C-CDA on FHIR
1.2.0 - STU 1 United States of America flag

This page is part of the C-CDA on FHIR Implementation Guide (v1.2.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: OperativeNote - Detailed Descriptions

Active as of 2024-03-12

Definitions for the Operative-Note resource profile.

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

0. Composition
2. Composition.type
Shorttype
BindingThe codes SHALL be taken from SurgicalOperationNoteDocumentTypeCode
(required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.1.1)
Must Supporttrue
4. Composition.section
SlicingThis element introduces a set of slices on Composition.section. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ code
  • 6. Composition.section:anesthesia_section
    Slice Nameanesthesia_section
    ShortAnesthesia Section
    Control1..1
    Must Supporttrue
    LabelAnesthesia Section
    8. Composition.section:anesthesia_section.title
    Shorttitle
    Control1..?
    Must Supporttrue
    10. Composition.section:anesthesia_section.code
    ShortAnesthesia
    Control1..?
    Must Supporttrue
    LabelAnesthesia
    Pattern Value{
      "coding" : [{
        "system" : "http://loinc.org",
        "code" : "59774-0"
      }]
    }
    12. Composition.section:anesthesia_section.text
    Shorttext
    Control1..?
    Must Supporttrue
    14. Composition.section:anesthesia_section.entry
    Shortentry
    SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
    • profile @ resolve()
    • 16. Composition.section:anesthesia_section.entry:anesthesia_entry
      Slice Nameanesthesia_entry
      TypeReference(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile, US Core Procedure Profile)
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      18. Composition.section:complications_section
      Slice Namecomplications_section
      ShortComplications Section
      Control1..1
      Must Supporttrue
      LabelComplications Section
      20. Composition.section:complications_section.title
      Shorttitle
      Control1..?
      Must Supporttrue
      22. Composition.section:complications_section.code
      ShortComplications
      Control1..?
      Must Supporttrue
      LabelComplications
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "55109-3"
        }]
      }
      24. Composition.section:complications_section.text
      Shorttext
      Control1..?
      Must Supporttrue
      26. Composition.section:complications_section.entry
      Shortentry
      SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
      • profile @ resolve()
      • 28. Composition.section:complications_section.entry:complications_entry
        Slice Namecomplications_entry
        TypeReference(US Core Condition Profile)
        Must Supporttrue
        30. Composition.section:preoperative_diagnosis_section
        Slice Namepreoperative_diagnosis_section
        ShortPreoperative Diagnosis Section
        Control1..1
        Must Supporttrue
        LabelPreoperative Diagnosis Section
        32. Composition.section:preoperative_diagnosis_section.title
        Shorttitle
        Control1..?
        Must Supporttrue
        34. Composition.section:preoperative_diagnosis_section.code
        ShortPreoperative Diagnosis
        Control1..?
        Must Supporttrue
        LabelPreoperative Diagnosis
        Pattern Value{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "10219-4"
          }]
        }
        36. Composition.section:preoperative_diagnosis_section.text
        Shorttext
        Control1..?
        Must Supporttrue
        38. Composition.section:preoperative_diagnosis_section.entry
        Shortentry
        SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
        • profile @ resolve()
        • 40. Composition.section:preoperative_diagnosis_section.entry:preoperative_diagnosis_entry
          Slice Namepreoperative_diagnosis_entry
          TypeReference(US Core Condition Profile)
          Must Supporttrue
          42. Composition.section:procedure_estimated_blood_loss_section
          Slice Nameprocedure_estimated_blood_loss_section
          ShortProcedure Estimated Blood Loss Section
          Control1..1
          Must Supporttrue
          LabelProcedure Estimated Blood Loss Section
          44. Composition.section:procedure_estimated_blood_loss_section.title
          Shorttitle
          Control1..?
          Must Supporttrue
          46. Composition.section:procedure_estimated_blood_loss_section.code
          ShortProcedure Estimated Blood Loss
          Control1..?
          Must Supporttrue
          LabelProcedure Estimated Blood Loss
          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "59770-8"
            }]
          }
          48. Composition.section:procedure_estimated_blood_loss_section.text
          ShortThis section contains only human readable content
          Control1..?
          Must Supporttrue
          50. Composition.section:procedure_findings_section
          Slice Nameprocedure_findings_section
          ShortProcedure Findings Section
          Control1..1
          Must Supporttrue
          LabelProcedure Findings Section
          52. Composition.section:procedure_findings_section.title
          Shorttitle
          Control1..?
          Must Supporttrue
          54. Composition.section:procedure_findings_section.code
          ShortProcedure Findings
          Control1..?
          Must Supporttrue
          LabelProcedure Findings
          Pattern Value{
            "coding" : [{
              "system" : "http://loinc.org",
              "code" : "59776-5"
            }]
          }
          56. Composition.section:procedure_findings_section.text
          Shorttext
          Control1..?
          Must Supporttrue
          58. Composition.section:procedure_findings_section.entry
          Shortentry
          SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
          • profile @ resolve()
          • 60. Composition.section:procedure_findings_section.entry:procedure_findings_entry
            Slice Nameprocedure_findings_entry
            TypeReference(US Core Condition Profile)
            Must Supporttrue
            62. Composition.section:procedure_specimens_taken_section
            Slice Nameprocedure_specimens_taken_section
            ShortProcedure Specimens Taken Section
            Control1..1
            Must Supporttrue
            LabelProcedure Specimens Taken Section
            64. Composition.section:procedure_specimens_taken_section.title
            Shorttitle
            Control1..?
            Must Supporttrue
            66. Composition.section:procedure_specimens_taken_section.code
            ShortProcedure Specimens Taken
            Control1..?
            Must Supporttrue
            LabelProcedure Specimens Taken
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "59773-2"
              }]
            }
            68. Composition.section:procedure_specimens_taken_section.text
            ShortThis section contains only human readable content
            Control1..?
            Must Supporttrue
            70. Composition.section:postoperative_diagnosis_section
            Slice Namepostoperative_diagnosis_section
            ShortPostoperative Diagnosis Section
            Control1..1
            Must Supporttrue
            LabelPostoperative Diagnosis Section
            72. Composition.section:postoperative_diagnosis_section.title
            Shorttitle
            Control1..?
            Must Supporttrue
            74. Composition.section:postoperative_diagnosis_section.code
            ShortPostoperative Diagnosis
            Control1..?
            Must Supporttrue
            LabelPostoperative Diagnosis
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "10218-6"
              }]
            }
            76. Composition.section:postoperative_diagnosis_section.text
            ShortThis section contains only human readable content
            Control1..?
            Must Supporttrue
            78. Composition.section:procedure_description_section
            Slice Nameprocedure_description_section
            ShortProcedure Description Section
            Control1..1
            Must Supporttrue
            LabelProcedure Description Section
            80. Composition.section:procedure_description_section.title
            Shorttitle
            Control1..?
            82. Composition.section:procedure_description_section.code
            ShortProcedure Description
            Control1..?
            Must Supporttrue
            LabelProcedure Description
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "29554-3"
              }]
            }
            84. Composition.section:procedure_description_section.text
            ShortThis section contains only human readable content
            Control1..?
            Must Supporttrue
            86. Composition.section:operative_note_surgical_procedure_section
            Slice Nameoperative_note_surgical_procedure_section
            ShortOperative Note Surgical Procedure Section
            Control0..1
            Must Supporttrue
            LabelOperative Note Surgical Procedure Section
            88. Composition.section:operative_note_surgical_procedure_section.title
            Shorttitle
            Control1..?
            Must Supporttrue
            90. Composition.section:operative_note_surgical_procedure_section.code
            ShortOperative Note Surgical Procedure
            Control1..?
            Must Supporttrue
            LabelOperative Note Surgical Procedure
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "10223-6"
              }]
            }
            92. Composition.section:operative_note_surgical_procedure_section.text
            ShortThis section contains only human readable content
            Control1..?
            Must Supporttrue
            94. Composition.section:operative_note_fluids_section
            Slice Nameoperative_note_fluids_section
            ShortOperative Note Fluids Section
            Control0..1
            Must Supporttrue
            LabelOperative Note Fluids Section
            96. Composition.section:operative_note_fluids_section.title
            Shorttitle
            Control1..?
            Must Supporttrue
            98. Composition.section:operative_note_fluids_section.code
            ShortOperative Note Fluids
            Control1..?
            Must Supporttrue
            LabelOperative Note Fluids
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "10216-0"
              }]
            }
            100. Composition.section:operative_note_fluids_section.text
            ShortThis section contains only human readable content
            Control1..?
            Must Supporttrue
            102. Composition.section:plan_of_treatment_section
            Slice Nameplan_of_treatment_section
            ShortPlan of Treatment Section
            Control0..1
            Must Supporttrue
            LabelPlan of Treatment Section
            104. Composition.section:plan_of_treatment_section.title
            Shorttitle
            Control1..?
            Must Supporttrue
            106. Composition.section:plan_of_treatment_section.code
            ShortPlan of Treatment
            Control1..?
            Must Supporttrue
            LabelPlan of Treatment
            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "18776-5"
              }]
            }
            108. Composition.section:plan_of_treatment_section.text
            Shorttext
            Control1..?
            Must Supporttrue
            110. Composition.section:plan_of_treatment_section.entry
            Shortentry
            Must Supporttrue
            SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
            • profile @ resolve()
            • 112. Composition.section:plan_of_treatment_section.entry:sliceEntry
              Slice NamesliceEntry
              ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
              TypeReference(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
              114. Composition.section:planned_procedure_section
              Slice Nameplanned_procedure_section
              ShortPlanned Procedure Section
              Control0..1
              Must Supporttrue
              LabelPlanned Procedure Section
              116. Composition.section:planned_procedure_section.title
              Shorttitle
              Control1..?
              Must Supporttrue
              118. Composition.section:planned_procedure_section.code
              ShortPlanned Procedure
              Control1..?
              Must Supporttrue
              LabelPlanned Procedure
              Pattern Value{
                "coding" : [{
                  "system" : "http://loinc.org",
                  "code" : "59772-4"
                }]
              }
              120. Composition.section:planned_procedure_section.text
              Shorttext
              Control1..?
              Must Supporttrue
              122. Composition.section:planned_procedure_section.entry
              Shortentry
              SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
              • profile @ resolve()
              • 124. Composition.section:planned_procedure_section.entry:planned_procedure_entry
                Slice Nameplanned_procedure_entry
                ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                TypeReference(ServiceRequest)
                Must Supporttrue
                126. Composition.section:procedure_disposition_section
                Slice Nameprocedure_disposition_section
                ShortProcedure Disposition Section
                Control0..1
                Must Supporttrue
                LabelProcedure Disposition Section
                128. Composition.section:procedure_disposition_section.title
                Shorttitle
                Control1..?
                Must Supporttrue
                130. Composition.section:procedure_disposition_section.code
                ShortProcedure Disposition
                Control1..?
                Must Supporttrue
                LabelProcedure Disposition
                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "59775-7"
                  }]
                }
                132. Composition.section:procedure_disposition_section.text
                ShortThis section contains only human readable content
                Control1..?
                Must Supporttrue
                134. Composition.section:procedure_indications_section
                Slice Nameprocedure_indications_section
                ShortProcedure Indications Section
                Control0..1
                Must Supporttrue
                LabelProcedure Indications Section
                136. Composition.section:procedure_indications_section.title
                Shorttitle
                Control1..?
                Must Supporttrue
                138. Composition.section:procedure_indications_section.code
                ShortProcedure Indications
                Control1..?
                Must Supporttrue
                LabelProcedure Indications
                Pattern Value{
                  "coding" : [{
                    "system" : "http://loinc.org",
                    "code" : "59768-2"
                  }]
                }
                140. Composition.section:procedure_indications_section.text
                ShortThis section contains only human readable content
                Control1..?
                Must Supporttrue
                142. Composition.section:procedure_indications_section.entry
                Shortentry
                SlicingThis element introduces a set of slices on Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                • profile @ resolve()
                • 144. Composition.section:procedure_indications_section.entry:problem_entry
                  Slice Nameproblem_entry
                  TypeReference(US Core Condition Profile)
                  Must Supporttrue
                  146. Composition.section:procedure_implants_section
                  Slice Nameprocedure_implants_section
                  ShortProcedure Implants Section
                  Control0..1
                  Must Supporttrue
                  LabelProcedure Implants Section
                  148. Composition.section:procedure_implants_section.title
                  Shorttitle
                  Control1..?
                  Must Supporttrue
                  150. Composition.section:procedure_implants_section.code
                  ShortProcedure Implants
                  Control1..?
                  Must Supporttrue
                  LabelProcedure Implants
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "59771-6"
                    }]
                  }
                  152. Composition.section:procedure_implants_section.text
                  ShortThis section contains only human readable content
                  Control1..?
                  Must Supporttrue
                  154. Composition.section:surgical_drains_section
                  Slice Namesurgical_drains_section
                  ShortSurgical Drains Section
                  Control0..1
                  Must Supporttrue
                  LabelSurgical Drains Section
                  156. Composition.section:surgical_drains_section.title
                  Shorttitle
                  Control1..?
                  Must Supporttrue
                  158. Composition.section:surgical_drains_section.code
                  ShortSurgical Drains
                  Control1..?
                  Must Supporttrue
                  LabelSurgical Drains
                  Pattern Value{
                    "coding" : [{
                      "system" : "http://loinc.org",
                      "code" : "11537-8"
                    }]
                  }
                  160. Composition.section:surgical_drains_section.text
                  ShortThis section contains only human readable content
                  Control1..?
                  Must Supporttrue

