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 Encounter

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

Profile of Encounter 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:

- identifier: (USCDI+ Quality) (USCDI) Identifier(s) by which this encounter is known
- identifier.system: (USCDI+ Quality) (USCDI) The namespace for the identifier value
- identifier.value: (USCDI+ Quality) (USCDI) The value that is unique
- status: (USCDI+ Quality) (USCDI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
- type: (USCDI+ Quality) (USCDI) Specific type of encounter
- priority: (USCDI+ Quality) Indicates the urgency of the encounter
- period: (USCDI+ Quality) (USCDI) The start and end time of the encounter
- diagnosis: (USCDI+ Quality) The list of diagnosis relevant to this encounter
- diagnosis.extension:diagnosisPresentOnAdmission: (USCDI+ Quality) onAdmission
- hospitalization: (USCDI+ Quality) (USCDI) Details about the admission to a healthcare service
- hospitalization.dischargeDisposition: (USCDI+ Quality) (USCDI) Category or kind of location after discharge
- location: (USCDI+ Quality) (USCDI) List of locations where the patient has been
- location.location: (USCDI+ Quality) (USCDI) Location the encounter takes place

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:

- Refer to this Profile: US Quality Core AdverseEvent, US Quality Core Claim, US Quality Core CommunicationRequest, US Quality Core Condition Encounter Diagnosis... Show 8 more, US Quality Core DiagnosticReport Profile for Report and Note Exchange, US Quality Core Encounter, US Quality Core ImagingStudy, US Quality Core MedicationAdministration, US Quality Core MedicationAdministration Not Done, US Quality Core Medication Not Requested, US Quality Core MedicationRequest and US Quality Core Task Rejected
- Examples for this Profile: Encounter/encounter-ed-example and Encounter/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
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile(6.1.0) | An interaction during which services are provided to the patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | (USCDI+ Quality) (USCDI) Identifier(s) by which this encounter is known
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 1..1 | uri | (USCDI+ Quality) (USCDI) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | (USCDI+ Quality) (USCDI) The value that is unique Example General: 123456
status | ?!S Σ | 1..1 | code | (USCDI+ Quality) (USCDI) planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class | S Σ | 1..1 | Coding | (USCDI) Classification of patient encounter Binding: V3 Value SetActEncounterCode (extensible): Classification of the encounter.
type | S Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
priority |  | 0..1 | CodeableConcept | (USCDI+ Quality) Indicates the urgency of the encounter Binding: v3 Code System ActPriority (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) The patient or group present at the encounter
participant | S Σ | 0..* | BackboneElement | (USCDI) List of participants involved in the encounter
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | (USCDI) Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | (USCDI) Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core RelatedPerson) | (USCDI) Persons involved in the encounter other than the patient
period | S | 0..1 | Period | (USCDI+ Quality) (USCDI) The start and end time of the encounter
reasonCode | S Σ | 0..* | CodeableConcept | (USCDI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | S Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis | US Quality Core Procedure | US Quality Core Simple Observation | US Quality Core ImmunizationRecommendation) | (USCDI) Reason the encounter takes place (reference)
diagnosis | Σ | 0..* | BackboneElement | (USCDI+ Quality) The list of diagnosis relevant to this encounter
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:diagnosisPresentOnAdmission | S | 0..1 | CodeableConcept | (USCDI+ Quality) onAdmission URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission Binding: USQualityCore Present On Admission Codes (required): Indicator of whether the Encounter diagnosis was present at the time of admission
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
hospitalization | S | 0..1 | BackboneElement | (USCDI+ Quality) (USCDI) Details about the admission to a healthcare service
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
origin |  | 0..1 | Reference(US Quality Core Location) | The location/organization from which the patient came before admission
destination |  | 0..1 | Reference(US Quality Core Location) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location | S | 0..* | BackboneElement | (USCDI+ Quality) (USCDI) List of locations where the patient has been
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(US Quality Core Location) | (USCDI+ Quality) (USCDI) Location the encounter takes place
period |  | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(US Quality Core Organization) | (USCDI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(US Quality Core Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Encounter.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Encounter.status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.class | Base | extensible | V3 Value SetActEncounterCode | 📦2014-03-26 | FHIR Std.
