Teleconsulto
0.1.0 - ballot

Teleconsulto - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: ServiceRequestRichiestaTeleconsulto - Detailed Descriptions

Draft as of 2025-09-26

Definitions for the ServiceRequestRichiestaTeleconsulto resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. ServiceRequest
Definition

A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

ShortA request for a service to be performed
Control0..*
Is Modifierfalse
Summaryfalse
Alternate Namesdiagnostic request, referral, referral request, transfer of care request
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
2. ServiceRequest.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ServiceRequest.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. ServiceRequest.extension:oscuramentoDati
    Slice NameoscuramentoDati
    Definition

    Extension per esprimere la volontà dell'assistito di oscurare i dati.

    ShortCampo che identifica la volontà del paziente nell'oscurare i propri dati.
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Extension Oscuramento Dati) (Extension Type: boolean)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. ServiceRequest.extension:medicoTitolare
    Slice NamemedicoTitolare
    Definition

    Extension per identificare i dati del medico titolare.

    ShortCampo che identifica il medico titolare.
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Extension Medico Titolare) (Extension Type: Reference)
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. ServiceRequest.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. ServiceRequest.identifier
    Definition

    Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

    ShortIdentifiicativi della richiesta inviata.Identifiers assigned to this order
    Comments

    The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. ServiceRequest.requisition
    Definition

    Un identificativo condiviso comune a tutte le singole istanze della richiesta, generate contemporaneamente da un singolo autore: rappresenta l'identificativo composito o di gruppo.

    Per i casi di richieste di prescrizione rappresenterà l'NRE oppure il numero di ricetta cartacea.


    A shared identifier common to all service requests that were authorized more or less simultaneously by a single author, representing the composite or group identifier.

    ShortCodice Identificativo della richiestaComposite Request ID
    Comments

    Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

    Control10..1
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

    Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

    Alternate NamesgrouperId, groupIdentifier
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. ServiceRequest.requisition.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary | old (If known)
    Comments

    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. ServiceRequest.requisition.type
    Definition

    Codice che specifica come l'identificativo può essere usato.


    A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

    ShortDescrizione della tipologia di identificativoDescription of identifier
    Comments

    This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

    Control0..1
    BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from ValueSet per Codici Assistenza Stranierihttp://hl7.org/fhir/ValueSet/identifier-type
    (required to http://hl7.it/fhir/teleconsulto/ValueSet/vs-tipo-ricetta)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows users to make use of identifiers when the identifier system is not known.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. ServiceRequest.status
    Definition

    The status of the order.

    ShortStato della richiesta.draft | active | on-hold | revoked | completed | entered-in-error | unknown
    Comments

    Lo stato è in genere completamente sotto il controllo del richiedente, che determina se l'ordine è in bozza o attivo e, dopo che è stato attivato, in gara, annullato o sospeso. Gli stati relativi alle attività dell'esecutore si riflettono nell'evento corrispondente (si veda Event Pattern per una discussione generale) o utilizzando la risorsa Task.


    The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, competed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding event (see Event Pattern for general discussion) or using the Task resource.

    Control1..1
    BindingThe codes SHALL be taken from RequestStatushttp://hl7.org/fhir/ValueSet/request-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

    The status of a service order.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. ServiceRequest.intent
    Definition

    Indica l'intento della richiesta, ovvero se si tratta di una proposta, un piano, un ordine originale o un ordine riflesso.

    Per i casi d'uso gestiti dell'ambito di questa IG deve essere valorizzato fisso ad order.


    Whether the request is a proposal, plan, an original order or a reflex order.

    ShortIntento della richiesta.proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
    Comments

    Questo elemento è etichettato come modificatore perché l'intento altera quando e come la risorsa è effettivamente applicabile.


    This element is labeled as a modifier because the intent alters when and how the resource is actually applicable.

    Control1..1
    BindingThe codes SHALL be taken from RequestIntenthttp://hl7.org/fhir/ValueSet/request-intent|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

    The kind of service request.

    Typecode
    Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. ServiceRequest.category
    Definition

    Un codice che classifica il servizio


    A code that classifies the service for searching, sorting and display purposes (e.g. "Surgical Procedure").

    ShortBranca medico consulente.Classification of service
    Comments

    There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

    Control10..*
    BindingThe codes SHOULD be taken from For example codes, see ValueSet Specialità Medichehttp://hl7.org/fhir/ValueSet/servicerequest-category
    (preferred to http://hl7.it/fhir/teleconsulto/ValueSet/specialita-mediche)
    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Requirements

    Used for filtering what service request are retrieved and displayed.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. ServiceRequest.priority
    Definition

    Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

    Shortpriorità della richiestaroutine | urgent | asap | stat
    Control10..1
    BindingThe codes SHALL be taken from RequestPriorityhttp://hl7.org/fhir/ValueSet/request-priority|4.0.1
    (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

    Identifies the level of importance to be assigned to actioning the request.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Meaning if MissingIf missing, this task should be performed with normal priority
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. ServiceRequest.doNotPerform
    Definition

    Set this to true if the record is saying that the service/procedure should NOT be performed.

    ShortTrue if service/procedure should not be performed
    Comments

    In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

    Control0..1
    Typeboolean
    Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

    Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. ServiceRequest.code
    Definition

    Indica cosa è stato richiesto, ovvero il codice della prestazione quando prevista


    A code that identifies a particular service (i.e., procedure, diagnostic investigation, or panel of investigations) that have been requested.

    ShortCosa viene richiesto/ordinato.What is being requested/ordered
    Comments

    Molti codici di procedure di laboratorio e radiologiche incorporano il sistema campione/organo nel nome dell'ordine del test, ad esempio il glucosio da siero o da siero/plasma, o una radiografia del torace. Il campione potrebbe non essere registrato separatamente dal codice dell'esame.


    Many laboratory and radiology procedure codes embed the specimen/organ system in the test order name, for example, serum or serum/plasma glucose, or a chest x-ray. The specimen might not be recorded separately from the test code.

