​See also the FHIR Shorthand.

Algorithm for populating Procedure.performed

• If there is only one date or time, use that value as the performedDateTime.
• If there is one date and one time, use the time as the performedDateTime.
• If there is more than one time, put the earliest in performedPeriod.start and the latest in performedPeriod.end, wherever they come from.

The following VistA SURGERY (130) file fields contain dates:

• DATE OF OPERATION (.09)
• TIME PROCEDURE BEGAN (121)
• TIME PROCEDURE ENDED (122)
• TIME OPERATION BEGAN (.22)
• TIME OPERATION ENDS (.23)

Use Case Overview

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	USCoreProcedureProfile(5.0.1)	An action that is being or was performed on a patient This profile also complies with the profiles US Core Procedure Profile (6.1.0) and US Core Procedure Profile (7.0.0) Constraints: us-core-7
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣC	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 387713003
display		1..1	string	Representation defined by the system Fixed Value: Surgical procedure
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	SΣ	1..1	CodeableConcept	Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure
coding	SΣ	0..*	Coding	Code defined by a terminology system
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
text	SΣ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	Who the procedure was performed on
encounter	SΣ	0..1	Reference(Encounter: Visit)	Encounter created as part of
Slices for performed[x]	SΣC	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime S
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedDateTime	SΣC	0..1	dateTime S	When the procedure was performed
performed[x]:performedPeriod	SΣC	0..1	Period	When the procedure was performed
start	SΣC	0..1	dateTime	Starting time with inclusive boundary Constraints: psp-25-1290, psp-25-1292
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing Constraints: psp-25-1291, psp-25-1293
Slices for performer	Σ	0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by value:$this
performer:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
performer:va-p0	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .167
display		1..1	string	Representation defined by the system Fixed Value: PERFUSIONIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: PERFUSIONIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p1	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .14
display		1..1	string	Representation defined by the system Fixed Value: PRIMARY SURGEON
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: PRIMARY SURGEON
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p2	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .15
display		1..1	string	Representation defined by the system Fixed Value: FIRST ASST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: FIRST ASST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p3	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .16
display		1..1	string	Representation defined by the system Fixed Value: SECOND ASST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: SECOND ASST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p4	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .164
display		1..1	string	Representation defined by the system Fixed Value: ATTENDING SURGEON
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: ATTENDING SURGEON
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p5	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .168
display		1..1	string	Representation defined by the system Fixed Value: ASST PERFUSIONIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: ASST PERFUSIONIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p6	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .18
display		1..1	string	Representation defined by the system Fixed Value: SKIN PREPPED BY (1)
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: SKIN PREPPED BY (1)
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p7	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .31
display		1..1	string	Representation defined by the system Fixed Value: PRINC ANESTHETIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: PRINC ANESTHETIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p8	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .32
display		1..1	string	Representation defined by the system Fixed Value: RELIEF ANESTHETIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: RELIEF ANESTHETIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p9	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .33
display		1..1	string	Representation defined by the system Fixed Value: ASST ANESTHETIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: ASST ANESTHETIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p10	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .34
display		1..1	string	Representation defined by the system Fixed Value: ANESTHESIOLOGIST SUPVR
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: ANESTHESIOLOGIST SUPVR
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p11	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .522
display		1..1	string	Representation defined by the system Fixed Value: VERIFIER
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: VERIFIER
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p12	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 123
display		1..1	string	Representation defined by the system Fixed Value: PROVIDER
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: PROVIDER
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p13	SΣ	0..1	BackboneElement	The people who performed the procedure
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .57
display		1..1	string	Representation defined by the system Fixed Value: FOLEY CATHETER INSERTED BY
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: FOLEY CATHETER INSERTED BY
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
location	SΣC	0..1	Reference(Location | Procedure: Surgery Location[OR])	Where the procedure happened Constraints: psp-25-1294, psp-25-1295
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
text	SΣ	0..1	string	Plain text representation of the concept
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
coding	SΣC	0..*	Coding	Code defined by a terminology system Constraints: psp-25-1296, psp-25-1297
text	SΣC	0..1	string	Plain text representation of the concept Constraints: psp-25-1296-1, psp-25-1297-1
note	S	0..*	Annotation	Additional information about the procedure
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.category	Base	example	Procedure Category Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.code	Base	extensible	US Core Procedure Codes	📦7.0.0	US Core v7.0
Procedure.performer:va-p0.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p1.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p2.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p3.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p4.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p5.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p6.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p7.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p8.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p9.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p10.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p11.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p12.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p13.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.reasonCode	Base	example	Procedure Reason Codes	📦4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	Procedure	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	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	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()
psp-25-1290	best practice	Procedure.performed[x]:performedPeriod.start	If 130-118 NON-OR PROCEDURE == ‘Y’ then source value from (130-121)	true
psp-25-1291	best practice	Procedure.performed[x]:performedPeriod.end	If 130-118 NON-OR PROCEDURE == ‘Y’ then source value from (130-122)	true
psp-25-1292	best practice	Procedure.performed[x]:performedPeriod.start	If 130-118 NON-OR PROCEDURE != ‘Y’ then source value from (130-.22)	true
psp-25-1293	best practice	Procedure.performed[x]:performedPeriod.end	If 130-118 NON-OR PROCEDURE != ‘Y’ then source value from (130-.23)	true
psp-25-1294	best practice	Procedure.location	If 130-118 NON-OR PROCEDURE == ‘Y’ then reference /Location based on (130-119)	true
psp-25-1295	best practice	Procedure.location	If 130-118 NON-OR PROCEDURE != ‘Y’ then reference LocationOR based on (130-.02)	true
psp-25-1296	best practice	Procedure.complication.coding	If (130-688) is == ‘Y’ then fixed value http://snomed.info/sct#88797001 "Complication of surgical procedure (disorder)"	true
psp-25-1297	best practice	Procedure.complication.coding	If (130-258) is == ‘Y’ then fixed value http://snomed.info/sct#22298006 "Myocardial infarction (disorder)"	true
psp-25-1296-1	best practice	Procedure.complication.text	If == ‘Y’ then fixed value STOMA COMPLICATIONS	true
psp-25-1297-1	best practice	Procedure.complication.text	If == ‘Y’ then fixed value MYOCARDIAL INFARCTION	true
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()