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

                  0. Composition
                  Definition

                  A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

                  ShortA set of resources composed into a single coherent clinical statement with clinical attestation
                  Comments

                  While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

                  Control0..*
                  Is Modifierfalse
                  Summaryfalse
                  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())
                  2. Composition.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. Composition.language
                  Definition

                  The base language in which the resource is written.

                  ShortlanguageLanguage 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).

                  Control10..1
                  BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
                  (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
                  Must Supporttrue
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  6. Composition.extension:versionNumber
                  Slice NameversionNumber
                  Definition

                  Version specific identifier for the composition, assigned when each version is created/updated.

                  ShortVersion-specific identifier for composition
                  Comments

                  While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(Composition Version Number) (Extension Type: string)
                  Is Modifierfalse
                  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. Composition.extension:version_number_extension
                  Slice Nameversion_number_extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..1
                  TypeExtension(Version Number) (Extension Type: integer)
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  10. Composition.extension:data_enterer_extension
                  Slice Namedata_enterer_extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..1
                  TypeExtension(Data Enterer Extension) (Extension Type: Reference)
                  Is Modifierfalse
                  Must Supporttrue
                  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())
                  12. Composition.extension:informant_extension
                  Slice Nameinformant_extension
                  Definition

                  An Extension

                  Shortinformant
                  Control0..*
                  TypeExtension(Informant Extension) (Extension Type: Reference)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Labelinformant
                  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())
                  14. Composition.extension:information_recipient_extension
                  Slice Nameinformation_recipient_extension
                  Definition

                  An Extension

                  ShortinformationRecipient
                  Control0..*
                  TypeExtension(Information Recipient Extension) (Extension Type: Reference)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  LabelinformationRecipient
                  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())
                  16. Composition.extension:participant_extension
                  Slice Nameparticipant_extension
                  Definition

                  An Extension

                  Shortparticipant
                  Control0..*
                  TypeExtension(Participant Extension) (Extension Type: Reference)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Labelparticipant
                  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. Composition.extension:performer_extension
                  Slice Nameperformer_extension
                  Definition

                  An Extension

                  Shortperformer
                  Control0..*
                  TypeExtension(Performer Extension) (Extension Type: Reference)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Labelperformer
                  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. Composition.extension:authorization_extension
                  Slice Nameauthorization_extension
                  Definition

                  An Extension

                  Shortauthorization
                  Control0..*
                  TypeExtension(Authorization Extension) (Extension Type: Reference)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Labelauthorization
                  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. Composition.extension:order_extension
                  Slice Nameorder_extension
                  Definition

                  An Extension

                  Shortauthorization
                  Control0..*
                  TypeExtension(Order Extension) (Extension Type: Reference)
                  Is Modifierfalse
                  Must Supporttrue
                  Summaryfalse
                  Labelauthorization
                  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())
                  24. Composition.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.


                  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())
                  26. Composition.identifier
                  Definition

                  A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

                  ShortidentifierVersion-independent identifier for the Composition
                  Comments

                  Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

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

                  The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

                  Shortpreliminary | final | amended | entered-in-error
                  Comments

                  If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

                  Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

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

                  The workflow/clinical status of the composition.

                  Typecode
                  Is Modifiertrue because This element is labelled 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
                  Requirements

                  Need to be able to mark interim, amended, or withdrawn compositions or documents.

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

                  Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

                  ShorttypeKind of composition (LOINC if possible)
                  Comments

                  For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

                  Control1..1
                  BindingThe codes SHALL be taken from The codes SHOULD be taken from SurgicalOperationNoteDocumentTypeCodehttp://hl7.org/fhir/ValueSet/doc-typecodes
                  (required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.1.1)
                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Key metadata element describing the composition, used in searching/filtering.

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

                  Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

                  ShortWho and/or what the composition is about
                  Comments

                  For clinical documents, this is usually the patient.

                  Control0..1
                  TypeReference(US Core Patient Profile, Group, Resource)
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Summarytrue
                  Requirements

                  Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  34. Composition.encounter
                  Definition

                  Describes the clinical encounter or type of care this documentation is associated with.

                  ShortContext of the Composition
                  Control0..1
                  TypeReference(US Core Encounter Profile, Encounter)
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Provides context for the composition and supports searching.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  36. Composition.date
                  Definition

                  The composition editing time, when the composition was last logically changed by the author.

                  ShortdateComposition editing time
                  Comments

                  The Last Modified Date on the composition may be after the date of the document was attested without being changed.

                  Control1..1
                  TypedateTime
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.


                  dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  38. Composition.author
                  Definition

                  Identifies who is responsible for the information in the composition, not necessarily who typed it in.

                  ShortWho and/or what authored the composition
                  Control1..*
                  TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, PractitionerRole, US Core Patient Profile, Device, RelatedPerson, Practitioner, Patient, Organization)
                  Is Modifierfalse
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Summarytrue
                  Requirements

                  Identifies who is responsible for the content.

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

                  Official human-readable label for the composition.

                  ShortDocument TitleHuman Readable name/title
                  Comments

                  For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

                  Control1..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Summarytrue
                  LabelDocument Title
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  42. Composition.confidentiality
                  Definition

                  Use the confidentiality codes in Meta.security (https://hl7.org/fhir/security-labels.html)


                  The code specifying the level of confidentiality of the Composition.

                  ShortUse the confidentiality codes in Meta.securityAs defined by affinity domain
                  Comments

                  The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

                  Control0..01
                  BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26
                  (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

                  Codes specifying the level of confidentiality of the composition.

                  Typecode
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supportfalse
                  Summarytrue
                  LabelUse the confidentiality codes in Meta.security
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  44. Composition.attester
                  Definition

                  A participant who has attested to the accuracy of the composition/document.

                  ShortAttests to accuracy of composition
                  Comments

                  Only list each attester once.

                  Control0..*
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supportfalse
                  Summaryfalse
                  Requirements

                  Identifies responsibility for the accuracy of the composition content.

                  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 Composition.attester. The slices are unordered and Open, and can be differentiated using the following discriminators:
                  • value @ mode
                  • 46. Composition.attester.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                    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 element that contains them
                    Summarytrue
                    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.


                    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, modifiers
                    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())
                    48. Composition.attester.mode
                    Definition

                    The type of attestation the authenticator offers.