    Control0..1
    BindingFor example codes, see ProcedureCodes(SNOMEDCT)http://hl7.org/fhir/ValueSet/procedure-code
    (example to http://hl7.org/fhir/ValueSet/procedure-code)

    Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.

    TypeCodeableConcept
    Is Modifierfalse
    Summarytrue
    Alternate Namesservice requested
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. ServiceRequest.code.coding
    Definition

    A reference to a code defined by a terminology system.

    ShortCode defined by a terminology system
    Comments

    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

    Control0..*
    TypeCoding
    Is Modifierfalse
    Summarytrue
    Requirements

    Allows for alternative encodings within a code system, and translations to other code systems.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ServiceRequest.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ extension.value
    • 34. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione
      Slice NamecodiceCatalogoRegionalePrestazione
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control0..1*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.system
      Definition

      Identificazione del sistema terminologico che definisce il significato del codice. https://terminology.agenas.gov.it/CodeSystem/catalogoRegionalePrestazioni


      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentifica il sistema di terminologiaIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

      Control0..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to be unambiguous about the source of the definition of the symbol.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.code
      Definition

      Un codice valido per il sistema terminologico di riferimento, i cui valori sono definiti nel CodeSystem dedicato


      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortCodice valido per il sistema terminologico di riferimentoSymbol in syntax defined by the system
      Control0..1
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione
      Slice NamecodiceCatalogoNazionalePrestazione
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control0..1*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.system
      Definition

      Identificazione del sistema terminologico che definisce il significato del codice.


      The identification of the code system that defines the meaning of the symbol in the code.

      ShortIdentifica il sistema di terminologiaIdentity of the terminology system
      Comments

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

      Control0..1
      Typeuri
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to be unambiguous about the source of the definition of the symbol.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.code
      Definition

      Un codice valido per il sistema terminologico di riferimento, i cui valori sono definiti nel CodeSystem dedicato


      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      ShortCodice valido per il sistema terminologico di riferimentoSymbol in syntax defined by the system
      Control0..1
      BindingThe codes SHOULD be taken from For codes, see ValueSet for Codesystem catalogo nazionale prestazioni
      (preferred to http://hl7.it/fhir/teleconsulto/ValueSet/VsCatalogoNazionalePrestazioni)
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Requirements

      Need to refer to a particular code in the system.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. ServiceRequest.orderDetail
      Definition

      Ulteriori dettagli e istruzioni sulla servizi da erogare.


      Additional details and instructions about the how the services are to be delivered. For example, and order for a urinary catheter may have an order detail for an external or indwelling catheter, or an order for a bandage may require additional instructions specifying how the bandage should be applied.

      ShortInformazioni aggiuntive sulla richiesta.Additional order information
      Comments

      For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

      Control0..*
      This element is affected by the following invariants: prr-1
      BindingFor example codes, see ServiceRequestOrderDetailsCodeshttp://hl7.org/fhir/ValueSet/servicerequest-orderdetail
      (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail)

      Codified order entry details which are based on order context.

      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Alternate Namesdetailed instructions
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. ServiceRequest.quantity[x]
      Definition

      Contiene la molteplicità della prestazione.


      An amount of service being requested which can be a quantity ( for example $1,500 home modification), a ratio ( for example, 20 half day visits per month), or a range (2.0 to 1.8 Gy per fraction).

      ShortQuantità prestazione.Service amount
      Control0..1
      TypeChoice of: Quantity, Ratio, Range
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Requirements

      When ordering a service the number of service items may need to be specified separately from the the service item.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. ServiceRequest.subject
      Definition

      Elemento di tipo Reference che contiene il riferimento alla risorsa Patient oggetto della richiesta.


      On whom or what the service is to be performed. This is usually a human patient, but can also be requested on animals, groups of humans or animals, devices such as dialysis machines, or even locations (typically for environmental scans).

      ShortReference a PatientIndividual or Entity the service is ordered for
      Comments

      I riferimenti DEVONO essere un riferimento a una risorsa FHIR effettiva e DEVONO essere risolvibili (consentendo il controllo dell'accesso, la non disponibilità temporanea, ecc.) La risoluzione può avvenire tramite recupero dall'URL o, se applicabile per tipo di risorsa, trattando un riferimento assoluto come un URL canonico e cercandolo in un registro/repository locale.

      Control1..1
      TypeReference(PatientTeleconsulto, Patient, Group, Location, Device)
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. ServiceRequest.encounter
      Definition

      Elemento di tipo Reference che contiene il riferimento alla risorsa Encounter.


      An encounter that provides additional information about the healthcare context in which this request is made.

      ShortRiferimento all'evento del teleconsulto (teleconsulto sincrono).Encounter in which the request was created
      Comments

      I riferimenti DEVONO essere un riferimento a una risorsa FHIR effettiva e DEVONO essere risolvibili (consentendo il controllo dell'accesso, la non disponibilità temporanea, ecc.) La risoluzione può avvenire tramite recupero dall'URL o, se applicabile per tipo di risorsa, trattando un riferimento assoluto come un URL canonico e cercandolo in un registro/repository locale.

      Control0..1
      TypeReference(EncounterTeleconsulto, Encounter)
      Is Modifierfalse
      Summarytrue
      Alternate Namescontext
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. ServiceRequest.occurrence[x]
      Definition

      Data di erogazione/erogazione desiderata Timing: Estensione per la definizione di un timing specifico ad uno specifico orario del giorno/settimana


      The date/time at which the requested service should occur.

      ShortSlot temporale per la presa in carico della teleconsulenza.When service should occur
      Control0..1
      TypeChoice of: dateTime, Period, Timing
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate Namesschedule
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      56. ServiceRequest.authoredOn
      Definition

      Nei casi di prescrizione, corrisponde alla data di compilazione della prescrizione.


      When the request transitioned to being actionable.

