<div class="note-to-balloters" markdown="1">
**Upcoming NCTS ValueSet Availability**

Balloters should note that a request has been submitted to NCTS to publish a new value set equivalent to the AU Base value set <a href="ValueSet-amt-mp-codes.html">AMT Medicinal Product and Substances</a>, for binding to <code class="highlighter-rouge language-plaintext">Medication.ingredient.item[x]</code>. At the time of publication, this NCTS value set is not yet available.
 
In the interim, the AU Base value set remains in use and it is expected to be deprecated upon release of the NCTS value set. 

Related JIRA issue with details is <a href="https://jira.hl7.org/browse/FHIR-44781">FHIR-44781</a>.
</div>

### Usage Notes

**Profile specific implementation guidance:**

- Medication definition includes coding as:
  - [PBS Item Code](https://www.pbs.gov.au/pbs/home) - Pharmaceutical Benefits Scheme coding, claiming context is not relevant as medicine coding
  - [Medication Package Global Trade Item Number](http://terminology.hl7.org/ValueSet/v3-GTIN) - Global Trade Item Number (GTIN) physical product reference
  - [AMT Medicines](https://healthterminologies.gov.au/fhir/ValueSet/australian-medication-1) - Australian Medicines Terminology, national drug terminology
  - [MIMS Package](https://www.mims.com.au/index.php) - commonly used medicine coding
- When a code for medication definition is unavailable, just text is allowed in `Medication.code.text`.
- When a medication is compounded and is a list of ingredients, `Medication.code` may contain only the list of ingredients as text in `Medication.code.text`.
- For support as text representation of other medicinal product information consider:
  - ​brand name in [Medication Brand Name](StructureDefinition-medication-brand-name.html) extension
  - ​generic name in [Medication Generic Name](StructureDefinition-medication-generic-name.html) extension
  - medication strength, for medication as a whole, in [Medication Strength](StructureDefinition-medication-strength.html) extension
  - medication form in `Medication.form.text`
  - item form and strength as part of medication definition in `Medication.code.text`
  - manufacturer in `Medication.manufacturer.display`
- When individual ingredient strength is unavailable as a ratio, it can be surfaced as text in `CodeableConcept.text` by using pre-adoption of the FHIR R5 [`Medication.ingredient.strength[x]`](https://www.hl7.org/fhir/R5/medication-definitions.html#Medication.ingredient) element with the extension URL [http://hl7.org/fhir/5.0/StructureDefinition/extension-Medication.ingredient.strength[x]](http://hl7.org/fhir/5.0/StructureDefinition/extension-Medication.ingredient.strength[x]). See this example of use [Tadim](Medication-IngredientStrengthExtension0.html). 
  - This is to be interpreted as the strength of that specific ingredient, not the strength of the medication as a whole.
  - Where possible use the existing `Medication.ingredient.strength` element in preference to pre-adopting the FHIR R5 `Medication.ingredient.strength[x]` element.
  - Details on cross version pre-adoption implementation can be found in the FHIR specification [Extensions for converting between versions](https://hl7.org/fhir/R5/versions.html#extensions) section.

**Potentially useful extensions:**

- Medication: [Medication Brand Name](StructureDefinition-medication-brand-name.html)
- Medication: [Medication Generic Name](StructureDefinition-medication-generic-name.html)
- Medication: [Medication Strength](StructureDefinition-medication-strength.html)