This structure is derived from USCoreProcedureProfile

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure		0..*	USCoreProcedureProfile(5.0.1)	An action that is being or was performed on a patient This profile also complies with the profiles US Core Procedure Profile (6.1.0) and US Core Procedure Profile (7.0.0)
status		1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown
category
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 387713003
display		1..1	string	Representation defined by the system Fixed Value: Surgical procedure
code
coding	S	0..*	Coding	Code defined by a terminology system
system	S	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
code	S	0..1	code	Symbol in syntax defined by the system
display	S	0..1	string	Representation defined by the system
text	S	0..1	string	Plain text representation of the concept
subject		1..1	Reference(Patient)	Who the procedure was performed on
encounter	S	0..1	Reference(Encounter: Visit)	Encounter created as part of
Slices for performed[x]		0..1	dateTime, Period, string, Age, Range	When the procedure was performed Slice: Unordered, Open by type:$this
performed[x]:performedDateTime	S	0..1	dateTime S	When the procedure was performed
performed[x]:performedPeriod		0..1	Period	When the procedure was performed
start	SC	0..1	dateTime	Starting time with inclusive boundary Constraints: psp-25-1290, psp-25-1292
end	SC	0..1	dateTime	End time with inclusive boundary, if not ongoing Constraints: psp-25-1291, psp-25-1293
Slices for performer		0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by value:$this
performer:va-p0	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .167
display		1..1	string	Representation defined by the system Fixed Value: PERFUSIONIST
text	S	0..1	string	Plain text representation of the concept Required Pattern: PERFUSIONIST
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p1	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .14
display		1..1	string	Representation defined by the system Fixed Value: PRIMARY SURGEON
text	S	0..1	string	Plain text representation of the concept Required Pattern: PRIMARY SURGEON
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p2	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .15
display		1..1	string	Representation defined by the system Fixed Value: FIRST ASST
text	S	0..1	string	Plain text representation of the concept Required Pattern: FIRST ASST
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p3	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .16
display		1..1	string	Representation defined by the system Fixed Value: SECOND ASST
text	S	0..1	string	Plain text representation of the concept Required Pattern: SECOND ASST
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p4	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .164
display		1..1	string	Representation defined by the system Fixed Value: ATTENDING SURGEON
text	S	0..1	string	Plain text representation of the concept Required Pattern: ATTENDING SURGEON
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p5	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .168
display		1..1	string	Representation defined by the system Fixed Value: ASST PERFUSIONIST
text	S	0..1	string	Plain text representation of the concept Required Pattern: ASST PERFUSIONIST
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p6	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .18
display		1..1	string	Representation defined by the system Fixed Value: SKIN PREPPED BY (1)
text	S	0..1	string	Plain text representation of the concept Required Pattern: SKIN PREPPED BY (1)
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p7	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .31
display		1..1	string	Representation defined by the system Fixed Value: PRINC ANESTHETIST
text	S	0..1	string	Plain text representation of the concept Required Pattern: PRINC ANESTHETIST
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p8	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .32
display		1..1	string	Representation defined by the system Fixed Value: RELIEF ANESTHETIST
text	S	0..1	string	Plain text representation of the concept Required Pattern: RELIEF ANESTHETIST
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p9	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .33
display		1..1	string	Representation defined by the system Fixed Value: ASST ANESTHETIST
text	S	0..1	string	Plain text representation of the concept Required Pattern: ASST ANESTHETIST
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p10	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .34
display		1..1	string	Representation defined by the system Fixed Value: ANESTHESIOLOGIST SUPVR
text	S	0..1	string	Plain text representation of the concept Required Pattern: ANESTHESIOLOGIST SUPVR
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p11	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .522
display		1..1	string	Representation defined by the system Fixed Value: VERIFIER
text	S	0..1	string	Plain text representation of the concept Required Pattern: VERIFIER
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p12	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 123
display		1..1	string	Representation defined by the system Fixed Value: PROVIDER
text	S	0..1	string	Plain text representation of the concept Required Pattern: PROVIDER
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
performer:va-p13	S	0..1	BackboneElement	The people who performed the procedure
function
coding	S	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .57
display		1..1	string	Representation defined by the system Fixed Value: FOLEY CATHETER INSERTED BY
text	S	0..1	string	Plain text representation of the concept Required Pattern: FOLEY CATHETER INSERTED BY
actor	S	1..1	Reference(Practitioner)	The reference to the practitioner
location	SC	0..1	Reference(Location | Procedure: Surgery Location[OR])	Where the procedure happened Constraints: psp-25-1294, psp-25-1295
reasonCode
text	S	0..1	string	Plain text representation of the concept
complication
coding	SC	0..*	Coding	Code defined by a terminology system Constraints: psp-25-1296, psp-25-1297
text	SC	0..1	string	Plain text representation of the concept Constraints: psp-25-1296-1, psp-25-1297-1
note	S	0..*	Annotation	Additional information about the procedure
Documentation for this format