      ShortData compilazione della ricetta da parte del medico.Date request signed
      Control0..1
      TypedateTime
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Alternate NamesorderedOn
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. ServiceRequest.requester
      Definition

      Elemento di tipo Reference che contiene il riferimento alla asl e medico richiedente.


      The individual who initiated the request and has responsibility for its activation.

      ShortMedico richiedente il teleconsulto.Who/what is requesting service
      Comments

      This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

      Control10..1
      TypeReference(PractitionerTeleconsulto, PractitionerRoleTeleconsulto, Practitioner, PractitionerRole, Organization, Patient, RelatedPerson, Device)
      Is Modifierfalse
      Summarytrue
      Alternate Namesauthor, orderer
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. ServiceRequest.performer
      Definition

      Elemento di tipo Reference che contiene il riferimento alle risorse Organization, Practitioner, PractitionerRole e HealthCareService.


      The desired performer for doing the requested service. For example, the surgeon, dermatopathologist, endoscopist, etc.

      ShortMedici consultati.Requested performer
      Comments

      *La reference ad HealthcareService fornirà indicazioni sulla tipologia di servizio di telemedicina da erogare

      *La reference ad Organization fornirà indicazioni sull'asl che erogherà la richiesta

      *La reference al Practitioner e PractitioneRole fornirà indicazioni sul medico/operatore erogatore ed il rispettivo ruolo


      If multiple performers are present, it is interpreted as a list of alternative performers without any preference regardless of order. If order of preference is needed use the request-performerOrder extension. Use CareTeam to represent a group of performers (for example, Practitioner A and Practitioner B).

      Control10..*
      TypeReference(PractitionerTeleconsulto, PractitionerRoleTeleconsulto, Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
      Is Modifierfalse
      Summarytrue
      Alternate Namesrequest recipient
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      62. ServiceRequest.reasonCode
      Definition

      Una spiegazione o giustificazione del motivo per cui viene richiesto il servizio, in forma codificata o testuale.


      An explanation or justification for why this service is being requested in coded or textual form. This is often for billing purposes. May relate to the resources referred to in supportingInfo.

      ShortCodice diagnosi/Quesito diagnostico.Explanation/Justification for procedure or service
      Comments

      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.


      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

      Control0..*
      BindingThe codes SHALL be taken from For example codes, see Diagnosi ICD-9-CM - Tutti i codicihttp://hl7.org/fhir/ValueSet/procedure-reason
      (required to http://hl7.it/fhir/teleconsulto/ValueSet/diagnosi-icd9cm)
      TypeCodeableConcept
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      64. ServiceRequest.insurance
      Definition

      Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.

      ShortIstituzione competente del soggetto assicurato da istituzioni estere.Associated insurance coverage
      Control0..*
      TypeReference(CoverageTeleconsulto, Coverage, ClaimResponse)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      66. ServiceRequest.note
      Definition

      Note o commenti relative alla richiesta.


      Any other notes and comments made about the service request. For example, internal billing notes.

      ShortUleriori note e indicazioni della prscrizioneComments
      Comments

      Per i sistemi che non dispongono di annotazioni strutturate, possono semplicemente comunicare una singola annotazione senza autore o tempo. Questo elemento potrebbe dover essere incluso nella narrativa a causa del potenziale di modifica delle informazioni. Le annotazioni NON DEVONO essere usate per comunicare informazioni "modificanti" che potrebbero essere calcolate. (Questo è un DOVERE perché far rispettare il comportamento dell'utente è quasi impossibile).

      Control0..*
      TypeAnnotation
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be foundhere

      0. ServiceRequest
      2. ServiceRequest.extension
      SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 4. ServiceRequest.extension:oscuramentoDati
        Slice NameoscuramentoDati
        ShortCampo che identifica la volontà del paziente nell'oscurare i propri dati.
        Control0..1
        TypeExtension(Extension Oscuramento Dati) (Extension Type: boolean)
        6. ServiceRequest.extension:medicoTitolare
        Slice NamemedicoTitolare
        ShortCampo che identifica il medico titolare.
        Control0..1
        TypeExtension(Extension Medico Titolare) (Extension Type: Reference)
        8. ServiceRequest.identifier
        ShortIdentifiicativi della richiesta inviata.
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..?
        10. ServiceRequest.requisition
        Definition

        Un identificativo condiviso comune a tutte le singole istanze della richiesta, generate contemporaneamente da un singolo autore: rappresenta l'identificativo composito o di gruppo.

        Per i casi di richieste di prescrizione rappresenterà l'NRE oppure il numero di ricetta cartacea.

        ShortCodice Identificativo della richiesta
        Control1..?
        12. ServiceRequest.requisition.type
        Definition

        Codice che specifica come l'identificativo può essere usato.

        ShortDescrizione della tipologia di identificativo
        BindingThe codes SHALL be taken from ValueSet per Codici Assistenza Stranieri
        (required to http://hl7.it/fhir/teleconsulto/ValueSet/vs-tipo-ricetta)
        14. ServiceRequest.status
        ShortStato della richiesta.
        Comments

        Lo stato è in genere completamente sotto il controllo del richiedente, che determina se l'ordine è in bozza o attivo e, dopo che è stato attivato, in gara, annullato o sospeso. Gli stati relativi alle attività dell'esecutore si riflettono nell'evento corrispondente (si veda Event Pattern per una discussione generale) o utilizzando la risorsa Task.

        16. ServiceRequest.intent
        Definition

        Indica l'intento della richiesta, ovvero se si tratta di una proposta, un piano, un ordine originale o un ordine riflesso.

        Per i casi d'uso gestiti dell'ambito di questa IG deve essere valorizzato fisso ad order.

        ShortIntento della richiesta.
        Comments

        Questo elemento è etichettato come modificatore perché l'intento altera quando e come la risorsa è effettivamente applicabile.