Encounter.type | Base | extensible | US Core Encounter Type | 📦7.0.0 | US Core v7.0
Encounter.priority | Base | example | v3 Code System ActPriority | 📦2018-08-12 | FHIR Std.
Encounter.participant.​type | Base | extensible | Participant type | 📦4.0.1 | FHIR Std.
Encounter.reasonCode | Base | preferred | Encounter Reason Codes | 📦4.0.1 | FHIR Std.
Encounter.diagnosis.​use | Base | preferred | DiagnosisRole | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Encounter | 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 | Encounter | 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 | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Encounter | 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()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile(6.1.0) | An interaction during which services are provided to the patient
identifier |  | 0..* | Identifier | (USCDI+ Quality) (USCDI) Identifier(s) by which this encounter is known
system |  | 1..1 | uri | (USCDI+ Quality) (USCDI) The namespace for the identifier value
value |  | 1..1 | string | (USCDI+ Quality) (USCDI) The value that is unique
status |  | 1..1 | code | (USCDI+ Quality) (USCDI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class |  | 1..1 | Coding | (USCDI) Classification of patient encounter
type |  | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Specific type of encounter
priority |  | 0..1 | CodeableConcept | (USCDI+ Quality) Indicates the urgency of the encounter
subject |  | 1..1 | Reference(US Quality Core Patient) | (USCDI) The patient or group present at the encounter
participant |  | 0..* | BackboneElement | (USCDI) List of participants involved in the encounter
individual |  | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core RelatedPerson) | (USCDI) Persons involved in the encounter other than the patient
period |  | 0..1 | Period | (USCDI+ Quality) (USCDI) The start and end time of the encounter
reasonCode |  | 0..* | CodeableConcept | (USCDI) Coded reason the encounter takes place
reasonReference | Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis | US Quality Core Procedure | US Quality Core Simple Observation | US Quality Core ImmunizationRecommendation) | (USCDI) Reason the encounter takes place (reference)
diagnosis |  | 0..* | BackboneElement | (USCDI+ Quality) The list of diagnosis relevant to this encounter
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ele-1, ext-1
extension:diagnosisPresentOnAdmission | S | 0..1 | CodeableConcept | (USCDI+ Quality) onAdmission URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission Binding: USQualityCore Present On Admission Codes (required): Indicator of whether the Encounter diagnosis was present at the time of admission Constraints: ele-1, ext-1
use |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
hospitalization |  | 0..1 | BackboneElement | (USCDI+ Quality) (USCDI) Details about the admission to a healthcare service
origin |  | 0..1 | Reference(US Quality Core Location) | The location/organization from which the patient came before admission
destination |  | 0..1 | Reference(US Quality Core Location) | Location/organization to which the patient is discharged
dischargeDisposition |  | 0..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location |  | 0..* | BackboneElement | (USCDI+ Quality) (USCDI) List of locations where the patient has been
location |  | 1..1 | Reference(US Quality Core Location) | (USCDI+ Quality) (USCDI) Location the encounter takes place
period |  | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider |  | 0..1 | Reference(US Quality Core Organization) | (USCDI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(US Quality Core Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | Encounter.diagnosis.extension, Encounter.diagnosis.extension:diagnosisPresentOnAdmission | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Encounter.diagnosis.extension, Encounter.diagnosis.extension:diagnosisPresentOnAdmission | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile(6.1.0) | An interaction during which services are provided to the patient
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 | S Σ | 0..* | Identifier | (USCDI+ Quality) (USCDI) Identifier(s) by which this encounter is known
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | (USCDI+ Quality) (USCDI) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | (USCDI+ Quality) (USCDI) The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | (USCDI+ Quality) (USCDI) planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses
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
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | (USCDI) Classification of patient encounter Binding: V3 Value SetActEncounterCode (extensible): Classification of the encounter.
classHistory |  | 0..* | BackboneElement | List of past encounter classes
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
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: V3 Value SetActEncounterCode (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType | Σ | 0..1 | CodeableConcept | Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority |  | 0..1 | CodeableConcept | (USCDI+ Quality) Indicates the urgency of the encounter Binding: v3 Code System ActPriority (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) The patient or group present at the encounter