Constraints

Id	Grade	Path(s)	Description	Expression
psp-25-1290	best practice	Procedure.performed[x]:performedPeriod.start	If 130-118 NON-OR PROCEDURE == ‘Y’ then source value from (130-121)	true
psp-25-1291	best practice	Procedure.performed[x]:performedPeriod.end	If 130-118 NON-OR PROCEDURE == ‘Y’ then source value from (130-122)	true
psp-25-1292	best practice	Procedure.performed[x]:performedPeriod.start	If 130-118 NON-OR PROCEDURE != ‘Y’ then source value from (130-.22)	true
psp-25-1293	best practice	Procedure.performed[x]:performedPeriod.end	If 130-118 NON-OR PROCEDURE != ‘Y’ then source value from (130-.23)	true
psp-25-1294	best practice	Procedure.location	If 130-118 NON-OR PROCEDURE == ‘Y’ then reference /Location based on (130-119)	true
psp-25-1295	best practice	Procedure.location	If 130-118 NON-OR PROCEDURE != ‘Y’ then reference LocationOR based on (130-.02)	true
psp-25-1296	best practice	Procedure.complication.coding	If (130-688) is == ‘Y’ then fixed value http://snomed.info/sct#88797001 "Complication of surgical procedure (disorder)"	true
psp-25-1297	best practice	Procedure.complication.coding	If (130-258) is == ‘Y’ then fixed value http://snomed.info/sct#22298006 "Myocardial infarction (disorder)"	true
psp-25-1296-1	best practice	Procedure.complication.text	If == ‘Y’ then fixed value STOMA COMPLICATIONS	true
psp-25-1297-1	best practice	Procedure.complication.text	If == ‘Y’ then fixed value MYOCARDIAL INFARCTION	true