                    Shortpersonal | professional | legal | official
                    Control1..1
                    BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                    The way in which a person authenticated a composition.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Indicates the level of authority of the attestation.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    50. Composition.attester:legal_attester
                    Slice Namelegal_attester
                    Definition

                    A participant who has attested to the accuracy of the composition/document.

                    ShortattesterAttests to accuracy of composition
                    Comments

                    Only list each attester once.

                    Control0..1*
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Identifies responsibility for the accuracy of the composition content.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    52. Composition.attester:legal_attester.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                    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 element that contains them
                    Summarytrue
                    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.


                    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, modifiers
                    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())
                    54. Composition.attester:legal_attester.mode
                    Definition

                    The type of attestation the authenticator offers.

                    Shortmodepersonal | professional | legal | official
                    Control1..1
                    BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                    The way in which a person authenticated a composition.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Indicates the level of authority of the attestation.

                    Fixed Valuelegal
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    56. Composition.attester:legal_attester.party
                    Definition

                    Who attested the composition in the specified way.

                    ShortpartyWho attested the composition
                    Control10..1
                    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Summaryfalse
                    Requirements

                    Identifies who has taken on the responsibility for accuracy of the composition content.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    58. Composition.attester:professional_attester
                    Slice Nameprofessional_attester
                    Definition

                    A participant who has attested to the accuracy of the composition/document.

                    ShortattesterAttests to accuracy of composition
                    Comments

                    Only list each attester once.

                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Identifies responsibility for the accuracy of the composition content.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    60. Composition.attester:professional_attester.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                    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 element that contains them
                    Summarytrue
                    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.


                    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, modifiers
                    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())
                    62. Composition.attester:professional_attester.mode
                    Definition

                    The type of attestation the authenticator offers.

                    Shortmodepersonal | professional | legal | official
                    Control1..1
                    BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                    The way in which a person authenticated a composition.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Indicates the level of authority of the attestation.

                    Fixed Valueprofessional
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. Composition.attester:professional_attester.party
                    Definition

                    Who attested the composition in the specified way.

                    ShortpartyWho attested the composition
                    Control10..1
                    TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Summaryfalse
                    Requirements

                    Identifies who has taken on the responsibility for accuracy of the composition content.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    66. Composition.attester:personal_attester
                    Slice Namepersonal_attester
                    Definition

                    A participant who has attested to the accuracy of the composition/document.

                    ShortattesterAttests to accuracy of composition
                    Comments

                    Only list each attester once.

                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Identifies responsibility for the accuracy of the composition content.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    68. Composition.attester:personal_attester.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                    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 element that contains them
                    Summarytrue
                    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.


                    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, modifiers
                    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())
                    70. Composition.attester:personal_attester.mode
                    Definition

                    The type of attestation the authenticator offers.

                    Shortmodepersonal | professional | legal | official
                    Control1..1
                    BindingThe codes SHALL be taken from CompositionAttestationModehttp://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1
                    (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                    The way in which a person authenticated a composition.

                    Typecode
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    Requirements

                    Indicates the level of authority of the attestation.

                    Fixed Valuepersonal
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    72. Composition.attester:personal_attester.party
                    Definition

                    Who attested the composition in the specified way.

                    ShortpartyWho attested the composition
                    Control10..1
                    TypeReference(US Core Patient Profile, RelatedPerson, Patient, Practitioner, PractitionerRole, Organization)
                    Is Modifierfalse
                    Must Supporttrue
                    Must Support TypesNo must-support rules about the choice of types/profiles
                    Summaryfalse
                    Requirements

                    Identifies who has taken on the responsibility for accuracy of the composition content.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    74. Composition.custodian
                    Definition

                    Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

                    ShortcustodianOrganization which maintains the composition
                    Comments

                    This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

                    Control10..1
                    TypeReference(US Core Organization Profile, Organization)
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Identifies where to go to find the current version, where to report issues, etc.

                    Labelcustodian
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    76. Composition.section
                    Definition

                    The root of the sections that make up the composition.

                    ShortComposition is broken into sections
                    Control0..*
                    TypeBackboneElement
                    Is Modifierfalse
                    Summaryfalse
                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                    SlicingThis element introduces a set of slices on Composition.section. The slices are unordered and Open, and can be differentiated using the following discriminators:
                    • value @ code
                    • 78. Composition.section.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                      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 element that contains them
                      Summarytrue
                      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.


                      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, modifiers
                      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())
                      80. Composition.section:anesthesia_section
                      Slice Nameanesthesia_section
                      Definition

                      The root of the sections that make up the composition.

                      ShortAnesthesia SectionComposition is broken into sections
                      Control10..1*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      LabelAnesthesia Section
                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                      82. Composition.section:anesthesia_section.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                      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 element that contains them
                      Summarytrue
                      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.


                      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, modifiers
                      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())
                      84. Composition.section:anesthesia_section.title
                      Definition

                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                      ShorttitleLabel for section (e.g. for ToC)
                      Comments

                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                      Control10..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                      Alternate Namesheader, label, caption
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      86. Composition.section:anesthesia_section.code
                      Definition

                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                      ShortAnesthesiaClassification of section (recommended)
                      Comments

                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                      Control10..1
                      BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                      Classification of a section of a composition/document.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Requirements

                      Provides computable standardized labels to topics within the document.

                      LabelAnesthesia
                      Pattern Value{
                        "coding" : [{
                          "system" : "http://loinc.org",
                          "code" : "59774-0"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      88. Composition.section:anesthesia_section.text
                      Definition

                      A human-readable narrative that contains the attested content of the section, 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.

                      ShorttextText summary of the section, for human interpretation
                      Comments

                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                      Control10..1
                      This element is affected by the following invariants: cmp-1
                      TypeNarrative
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      90. Composition.section:anesthesia_section.entry
                      Definition

                      A reference to the actual resource from which the narrative in the section is derived.

                      ShortentryA reference to data that supports this section
                      Comments

                      If there are no entries in the list, an emptyReason SHOULD be provided.

                      Control0..*
                      This element is affected by the following invariants: cmp-2
                      TypeReference(Resource)
                      Is Modifierfalse
                      Summaryfalse
                      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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                      • profile @ resolve()
                      • 92. Composition.section:anesthesia_section.entry:anesthesia_entry
                        Slice Nameanesthesia_entry
                        Definition

                        A reference to the actual resource from which the narrative in the section is derived.

                        ShortA reference to data that supports this section
                        Comments

                        If there are no entries in the list, an emptyReason SHOULD be provided.

                        Control0..*
                        This element is affected by the following invariants: cmp-2
                        TypeReference(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile, US Core Procedure Profile, Resource)
                        Is Modifierfalse
                        Must Supporttrue
                        Must Support TypesNo must-support rules about the choice of types/profiles
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        94. Composition.section:complications_section
                        Slice Namecomplications_section
                        Definition

                        The root of the sections that make up the composition.

                        ShortComplications SectionComposition is broken into sections
                        Control10..1*
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        LabelComplications Section
                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                        96. Composition.section:complications_section.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                        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 element that contains them
                        Summarytrue
                        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.


                        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, modifiers
                        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())
                        98. Composition.section:complications_section.title
                        Definition

                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                        ShorttitleLabel for section (e.g. for ToC)
                        Comments

                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                        Control10..1
                        Typestring
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Must Supporttrue
                        Summaryfalse
                        Requirements

                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                        Alternate Namesheader, label, caption
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        100. Composition.section:complications_section.code
                        Definition

                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                        ShortComplicationsClassification of section (recommended)
                        Comments

                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                        Control10..1
                        BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                        Classification of a section of a composition/document.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Requirements

                        Provides computable standardized labels to topics within the document.

                        LabelComplications
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://loinc.org",
                            "code" : "55109-3"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        102. Composition.section:complications_section.text
                        Definition

                        A human-readable narrative that contains the attested content of the section, 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.

                        ShorttextText summary of the section, for human interpretation
                        Comments

                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                        Control10..1
                        This element is affected by the following invariants: cmp-1
                        TypeNarrative
                        Is Modifierfalse
                        Must Supporttrue
                        Summaryfalse
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        104. Composition.section:complications_section.entry
                        Definition

                        A reference to the actual resource from which the narrative in the section is derived.

                        ShortentryA reference to data that supports this section
                        Comments

                        If there are no entries in the list, an emptyReason SHOULD be provided.

                        Control0..*
                        This element is affected by the following invariants: cmp-2
                        TypeReference(Resource)
                        Is Modifierfalse
                        Summaryfalse
                        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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                        • profile @ resolve()
                        • 106. Composition.section:complications_section.entry:complications_entry
                          Slice Namecomplications_entry
                          Definition

                          A reference to the actual resource from which the narrative in the section is derived.

                          ShortA reference to data that supports this section
                          Comments

                          If there are no entries in the list, an emptyReason SHOULD be provided.

                          Control0..*
                          This element is affected by the following invariants: cmp-2
                          TypeReference(US Core Condition Profile, Resource)
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          108. Composition.section:preoperative_diagnosis_section
                          Slice Namepreoperative_diagnosis_section
                          Definition

                          The root of the sections that make up the composition.

                          ShortPreoperative Diagnosis SectionComposition is broken into sections
                          Control10..1*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          LabelPreoperative Diagnosis Section
                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                          110. Composition.section:preoperative_diagnosis_section.modifierExtension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                          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 element that contains them
                          Summarytrue
                          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.


                          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, modifiers
                          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())
                          112. Composition.section:preoperative_diagnosis_section.title
                          Definition

                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                          ShorttitleLabel for section (e.g. for ToC)
                          Comments

                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                          Control10..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                          Alternate Namesheader, label, caption
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          114. Composition.section:preoperative_diagnosis_section.code
                          Definition

                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                          ShortPreoperative DiagnosisClassification of section (recommended)
                          Comments

                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                          Control10..1
                          BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                          Classification of a section of a composition/document.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Requirements

                          Provides computable standardized labels to topics within the document.