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against
basedOn |  | 0..* | Reference(ServiceRequest) | The ServiceRequest that initiated this encounter
participant | S Σ | 0..* | BackboneElement | (USCDI) List of participants involved in the encounter
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
type | S Σ | 0..* | CodeableConcept | (USCDI) Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | (USCDI) Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core RelatedPerson) | (USCDI) Persons involved in the encounter other than the patient
appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter
period | S | 0..1 | Period | (USCDI+ Quality) (USCDI) The start and end time of the encounter
length |  | 0..1 | Duration | Quantity of time the encounter lasted (less time absent)
reasonCode | S Σ | 0..* | CodeableConcept | (USCDI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | S Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis | US Quality Core Procedure | US Quality Core Simple Observation | US Quality Core ImmunizationRecommendation) | (USCDI) Reason the encounter takes place (reference)
diagnosis | Σ | 0..* | BackboneElement | (USCDI+ Quality) The list of diagnosis relevant to this encounter
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:diagnosisPresentOnAdmission | S | 0..1 | CodeableConcept | (USCDI+ Quality) onAdmission URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission Binding: USQualityCore Present On Admission Codes (required): Indicator of whether the Encounter diagnosis was present at the time of admission
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
account |  | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter
hospitalization | S | 0..1 | BackboneElement | (USCDI+ Quality) (USCDI) Details about the admission to a healthcare service
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
preAdmissionIdentifier |  | 0..1 | Identifier | Pre-admission identifier
origin |  | 0..1 | Reference(US Quality Core Location) | The location/organization from which the patient came before admission
admitSource |  | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission |  | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: v2 RE-ADMISSION INDICATOR (example): The reason for re-admission of this hospitalization encounter.
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination |  | 0..1 | Reference(US Quality Core Location) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location | S | 0..* | BackboneElement | (USCDI+ Quality) (USCDI) List of locations where the patient has been
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
location | S | 1..1 | Reference(US Quality Core Location) | (USCDI+ Quality) (USCDI) Location the encounter takes place
status |  | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period |  | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(US Quality Core Organization) | (USCDI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(US Quality Core Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Encounter.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
Encounter.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Encounter.identifier.​type | Base | extensible | IdentifierType | 📦4.0.1 | FHIR Std.
Encounter.status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.statusHistory.​status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.class | Base | extensible | V3 Value SetActEncounterCode | 📦2014-03-26 | FHIR Std.
Encounter.classHistory.​class | Base | extensible | V3 Value SetActEncounterCode | 📦2014-03-26 | FHIR Std.
Encounter.type | Base | extensible | US Core Encounter Type | 📦7.0.0 | US Core v7.0
Encounter.serviceType | Base | example | Service type | 📦4.0.1 | FHIR Std.
Encounter.priority | Base | example | v3 Code System ActPriority | 📦2018-08-12 | FHIR Std.
Encounter.participant.​type | Base | extensible | Participant type | 📦4.0.1 | FHIR Std.
Encounter.reasonCode | Base | preferred | Encounter Reason Codes | 📦4.0.1 | FHIR Std.
Encounter.diagnosis.​use | Base | preferred | DiagnosisRole | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​admitSource | Base | preferred | Admit source | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​reAdmission | Base | example | v2 RE-ADMISSION INDICATOR | 📦2.9 | FHIR Std.
Encounter.hospitalization.​dietPreference | Base | example | Diet | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​specialCourtesy | Base | preferred | Special courtesy | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​specialArrangement | Base | preferred | Special arrangements | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v7.1
Encounter.location.status | Base | required | EncounterLocationStatus | 📍4.0.1 | FHIR Std.
Encounter.location.physicalType | Base | example | Location type | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Encounter | 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 | Encounter | 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 | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Encounter | 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

