections. Required Pattern: At least the following
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
code |  | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) US Core Laboratory Report Order Code
subject |  | 1..1 | Reference(US Quality Core Patient) | (USCDI) The subject of the report - usually, but not always, the patient
effective[x] | Σ | 0..1 |  | (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of specimen collection)
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
performer |  | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization) | (USCDI) Responsible Diagnostic Service
result |  | 0..* | Reference(US Quality Core Laboratory Result Observation) | (USCDI+ Quality) (USCDI) Observations
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.category | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.category:LaboratorySlice | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
DiagnosticReport | C | 0..* | USCoreDiagnosticReportProfileLaboratoryReporting(6.1.0) | A Diagnostic report - a combination of request information, atomic results, images, interpretation, as well as formatted reports Constraints: us-core-8, us-core-9
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
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business identifier for report
basedOn |  | 0..* | Reference(US Quality Core CarePlan | US Quality Core ImmunizationRecommendation | US Quality Core MedicationRequest | US Quality Core NutritionOrder | US Quality Core ServiceRequest) | What was requested
status | ?!S Σ C | 1..1 | code | (USCDI+ Quality) (USCDI) registered | partial | preliminary | final + Binding: DiagnosticReportStatus (required)
Slices for category | S Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Slice: Unordered, Open by pattern:$this Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections.
category:LaboratorySlice | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Service category Binding: DiagnosticServiceSectionCodes (preferred): Codes for diagnostic service sections. Required Pattern: At least the following
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
coding |  | 1..* | Coding | Code defined by a terminology system Fixed Value: (Complex)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
system |  | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version |  | 0..1 | string | Version of the system - if relevant
code |  | 1..1 | code | Symbol in syntax defined by the system Fixed Value: LAB
display |  | 0..1 | string | Representation defined by the system
userSelected |  | 0..1 | boolean | If this coding was chosen directly by the user
text |  | 0..1 | string | Plain text representation of the concept
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) US Core Laboratory Report Order Code Binding: US Core Laboratory Test Codes (extensible): LOINC codes
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) The subject of the report - usually, but not always, the patient
encounter | Σ | 0..1 | Reference(Encounter) | Health care event when test ordered
effective[x] | S Σ C | 0..1 |  | (USCDI+ Quality) (USCDI) Diagnostically relevant time (typically the time of specimen collection)
effectiveDateTime |  |  | dateTime S |
effectivePeriod |  |  | Period |
issued | S Σ C | 0..1 | instant | (USCDI) When the report was released
performer | S Σ | 0..* | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core Organization) | (USCDI) Responsible Diagnostic Service
resultsInterpreter | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam) | Primary result interpreter
specimen |  | 0..* | Reference(Specimen) | Specimens this report is based on
result | S | 0..* | Reference(US Quality Core Laboratory Result Observation) | (USCDI+ Quality) (USCDI) Observations
imagingStudy |  | 0..* | Reference(ImagingStudy) | Reference to full details of imaging associated with the diagnostic report
media | Σ | 0..* | BackboneElement | Key images associated with this report
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
comment |  | 0..1 | string | Comment about the image (e.g. explanation)
link | Σ | 1..1 | Reference(Media) | Reference to the image source
conclusion |  | 0..1 | string | Clinical conclusion (interpretation) of test results
conclusionCode |  | 0..* | CodeableConcept | Codes for the clinical conclusion of test results Binding: SNOMEDCTClinicalFindings (example): Diagnosis codes provided as adjuncts to the report.
presentedForm |  | 0..* | Attachment | Entire report as issued
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
DiagnosticReport.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
DiagnosticReport.status | Base | required | DiagnosticReportStatus | 📦4.0.1 | FHIR Std.
DiagnosticReport.category | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.category:LaboratorySlice | Base | preferred | Diagnostic Service Section Codes | 📦4.0.1 | FHIR Std.
DiagnosticReport.code | Base | extensible | US Core Laboratory Test Codes | 📦7.0.0 | US Core v7.0
DiagnosticReport.conclusionCode | Base | example | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | DiagnosticReport | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | DiagnosticReport | 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 | DiagnosticReport | 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 | DiagnosticReport | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | DiagnosticReport | 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()`
us-core-8 | error | DiagnosticReport | effective[x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | `(status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists()`
us-core-9 | error | DiagnosticReport | issued SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' | `(status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies issued.exists()`

Summary

Structures

This structure refers to these other structures:

- US Quality Core CarePlan (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-careplan)
- US Quality Core ImmunizationRecommendation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunizationrecommendation)
- US Quality Core MedicationRequest (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-medicationrequest)
- US Quality Core NutritionOrder (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-nutritionorder)
- US Quality Core ServiceRequest (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-servicerequest)
- 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 Laboratory Result Observation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-observation-lab)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of DiagnosticReport.category

Other representations of profile: CSV, Excel, Schematron