                          LabelPreoperative Diagnosis
                          Pattern Value{
                            "coding" : [{
                              "system" : "http://loinc.org",
                              "code" : "10219-4"
                            }]
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          116. Composition.section:preoperative_diagnosis_section.text
                          Definition

                          A human-readable narrative that contains the attested content of the section, 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.

                          ShorttextText summary of the section, for human interpretation
                          Comments

                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                          Control10..1
                          This element is affected by the following invariants: cmp-1
                          TypeNarrative
                          Is Modifierfalse
                          Must Supporttrue
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          118. Composition.section:preoperative_diagnosis_section.entry
                          Definition

                          A reference to the actual resource from which the narrative in the section is derived.

                          ShortentryA reference to data that supports this section
                          Comments

                          If there are no entries in the list, an emptyReason SHOULD be provided.

                          Control0..*
                          This element is affected by the following invariants: cmp-2
                          TypeReference(Resource)
                          Is Modifierfalse
                          Summaryfalse
                          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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                          • profile @ resolve()
                          • 120. Composition.section:preoperative_diagnosis_section.entry:preoperative_diagnosis_entry
                            Slice Namepreoperative_diagnosis_entry
                            Definition

                            A reference to the actual resource from which the narrative in the section is derived.

                            ShortA reference to data that supports this section
                            Comments

                            If there are no entries in the list, an emptyReason SHOULD be provided.

                            Control0..*
                            This element is affected by the following invariants: cmp-2
                            TypeReference(US Core Condition Profile, Resource)
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            122. Composition.section:procedure_estimated_blood_loss_section
                            Slice Nameprocedure_estimated_blood_loss_section
                            Definition

                            The root of the sections that make up the composition.

                            ShortProcedure Estimated Blood Loss SectionComposition is broken into sections
                            Control10..1*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            LabelProcedure Estimated Blood Loss Section
                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                            124. Composition.section:procedure_estimated_blood_loss_section.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                            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 element that contains them
                            Summarytrue
                            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.


                            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, modifiers
                            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())
                            126. Composition.section:procedure_estimated_blood_loss_section.title
                            Definition

                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                            ShorttitleLabel for section (e.g. for ToC)
                            Comments

                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                            Control10..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                            Alternate Namesheader, label, caption
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. Composition.section:procedure_estimated_blood_loss_section.code
                            Definition

                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                            ShortProcedure Estimated Blood LossClassification of section (recommended)
                            Comments

                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                            Control10..1
                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                            Classification of a section of a composition/document.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Provides computable standardized labels to topics within the document.

                            LabelProcedure Estimated Blood Loss
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "59770-8"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            130. Composition.section:procedure_estimated_blood_loss_section.text
                            Definition

                            A human-readable narrative that contains the attested content of the section, 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.

                            ShortThis section contains only human readable contentText summary of the section, for human interpretation
                            Comments

                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                            Control10..1
                            This element is affected by the following invariants: cmp-1
                            TypeNarrative
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            132. Composition.section:procedure_findings_section
                            Slice Nameprocedure_findings_section
                            Definition

                            The root of the sections that make up the composition.

                            ShortProcedure Findings SectionComposition is broken into sections
                            Control10..1*
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            LabelProcedure Findings Section
                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                            134. Composition.section:procedure_findings_section.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                            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 element that contains them
                            Summarytrue
                            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.


                            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, modifiers
                            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())
                            136. Composition.section:procedure_findings_section.title
                            Definition

                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                            ShorttitleLabel for section (e.g. for ToC)
                            Comments

                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                            Control10..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                            Alternate Namesheader, label, caption
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            138. Composition.section:procedure_findings_section.code
                            Definition

                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                            ShortProcedure FindingsClassification of section (recommended)
                            Comments

                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                            Control10..1
                            BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                            Classification of a section of a composition/document.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Requirements

                            Provides computable standardized labels to topics within the document.

                            LabelProcedure Findings
                            Pattern Value{
                              "coding" : [{
                                "system" : "http://loinc.org",
                                "code" : "59776-5"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            140. Composition.section:procedure_findings_section.text
                            Definition

                            A human-readable narrative that contains the attested content of the section, 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.

                            ShorttextText summary of the section, for human interpretation
                            Comments

                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                            Control10..1
                            This element is affected by the following invariants: cmp-1
                            TypeNarrative
                            Is Modifierfalse
                            Must Supporttrue
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            142. Composition.section:procedure_findings_section.entry
                            Definition

                            A reference to the actual resource from which the narrative in the section is derived.

                            ShortentryA reference to data that supports this section
                            Comments

                            If there are no entries in the list, an emptyReason SHOULD be provided.

                            Control0..*
                            This element is affected by the following invariants: cmp-2
                            TypeReference(Resource)
                            Is Modifierfalse
                            Summaryfalse
                            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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                            • profile @ resolve()
                            • 144. Composition.section:procedure_findings_section.entry:procedure_findings_entry
                              Slice Nameprocedure_findings_entry
                              Definition

                              A reference to the actual resource from which the narrative in the section is derived.

                              ShortA reference to data that supports this section
                              Comments

                              If there are no entries in the list, an emptyReason SHOULD be provided.

                              Control0..*
                              This element is affected by the following invariants: cmp-2
                              TypeReference(US Core Condition Profile, Resource)
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              146. Composition.section:procedure_specimens_taken_section
                              Slice Nameprocedure_specimens_taken_section
                              Definition

                              The root of the sections that make up the composition.

                              ShortProcedure Specimens Taken SectionComposition is broken into sections
                              Control10..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              LabelProcedure Specimens Taken Section
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              148. Composition.section:procedure_specimens_taken_section.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                              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 element that contains them
                              Summarytrue
                              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.


                              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, modifiers
                              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())
                              150. Composition.section:procedure_specimens_taken_section.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShorttitleLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              152. Composition.section:procedure_specimens_taken_section.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortProcedure Specimens TakenClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control10..1
                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              LabelProcedure Specimens Taken
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "59773-2"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              154. Composition.section:procedure_specimens_taken_section.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShortThis section contains only human readable contentText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control10..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              156. Composition.section:postoperative_diagnosis_section
                              Slice Namepostoperative_diagnosis_section
                              Definition

                              The root of the sections that make up the composition.

                              ShortPostoperative Diagnosis SectionComposition is broken into sections
                              Control10..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              LabelPostoperative Diagnosis Section
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              158. Composition.section:postoperative_diagnosis_section.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                              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 element that contains them
                              Summarytrue
                              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.


                              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, modifiers
                              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())
                              160. Composition.section:postoperative_diagnosis_section.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShorttitleLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              162. Composition.section:postoperative_diagnosis_section.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortPostoperative DiagnosisClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control10..1
                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              LabelPostoperative Diagnosis
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "10218-6"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              164. Composition.section:postoperative_diagnosis_section.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShortThis section contains only human readable contentText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control10..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              166. Composition.section:procedure_description_section
                              Slice Nameprocedure_description_section
                              Definition

                              The root of the sections that make up the composition.

                              ShortProcedure Description SectionComposition is broken into sections
                              Control10..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              LabelProcedure Description Section
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              168. Composition.section:procedure_description_section.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                              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 element that contains them
                              Summarytrue
                              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.


                              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, modifiers
                              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())
                              170. Composition.section:procedure_description_section.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShorttitleLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              172. Composition.section:procedure_description_section.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortProcedure DescriptionClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control10..1
                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              LabelProcedure Description
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "29554-3"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              174. Composition.section:procedure_description_section.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShortThis section contains only human readable contentText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control10..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              176. Composition.section:operative_note_surgical_procedure_section
                              Slice Nameoperative_note_surgical_procedure_section
                              Definition

                              The root of the sections that make up the composition.

                              ShortOperative Note Surgical Procedure SectionComposition is broken into sections
                              Control0..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              LabelOperative Note Surgical Procedure Section
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              178. Composition.section:operative_note_surgical_procedure_section.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                              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 element that contains them
                              Summarytrue
                              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.


                              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, modifiers
                              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())
                              180. Composition.section:operative_note_surgical_procedure_section.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShorttitleLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              182. Composition.section:operative_note_surgical_procedure_section.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortOperative Note Surgical ProcedureClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control10..1
                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              LabelOperative Note Surgical Procedure
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "10223-6"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              184. Composition.section:operative_note_surgical_procedure_section.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShortThis section contains only human readable contentText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control10..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              186. Composition.section:operative_note_fluids_section
                              Slice Nameoperative_note_fluids_section
                              Definition

                              The root of the sections that make up the composition.

                              ShortOperative Note Fluids SectionComposition is broken into sections
                              Control0..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              LabelOperative Note Fluids Section
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              188. Composition.section:operative_note_fluids_section.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                              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 element that contains them
                              Summarytrue
                              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.


                              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, modifiers
                              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())
                              190. Composition.section:operative_note_fluids_section.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShorttitleLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              192. Composition.section:operative_note_fluids_section.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortOperative Note FluidsClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control10..1
                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              LabelOperative Note Fluids
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "10216-0"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              194. Composition.section:operative_note_fluids_section.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShortThis section contains only human readable contentText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control10..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              196. Composition.section:plan_of_treatment_section
                              Slice Nameplan_of_treatment_section
                              Definition

                              The root of the sections that make up the composition.

                              ShortPlan of Treatment SectionComposition is broken into sections
                              Control0..1*
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              LabelPlan of Treatment Section
                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                              198. Composition.section:plan_of_treatment_section.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                              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 element that contains them
                              Summarytrue
                              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.


