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 AllergyIntolerance

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

Profile of AllergyIntolerance for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.

### USCDI+ Quality Element Support Expectations

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

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

USCDI+ Quality Elements:

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

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

### Profile Specific Implementation Guidance

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

Usages:

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

#### Terminology Bindings

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

#### Constraints

Id | Grade | Path(s) | Description | Expression
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()`
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | AllergyIntolerance | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | USCoreAllergyIntolerance(6.1.0) | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:resolutionAge |  | 0..1 | Age | Age that the allergy or intolerance resolved URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External ids for this item
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required)
type | Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance Binding: Common substances for allergy and intolerance documentation including refutations (extensible)
patient | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) Who the sensitivity is for
encounter |  | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted
onset[x] |  | 0..1 |  | (USCDI+ Quality) When allergy or intolerance was identified
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
recordedDate |  | 0..1 | dateTime | (USCDI+ Quality) Date first version of the resource instance was recorded
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the sensitivity
asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
lastOccurrence |  | 0..1 | dateTime | (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
note |  | 0..* | Annotation | Additional text not captured in other fields
reaction | S | 0..* | BackboneElement | (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
manifestation | S | 1..* | CodeableConcept | (USCDI) Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
description |  | 0..1 | string | Description of the event as a whole
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
severity |  | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

#### Terminology Bindings

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

#### Constraints

Id | Grade | Path(s) | Description | Expression
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()`
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | AllergyIntolerance | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge

Key Elements View

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

#### Terminology Bindings

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

#### Constraints

Id | Grade | Path(s) | Description | Expression
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()`
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | AllergyIntolerance | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

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

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | USCoreAllergyIntolerance(6.1.0) | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:resolutionAge |  | 0..1 | Age | Age that the allergy or intolerance resolved URL: http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External ids for this item
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | (USCDI) unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required)
type | Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.
code | S Σ | 1..1 | CodeableConcept | (USCDI+ Quality) (USCDI) Code that identifies the allergy or intolerance Binding: Common substances for allergy and intolerance documentation including refutations (extensible)
patient | S Σ | 1..1 | Reference(US Quality Core Patient) | (USCDI) Who the sensitivity is for
encounter |  | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted
onset[x] |  | 0..1 |  | (USCDI+ Quality) When allergy or intolerance was identified
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
recordedDate |  | 0..1 | dateTime | (USCDI+ Quality) Date first version of the resource instance was recorded
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) | Who recorded the sensitivity
asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
lastOccurrence |  | 0..1 | dateTime | (USCDI+ Quality) Date(/time) of last known occurrence of a reaction
note |  | 0..* | Annotation | Additional text not captured in other fields
reaction | S | 0..* | BackboneElement | (USCDI+ Quality) (USCDI) Adverse Reaction Events linked to exposure to substance
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
manifestation | S | 1..* | CodeableConcept | (USCDI) Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
description |  | 0..1 | string | Description of the event as a whole
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
severity |  | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

#### Terminology Bindings

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

#### Constraints

Id | Grade | Path(s) | Description | Expression
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()`
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | AllergyIntolerance | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Mandatory: 1 element

Structures

This structure refers to these other structures:

- US Quality Core Patient (http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge

Other representations of profile: CSV, Excel, Schematron

### Notes:

#### CQL Authoring Usage (Informational)

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

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