PLUGIN
0.7.0-public-consultation-1 - draft NL

PLUGIN - Local Development build (v0.7.0-public-consultation-1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## Resource Profile: Procedure

Official URL: https://plugin.healthcare/fhir/StructureDefinition/plugin-procedure | Version: 0.7.0-public-consultation-1
Draft as of 2026-02-27 | Computable Name: PluginProcedure
Copyright/Legal: Used by permission of the PLUGIN team, all rights reserved Creative Commons License

Procedure as used within PLUGIN. Inherits from nl-core-Procedure-event. Maturity Level: 0 Draft. Open issues see Github.

Usages:

- This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure |  | 0..* | NlcoreProcedureevent | Procedure
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:procedureMethod | N | 0..* | CodeableConcept | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required)
extension:episodeOfCare |  | 1..1 | Reference(EpisodeOfCare) | Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
code | Σ | 1..1 | CodeableConcept | ProcedureType Binding: VerrichtingTypeCodelijsten (required): A code to identify a specific procedure .
subject | Σ | 1..1 | Reference(Patient | nl core Patient | Patient) | Who the procedure was performed on
Slices for performed[x] | Σ | 0..1 |  | When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime |  |  | dateTime |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
performed[x]:performedPeriod | Σ | 0..1 | Period | When the procedure was performed
performed[x]:performedDateTime | Σ | 0..1 | dateTime | ProcedureStartDate
reasonReference | Σ | 1..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem) | Indication
bodySite | Σ | 0..1 | NlcoreAnatomicalLocation | Location Binding: LocatieCodelijsten (required): Codes describing anatomical locations. May include laterality.
Slices for extension |  |  |  | Content/Rules for all slices
extension:laterality | S | 0..1 | CodeableConcept | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Binding: LateraliteitCodelijst (required)
Slices for report |  | 0..* | Reference(DiagnosticReport | DocumentReference | Composition) | Any report resulting from the procedure Slice: Unordered, Open by profile:resolve()
report:textResult |  | 0..* | Reference(nl core TextResult) | TextResult
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Procedure.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Procedure.code | Base | required | VerrichtingTypeCodelijsten | 📦2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12
Procedure.bodySite | Base | required | LocatieCodelijsten | 📦2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12

#### 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()`

This structure is derived from NlcoreProcedureevent

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure |  | 0..* | NlcoreProcedureevent | Procedure
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:episodeOfCare |  | 1..1 | Reference(EpisodeOfCare) | Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
code |  | 1..1 | CodeableConcept | ProcedureType
subject |  | 1..1 | Reference(Patient | nl core Patient | Patient) | Who the procedure was performed on
reasonReference |  | 1..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem) | Indication
bodySite |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:laterality | S | 0..1 | ExtAnatomicalLocationLaterality | Optional Extensions Element
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure |  | 0..* | NlcoreProcedureevent | Procedure
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:procedureMethod | N | 0..* | CodeableConcept | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required)
extension:episodeOfCare |  | 1..1 | Reference(EpisodeOfCare) | Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
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 | nl core Procedure request) | A request for this procedure
partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
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.
code | Σ | 1..1 | CodeableConcept | ProcedureType Binding: VerrichtingTypeCodelijsten (required): A code to identify a specific procedure .
subject | Σ | 1..1 | Reference(Patient | nl core Patient | Patient) | Who the procedure was performed on
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
Slices for performed[x] | Σ | 0..1 |  | When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime |  |  | dateTime |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
performed[x]:performedPeriod | Σ | 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 | Σ C | 0..1 | dateTime | ProcedureStartDate
end | Σ C | 0..1 | dateTime | ProcedureEndDate
performed[x]:performedDateTime | Σ | 0..1 | dateTime | ProcedureStartDate
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
performer | Σ | 0..* | 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.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | nl core HealthProfessional PractitionerRole) | Performer
onBehalfOf |  | 0..1 | Reference(Organization) | Organization the device or practitioner was acting for
location | Σ | 0..1 | Reference(Location | nl core HealthcareProvider) | Location
reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference | Σ | 1..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem) | Indication
bodySite | Σ | 0..1 | NlcoreAnatomicalLocation | Location Binding: LocatieCodelijsten (required): Codes describing anatomical locations. May include laterality.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:laterality | S | 0..1 | CodeableConcept | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Binding: LateraliteitCodelijst (required)
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
outcome | Σ | 0..1 | CodeableConcept | The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
Slices for report |  | 0..* | Reference(DiagnosticReport | DocumentReference | Composition) | Any report resulting from the procedure Slice: Unordered, Open by profile:resolve()
report:textResult |  | 0..* | Reference(nl core TextResult) | TextResult
complication |  | 0..* | CodeableConcept | Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
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 |  | 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 | required | VerrichtingTypeCodelijsten | 📦2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12
Procedure.performer.​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 | required | LocatieCodelijsten | 📦2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12
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()`