                              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, modifiers
                              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())
                              200. Composition.section:plan_of_treatment_section.title
                              Definition

                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                              ShorttitleLabel for section (e.g. for ToC)
                              Comments

                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                              Control10..1
                              Typestring
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                              Alternate Namesheader, label, caption
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              202. Composition.section:plan_of_treatment_section.code
                              Definition

                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                              ShortPlan of TreatmentClassification of section (recommended)
                              Comments

                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                              Control10..1
                              BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                              Classification of a section of a composition/document.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Requirements

                              Provides computable standardized labels to topics within the document.

                              LabelPlan of Treatment
                              Pattern Value{
                                "coding" : [{
                                  "system" : "http://loinc.org",
                                  "code" : "18776-5"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              204. Composition.section:plan_of_treatment_section.text
                              Definition

                              A human-readable narrative that contains the attested content of the section, 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.

                              ShorttextText summary of the section, for human interpretation
                              Comments

                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                              Control10..1
                              This element is affected by the following invariants: cmp-1
                              TypeNarrative
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              206. Composition.section:plan_of_treatment_section.entry
                              Definition

                              A reference to the actual resource from which the narrative in the section is derived.

                              ShortentryA reference to data that supports this section
                              Comments

                              If there are no entries in the list, an emptyReason SHOULD be provided.

                              Control0..*
                              This element is affected by the following invariants: cmp-2
                              TypeReference(Resource)
                              Is Modifierfalse
                              Must Supporttrue
                              Summaryfalse
                              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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                              • profile @ resolve()
                              • 208. Composition.section:plan_of_treatment_section.entry:sliceEntry
                                Slice NamesliceEntry
                                Definition

                                A reference to the actual resource from which the narrative in the section is derived.

                                ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                Comments

                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                Control0..*
                                This element is affected by the following invariants: cmp-2
                                TypeReference(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup, Resource)
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                210. Composition.section:planned_procedure_section
                                Slice Nameplanned_procedure_section
                                Definition

                                The root of the sections that make up the composition.

                                ShortPlanned Procedure SectionComposition is broken into sections
                                Control0..1*
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                LabelPlanned Procedure Section
                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                212. Composition.section:planned_procedure_section.modifierExtension
                                Definition

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                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 element that contains them
                                Summarytrue
                                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.


                                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, modifiers
                                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())
                                214. Composition.section:planned_procedure_section.title
                                Definition

                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                ShorttitleLabel for section (e.g. for ToC)
                                Comments

                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                Control10..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                Alternate Namesheader, label, caption
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                216. Composition.section:planned_procedure_section.code
                                Definition

                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                ShortPlanned ProcedureClassification of section (recommended)
                                Comments

                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                Control10..1
                                BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                Classification of a section of a composition/document.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Requirements

                                Provides computable standardized labels to topics within the document.

                                LabelPlanned Procedure
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "http://loinc.org",
                                    "code" : "59772-4"
                                  }]
                                }
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                218. Composition.section:planned_procedure_section.text
                                Definition

                                A human-readable narrative that contains the attested content of the section, 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.

                                ShorttextText summary of the section, for human interpretation
                                Comments

                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                Control10..1
                                This element is affected by the following invariants: cmp-1
                                TypeNarrative
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                220. Composition.section:planned_procedure_section.entry
                                Definition

                                A reference to the actual resource from which the narrative in the section is derived.

                                ShortentryA reference to data that supports this section
                                Comments

                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                Control0..*
                                This element is affected by the following invariants: cmp-2
                                TypeReference(Resource)
                                Is Modifierfalse
                                Summaryfalse
                                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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                • profile @ resolve()
                                • 222. Composition.section:planned_procedure_section.entry:planned_procedure_entry
                                  Slice Nameplanned_procedure_entry
                                  Definition

                                  A reference to the actual resource from which the narrative in the section is derived.

                                  ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.A reference to data that supports this section
                                  Comments

                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                  Control0..*
                                  This element is affected by the following invariants: cmp-2
                                  TypeReference(ServiceRequest, Resource)
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  224. Composition.section:procedure_disposition_section
                                  Slice Nameprocedure_disposition_section
                                  Definition

                                  The root of the sections that make up the composition.

                                  ShortProcedure Disposition SectionComposition is broken into sections
                                  Control0..1*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  LabelProcedure Disposition Section
                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                  226. Composition.section:procedure_disposition_section.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                  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 element that contains them
                                  Summarytrue
                                  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.


                                  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, modifiers
                                  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())
                                  228. Composition.section:procedure_disposition_section.title
                                  Definition

                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                  ShorttitleLabel for section (e.g. for ToC)
                                  Comments

                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                  Control10..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                  Alternate Namesheader, label, caption
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  230. Composition.section:procedure_disposition_section.code
                                  Definition

                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                  ShortProcedure DispositionClassification of section (recommended)
                                  Comments

                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                  Control10..1
                                  BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                  Classification of a section of a composition/document.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Provides computable standardized labels to topics within the document.

                                  LabelProcedure Disposition
                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://loinc.org",
                                      "code" : "59775-7"
                                    }]
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  232. Composition.section:procedure_disposition_section.text
                                  Definition

                                  A human-readable narrative that contains the attested content of the section, 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.

                                  ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                  Comments

                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                  Control10..1
                                  This element is affected by the following invariants: cmp-1
                                  TypeNarrative
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  234. Composition.section:procedure_indications_section
                                  Slice Nameprocedure_indications_section
                                  Definition

                                  The root of the sections that make up the composition.

                                  ShortProcedure Indications SectionComposition is broken into sections
                                  Control0..1*
                                  TypeBackboneElement
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  LabelProcedure Indications Section
                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                  236. Composition.section:procedure_indications_section.modifierExtension
                                  Definition

                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                  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 element that contains them
                                  Summarytrue
                                  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.


                                  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, modifiers
                                  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())
                                  238. Composition.section:procedure_indications_section.title
                                  Definition

                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                  ShorttitleLabel for section (e.g. for ToC)
                                  Comments

                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                  Control10..1
                                  Typestring
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                  Alternate Namesheader, label, caption
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  240. Composition.section:procedure_indications_section.code
                                  Definition

                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                  ShortProcedure IndicationsClassification of section (recommended)
                                  Comments

                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                  Control10..1
                                  BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                  Classification of a section of a composition/document.

                                  TypeCodeableConcept
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Requirements

                                  Provides computable standardized labels to topics within the document.

                                  LabelProcedure Indications
                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "http://loinc.org",
                                      "code" : "59768-2"
                                    }]
                                  }
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  242. Composition.section:procedure_indications_section.text
                                  Definition

                                  A human-readable narrative that contains the attested content of the section, 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.

                                  ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                  Comments

                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                  Control10..1
                                  This element is affected by the following invariants: cmp-1
                                  TypeNarrative
                                  Is Modifierfalse
                                  Must Supporttrue
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  244. Composition.section:procedure_indications_section.entry
                                  Definition

                                  A reference to the actual resource from which the narrative in the section is derived.

                                  ShortentryA reference to data that supports this section
                                  Comments

                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                  Control0..*
                                  This element is affected by the following invariants: cmp-2
                                  TypeReference(Resource)
                                  Is Modifierfalse
                                  Summaryfalse
                                  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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                  • profile @ resolve()
                                  • 246. Composition.section:procedure_indications_section.entry:problem_entry
                                    Slice Nameproblem_entry
                                    Definition

                                    A reference to the actual resource from which the narrative in the section is derived.

                                    ShortA reference to data that supports this section
                                    Comments

                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                    Control0..*
                                    This element is affected by the following invariants: cmp-2
                                    TypeReference(US Core Condition Profile, Resource)
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    248. Composition.section:procedure_implants_section
                                    Slice Nameprocedure_implants_section
                                    Definition

                                    The root of the sections that make up the composition.

                                    ShortProcedure Implants SectionComposition is broken into sections
                                    Control0..1*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    LabelProcedure Implants Section
                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                    250. Composition.section:procedure_implants_section.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                    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 element that contains them
                                    Summarytrue
                                    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.


                                    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, modifiers
                                    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())
                                    252. Composition.section:procedure_implants_section.title
                                    Definition

                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                    ShorttitleLabel for section (e.g. for ToC)
                                    Comments

                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                    Control10..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                    Alternate Namesheader, label, caption
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    254. Composition.section:procedure_implants_section.code
                                    Definition

                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                    ShortProcedure ImplantsClassification of section (recommended)
                                    Comments

                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                    Control10..1
                                    BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                    Classification of a section of a composition/document.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Provides computable standardized labels to topics within the document.

                                    LabelProcedure Implants
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "59771-6"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    256. Composition.section:procedure_implants_section.text
                                    Definition

                                    A human-readable narrative that contains the attested content of the section, 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.

                                    ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                    Comments

                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                    Control10..1
                                    This element is affected by the following invariants: cmp-1
                                    TypeNarrative
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    258. Composition.section:surgical_drains_section
                                    Slice Namesurgical_drains_section
                                    Definition

                                    The root of the sections that make up the composition.

                                    ShortSurgical Drains SectionComposition is broken into sections
                                    Control0..1*
                                    TypeBackboneElement
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    LabelSurgical Drains Section
                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    cmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                    260. Composition.section:surgical_drains_section.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                    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 element that contains them
                                    Summarytrue
                                    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.


                                    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, modifiers
                                    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())
                                    262. Composition.section:surgical_drains_section.title
                                    Definition

                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                    ShorttitleLabel for section (e.g. for ToC)
                                    Comments

                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                    Control10..1
                                    Typestring
                                    Is Modifierfalse
                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                    Alternate Namesheader, label, caption
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    264. Composition.section:surgical_drains_section.code
                                    Definition

                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                    ShortSurgical DrainsClassification of section (recommended)
                                    Comments

                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                    Control10..1
                                    BindingFor example codes, see DocumentSectionCodeshttp://hl7.org/fhir/ValueSet/doc-section-codes
                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                    Classification of a section of a composition/document.

                                    TypeCodeableConcept
                                    Is Modifierfalse
                                    Must Supporttrue
                                    Summaryfalse
                                    Requirements

                                    Provides computable standardized labels to topics within the document.