Must-Support: 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 RelatedPerson (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson)
- US Quality Core Condition Problems Health Concerns (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns)
- US Quality Core Condition Encounter Diagnosis (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis)
- US Quality Core Procedure (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-procedure)
- US Quality Core Simple Observation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-simple-observation)
- US Quality Core ImmunizationRecommendation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunizationrecommendation)
- US Quality Core Location (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-location)
- US Quality Core Organization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization)
- US Quality Core Encounter (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile(6.1.0) | An interaction during which services are provided to the patient
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 0..* | Identifier | (USCDI+ Quality) (USCDI) Identifier(s) by which this encounter is known
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system | S Σ | 1..1 | uri | (USCDI+ Quality) (USCDI) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | (USCDI+ Quality) (USCDI) The value that is unique Example General: 123456
status | ?!S Σ | 1..1 | code | (USCDI+ Quality) (USCDI) planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class | S Σ | 1..1 | Coding | (USCDI) Classification of patient encounter Binding: V3 Value SetActEncounterCode (extensible): Classification of the encounter.
type | S Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
priority |  | 0..1 | CodeableConcept | (USCDI+ Quality) Indicates the urgency of the encounter Binding: v3 Code System ActPriority (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) The patient or group present at the encounter
participant | S Σ | 0..* | BackboneElement | (USCDI) List of participants involved in the encounter
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
type | S Σ | 0..* | CodeableConcept | (USCDI) Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | (USCDI) Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core RelatedPerson) | (USCDI) Persons involved in the encounter other than the patient
period | S | 0..1 | Period | (USCDI+ Quality) (USCDI) The start and end time of the encounter
reasonCode | S Σ | 0..* | CodeableConcept | (USCDI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | S Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis | US Quality Core Procedure | US Quality Core Simple Observation | US Quality Core ImmunizationRecommendation) | (USCDI) Reason the encounter takes place (reference)
diagnosis | Σ | 0..* | BackboneElement | (USCDI+ Quality) The list of diagnosis relevant to this encounter
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:diagnosisPresentOnAdmission | S | 0..1 | CodeableConcept | (USCDI+ Quality) onAdmission URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission Binding: USQualityCore Present On Admission Codes (required): Indicator of whether the Encounter diagnosis was present at the time of admission
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
hospitalization | S | 0..1 | BackboneElement | (USCDI+ Quality) (USCDI) Details about the admission to a healthcare service
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
origin |  | 0..1 | Reference(US Quality Core Location) | The location/organization from which the patient came before admission
destination |  | 0..1 | Reference(US Quality Core Location) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location | S | 0..* | BackboneElement | (USCDI+ Quality) (USCDI) List of locations where the patient has been
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
location | S | 1..1 | Reference(US Quality Core Location) | (USCDI+ Quality) (USCDI) Location the encounter takes place
period |  | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(US Quality Core Organization) | (USCDI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(US Quality Core Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Encounter.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Encounter.status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.class | Base | extensible | V3 Value SetActEncounterCode | 📦2014-03-26 | FHIR Std.
Encounter.type | Base | extensible | US Core Encounter Type | 📦7.0.0 | US Core v7.0
Encounter.priority | Base | example | v3 Code System ActPriority | 📦2018-08-12 | FHIR Std.
Encounter.participant.​type | Base | extensible | Participant type | 📦4.0.1 | FHIR Std.
Encounter.reasonCode | Base | preferred | Encounter Reason Codes | 📦4.0.1 | FHIR Std.
Encounter.diagnosis.​use | Base | preferred | DiagnosisRole | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Encounter | 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 | Encounter | 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 | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Encounter | 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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile(6.1.0) | An interaction during which services are provided to the patient
identifier |  | 0..* | Identifier | (USCDI+ Quality) (USCDI) Identifier(s) by which this encounter is known
system |  | 1..1 | uri | (USCDI+ Quality) (USCDI) The namespace for the identifier value
value |  | 1..1 | string | (USCDI+ Quality) (USCDI) The value that is unique
status |  | 1..1 | code | (USCDI+ Quality) (USCDI) planned | arrived | triaged | in-progress | onleave | finished | cancelled +
class |  | 1..1 | Coding | (USCDI) Classification of patient encounter
type |  | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Specific type of encounter
priority |  | 0..1 | CodeableConcept | (USCDI+ Quality) Indicates the urgency of the encounter
subject |  | 1..1 | Reference(US Quality Core Patient) | (USCDI) The patient or group present at the encounter
participant |  | 0..* | BackboneElement | (USCDI) List of participants involved in the encounter
individual |  | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core RelatedPerson) | (USCDI) Persons involved in the encounter other than the patient