        18. ServiceRequest.category
        Definition

        Un codice che classifica il servizio

        ShortBranca medico consulente.
        Control1..?
        BindingThe codes SHOULD be taken from ValueSet Specialità Mediche
        (preferred to http://hl7.it/fhir/teleconsulto/ValueSet/specialita-mediche)
        20. ServiceRequest.priority
        Shortpriorità della richiesta
        Control1..?
        22. ServiceRequest.code
        Definition

        Indica cosa è stato richiesto, ovvero il codice della prestazione quando prevista

        ShortCosa viene richiesto/ordinato.
        Comments

        Molti codici di procedure di laboratorio e radiologiche incorporano il sistema campione/organo nel nome dell'ordine del test, ad esempio il glucosio da siero o da siero/plasma, o una radiografia del torace. Il campione potrebbe non essere registrato separatamente dal codice dell'esame.

        24. ServiceRequest.code.coding
        SlicingThis element introduces a set of slices on ServiceRequest.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ extension.value
        • 26. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione
          Slice NamecodiceCatalogoRegionalePrestazione
          Control0..1
          28. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.system
          Definition

          Identificazione del sistema terminologico che definisce il significato del codice. https://terminology.agenas.gov.it/CodeSystem/catalogoRegionalePrestazioni

          ShortIdentifica il sistema di terminologia
          30. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.code
          Definition

          Un codice valido per il sistema terminologico di riferimento, i cui valori sono definiti nel CodeSystem dedicato

          ShortCodice valido per il sistema terminologico di riferimento
          32. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione
          Slice NamecodiceCatalogoNazionalePrestazione
          Control0..1
          34. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.system
          Definition

          Identificazione del sistema terminologico che definisce il significato del codice.

          ShortIdentifica il sistema di terminologia
          36. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.code
          Definition

          Un codice valido per il sistema terminologico di riferimento, i cui valori sono definiti nel CodeSystem dedicato

          ShortCodice valido per il sistema terminologico di riferimento
          BindingThe codes SHOULD be taken from ValueSet for Codesystem catalogo nazionale prestazioni
          (preferred to http://hl7.it/fhir/teleconsulto/ValueSet/VsCatalogoNazionalePrestazioni)
          38. ServiceRequest.orderDetail
          Definition

          Ulteriori dettagli e istruzioni sulla servizi da erogare.

          ShortInformazioni aggiuntive sulla richiesta.
          40. ServiceRequest.quantity[x]
          Definition

          Contiene la molteplicità della prestazione.

          ShortQuantità prestazione.
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          42. ServiceRequest.subject
          Definition

          Elemento di tipo Reference che contiene il riferimento alla risorsa Patient oggetto della richiesta.

          ShortReference a Patient
          Comments

          I riferimenti DEVONO essere un riferimento a una risorsa FHIR effettiva e DEVONO essere risolvibili (consentendo il controllo dell'accesso, la non disponibilità temporanea, ecc.) La risoluzione può avvenire tramite recupero dall'URL o, se applicabile per tipo di risorsa, trattando un riferimento assoluto come un URL canonico e cercandolo in un registro/repository locale.

          TypeReference(PatientTeleconsulto)
          44. ServiceRequest.encounter
          Definition

          Elemento di tipo Reference che contiene il riferimento alla risorsa Encounter.

          ShortRiferimento all'evento del teleconsulto (teleconsulto sincrono).
          Comments

          I riferimenti DEVONO essere un riferimento a una risorsa FHIR effettiva e DEVONO essere risolvibili (consentendo il controllo dell'accesso, la non disponibilità temporanea, ecc.) La risoluzione può avvenire tramite recupero dall'URL o, se applicabile per tipo di risorsa, trattando un riferimento assoluto come un URL canonico e cercandolo in un registro/repository locale.

          TypeReference(EncounterTeleconsulto)
          46. ServiceRequest.occurrence[x]
          Definition

          Data di erogazione/erogazione desiderata Timing: Estensione per la definizione di un timing specifico ad uno specifico orario del giorno/settimana

          ShortSlot temporale per la presa in carico della teleconsulenza.
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          48. ServiceRequest.authoredOn
          Definition

          Nei casi di prescrizione, corrisponde alla data di compilazione della prescrizione.

          ShortData compilazione della ricetta da parte del medico.
          50. ServiceRequest.requester
          Definition

          Elemento di tipo Reference che contiene il riferimento alla asl e medico richiedente.

          ShortMedico richiedente il teleconsulto.
          Control1..?
          TypeReference(PractitionerTeleconsulto, PractitionerRoleTeleconsulto)
          52. ServiceRequest.performer
          Definition

          Elemento di tipo Reference che contiene il riferimento alle risorse Organization, Practitioner, PractitionerRole e HealthCareService.

          ShortMedici consultati.
          Comments

          *La reference ad HealthcareService fornirà indicazioni sulla tipologia di servizio di telemedicina da erogare

          *La reference ad Organization fornirà indicazioni sull'asl che erogherà la richiesta

          *La reference al Practitioner e PractitioneRole fornirà indicazioni sul medico/operatore erogatore ed il rispettivo ruolo

          Control1..?
          TypeReference(PractitionerTeleconsulto, PractitionerRoleTeleconsulto)
          54. ServiceRequest.reasonCode
          Definition

          Una spiegazione o giustificazione del motivo per cui viene richiesto il servizio, in forma codificata o testuale.

          ShortCodice diagnosi/Quesito diagnostico.
          BindingThe codes SHALL be taken from Diagnosi ICD-9-CM - Tutti i codici
          (required to http://hl7.it/fhir/teleconsulto/ValueSet/diagnosi-icd9cm)
          56. ServiceRequest.insurance
          ShortIstituzione competente del soggetto assicurato da istituzioni estere.
          TypeReference(CoverageTeleconsulto)
          58. ServiceRequest.note
          Definition

          Note o commenti relative alla richiesta.