                                    LabelSurgical Drains
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://loinc.org",
                                        "code" : "11537-8"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    266. Composition.section:surgical_drains_section.text
                                    Definition

                                    A human-readable narrative that contains the attested content of the section, 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.

                                    ShortThis section contains only human readable contentText summary of the section, for human interpretation
                                    Comments

                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                    Control10..1
                                    This element is affected by the following invariants: cmp-1
                                    TypeNarrative
                                    Is Modifierfalse
                                    Must Supporttrue
                                    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 found here

                                    0. Composition
                                    Definition

                                    A set of healthcare-related information that is assembled together into a single logical package that provides a single coherent statement of meaning, establishes its own context and that has clinical attestation with regard to who is making the statement. A Composition defines the structure and narrative content necessary for a document. However, a Composition alone does not constitute a document. Rather, the Composition must be the first entry in a Bundle where Bundle.type=document, and any other resources referenced from Composition must be included as subsequent entries in the Bundle (for example Patient, Practitioner, Encounter, etc.).

                                    ShortA set of resources composed into a single coherent clinical statement with clinical attestation
                                    Comments

                                    While the focus of this specification is on patient-specific clinical statements, this resource can also apply to other healthcare-related statements such as study protocol designs, healthcare invoices and other activities that are not necessarily patient-specific or clinical.

                                    Control0..*
                                    Is Modifierfalse
                                    Summaryfalse
                                    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())
                                    2. Composition.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. Composition.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. Composition.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. Composition.language
                                    Definition

                                    The base language in which the resource is written.

                                    Shortlanguage
                                    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).

                                    Control1..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
                                    Must Supporttrue
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    10. Composition.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. Composition.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. Composition.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 Composition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 16. Composition.extension:versionNumber
                                      Slice NameversionNumber
                                      Definition

                                      Version specific identifier for the composition, assigned when each version is created/updated.

                                      ShortVersion-specific identifier for composition
                                      Comments

                                      While each resource, including the composition itself, has its own version identifier, this is a formal identifier for the logical version of the composition as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

                                      Control0..*
                                      This element is affected by the following invariants: ele-1
                                      TypeExtension(Composition Version Number) (Extension Type: string)
                                      Is Modifierfalse
                                      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. Composition.extension:version_number_extension
                                      Slice Nameversion_number_extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..1
                                      TypeExtension(Version Number) (Extension Type: integer)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      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. Composition.extension:data_enterer_extension
                                      Slice Namedata_enterer_extension
                                      Definition

                                      An Extension

                                      ShortExtension
                                      Control0..1
                                      TypeExtension(Data Enterer Extension) (Extension Type: Reference)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      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())
                                      22. Composition.extension:informant_extension
                                      Slice Nameinformant_extension
                                      Definition

                                      An Extension

                                      Shortinformant
                                      Control0..*
                                      TypeExtension(Informant Extension) (Extension Type: Reference)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Labelinformant
                                      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())
                                      24. Composition.extension:information_recipient_extension
                                      Slice Nameinformation_recipient_extension
                                      Definition

                                      An Extension

                                      ShortinformationRecipient
                                      Control0..*
                                      TypeExtension(Information Recipient Extension) (Extension Type: Reference)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      LabelinformationRecipient
                                      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())
                                      26. Composition.extension:participant_extension
                                      Slice Nameparticipant_extension
                                      Definition

                                      An Extension

                                      Shortparticipant
                                      Control0..*
                                      TypeExtension(Participant Extension) (Extension Type: Reference)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Labelparticipant
                                      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())
                                      28. Composition.extension:performer_extension
                                      Slice Nameperformer_extension
                                      Definition

                                      An Extension

                                      Shortperformer
                                      Control0..*
                                      TypeExtension(Performer Extension) (Extension Type: Reference)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Labelperformer
                                      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())
                                      30. Composition.extension:authorization_extension
                                      Slice Nameauthorization_extension
                                      Definition

                                      An Extension

                                      Shortauthorization
                                      Control0..*
                                      TypeExtension(Authorization Extension) (Extension Type: Reference)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Labelauthorization
                                      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())
                                      32. Composition.extension:order_extension
                                      Slice Nameorder_extension
                                      Definition

                                      An Extension

                                      Shortauthorization
                                      Control0..*
                                      TypeExtension(Order Extension) (Extension Type: Reference)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summaryfalse
                                      Labelauthorization
                                      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())
                                      34. Composition.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())
                                      36. Composition.identifier
                                      Definition

                                      A version-independent identifier for the Composition. This identifier stays constant as the composition is changed over time.

                                      Shortidentifier
                                      Comments

                                      Similar to ClinicalDocument/setId in CDA. See discussion in resource definition for how these relate.

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

                                      The workflow/clinical status of this composition. The status is a marker for the clinical standing of the document.

                                      Shortpreliminary | final | amended | entered-in-error
                                      Comments

                                      If a composition is marked as withdrawn, the compositions/documents in the series, or data from the composition or document series, should never be displayed to a user without being clearly marked as untrustworthy. The flag "entered-in-error" is why this element is labeled as a modifier of other elements.

                                      Some reporting work flows require that the original narrative of a final document never be altered; instead, only new narrative can be added. The composition resource has no explicit status for explicitly noting whether this business rule is in effect. This would be handled by an extension if required.

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

                                      The workflow/clinical status of the composition.

                                      Typecode
                                      Is Modifiertrue because This element is labelled 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
                                      Requirements

                                      Need to be able to mark interim, amended, or withdrawn compositions or documents.

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

                                      Specifies the particular kind of composition (e.g. History and Physical, Discharge Summary, Progress Note). This usually equates to the purpose of making the composition.

                                      Shorttype
                                      Comments

                                      For Composition type, LOINC is ubiquitous and strongly endorsed by HL7. Most implementation guides will require a specific LOINC code, or use LOINC as an extensible binding.

                                      Control1..1
                                      BindingThe codes SHALL be taken from SurgicalOperationNoteDocumentTypeCode
                                      (required to http://hl7.org/fhir/us/ccda/ValueSet/2.16.840.1.113883.11.20.1.1)
                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Key metadata element describing the composition, used in searching/filtering.

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

                                      A categorization for the type of the composition - helps for indexing and searching. This may be implied by or derived from the code specified in the Composition Type.

                                      ShortCategorization of Composition
                                      Comments

                                      This is a metadata field from XDS/MHD.

                                      Control0..*
                                      BindingFor example codes, see DocumentClassValueSet
                                      (example to http://hl7.org/fhir/ValueSet/document-classcodes)

                                      High-level kind of a clinical document at a macro level.

                                      TypeCodeableConcept
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Helps humans to assess whether the composition is of interest when viewing an index of compositions or documents.

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

                                      Who or what the composition is about. The composition can be about a person, (patient or healthcare practitioner), a device (e.g. a machine) or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure).

                                      ShortWho and/or what the composition is about
                                      Comments

                                      For clinical documents, this is usually the patient.

                                      Control0..1
                                      TypeReference(US Core Patient Profile, Group)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                      Summarytrue
                                      Requirements

                                      Essential metadata for searching for the composition. Identifies who and/or what the composition/document is about.

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

                                      Describes the clinical encounter or type of care this documentation is associated with.

                                      ShortContext of the Composition
                                      Control0..1
                                      TypeReference(US Core Encounter Profile)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      Provides context for the composition and supports searching.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      48. Composition.date
                                      Definition

                                      The composition editing time, when the composition was last logically changed by the author.

                                      Shortdate
                                      Comments

                                      The Last Modified Date on the composition may be after the date of the document was attested without being changed.

                                      Control1..1
                                      TypedateTime
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      Requirements

                                      dateTime is used for tracking, organizing versions and searching. Note that this is the time of authoring. When packaged in a document, Bundle.timestamp is the date of packaging.

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

                                      Identifies who is responsible for the information in the composition, not necessarily who typed it in.

                                      ShortWho and/or what authored the composition
                                      Control1..*
                                      TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile, PractitionerRole, US Core Patient Profile, Device, RelatedPerson)
                                      Is Modifierfalse
                                      Must Supporttrue
                                      Must Support TypesNo must-support rules about the choice of types/profiles
                                      Summarytrue
                                      Requirements

                                      Identifies who is responsible for the content.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      52. Composition.title
                                      Definition

                                      Official human-readable label for the composition.

                                      ShortDocument Title
                                      Comments

                                      For many compositions, the title is the same as the text or a display name of Composition.type (e.g. a "consultation" or "progress note"). Note that CDA does not make title mandatory, but there are no known cases where it is useful for title to be omitted, so it is mandatory here. Feedback on this requirement is welcome during the trial use period.

                                      Control1..1
                                      Typestring
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supporttrue
                                      Summarytrue
                                      LabelDocument Title
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      54. Composition.confidentiality
                                      Definition

                                      Use the confidentiality codes in Meta.security (https://hl7.org/fhir/security-labels.html)

                                      ShortUse the confidentiality codes in Meta.security
                                      Comments

                                      The exact use of this element, and enforcement and issues related to highly sensitive documents are out of scope for the base specification, and delegated to implementation profiles (see security section). This element is labeled as a modifier because highly confidential documents must not be treated as if they are not.

                                      Control0..0
                                      BindingThe codes SHALL be taken from v3.ConfidentialityClassification (2014-03-26)
                                      (required to http://terminology.hl7.org/ValueSet/v3-ConfidentialityClassification|2014-03-26)

                                      Codes specifying the level of confidentiality of the composition.

                                      Typecode
                                      Is Modifierfalse
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Must Supportfalse
                                      Summarytrue
                                      LabelUse the confidentiality codes in Meta.security
                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      56. Composition.attester
                                      Definition

                                      A participant who has attested to the accuracy of the composition/document.

                                      ShortAttests to accuracy of composition
                                      Comments

                                      Only list each attester once.