This structure is derived from NlcoreProcedureevent

Summary

Mandatory: 4 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

- nl core Patient (http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient)
- Patient (https://plugin.healthcare/fhir/StructureDefinition/plugin-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure |  | 0..* | NlcoreProcedureevent | Procedure
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:procedureMethod | N | 0..* | CodeableConcept | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required)
extension:episodeOfCare |  | 1..1 | Reference(EpisodeOfCare) | Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
code | Σ | 1..1 | CodeableConcept | ProcedureType Binding: VerrichtingTypeCodelijsten (required): A code to identify a specific procedure .
subject | Σ | 1..1 | Reference(Patient | nl core Patient | Patient) | Who the procedure was performed on
Slices for performed[x] | Σ | 0..1 |  | When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime |  |  | dateTime |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
performed[x]:performedPeriod | Σ | 0..1 | Period | When the procedure was performed
performed[x]:performedDateTime | Σ | 0..1 | dateTime | ProcedureStartDate
reasonReference | Σ | 1..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem) | Indication
bodySite | Σ | 0..1 | NlcoreAnatomicalLocation | Location Binding: LocatieCodelijsten (required): Codes describing anatomical locations. May include laterality.
Slices for extension |  |  |  | Content/Rules for all slices
extension:laterality | S | 0..1 | CodeableConcept | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Binding: LateraliteitCodelijst (required)
Slices for report |  | 0..* | Reference(DiagnosticReport | DocumentReference | Composition) | Any report resulting from the procedure Slice: Unordered, Open by profile:resolve()
report:textResult |  | 0..* | Reference(nl core TextResult) | TextResult
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Procedure.status | Base | required | EventStatus | 📍4.0.1 | FHIR Std.
Procedure.code | Base | required | VerrichtingTypeCodelijsten | 📦2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12
Procedure.bodySite | Base | required | LocatieCodelijsten | 📦2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12

#### 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()`

Differential View

This structure is derived from NlcoreProcedureevent

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure |  | 0..* | NlcoreProcedureevent | Procedure
extension |  | 1..* | Extension | Extension
Slices for extension |  |  |  | Content/Rules for all slices
extension:episodeOfCare |  | 1..1 | Reference(EpisodeOfCare) | Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
code |  | 1..1 | CodeableConcept | ProcedureType
subject |  | 1..1 | Reference(Patient | nl core Patient | Patient) | Who the procedure was performed on
reasonReference |  | 1..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem) | Indication
bodySite |  |  |  |
Slices for extension |  |  |  | Content/Rules for all slices
extension:laterality | S | 0..1 | ExtAnatomicalLocationLaterality | Optional Extensions Element
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Procedure |  | 0..* | NlcoreProcedureevent | Procedure
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 1..* | Extension | Extension Slice: Unordered, Open by value:url
extension:procedureMethod | N | 0..* | CodeableConcept | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-Procedure.ProcedureMethod Binding: VerrichtingMethodeCodelijst (required)
extension:episodeOfCare |  | 1..1 | Reference(EpisodeOfCare) | Associated Encounter episode of care URL: http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare
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 | nl core Procedure request) | A request for this procedure
partOf | Σ | 0..* | Reference(Procedure | Observation | MedicationAdministration) | Part of referenced event
status | ?!Σ | 1..1 | code | preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown Binding: EventStatus (required): A code specifying the state of the procedure.
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.
code | Σ | 1..1 | CodeableConcept | ProcedureType Binding: VerrichtingTypeCodelijsten (required): A code to identify a specific procedure .
subject | Σ | 1..1 | Reference(Patient | nl core Patient | Patient) | Who the procedure was performed on
encounter | Σ | 0..1 | Reference(Encounter) | Encounter created as part of
Slices for performed[x] | Σ | 0..1 |  | When the procedure was performed Slice: Unordered, Open by type:$this
performedDateTime |  |  | dateTime |
performedPeriod |  |  | Period |
performedString |  |  | string |
performedAge |  |  | Age |
performedRange |  |  | Range |
performed[x]:performedPeriod | Σ | 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 | Σ C | 0..1 | dateTime | ProcedureStartDate
end | Σ C | 0..1 | dateTime | ProcedureEndDate
performed[x]:performedDateTime | Σ | 0..1 | dateTime | ProcedureStartDate
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
performer | Σ | 0..* | 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.
actor | Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device | nl core HealthProfessional PractitionerRole) | Performer
onBehalfOf |  | 0..1 | Reference(Organization) | Organization the device or practitioner was acting for
location | Σ | 0..1 | Reference(Location | nl core HealthcareProvider) | Location
reasonCode | Σ | 0..* | CodeableConcept | Coded reason procedure performed Binding: ProcedureReasonCodes (example): A code that identifies the reason a procedure is required.
reasonReference | Σ | 1..* | Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference | nl core Problem) | Indication
bodySite | Σ | 0..1 | NlcoreAnatomicalLocation | Location Binding: LocatieCodelijsten (required): Codes describing anatomical locations. May include laterality.
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:laterality | S | 0..1 | CodeableConcept | Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/ext-AnatomicalLocation.Laterality Binding: LateraliteitCodelijst (required)
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
outcome | Σ | 0..1 | CodeableConcept | The result of procedure Binding: ProcedureOutcomeCodes(SNOMEDCT) (example): An outcome of a procedure - whether it was resolved or otherwise.
Slices for report |  | 0..* | Reference(DiagnosticReport | DocumentReference | Composition) | Any report resulting from the procedure Slice: Unordered, Open by profile:resolve()
report:textResult |  | 0..* | Reference(nl core TextResult) | TextResult
complication |  | 0..* | CodeableConcept | Complication following the procedure Binding: Condition/Problem/DiagnosisCodes (example): Codes describing complications that resulted from a procedure.
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 |  | 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 | required | VerrichtingTypeCodelijsten | 📦2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12
Procedure.performer.​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 | required | LocatieCodelijsten | 📦2020-09-01T00:00:00 | FHIR implementation of zibs 2020 v0.12
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()`

This structure is derived from NlcoreProcedureevent

Summary

Mandatory: 4 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

- nl core Patient (http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient)
- Patient (https://plugin.healthcare/fhir/StructureDefinition/plugin-patient)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/StructureDefinition/workflow-episodeOfCare

Other representations of profile: CSV, Excel, Schematron