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Procedure	C	0..*	USCoreProcedureProfile(5.0.1)	An action that is being or was performed on a patient This profile also complies with the profiles US Core Procedure Profile (6.1.0) and US Core Procedure Profile (7.0.0) Constraints: us-core-7
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Identifiers for this procedure
instantiatesCanonical	Σ	0..*	canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | ServiceRequest)	A request for this procedure
partOf	Σ	0..*	Reference(Procedure | Observation | MedicationAdministration)	Part of referenced event
status	?!SΣC	1..1	code	preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required)
statusReason	Σ	0..1	CodeableConcept	Reason for current status Binding: ProcedureNotPerformedReason(SNOMED-CT) (example): A code that identifies the reason a procedure was not performed.
category	Σ	0..1	CodeableConcept	Classification of the procedure Binding: ProcedureCategoryCodes(SNOMEDCT) (example): A code that classifies a procedure for searching, sorting and display purposes.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 387713003
display		1..1	string	Representation defined by the system Fixed Value: Surgical procedure
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Identification of the procedure Binding: US Core Procedure Codes (extensible): Codes describing the type of Procedure
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	0..1	uri	Identity of the terminology system Required Pattern: http://www.ama-assn.org/go/cpt
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	Who the procedure was performed on
encounter	SΣ	0..1	Reference(Encounter: Visit)	Encounter created as part of
Slices for performed[x]	SΣC	0..1		When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime			dateTime S
performedPeriod			Period
performedString			string
performedAge			Age
performedRange			Range
performed[x]:performedDateTime	SΣC	0..1	dateTime S	When the procedure was performed
performed[x]:performedPeriod	SΣC	0..1	Period	When the procedure was performed
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	0..1	dateTime	Starting time with inclusive boundary Constraints: psp-25-1290, psp-25-1292
end	SΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing Constraints: psp-25-1291, psp-25-1293
recorder	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Who recorded the procedure
asserter	Σ	0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)	Person who asserts this procedure
Slices for performer	Σ	0..*	BackboneElement	The people who performed the procedure Slice: Unordered, Open by value:$this
performer:All Slices				Content/Rules for all slices
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
actor	Σ	1..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p0	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .167
display		1..1	string	Representation defined by the system Fixed Value: PERFUSIONIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: PERFUSIONIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p1	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .14
display		1..1	string	Representation defined by the system Fixed Value: PRIMARY SURGEON
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: PRIMARY SURGEON
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p2	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .15
display		1..1	string	Representation defined by the system Fixed Value: FIRST ASST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: FIRST ASST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p3	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .16
display		1..1	string	Representation defined by the system Fixed Value: SECOND ASST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: SECOND ASST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p4	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .164
display		1..1	string	Representation defined by the system Fixed Value: ATTENDING SURGEON
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: ATTENDING SURGEON
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p5	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .168
display		1..1	string	Representation defined by the system Fixed Value: ASST PERFUSIONIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: ASST PERFUSIONIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p6	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .18
display		1..1	string	Representation defined by the system Fixed Value: SKIN PREPPED BY (1)
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: SKIN PREPPED BY (1)
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p7	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .31
display		1..1	string	Representation defined by the system Fixed Value: PRINC ANESTHETIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: PRINC ANESTHETIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p8	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .32
display		1..1	string	Representation defined by the system Fixed Value: RELIEF ANESTHETIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: RELIEF ANESTHETIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p9	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .33
display		1..1	string	Representation defined by the system Fixed Value: ASST ANESTHETIST
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: ASST ANESTHETIST
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p10	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .34
display		1..1	string	Representation defined by the system Fixed Value: ANESTHESIOLOGIST SUPVR
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: ANESTHESIOLOGIST SUPVR
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p11	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .522
display		1..1	string	Representation defined by the system Fixed Value: VERIFIER
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: VERIFIER
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p12	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 123
display		1..1	string	Representation defined by the system Fixed Value: PROVIDER
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: PROVIDER
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
performer:va-p13	SΣ	0..1	BackboneElement	The people who performed the procedure
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