                                      Control0..*
                                      TypeBackboneElement
                                      Is Modifierfalse
                                      Must Supportfalse
                                      Summaryfalse
                                      Requirements

                                      Identifies responsibility for the accuracy of the composition content.

                                      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 Composition.attester. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                      • value @ mode
                                      • 58. Composition.attester.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
                                        60. Composition.attester.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())
                                        62. Composition.attester.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                        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 element that contains them
                                        Summarytrue
                                        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, modifiers
                                        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())
                                        64. Composition.attester.mode
                                        Definition

                                        The type of attestation the authenticator offers.

                                        Shortpersonal | professional | legal | official
                                        Control1..1
                                        BindingThe codes SHALL be taken from CompositionAttestationMode
                                        (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                        The way in which a person authenticated a composition.

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Requirements

                                        Indicates the level of authority of the attestation.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        66. Composition.attester.time
                                        Definition

                                        When the composition was attested by the party.

                                        ShortWhen the composition was attested
                                        Control0..1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Requirements

                                        Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        68. Composition.attester.party
                                        Definition

                                        Who attested the composition in the specified way.

                                        ShortWho attested the composition
                                        Control0..1
                                        TypeReference(Patient, RelatedPerson, Practitioner, PractitionerRole, Organization)
                                        Is Modifierfalse
                                        Summaryfalse
                                        Requirements

                                        Identifies who has taken on the responsibility for accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        70. Composition.attester:legal_attester
                                        Slice Namelegal_attester
                                        Definition

                                        A participant who has attested to the accuracy of the composition/document.

                                        Shortattester
                                        Comments

                                        Only list each attester once.

                                        Control0..1
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Identifies responsibility for the accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        72. Composition.attester:legal_attester.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
                                        74. Composition.attester:legal_attester.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())
                                        76. Composition.attester:legal_attester.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                        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 element that contains them
                                        Summarytrue
                                        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, modifiers
                                        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())
                                        78. Composition.attester:legal_attester.mode
                                        Definition

                                        The type of attestation the authenticator offers.

                                        Shortmode
                                        Control1..1
                                        BindingThe codes SHALL be taken from CompositionAttestationMode
                                        (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                        The way in which a person authenticated a composition.

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Indicates the level of authority of the attestation.

                                        Fixed Valuelegal
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        80. Composition.attester:legal_attester.time
                                        Definition

                                        When the composition was attested by the party.

                                        ShortWhen the composition was attested
                                        Control0..1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Requirements

                                        Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        82. Composition.attester:legal_attester.party
                                        Definition

                                        Who attested the composition in the specified way.

                                        Shortparty
                                        Control1..1
                                        TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summaryfalse
                                        Requirements

                                        Identifies who has taken on the responsibility for accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        84. Composition.attester:professional_attester
                                        Slice Nameprofessional_attester
                                        Definition

                                        A participant who has attested to the accuracy of the composition/document.

                                        Shortattester
                                        Comments

                                        Only list each attester once.

                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Identifies responsibility for the accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        86. Composition.attester:professional_attester.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. Composition.attester:professional_attester.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())
                                        90. Composition.attester:professional_attester.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                        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 element that contains them
                                        Summarytrue
                                        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, modifiers
                                        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())
                                        92. Composition.attester:professional_attester.mode
                                        Definition

                                        The type of attestation the authenticator offers.

                                        Shortmode
                                        Control1..1
                                        BindingThe codes SHALL be taken from CompositionAttestationMode
                                        (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                        The way in which a person authenticated a composition.

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Indicates the level of authority of the attestation.

                                        Fixed Valueprofessional
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        94. Composition.attester:professional_attester.time
                                        Definition

                                        When the composition was attested by the party.

                                        ShortWhen the composition was attested
                                        Control0..1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Requirements

                                        Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        96. Composition.attester:professional_attester.party
                                        Definition

                                        Who attested the composition in the specified way.

                                        Shortparty
                                        Control1..1
                                        TypeReference(US Core Practitioner Profile, US Core PractitionerRole Profile)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summaryfalse
                                        Requirements

                                        Identifies who has taken on the responsibility for accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        98. Composition.attester:personal_attester
                                        Slice Namepersonal_attester
                                        Definition

                                        A participant who has attested to the accuracy of the composition/document.

                                        Shortattester
                                        Comments

                                        Only list each attester once.

                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Identifies responsibility for the accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        100. Composition.attester:personal_attester.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
                                        102. Composition.attester:personal_attester.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())
                                        104. Composition.attester:personal_attester.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                        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 element that contains them
                                        Summarytrue
                                        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, modifiers
                                        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())
                                        106. Composition.attester:personal_attester.mode
                                        Definition

                                        The type of attestation the authenticator offers.

                                        Shortmode
                                        Control1..1
                                        BindingThe codes SHALL be taken from CompositionAttestationMode
                                        (required to http://hl7.org/fhir/ValueSet/composition-attestation-mode|4.0.1)

                                        The way in which a person authenticated a composition.

                                        Typecode
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Must Supporttrue
                                        Summaryfalse
                                        Requirements

                                        Indicates the level of authority of the attestation.

                                        Fixed Valuepersonal
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        108. Composition.attester:personal_attester.time
                                        Definition

                                        When the composition was attested by the party.

                                        ShortWhen the composition was attested
                                        Control0..1
                                        TypedateTime
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summaryfalse
                                        Requirements

                                        Identifies when the information in the composition was deemed accurate. (Things may have changed since then.).

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        110. Composition.attester:personal_attester.party
                                        Definition

                                        Who attested the composition in the specified way.

                                        Shortparty
                                        Control1..1
                                        TypeReference(US Core Patient Profile, RelatedPerson)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Must Support TypesNo must-support rules about the choice of types/profiles
                                        Summaryfalse
                                        Requirements

                                        Identifies who has taken on the responsibility for accuracy of the composition content.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        112. Composition.custodian
                                        Definition

                                        Identifies the organization or group who is responsible for ongoing maintenance of and access to the composition/document information.

                                        Shortcustodian
                                        Comments

                                        This is useful when documents are derived from a composition - provides guidance for how to get the latest version of the document. This is optional because this is sometimes not known by the authoring system, and can be inferred by context. However, it is important that this information be known when working with a derived document, so providing a custodian is encouraged.

                                        Control1..1
                                        TypeReference(US Core Organization Profile)
                                        Is Modifierfalse
                                        Must Supporttrue
                                        Summarytrue
                                        Requirements

                                        Identifies where to go to find the current version, where to report issues, etc.

                                        Labelcustodian
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        114. Composition.relatesTo
                                        Definition

                                        Relationships that this composition has with other compositions or documents that already exist.

                                        ShortRelationships to other compositions/documents
                                        Comments

                                        A document is a version specific composition.

                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        116. Composition.relatesTo.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
                                        118. Composition.relatesTo.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())
                                        120. Composition.relatesTo.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                        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 element that contains them
                                        Summarytrue
                                        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, modifiers
                                        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())
                                        122. Composition.relatesTo.code
                                        Definition

                                        The type of relationship that this composition has with anther composition or document.

                                        Shortreplaces | transforms | signs | appends
                                        Comments

                                        If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

                                        Control1..1
                                        BindingThe codes SHALL be taken from DocumentRelationshipType
                                        (required to http://hl7.org/fhir/ValueSet/document-relationship-type|4.0.1)

                                        The type of relationship between documents.

                                        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()))
                                        124. Composition.relatesTo.target[x]
                                        Definition

                                        The target composition/document of this relationship.

                                        ShortTarget of the relationship
                                        Control1..1
                                        TypeChoice of: Identifier, Reference(Composition)
                                        [x] NoteSee Choice of Data Types for further information about how to use [x]
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        126. Composition.event
                                        Definition

                                        The clinical service, such as a colonoscopy or an appendectomy, being documented.

                                        ShortThe clinical service(s) being documented
                                        Comments

                                        The event needs to be consistent with the type element, though can provide further information if desired.

                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Provides context for the composition and creates a linkage between a resource describing an event and the composition created describing the event.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        128. Composition.event.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
                                        130. Composition.event.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())
                                        132. Composition.event.modifierExtension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                        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 element that contains them
                                        Summarytrue
                                        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, modifiers
                                        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())
                                        134. Composition.event.code
                                        Definition

                                        This list of codes represents the main clinical acts, such as a colonoscopy or an appendectomy, being documented. In some cases, the event is inherent in the typeCode, such as a "History and Physical Report" in which the procedure being documented is necessarily a "History and Physical" act.

                                        ShortCode(s) that apply to the event being documented
                                        Comments

                                        An event can further specialize the act inherent in the typeCode, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more eventCodes are included, they SHALL NOT conflict with the values inherent in the classCode, practiceSettingCode or typeCode, as such a conflict would create an ambiguous situation. This short list of codes is provided to be used as key words for certain types of queries.

                                        Control0..*
                                        BindingFor example codes, see v3 Code System ActCode
                                        (example to http://terminology.hl7.org/ValueSet/v3-ActCode)

                                        This list of codes represents the main clinical acts being documented.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        136. Composition.event.period
                                        Definition

                                        The period of time covered by the documentation. There is no assertion that the documentation is a complete representation for this period, only that it documents events during this time.

                                        ShortThe period covered by the documentation
                                        Control0..1
                                        TypePeriod
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        138. Composition.event.detail
                                        Definition

                                        The description and/or reference of the event(s) being documented. For example, this could be used to document such a colonoscopy or an appendectomy.

                                        ShortThe event(s) being documented
                                        Control0..*
                                        TypeReference(Resource)
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        140. Composition.section
                                        Definition

                                        The root of the sections that make up the composition.

