For AI agents: the documentation index is at /docs/payerbox/llms.txt. A Markdown version of this page is available at /docs/payerbox/data-integration/uscdi/procedures.md or by requesting it with the Accept: text/markdown header.
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Procedures

Datasets

US Core 6.1.0 maps each USCDI element to FHIR.

DatasetUS Core 6.1.0 target profile(s)
proceduresUS Core Procedure
service_requestsUS Core ServiceRequest

procedures

One row per procedure performed. This dataset carries the Procedures element of the class.

ColumnRequiredFormat / valuesExample
patient_identifierYespatient keyMRN-4471903
statusYespreparation, in-progress, on-hold, stopped, completed, not-done, entered-in-error, unknown event-statuscompleted
codeYesCPT, HCPCS, ICD-10-PCS, or SNOMED CT code, with code_system; CPT if omitted US Core Procedure Codes80146002 appendectomy
performed_startRecommendeddate or datetime2026-04-18
performed_endIf a perioddate or datetime
performer_npiIf available10 digits1407006835
encounter_idIf applicableencounters keyENC-9912
service_request_idIf availableservice_requests key, when the procedure fulfils a request
reason_codeIf availableSNOMED CT or ICD-10-CM code(s), ;-separated, with reason_system; SNOMED CT if omitted procedure-reason733423003 food insecurity
  • performed_end marks a procedure that spans time. Send it only then; a single performed_start is a point in time.
  • service_request_id links a performed procedure back to the request that ordered it, including an SDOH intervention recorded in service_requests.

service_requests

One row per requested service: a referral, an order, or an SDOH intervention. This dataset carries the Reason for Referral and SDOH Interventions elements of the class; the services actually performed go in procedures.

ColumnRequiredFormat / valuesExample
patient_identifierYespatient keyMRN-4471903
statusYesdraft, active, on-hold, completed, revoked, entered-in-error, unknown request-statusactive
intentYesproposal, plan, directive, order, original-order, reflex-order, filler-order, instance-order, option request-intentorder
codeYesCPT, HCPCS, SNOMED CT, or LOINC code, with code_system; CPT if omitted US Core Procedure Codes103696004 patient referral to specialist
categoryRecommendedsdoh marks an SDOH intervention. The US Core ServiceRequest Category codes are extensible, so another code is accepted with category_systemsdoh
reason_codeIf availableSNOMED CT or ICD-10-CM code(s), ;-separated, with reason_system; SNOMED CT if omitted US Core Condition Codes733423003 food insecurity
authored_onIf availabledatetime2026-05-10
occurrence_dateIf availabledatetime2026-05-24
requester_npiIf available10 digits1407006835
  • status and intent are both required bindings, so a value outside these lists is rejected. A referral a payer holds is normally active with intent order.
  • code says what was requested. It is the one coded field with no fallback: a row without it cannot become a ServiceRequest. Its value set is deliberately broad, so use the system your domain uses — LOINC for a lab order, CPT or HCPCS off a claim.
  • reason_code is why it was requested — the Reason for Referral element. For an SDOH intervention this is the need being addressed, such as food insecurity or lack of transport.
  • authored_on is when the request was written; occurrence_date is when the service should happen.
  • requester_npi must match a row in practitioners.
  • category is what marks a row as an SDOH intervention, whatever the service is. The APIs that report on SDOH read it, not code.

These resources are served by Patient Access, Provider Access, Payer-to-Payer, and Prior Auth.

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