Bangladesh Core FHIR Implementation Guide
0.4.4 - Published by DGHS, MoHFW

Bangladesh Core FHIR Implementation Guide - Published by Ministry of Health and Family Welfare. See the Directory of published versions

## Extension: ICD11ClusterExpression - Detailed Descriptions

Page standards status: Informative | Maturity Level: 1

Definitions for the icd11-cluster-expression extension.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

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

0. Extension
Definition | Carries a postcoordinated ICD-11 cluster expression as a single string on a Coding element where the stem code alone is insufficient to fully represent the clinical concept. A cluster expression combines a stem code with one or more satellite codes using the & operator (combination) or / operator (specificity). Example: NC72.Z&XK8G&XJ7ZH&XJ7YM NC72.Z — stem: Fracture of femur, unspecified XK8G — satellite: laterality XJ7ZH — satellite: fracture subtype XJ7YM — satellite: fracture open or closed Usage rules: SHALL only be present when the expression contains at least one satellite code joined by & or / operators. Single stem codes SHALL be represented in Coding.code only and validated via OCL $validate-code. The cluster validator at https://icd11.dghs.gov.bd/cluster/validate explicitly rejects stem-only expressions. The stem code in Coding.code SHALL match the leading stem code in this expression string. Satellite codes in the cluster expression are exempt from the Diagnosis/Finding class restriction that applies to stem codes in Condition.code. Cluster expressions SHALL be validated against the Bangladesh ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate prior to submission to the HIE. Cluster validator endpoint: POST https://icd11.dghs.gov.bd/cluster/validate Body: { "expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM" } This extension is not MustSupport and is not mandatory. It is present only when postcoordination is clinically required. Cluster expressions are typically sourced from the WHO Electronic Coding Tool (ECT) at the point of care. Optional Extension Element - found in all resources.
Short | ICD-11 Cluster ExpressionOptional Extensions Element
Control | 0..* This element is affected by the following invariants: ele-1
Is Modifier | false
Invariants | ele-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())
2. Extension.extension
Definition | An Extension 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.
Short | ExtensionAdditional 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.
Control | 0..0*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-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())
Slicing | This element introduces a set of slices on `Extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
4. Extension.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression`
6. Extension.value[x]
Definition | The full postcoordinated cluster expression, including the stem code and all satellite codes joined by & or / operators. Example: NC72.Z&XK8G&XJ7ZH&XJ7YM. The stem code in this string SHALL match Coding.code on the parent Coding element. Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Short | ICD-11 postcoordinated cluster expression stringValue of extension
Control | 10..1
Type | string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-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. Extension
Definition | Carries a postcoordinated ICD-11 cluster expression as a single string on a Coding element where the stem code alone is insufficient to fully represent the clinical concept. A cluster expression combines a stem code with one or more satellite codes using the & operator (combination) or / operator (specificity). Example: NC72.Z&XK8G&XJ7ZH&XJ7YM NC72.Z — stem: Fracture of femur, unspecified XK8G — satellite: laterality XJ7ZH — satellite: fracture subtype XJ7YM — satellite: fracture open or closed Usage rules: SHALL only be present when the expression contains at least one satellite code joined by & or / operators. Single stem codes SHALL be represented in Coding.code only and validated via OCL $validate-code. The cluster validator at https://icd11.dghs.gov.bd/cluster/validate explicitly rejects stem-only expressions. The stem code in Coding.code SHALL match the leading stem code in this expression string. Satellite codes in the cluster expression are exempt from the Diagnosis/Finding class restriction that applies to stem codes in Condition.code. Cluster expressions SHALL be validated against the Bangladesh ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate prior to submission to the HIE. Cluster validator endpoint: POST https://icd11.dghs.gov.bd/cluster/validate Body: { "expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM" } This extension is not MustSupport and is not mandatory. It is present only when postcoordination is clinically required. Cluster expressions are typically sourced from the WHO Electronic Coding Tool (ECT) at the point of care.
Short | ICD-11 Cluster Expression
2. Extension.extension
Control | 0..0
4. Extension.url
Fixed Value | `https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression`
6. Extension.value[x]
Definition | The full postcoordinated cluster expression, including the stem code and all satellite codes joined by & or / operators. Example: NC72.Z&XK8G&XJ7ZH&XJ7YM. The stem code in this string SHALL match Coding.code on the parent Coding element.
Short | ICD-11 postcoordinated cluster expression string
Control | 1..?
Type | string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension

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

0. Extension
Definition | Carries a postcoordinated ICD-11 cluster expression as a single string on a Coding element where the stem code alone is insufficient to fully represent the clinical concept. A cluster expression combines a stem code with one or more satellite codes using the & operator (combination) or / operator (specificity). Example: NC72.Z&XK8G&XJ7ZH&XJ7YM NC72.Z — stem: Fracture of femur, unspecified XK8G — satellite: laterality XJ7ZH — satellite: fracture subtype XJ7YM — satellite: fracture open or closed Usage rules: SHALL only be present when the expression contains at least one satellite code joined by & or / operators. Single stem codes SHALL be represented in Coding.code only and validated via OCL $validate-code. The cluster validator at https://icd11.dghs.gov.bd/cluster/validate explicitly rejects stem-only expressions. The stem code in Coding.code SHALL match the leading stem code in this expression string. Satellite codes in the cluster expression are exempt from the Diagnosis/Finding class restriction that applies to stem codes in Condition.code. Cluster expressions SHALL be validated against the Bangladesh ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate prior to submission to the HIE. Cluster validator endpoint: POST https://icd11.dghs.gov.bd/cluster/validate Body: { "expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM" } This extension is not MustSupport and is not mandatory. It is present only when postcoordination is clinically required. Cluster expressions are typically sourced from the WHO Electronic Coding Tool (ECT) at the point of care.
Short | ICD-11 Cluster Expression
Control | 0..* This element is affected by the following invariants: ele-1
Is Modifier | false
Invariants | ele-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()`)
2. Extension.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
4. Extension.extension
Definition | An Extension
Short | Extension
Control | 0..0
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-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()`)
Slicing | This element introduces a set of slices on `Extension.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
6. Extension.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Short | identifies the meaning of the extension
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Control | 1..1
Type | uri
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
Fixed Value | `https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression`
8. Extension.value[x]
Definition | The full postcoordinated cluster expression, including the stem code and all satellite codes joined by & or / operators. Example: NC72.Z&XK8G&XJ7ZH&XJ7YM. The stem code in this string SHALL match Coding.code on the parent Coding element.
Short | ICD-11 postcoordinated cluster expression string
Control | 1..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)