          ShortUleriori note e indicazioni della prscrizione
          Comments

          Per i sistemi che non dispongono di annotazioni strutturate, possono semplicemente comunicare una singola annotazione senza autore o tempo. Questo elemento potrebbe dover essere incluso nella narrativa a causa del potenziale di modifica delle informazioni. Le annotazioni NON DEVONO essere usate per comunicare informazioni "modificanti" che potrebbero essere calcolate. (Questo è un DOVERE perché far rispettare il comportamento dell'utente è quasi impossibile).

          Guidance on how to interpret the contents of this table can be foundhere

          0. ServiceRequest
          Definition

          A record of a request for service such as diagnostic investigations, treatments, or operations to be performed.

          ShortA request for a service to be performed
          Control0..*
          Is Modifierfalse
          Summaryfalse
          Alternate Namesdiagnostic request, referral, referral request, transfer of care request
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          prr-1: orderDetail SHALL only be present if code is present (orderDetail.empty() or code.exists())
          2. ServiceRequest.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Control0..1
          Typeid
          Is Modifierfalse
          Summarytrue
          4. ServiceRequest.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. ServiceRequest.implicitRules
          Definition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. ServiceRequest.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. ServiceRequest.text
          Definition

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Control0..1
          TypeNarrative
          Is Modifierfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. ServiceRequest.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          ShortContained, inline Resources
          Comments

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Control0..*
          TypeResource
          Is Modifierfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. ServiceRequest.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on ServiceRequest.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. ServiceRequest.extension:oscuramentoDati
            Slice NameoscuramentoDati
            Definition

            Extension per esprimere la volontà dell'assistito di oscurare i dati.

            ShortCampo che identifica la volontà del paziente nell'oscurare i propri dati.
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Extension Oscuramento Dati) (Extension Type: boolean)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. ServiceRequest.extension:medicoTitolare
            Slice NamemedicoTitolare
            Definition

            Extension per identificare i dati del medico titolare.

            ShortCampo che identifica il medico titolare.
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Extension Medico Titolare) (Extension Type: Reference)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. ServiceRequest.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            22. ServiceRequest.identifier
            Definition

            Identifiers assigned to this order instance by the orderer and/or the receiver and/or order fulfiller.

            ShortIdentifiicativi della richiesta inviata.
            Comments

            The identifier.type element is used to distinguish between the identifiers assigned by the orderer (known as the 'Placer' in HL7 v2) and the producer of the observations in response to the order (known as the 'Filler' in HL7 v2). For further discussion and examples see the resource notes section below.

            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control1..*
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            24. ServiceRequest.instantiatesCanonical
            Definition

            The URL pointing to a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.

            ShortInstantiates FHIR protocol or definition
            Comments

            Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

            Control0..*
            Typecanonical(ActivityDefinition, PlanDefinition)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. ServiceRequest.instantiatesUri
            Definition

            The URL pointing to an externally maintained protocol, guideline, orderset or other definition that is adhered to in whole or in part by this ServiceRequest.

            ShortInstantiates external protocol or definition
            Comments

            This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.

            Control0..*
            Typeuri
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. ServiceRequest.basedOn
            Definition

            Plan/proposal/order fulfilled by this request.

            ShortWhat request fulfills
            Control0..*
            TypeReference(CarePlan, ServiceRequest, MedicationRequest)
            Is Modifierfalse
            Summarytrue
            Alternate Namesfulfills
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. ServiceRequest.replaces
            Definition

            The request takes the place of the referenced completed or terminated request(s).

            ShortWhat request replaces
            Control0..*
            TypeReference(ServiceRequest)
            Is Modifierfalse
            Summarytrue
            Alternate Namessupersedes, prior, renewed order
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. ServiceRequest.requisition
            Definition

            Un identificativo condiviso comune a tutte le singole istanze della richiesta, generate contemporaneamente da un singolo autore: rappresenta l'identificativo composito o di gruppo.

            Per i casi di richieste di prescrizione rappresenterà l'NRE oppure il numero di ricetta cartacea.

            ShortCodice Identificativo della richiesta
            Comments

            Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.

            Control1..1
            TypeIdentifier
            Is Modifierfalse
            Summarytrue
            Requirements

            Some business processes need to know if multiple items were ordered as part of the same "requisition" for billing or other purposes.

            Alternate NamesgrouperId, groupIdentifier
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. ServiceRequest.requisition.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            36. ServiceRequest.requisition.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on ServiceRequest.requisition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 38. ServiceRequest.requisition.use
              Definition

              The purpose of this identifier.

              Shortusual | official | temp | secondary | old (If known)
              Comments

              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

              Control0..1
              BindingThe codes SHALL be taken from IdentifierUse
              (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

              Identifies the purpose for this identifier, if known .

              Typecode
              Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. ServiceRequest.requisition.type
              Definition

              Codice che specifica come l'identificativo può essere usato.

              ShortDescrizione della tipologia di identificativo
              Comments

              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

              Control0..1
              BindingThe codes SHALL be taken from ValueSet per Codici Assistenza Stranieri
              (required to http://hl7.it/fhir/teleconsulto/ValueSet/vs-tipo-ricetta)
              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows users to make use of identifiers when the identifier system is not known.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. ServiceRequest.requisition.system
              Definition

              Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

              ShortThe namespace for the identifier value
              Comments

              Identifier.system is always case sensitive.

              Control0..1
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

              Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. ServiceRequest.requisition.value
              Definition

              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

              ShortThe value that is unique
              Comments

              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Example<br/><b>General</b>:123456
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. ServiceRequest.requisition.period
              Definition

              Time period during which identifier is/was valid for use.

              ShortTime period when id is/was valid for use
              Control0..1
              TypePeriod
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. ServiceRequest.requisition.assigner
              Definition

              Organization that issued/manages the identifier.

              ShortOrganization that issued id (may be just text)
              Comments

              The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

              Control0..1
              TypeReference(Organization)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. ServiceRequest.status
              Definition

              The status of the order.