period |  | 0..1 | Period | (USCDI+ Quality) (USCDI) The start and end time of the encounter
reasonCode |  | 0..* | CodeableConcept | (USCDI) Coded reason the encounter takes place
reasonReference | Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis | US Quality Core Procedure | US Quality Core Simple Observation | US Quality Core ImmunizationRecommendation) | (USCDI) Reason the encounter takes place (reference)
diagnosis |  | 0..* | BackboneElement | (USCDI+ Quality) The list of diagnosis relevant to this encounter
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url Constraints: ele-1, ext-1
extension:diagnosisPresentOnAdmission | S | 0..1 | CodeableConcept | (USCDI+ Quality) onAdmission URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission Binding: USQualityCore Present On Admission Codes (required): Indicator of whether the Encounter diagnosis was present at the time of admission Constraints: ele-1, ext-1
use |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …)
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
hospitalization |  | 0..1 | BackboneElement | (USCDI+ Quality) (USCDI) Details about the admission to a healthcare service
origin |  | 0..1 | Reference(US Quality Core Location) | The location/organization from which the patient came before admission
destination |  | 0..1 | Reference(US Quality Core Location) | Location/organization to which the patient is discharged
dischargeDisposition |  | 0..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location |  | 0..* | BackboneElement | (USCDI+ Quality) (USCDI) List of locations where the patient has been
location |  | 1..1 | Reference(US Quality Core Location) | (USCDI+ Quality) (USCDI) Location the encounter takes place
period |  | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider |  | 0..1 | Reference(US Quality Core Organization) | (USCDI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(US Quality Core Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
ele-1 | error | Encounter.diagnosis.extension, Encounter.diagnosis.extension:diagnosisPresentOnAdmission | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | Encounter.diagnosis.extension, Encounter.diagnosis.extension:diagnosisPresentOnAdmission | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Encounter |  | 0..* | USCoreEncounterProfile(6.1.0) | An interaction during which services are provided to the patient
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 | S Σ | 0..* | Identifier | (USCDI+ Quality) (USCDI) Identifier(s) by which this encounter is known
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
use | ?!Σ | 0..1 | code | usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type | Σ | 0..1 | CodeableConcept | Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system | S Σ | 1..1 | uri | (USCDI+ Quality) (USCDI) The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value | S Σ | 1..1 | string | (USCDI+ Quality) (USCDI) The value that is unique Example General: 123456
period | Σ | 0..1 | Period | Time period when id is/was valid for use
assigner | Σ | 0..1 | Reference(Organization) | Organization that issued id (may be just text)
status | ?!S Σ | 1..1 | code | (USCDI+ Quality) (USCDI) planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory |  | 0..* | BackboneElement | List of past encounter statuses
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
status |  | 1..1 | code | planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified status
class | S Σ | 1..1 | Coding | (USCDI) Classification of patient encounter Binding: V3 Value SetActEncounterCode (extensible): Classification of the encounter.
classHistory |  | 0..* | BackboneElement | List of past encounter classes
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
class |  | 1..1 | Coding | inpatient | outpatient | ambulatory | emergency + Binding: V3 Value SetActEncounterCode (extensible): Classification of the encounter.
period |  | 1..1 | Period | The time that the episode was in the specified class
type | S Σ | 1..* | CodeableConcept | (USCDI+ Quality) (USCDI) Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType | Σ | 0..1 | CodeableConcept | Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority |  | 0..1 | CodeableConcept | (USCDI+ Quality) Indicates the urgency of the encounter Binding: v3 Code System ActPriority (example): Indicates the urgency of the encounter.
subject | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) The patient or group present at the encounter
episodeOfCare | Σ | 0..* | Reference(EpisodeOfCare) | Episode(s) of care that this encounter should be recorded against
basedOn |  | 0..* | Reference(ServiceRequest) | The ServiceRequest that initiated this encounter
participant | S Σ | 0..* | BackboneElement | (USCDI) List of participants involved in the encounter
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
type | S Σ | 0..* | CodeableConcept | (USCDI) Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period | S | 0..1 | Period | (USCDI) Period of time during the encounter that the participant participated
individual | S Σ | 0..1 | Reference(US Quality Core Practitioner | US Quality Core PractitionerRole | US Quality Core RelatedPerson) | (USCDI) Persons involved in the encounter other than the patient
appointment | Σ | 0..* | Reference(Appointment) | The appointment that scheduled this encounter
period | S | 0..1 | Period | (USCDI+ Quality) (USCDI) The start and end time of the encounter
length |  | 0..1 | Duration | Quantity of time the encounter lasted (less time absent)
reasonCode | S Σ | 0..* | CodeableConcept | (USCDI) Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference | S Σ | 0..* | Reference(US Quality Core Condition Problems Health Concerns | US Quality Core Condition Encounter Diagnosis | US Quality Core Procedure | US Quality Core Simple Observation | US Quality Core ImmunizationRecommendation) | (USCDI) Reason the encounter takes place (reference)
diagnosis | Σ | 0..* | BackboneElement | (USCDI+ Quality) The list of diagnosis relevant to this encounter
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:diagnosisPresentOnAdmission | S | 0..1 | CodeableConcept | (USCDI+ Quality) onAdmission URL: http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission Binding: USQualityCore Present On Admission Codes (required): Indicator of whether the Encounter diagnosis was present at the time of admission
