--- description: >- Columns for conditions, mapped from the USCDI v3.1 Problems, Health Concerns, and Encounter Diagnosis data classes to US Core 6.1.0 FHIR. --- > For the complete documentation index, see [llms.txt](https://www.health-samurai.io/docs/payerbox/llms.txt). > Use it to discover all available pages before guessing URLs. --- # Problems ## Datasets [US Core 6.1.0](https://hl7.org/fhir/us/core/STU6.1/) maps each [USCDI](https://isp.healthit.gov/united-states-core-data-interoperability-uscdi#uscdi-v3-1) element to FHIR. | Dataset | US Core 6.1.0 target profile(s) | |---|---| | [`conditions`](#conditions) | [US Core Condition Problems and Health Concerns](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-condition-problems-health-concerns.html); [US Core Condition Encounter Diagnosis](https://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-condition-encounter-diagnosis.html) | ## conditions One file covers all four USCDI condition flavours — problems, health concerns, encounter diagnoses, and SDOH — one row per condition per patient; the `category` column tells them apart. | Column | Required | Format / values | Example | |---|---|---|---| | `patient_identifier` | Yes | patient key | `MRN-4471903` | | `category` | Yes | one of seven values — see [Categories](#categories) | `problem-list-item` | | `code` | Yes | SNOMED CT or ICD-10-CM code, with `code_system` [us-core-condition-code](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code) | `44054006` Type 2 diabetes mellitus | | `clinical_status` | Recommended | `active`, `recurrence`, `relapse`, `inactive`, `remission`, `resolved` [condition-clinical](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/ValueSet/condition-clinical) | `active` | | `verification_status` | Recommended | `unconfirmed`, `provisional`, `differential`, `confirmed`, `refuted`, `entered-in-error` [condition-ver-status](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/ValueSet/condition-ver-status) | `confirmed` | | `onset_date` | Recommended | datetime | `2021-08-14` | | `abatement_date` | If resolved | datetime | `2023-11-30` | | `recorded_date` | Recommended | datetime | `2021-08-15` | | `asserted_date` | If available | datetime | `2021-08-15` | | `encounter_id` | If `encounter-diagnosis` | encounter key | `ENC-9912` | - `code` is the one coded field with no fallback: a row without it cannot become a Condition. The value set spans SNOMED CT, ICD-10-CM, and ICD-9-CM, so send problems and health concerns as SNOMED CT (`code_system` = `http://snomed.info/sct`) and claims-sourced encounter diagnoses as ICD-10-CM (`code_system` = `http://hl7.org/fhir/sid/icd-10-cm`) — no crosswalk needed. ICD-9-CM (`http://hl7.org/fhir/sid/icd-9-cm`) exists in the value set for historical records only. - `clinical_status` and `verification_status` are coupled: FHIR requires `clinical_status` on every `problem-list-item` row whose `verification_status` is not `entered-in-error`, and forbids it on any row that is `entered-in-error`. Sending `active` on live rows and `resolved` or `inactive` on closed ones satisfies this. - A row with an `abatement_date` must carry a `clinical_status` of `inactive`, `resolved`, or `remission` — FHIR rejects an abated condition still marked `active`. - The three onset-side dates differ: `onset_date` is when the condition clinically began (USCDI Date of Diagnosis), `asserted_date` is when a practitioner first asserted it, and `recorded_date` is when the record entered the system. `abatement_date` is the Date of Resolution. Send whichever your source distinguishes — a source with one condition date puts it in `onset_date`. - `encounter_id` belongs on `encounter-diagnosis` rows and must match a row in the `encounters` dataset. ### Categories `category` says what kind of condition the row is, and that decides which US Core profile it becomes. `encounter-diagnosis` rows become Encounter Diagnosis resources; every other value becomes a Problems and Health Concerns resource. The four screening values also add their code to the resource as a second category, so the origin of the finding stays visible. | `category` | Row is | FHIR it becomes | Binding | |---|---|---|---| | `problem-list-item` | an item managed over time on the problem list | Problems and Health Concerns | [us-core-problem-or-health-concern](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern) | | `health-concern` | a concern not on the formal problem list | Problems and Health Concerns | [us-core-problem-or-health-concern](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/us/core/ValueSet/us-core-problem-or-health-concern) | | `encounter-diagnosis` | a diagnosis made during a visit | Encounter Diagnosis, tied to the encounter via `encounter_id` | [condition-category](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/ValueSet/condition-category), fixed by the profile | | `sdoh` | social-determinants screening finding | health concern + `sdoh` screening category | [us-core-screening-assessment-condition-category](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category) | | `functional-status` | functional-status screening finding | health concern + `functional-status` screening category | [us-core-screening-assessment-condition-category](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category) | | `disability-status` | disability screening finding | health concern + `disability-status` screening category | [us-core-screening-assessment-condition-category](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category) | | `cognitive-status` | cognitive screening finding | health concern + `cognitive-status` screening category | [us-core-screening-assessment-condition-category](https://healthsamurai.github.io/fhir-valueset-viewer/#url=http://hl7.org/fhir/us/core/ValueSet/us-core-screening-assessment-condition-category) | These resources are served by [Patient Access](../../interop-apis/patient-access.md), [Provider Access](../../interop-apis/provider-access.md), [Payer-to-Payer](../../interop-apis/payer-to-payer.md), and [Prior Auth](../../prior-auth/README.md).