              ShortStato della richiesta.
              Comments

              Lo stato è in genere completamente sotto il controllo del richiedente, che determina se l'ordine è in bozza o attivo e, dopo che è stato attivato, in gara, annullato o sospeso. Gli stati relativi alle attività dell'esecutore si riflettono nell'evento corrispondente (si veda Event Pattern per una discussione generale) o utilizzando la risorsa Task.

              Control1..1
              BindingThe codes SHALL be taken from RequestStatus
              (required to http://hl7.org/fhir/ValueSet/request-status|4.0.1)

              The status of a service order.

              Typecode
              Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. ServiceRequest.intent
              Definition

              Indica l'intento della richiesta, ovvero se si tratta di una proposta, un piano, un ordine originale o un ordine riflesso.

              Per i casi d'uso gestiti dell'ambito di questa IG deve essere valorizzato fisso ad order.

              ShortIntento della richiesta.
              Comments

              Questo elemento è etichettato come modificatore perché l'intento altera quando e come la risorsa è effettivamente applicabile.

              Control1..1
              BindingThe codes SHALL be taken from RequestIntent
              (required to http://hl7.org/fhir/ValueSet/request-intent|4.0.1)

              The kind of service request.

              Typecode
              Is Modifiertrue because This element changes the interpretation of all descriptive attributes. For example "the time the request is recommended to occur" vs. "the time the request is authorized to occur" or "who is recommended to perform the request" vs. "who is authorized to perform the request
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. ServiceRequest.category
              Definition

              Un codice che classifica il servizio

              ShortBranca medico consulente.
              Comments

              There may be multiple axis of categorization depending on the context or use case for retrieving or displaying the resource. The level of granularity is defined by the category concepts in the value set.

              Control1..*
              BindingThe codes SHOULD be taken from ValueSet Specialità Mediche
              (preferred to http://hl7.it/fhir/teleconsulto/ValueSet/specialita-mediche)
              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Used for filtering what service request are retrieved and displayed.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. ServiceRequest.priority
              Definition

              Indicates how quickly the ServiceRequest should be addressed with respect to other requests.

              Shortpriorità della richiesta
              Control1..1
              BindingThe codes SHALL be taken from RequestPriority
              (required to http://hl7.org/fhir/ValueSet/request-priority|4.0.1)

              Identifies the level of importance to be assigned to actioning the request.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Meaning if MissingIf missing, this task should be performed with normal priority
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. ServiceRequest.doNotPerform
              Definition

              Set this to true if the record is saying that the service/procedure should NOT be performed.

              ShortTrue if service/procedure should not be performed
              Comments

              In general, only the code and timeframe will be present, though occasional additional qualifiers such as body site or even performer could be included to narrow the scope of the prohibition. If the ServiceRequest.code and ServiceRequest.doNotPerform both contain negation, that will reinforce prohibition and should not have a double negative interpretation.

              Control0..1
              Typeboolean
              Is Modifiertrue because If true this element negates the specified action. For Example, instead of a request for a procedure, it is a request for the procedure to not occur.
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              Used for do not ambulate, do not elevate head of bed, do not flush NG tube, do not take blood pressure on a certain arm, etc.

              Meaning if MissingIf missing, the request is a positive request e.g. "do perform"
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              60. ServiceRequest.code
              Definition

              Indica cosa è stato richiesto, ovvero il codice della prestazione quando prevista

              ShortCosa viene richiesto/ordinato.
              Comments

              Molti codici di procedure di laboratorio e radiologiche incorporano il sistema campione/organo nel nome dell'ordine del test, ad esempio il glucosio da siero o da siero/plasma, o una radiografia del torace. Il campione potrebbe non essere registrato separatamente dal codice dell'esame.

              Control0..1
              BindingFor example codes, see ProcedureCodes(SNOMEDCT)
              (example to http://hl7.org/fhir/ValueSet/procedure-code)

              Codes for tests or services that can be carried out by a designated individual, organization or healthcare service. For laboratory, LOINC is preferred.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Alternate Namesservice requested
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              62. ServiceRequest.code.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              64. ServiceRequest.code.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on ServiceRequest.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 66. ServiceRequest.code.coding
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..*
                TypeCoding
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows for alternative encodings within a code system, and translations to other code systems.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on ServiceRequest.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ extension.value
                • 68. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione
                  Slice NamecodiceCatalogoRegionalePrestazione
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..1
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  70. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  72. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on ServiceRequest.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 74. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.system
                    Definition

                    Identificazione del sistema terminologico che definisce il significato del codice. https://terminology.agenas.gov.it/CodeSystem/catalogoRegionalePrestazioni

                    ShortIdentifica il sistema di terminologia
                    Comments

                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                    Control0..1
                    Typeuri
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to be unambiguous about the source of the definition of the symbol.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    76. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.version
                    Definition

                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                    ShortVersion of the system - if relevant
                    Comments

                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                    NoteThis is a business version Id, not a resource version Id (see discussion)
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    78. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.code
                    Definition

                    Un codice valido per il sistema terminologico di riferimento, i cui valori sono definiti nel CodeSystem dedicato

                    ShortCodice valido per il sistema terminologico di riferimento
                    Control0..1
                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to refer to a particular code in the system.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    80. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.display
                    Definition

                    A representation of the meaning of the code in the system, following the rules of the system.

                    ShortRepresentation defined by the system
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    82. ServiceRequest.code.coding:codiceCatalogoRegionalePrestazione.userSelected
                    Definition

                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                    ShortIf this coding was chosen directly by the user
                    Comments

                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                    Control0..1
                    Typeboolean
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione
                    Slice NamecodiceCatalogoNazionalePrestazione
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortCode defined by a terminology system
                    Comments

                    Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                    Control0..1
                    TypeCoding
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows for alternative encodings within a code system, and translations to other code systems.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    86. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    Typestring
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    88. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on ServiceRequest.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 90. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.system
                      Definition

                      Identificazione del sistema terminologico che definisce il significato del codice.