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
condition | Σ | 1..1 | Reference(Condition | Procedure) | The diagnosis or procedure relevant to the encounter
use |  | 0..1 | CodeableConcept | Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank |  | 0..1 | positiveInt | Ranking of the diagnosis (for each role type)
account |  | 0..* | Reference(Account) | The set of accounts that may be used for billing for this Encounter
hospitalization | S | 0..1 | BackboneElement | (USCDI+ Quality) (USCDI) Details about the admission to a healthcare service
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
preAdmissionIdentifier |  | 0..1 | Identifier | Pre-admission identifier
origin |  | 0..1 | Reference(US Quality Core Location) | The location/organization from which the patient came before admission
admitSource |  | 0..1 | CodeableConcept | From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission |  | 0..1 | CodeableConcept | The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: v2 RE-ADMISSION INDICATOR (example): The reason for re-admission of this hospitalization encounter.
dietPreference |  | 0..* | CodeableConcept | Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy |  | 0..* | CodeableConcept | Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement |  | 0..* | CodeableConcept | Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination |  | 0..1 | Reference(US Quality Core Location) | Location/organization to which the patient is discharged
dischargeDisposition | S | 0..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Category or kind of location after discharge Binding: Clinical Discharge Disposition (extensible)
location | S | 0..* | BackboneElement | (USCDI+ Quality) (USCDI) List of locations where the patient has been
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
location | S | 1..1 | Reference(US Quality Core Location) | (USCDI+ Quality) (USCDI) Location the encounter takes place
status |  | 0..1 | code | planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType |  | 0..1 | CodeableConcept | The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period |  | 0..1 | Period | Time period during which the patient was present at the location
serviceProvider | S | 0..1 | Reference(US Quality Core Organization) | (USCDI) The organization (facility) responsible for this encounter
partOf |  | 0..1 | Reference(US Quality Core Encounter) | Another Encounter this encounter is part of
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Encounter.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
Encounter.identifier.​use | Base | required | IdentifierUse | 📍4.0.1 | FHIR Std.
Encounter.identifier.​type | Base | extensible | IdentifierType | 📦4.0.1 | FHIR Std.
Encounter.status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.statusHistory.​status | Base | required | EncounterStatus | 📍4.0.1 | FHIR Std.
Encounter.class | Base | extensible | V3 Value SetActEncounterCode | 📦2014-03-26 | FHIR Std.
Encounter.classHistory.​class | Base | extensible | V3 Value SetActEncounterCode | 📦2014-03-26 | FHIR Std.
Encounter.type | Base | extensible | US Core Encounter Type | 📦7.0.0 | US Core v7.0
Encounter.serviceType | Base | example | Service type | 📦4.0.1 | FHIR Std.
Encounter.priority | Base | example | v3 Code System ActPriority | 📦2018-08-12 | FHIR Std.
Encounter.participant.​type | Base | extensible | Participant type | 📦4.0.1 | FHIR Std.
Encounter.reasonCode | Base | preferred | Encounter Reason Codes | 📦4.0.1 | FHIR Std.
Encounter.diagnosis.​use | Base | preferred | DiagnosisRole | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​admitSource | Base | preferred | Admit source | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​reAdmission | Base | example | v2 RE-ADMISSION INDICATOR | 📦2.9 | FHIR Std.
Encounter.hospitalization.​dietPreference | Base | example | Diet | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​specialCourtesy | Base | preferred | Special courtesy | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​specialArrangement | Base | preferred | Special arrangements | 📦4.0.1 | FHIR Std.
Encounter.hospitalization.​dischargeDisposition | Base | extensible | Clinical Discharge Disposition | 📦2.0.0 | THO v7.1
Encounter.location.status | Base | required | EncounterLocationStatus | 📍4.0.1 | FHIR Std.
Encounter.location.physicalType | Base | example | Location type | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | Encounter | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Encounter | 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 | Encounter | 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 | Encounter | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Encounter | 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

Must-Support: 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 RelatedPerson (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-relatedperson)
- US Quality Core Condition Problems Health Concerns (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns)
- US Quality Core Condition Encounter Diagnosis (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis)
- US Quality Core Procedure (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-procedure)
- US Quality Core Simple Observation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-simple-observation)
- US Quality Core ImmunizationRecommendation (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-immunizationrecommendation)
- US Quality Core Location (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-location)
- US Quality Core Organization (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-organization)
- US Quality Core Encounter (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter)

Extensions

This structure refers to these extensions:

- http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-encounter-diagnosisPresentOnAdmission

Other representations of profile: CSV, Excel, Schematron

### Notes:

#### CQL Authoring Usage (Informational)

The following example illustrates accessing an inpatient encounter:

    define "Ophthalmology Encounter Codes":
      [Encounter: class in "Inpatient Encounter Classes"] InpatientEncounter
        where InpatientEncounter.type in "Ophthalmology Encounter Codes"