function	Σ	0..1	CodeableConcept	Type of performance Binding: ProcedurePerformerRoleCodes (example): A code that identifies the role of a performer of the procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://va.gov/terminology/vistaDefinedTerms/130
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: .57
display		1..1	string	Representation defined by the system Fixed Value: FOLEY CATHETER INSERTED BY
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	SΣ	0..1	string	Plain text representation of the concept Required Pattern: FOLEY CATHETER INSERTED BY
actor	SΣ	1..1	Reference(Practitioner)	The reference to the practitioner
onBehalfOf		0..1	Reference(Organization)	Organization the device or practitioner was acting for
location	SΣC	0..1	Reference(Location | Procedure: Surgery Location[OR])	Where the procedure happened Constraints: psp-25-1294, psp-25-1295
reasonCode	Σ	0..*	CodeableConcept	Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
text	SΣ	0..1	string	Plain text representation of the concept
reasonReference	Σ	0..*	Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference)	The justification that the procedure was performed
bodySite	Σ	0..*	CodeableConcept	Target body sites Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
outcome	Σ	0..1	CodeableConcept	The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
report		0..*	Reference(DiagnosticReport | DocumentReference | Composition)	Any report resulting from the procedure
complication		0..*	CodeableConcept	Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣC	0..*	Coding	Code defined by a terminology system Constraints: psp-25-1296, psp-25-1297
text	SΣC	0..1	string	Plain text representation of the concept Constraints: psp-25-1296-1, psp-25-1297-1
complicationDetail		0..*	Reference(Condition)	A condition that is a result of the procedure
followUp		0..*	CodeableConcept	Instructions for follow up Binding: ProcedureFollowUpCodes(SNOMEDCT) (example): Specific follow up required for a procedure e.g. removal of sutures.
note	S	0..*	Annotation	Additional information about the procedure
focalDevice		0..*	BackboneElement	Manipulated, implanted, or removed device
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
action		0..1	CodeableConcept	Kind of change to device Binding: ProcedureDeviceActionCodes (preferred): A kind of change that happened to the device during the procedure.
manipulated		1..1	Reference(Device)	Device that was changed
usedReference		0..*	Reference(Device | Medication | Substance)	Items used during procedure
usedCode		0..*	CodeableConcept	Coded items used during the procedure Binding: FHIRDeviceTypes (example): Codes describing items used during a procedure.
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Procedure.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Procedure.status	Base	required	EventStatus	📦4.0.1	FHIR Std.
Procedure.statusReason	Base	example	Procedure Not Performed Reason (SNOMED-CT)	📦4.0.1	FHIR Std.
Procedure.category	Base	example	Procedure Category Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.code	Base	extensible	US Core Procedure Codes	📦7.0.0	US Core v7.0
Procedure.performer.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p0.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p1.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p2.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p3.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p4.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p5.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p6.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p7.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p8.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p9.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p10.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p11.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p12.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.performer:va-p13.​function	Base	example	Procedure Performer Role Codes	📦4.0.1	FHIR Std.
Procedure.reasonCode	Base	example	Procedure Reason Codes	📦4.0.1	FHIR Std.
Procedure.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Procedure.outcome	Base	example	Procedure Outcome Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.complication	Base	example	Condition/Problem/Diagnosis Codes	📦4.0.1	FHIR Std.
Procedure.followUp	Base	example	Procedure Follow up Codes (SNOMED CT)	📦4.0.1	FHIR Std.
Procedure.focalDevice.​action	Base	preferred	Procedure Device Action Codes	📦4.0.1	FHIR Std.
Procedure.usedCode	Base	example	FHIR Device Types	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Procedure	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Procedure	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	Procedure	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	Procedure	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Procedure	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()
psp-25-1290	best practice	Procedure.performed[x]:performedPeriod.start	If 130-118 NON-OR PROCEDURE == ‘Y’ then source value from (130-121)	true
psp-25-1291	best practice	Procedure.performed[x]:performedPeriod.end	If 130-118 NON-OR PROCEDURE == ‘Y’ then source value from (130-122)	true
psp-25-1292	best practice	Procedure.performed[x]:performedPeriod.start	If 130-118 NON-OR PROCEDURE != ‘Y’ then source value from (130-.22)	true
psp-25-1293	best practice	Procedure.performed[x]:performedPeriod.end	If 130-118 NON-OR PROCEDURE != ‘Y’ then source value from (130-.23)	true
psp-25-1294	best practice	Procedure.location	If 130-118 NON-OR PROCEDURE == ‘Y’ then reference /Location based on (130-119)	true
psp-25-1295	best practice	Procedure.location	If 130-118 NON-OR PROCEDURE != ‘Y’ then reference LocationOR based on (130-.02)	true
psp-25-1296	best practice	Procedure.complication.coding	If (130-688) is == ‘Y’ then fixed value http://snomed.info/sct#88797001 "Complication of surgical procedure (disorder)"	true
psp-25-1297	best practice	Procedure.complication.coding	If (130-258) is == ‘Y’ then fixed value http://snomed.info/sct#22298006 "Myocardial infarction (disorder)"	true
psp-25-1296-1	best practice	Procedure.complication.text	If == ‘Y’ then fixed value STOMA COMPLICATIONS	true
psp-25-1297-1	best practice	Procedure.complication.text	If == ‘Y’ then fixed value MYOCARDIAL INFARCTION	true
us-core-7	error	Procedure	Performed SHALL be present if the status is 'completed' or 'in-progress'	(status='completed' or status='in-progress') implies performed.exists()