                      ShortIdentifica il sistema di terminologia
                      Comments

                      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                      Control0..1
                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be unambiguous about the source of the definition of the symbol.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      92. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.version
                      Definition

                      The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                      ShortVersion of the system - if relevant
                      Comments

                      Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                      NoteThis is a business version Id, not a resource version Id (see discussion)
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      94. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.code
                      Definition

                      Un codice valido per il sistema terminologico di riferimento, i cui valori sono definiti nel CodeSystem dedicato

                      ShortCodice valido per il sistema terminologico di riferimento
                      Control0..1
                      BindingThe codes SHOULD be taken from ValueSet for Codesystem catalogo nazionale prestazioni
                      (preferred to http://hl7.it/fhir/teleconsulto/ValueSet/VsCatalogoNazionalePrestazioni)
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to refer to a particular code in the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      96. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.display
                      Definition

                      A representation of the meaning of the code in the system, following the rules of the system.

                      ShortRepresentation defined by the system
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      98. ServiceRequest.code.coding:codiceCatalogoNazionalePrestazione.userSelected
                      Definition

                      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                      ShortIf this coding was chosen directly by the user
                      Comments

                      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                      Control0..1
                      Typeboolean
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      100. ServiceRequest.code.text
                      Definition

                      A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                      ShortPlain text representation of the concept
                      Comments

                      Very often the text is the same as a displayName of one of the codings.

                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      102. ServiceRequest.orderDetail
                      Definition

                      Ulteriori dettagli e istruzioni sulla servizi da erogare.

                      ShortInformazioni aggiuntive sulla richiesta.
                      Comments

                      For information from the medical record intended to support the delivery of the requested services, use the supportingInformation element.

                      Control0..*
                      This element is affected by the following invariants: prr-1
                      BindingFor example codes, see ServiceRequestOrderDetailsCodes
                      (example to http://hl7.org/fhir/ValueSet/servicerequest-orderdetail)

                      Codified order entry details which are based on order context.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Alternate Namesdetailed instructions
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      104. ServiceRequest.quantity[x]
                      Definition

                      Contiene la molteplicità della prestazione.

                      ShortQuantità prestazione.
                      Control0..1
                      TypeChoice of: Quantity, Ratio, Range
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      When ordering a service the number of service items may need to be specified separately from the the service item.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      106. ServiceRequest.subject
                      Definition

                      Elemento di tipo Reference che contiene il riferimento alla risorsa Patient oggetto della richiesta.

                      ShortReference a Patient
                      Comments

                      I riferimenti DEVONO essere un riferimento a una risorsa FHIR effettiva e DEVONO essere risolvibili (consentendo il controllo dell'accesso, la non disponibilità temporanea, ecc.) La risoluzione può avvenire tramite recupero dall'URL o, se applicabile per tipo di risorsa, trattando un riferimento assoluto come un URL canonico e cercandolo in un registro/repository locale.

                      Control1..1
                      TypeReference(PatientTeleconsulto)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      108. ServiceRequest.encounter
                      Definition

                      Elemento di tipo Reference che contiene il riferimento alla risorsa Encounter.

                      ShortRiferimento all'evento del teleconsulto (teleconsulto sincrono).
                      Comments

                      I riferimenti DEVONO essere un riferimento a una risorsa FHIR effettiva e DEVONO essere risolvibili (consentendo il controllo dell'accesso, la non disponibilità temporanea, ecc.) La risoluzione può avvenire tramite recupero dall'URL o, se applicabile per tipo di risorsa, trattando un riferimento assoluto come un URL canonico e cercandolo in un registro/repository locale.

                      Control0..1
                      TypeReference(EncounterTeleconsulto)
                      Is Modifierfalse
                      Summarytrue
                      Alternate Namescontext
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      110. ServiceRequest.occurrence[x]
                      Definition

                      Data di erogazione/erogazione desiderata Timing: Estensione per la definizione di un timing specifico ad uno specifico orario del giorno/settimana

                      ShortSlot temporale per la presa in carico della teleconsulenza.
                      Control0..1
                      TypeChoice of: dateTime, Period, Timing
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Alternate Namesschedule
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      112. ServiceRequest.asNeeded[x]
                      Definition

                      If a CodeableConcept is present, it indicates the pre-condition for performing the service. For example "pain", "on flare-up", etc.

                      ShortPreconditions for service
                      Control0..1
                      BindingFor example codes, see SNOMEDCTMedicationAsNeededReasonCodes
                      (example to http://hl7.org/fhir/ValueSet/medication-as-needed-reason)

                      A coded concept identifying the pre-condition that should hold prior to performing a procedure. For example "pain", "on flare-up", etc.

                      TypeChoice of: boolean, CodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      114. ServiceRequest.authoredOn
                      Definition

                      Nei casi di prescrizione, corrisponde alla data di compilazione della prescrizione.

                      ShortData compilazione della ricetta da parte del medico.
                      Control0..1
                      TypedateTime
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Alternate NamesorderedOn
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      116. ServiceRequest.requester
                      Definition

                      Elemento di tipo Reference che contiene il riferimento alla asl e medico richiedente.

                      ShortMedico richiedente il teleconsulto.
                      Comments

                      This not the dispatcher, but rather who is the authorizer. This element is not intended to handle delegation which would generally be managed through the Provenance resource.

                      Control1..1
                      TypeReference(PractitionerTeleconsulto, PractitionerRoleTeleconsulto)
                      Is Modifierfalse
                      Summarytrue
                      Alternate Namesauthor, orderer
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      118. ServiceRequest.performerType
                      Definition

                      Desired type of performer for doing the requested service.

                      ShortPerformer role
                      Comments

                      This is a role, not a participation type. In other words, does not describe the task but describes the capacity. For example, “compounding pharmacy”, “psychiatrist” or “internal referral”.

                      Control0..1
                      BindingFor example codes, see ParticipantRoles
                      (example to http://hl7.org/fhir/ValueSet/participant-role)

                      Indicates specific responsibility of an individual within the care team, such as "Primary physician", "Team coordinator", "Caregiver", etc.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Alternate Namesspecialty
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      120. ServiceRequest.performer
                      Definition

                      Elemento di tipo Reference che contiene il riferimento alle risorse Organization, Practitioner, PractitionerRole e HealthCareService.

                      ShortMedici consultati.
                      Comments

                      *La reference ad HealthcareService fornirà indicazioni sulla tipologia di servizio di telemedicina da erogare

                      *La reference ad Organization fornirà indicazioni sull'asl che erogherà la richiesta

                      *La reference al Practitioner e PractitioneRole fornirà indicazioni sul medico/operatore erogatore ed il rispettivo ruolo

                      Control1..*
                      TypeReference(PractitionerTeleconsulto, PractitionerRoleTeleconsulto)
                      Is Modifierfalse
                      Summarytrue
                      Alternate Namesrequest recipient
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      122. ServiceRequest.locationCode
                      Definition

                      The preferred location(s) where the procedure should actually happen in coded or free text form. E.g. at home or nursing day care center.

                      ShortRequested location
                      Control0..*
                      BindingFor example codes, see ServiceDeliveryLocationRoleType
                      (example to http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType)

                      A location type where services are delivered.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      124. ServiceRequest.locationReference
                      Definition

                      A reference to the the preferred location(s) where the procedure should actually happen. E.g. at home or nursing day care center.

                      ShortRequested location
                      Control0..*
                      TypeReference(Location)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      126. ServiceRequest.reasonCode
                      Definition

                      Una spiegazione o giustificazione del motivo per cui viene richiesto il servizio, in forma codificata o testuale.

                      ShortCodice diagnosi/Quesito diagnostico.
                      Comments

                      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. Use CodeableConcept.text element if the data is free (uncoded) text as shown in the CT Scan example.

                      Control0..*
                      BindingThe codes SHALL be taken from Diagnosi ICD-9-CM - Tutti i codici
                      (required to http://hl7.it/fhir/teleconsulto/ValueSet/diagnosi-icd9cm)
                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      128. ServiceRequest.reasonReference
                      Definition

                      Indicates another resource that provides a justification for why this service is being requested. May relate to the resources referred to in supportingInfo.

                      ShortExplanation/Justification for service or service
                      Comments

                      This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all. To be as specific as possible, a reference to Observation or Condition should be used if available. Otherwise when referencing DiagnosticReport it should contain a finding in DiagnosticReport.conclusion and/or DiagnosticReport.conclusionCode. When using a reference to DocumentReference, the target document should contain clear findings language providing the relevant reason for this service request. Use the CodeableConcept text element in ServiceRequest.reasonCode if the data is free (uncoded) text as shown in the CT Scan example.

                      Control0..*
                      TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      130. ServiceRequest.insurance
                      Definition

                      Insurance plans, coverage extensions, pre-authorizations and/or pre-determinations that may be needed for delivering the requested service.

                      ShortIstituzione competente del soggetto assicurato da istituzioni estere.
                      Control0..*
                      TypeReference(CoverageTeleconsulto)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      132. ServiceRequest.supportingInfo
                      Definition

                      Additional clinical information about the patient or specimen that may influence the services or their interpretations. This information includes diagnosis, clinical findings and other observations. In laboratory ordering these are typically referred to as "ask at order entry questions (AOEs)". This includes observations explicitly requested by the producer (filler) to provide context or supporting information needed to complete the order. For example, reporting the amount of inspired oxygen for blood gas measurements.

                      ShortAdditional clinical information
                      Comments

                      To represent information about how the services are to be delivered use the instructions element.

                      Control0..*
                      TypeReference(Resource)
                      Is Modifierfalse
                      Summaryfalse
                      Alternate NamesAsk at order entry question, AOE
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      134. ServiceRequest.specimen
                      Definition

                      One or more specimens that the laboratory procedure will use.

                      ShortProcedure Samples
                      Comments

                      Many diagnostic procedures need a specimen, but the request itself is not actually about the specimen. This element is for when the diagnostic is requested on already existing specimens and the request points to the specimen it applies to. Conversely, if the request is entered first with an unknown specimen, then the Specimen resource points to the ServiceRequest.

                      Control0..*
                      TypeReference(Specimen)
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      136. ServiceRequest.bodySite
                      Definition

                      Anatomic location where the procedure should be performed. This is the target site.

                      ShortLocation on Body
                      Comments

                      Only used if not implicit in the code found in ServiceRequest.code. If the use case requires BodySite to be handled as a separate resource instead of an inline coded element (e.g. to identify and track separately) then use the standard extension procedure-targetBodyStructure.

                      Control0..*
                      BindingFor example codes, see SNOMEDCTBodyStructures
                      (example to http://hl7.org/fhir/ValueSet/body-site)

                      Codes describing anatomical locations. May include laterality.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Knowing where the procedure is performed is important for tracking if multiple sites are possible.

                      Alternate Nameslocation
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      138. ServiceRequest.note
                      Definition

                      Note o commenti relative alla richiesta.

                      ShortUleriori note e indicazioni della prscrizione
                      Comments

                      Per i sistemi che non dispongono di annotazioni strutturate, possono semplicemente comunicare una singola annotazione senza autore o tempo. Questo elemento potrebbe dover essere incluso nella narrativa a causa del potenziale di modifica delle informazioni. Le annotazioni NON DEVONO essere usate per comunicare informazioni "modificanti" che potrebbero essere calcolate. (Questo è un DOVERE perché far rispettare il comportamento dell'utente è quasi impossibile).

                      Control0..*
                      TypeAnnotation
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      140. ServiceRequest.patientInstruction
                      Definition

                      Instructions in terms that are understood by the patient or consumer.

                      ShortPatient or consumer-oriented instructions
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      142. ServiceRequest.relevantHistory
                      Definition

                      Key events in the history of the request.

                      ShortRequest provenance
                      Comments

                      This might not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.

                      Control0..*
                      TypeReference(Provenance)
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))