                                        ShortComposition is broken into sections
                                        Control0..*
                                        TypeBackboneElement
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        SlicingThis element introduces a set of slices on Composition.section. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                        • value @ code
                                        • 142. Composition.section.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
                                          144. Composition.section.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())
                                          146. Composition.section.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                          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 element that contains them
                                          Summarytrue
                                          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, modifiers
                                          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())
                                          148. Composition.section.title
                                          Definition

                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                          ShortLabel for section (e.g. for ToC)
                                          Comments

                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

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

                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                          Alternate Namesheader, label, caption
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          150. Composition.section.code
                                          Definition

                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                          ShortClassification of section (recommended)
                                          Comments

                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                          Control0..1
                                          BindingFor example codes, see DocumentSectionCodes
                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                          Classification of a section of a composition/document.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Provides computable standardized labels to topics within the document.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          152. Composition.section.author
                                          Definition

                                          Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                          ShortWho and/or what authored the section
                                          Control0..*
                                          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Identifies who is responsible for the content.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          154. Composition.section.focus
                                          Definition

                                          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                          ShortWho/what the section is about, when it is not about the subject of composition
                                          Comments

                                          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                          Control0..1
                                          TypeReference(Resource)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          156. Composition.section.text
                                          Definition

                                          A human-readable narrative that contains the attested content of the section, 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.

                                          ShortText summary of the section, for human interpretation
                                          Comments

                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                          Control0..1
                                          This element is affected by the following invariants: cmp-1
                                          TypeNarrative
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          158. Composition.section.mode
                                          Definition

                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                          Shortworking | snapshot | changes
                                          Comments

                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                          Control0..1
                                          BindingThe codes SHALL be taken from ListMode
                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                          The processing mode that applies to this section.

                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Requirements

                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          160. Composition.section.orderedBy
                                          Definition

                                          Specifies the order applied to the items in the section entries.

                                          ShortOrder of section entries
                                          Comments

                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                          Control0..1
                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                          What order applies to the items in the entry.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          162. Composition.section.entry
                                          Definition

                                          A reference to the actual resource from which the narrative in the section is derived.

                                          ShortA reference to data that supports this section
                                          Comments

                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                          Control0..*
                                          This element is affected by the following invariants: cmp-2
                                          TypeReference(Resource)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          164. Composition.section.emptyReason
                                          Definition

                                          If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                          ShortWhy the section is empty
                                          Comments

                                          The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                          Control0..1
                                          This element is affected by the following invariants: cmp-2
                                          BindingThe codes SHOULD be taken from ListEmptyReasons
                                          (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                          If a section is empty, why it is empty.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          166. Composition.section.section
                                          Definition

                                          A nested sub-section within this section.

                                          ShortNested Section
                                          Comments

                                          Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                          Control0..*
                                          This element is affected by the following invariants: cmp-1
                                          TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          168. Composition.section:anesthesia_section
                                          Slice Nameanesthesia_section
                                          Definition

                                          The root of the sections that make up the composition.

                                          ShortAnesthesia Section
                                          Control1..1
                                          TypeBackboneElement
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          LabelAnesthesia Section
                                          Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                          cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          170. Composition.section:anesthesia_section.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
                                          172. Composition.section:anesthesia_section.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())
                                          174. Composition.section:anesthesia_section.modifierExtension
                                          Definition

                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                          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 element that contains them
                                          Summarytrue
                                          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, modifiers
                                          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())
                                          176. Composition.section:anesthesia_section.title
                                          Definition

                                          The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                          Shorttitle
                                          Comments

                                          The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                          Control1..1
                                          Typestring
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                          Alternate Namesheader, label, caption
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          178. Composition.section:anesthesia_section.code
                                          Definition

                                          A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                          ShortAnesthesia
                                          Comments

                                          The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                          If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                          Control1..1
                                          BindingFor example codes, see DocumentSectionCodes
                                          (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                          Classification of a section of a composition/document.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Requirements

                                          Provides computable standardized labels to topics within the document.

                                          LabelAnesthesia
                                          Pattern Value{
                                            "coding" : [{
                                              "system" : "http://loinc.org",
                                              "code" : "59774-0"
                                            }]
                                          }
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          180. Composition.section:anesthesia_section.author
                                          Definition

                                          Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                          ShortWho and/or what authored the section
                                          Control0..*
                                          TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Identifies who is responsible for the content.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          182. Composition.section:anesthesia_section.focus
                                          Definition

                                          The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                          ShortWho/what the section is about, when it is not about the subject of composition
                                          Comments

                                          Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                          Control0..1
                                          TypeReference(Resource)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          184. Composition.section:anesthesia_section.text
                                          Definition

                                          A human-readable narrative that contains the attested content of the section, 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.

                                          Shorttext
                                          Comments

                                          Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                          Control1..1
                                          This element is affected by the following invariants: cmp-1
                                          TypeNarrative
                                          Is Modifierfalse
                                          Must Supporttrue
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          186. Composition.section:anesthesia_section.mode
                                          Definition

                                          How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                          Shortworking | snapshot | changes
                                          Comments

                                          This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                          Control0..1
                                          BindingThe codes SHALL be taken from ListMode
                                          (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                          The processing mode that applies to this section.

                                          Typecode
                                          Is Modifierfalse
                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                          Summaryfalse
                                          Requirements

                                          Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          188. Composition.section:anesthesia_section.orderedBy
                                          Definition

                                          Specifies the order applied to the items in the section entries.

                                          ShortOrder of section entries
                                          Comments

                                          Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                          Control0..1
                                          BindingThe codes SHOULD be taken from ListOrderCodes
                                          (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                          What order applies to the items in the entry.

                                          TypeCodeableConcept
                                          Is Modifierfalse
                                          Summaryfalse
                                          Requirements

                                          Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          190. Composition.section:anesthesia_section.entry
                                          Definition

                                          A reference to the actual resource from which the narrative in the section is derived.

                                          Shortentry
                                          Comments

                                          If there are no entries in the list, an emptyReason SHOULD be provided.

                                          Control0..*
                                          This element is affected by the following invariants: cmp-2
                                          TypeReference(Resource)
                                          Is Modifierfalse
                                          Summaryfalse
                                          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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                          • profile @ resolve()
                                          • 192. Composition.section:anesthesia_section.entry:anesthesia_entry
                                            Slice Nameanesthesia_entry
                                            Definition

                                            A reference to the actual resource from which the narrative in the section is derived.

                                            ShortA reference to data that supports this section
                                            Comments

                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                            Control0..*
                                            This element is affected by the following invariants: cmp-2
                                            TypeReference(MedicationStatement, US Core Medication Profile, US Core MedicationRequest Profile, US Core Procedure Profile)
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Must Support TypesNo must-support rules about the choice of types/profiles
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            194. Composition.section:anesthesia_section.emptyReason
                                            Definition

                                            If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                            ShortWhy the section is empty
                                            Comments

                                            The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                            Control0..1
                                            This element is affected by the following invariants: cmp-2
                                            BindingThe codes SHOULD be taken from ListEmptyReasons
                                            (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                            If a section is empty, why it is empty.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            196. Composition.section:anesthesia_section.section
                                            Definition

                                            A nested sub-section within this section.

                                            ShortNested Section
                                            Comments

                                            Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                            Control0..*
                                            This element is affected by the following invariants: cmp-1
                                            TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            198. Composition.section:complications_section
                                            Slice Namecomplications_section
                                            Definition

                                            The root of the sections that make up the composition.

                                            ShortComplications Section
                                            Control1..1
                                            TypeBackboneElement
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            LabelComplications Section
                                            Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                            cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            200. Composition.section:complications_section.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
                                            202. Composition.section:complications_section.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())
                                            204. Composition.section:complications_section.modifierExtension
                                            Definition

                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                            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 element that contains them
                                            Summarytrue
                                            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, modifiers
                                            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())
                                            206. Composition.section:complications_section.title
                                            Definition

                                            The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                            Shorttitle
                                            Comments

                                            The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                            Control1..1
                                            Typestring
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                            Alternate Namesheader, label, caption
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            208. Composition.section:complications_section.code
                                            Definition

                                            A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                            ShortComplications
                                            Comments

                                            The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                            If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                            Control1..1
                                            BindingFor example codes, see DocumentSectionCodes
                                            (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                            Classification of a section of a composition/document.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Requirements

                                            Provides computable standardized labels to topics within the document.

                                            LabelComplications
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "http://loinc.org",
                                                "code" : "55109-3"
                                              }]
                                            }
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            210. Composition.section:complications_section.author
                                            Definition

                                            Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                            ShortWho and/or what authored the section
                                            Control0..*
                                            TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Identifies who is responsible for the content.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            212. Composition.section:complications_section.focus
                                            Definition

                                            The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                            ShortWho/what the section is about, when it is not about the subject of composition
                                            Comments

                                            Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                            Control0..1
                                            TypeReference(Resource)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            214. Composition.section:complications_section.text
                                            Definition

                                            A human-readable narrative that contains the attested content of the section, 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.

                                            Shorttext
                                            Comments

                                            Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                            Control1..1
                                            This element is affected by the following invariants: cmp-1
                                            TypeNarrative
                                            Is Modifierfalse
                                            Must Supporttrue
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            216. Composition.section:complications_section.mode
                                            Definition

                                            How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                            Shortworking | snapshot | changes
                                            Comments

                                            This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                            Control0..1
                                            BindingThe codes SHALL be taken from ListMode
                                            (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                            The processing mode that applies to this section.

                                            Typecode
                                            Is Modifierfalse
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Summaryfalse
                                            Requirements

                                            Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            218. Composition.section:complications_section.orderedBy
                                            Definition

                                            Specifies the order applied to the items in the section entries.

                                            ShortOrder of section entries
                                            Comments

                                            Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                            Control0..1
                                            BindingThe codes SHOULD be taken from ListOrderCodes
                                            (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                            What order applies to the items in the entry.

                                            TypeCodeableConcept
                                            Is Modifierfalse
                                            Summaryfalse
                                            Requirements

                                            Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            220. Composition.section:complications_section.entry
                                            Definition

                                            A reference to the actual resource from which the narrative in the section is derived.

                                            Shortentry
                                            Comments

                                            If there are no entries in the list, an emptyReason SHOULD be provided.

                                            Control0..*
                                            This element is affected by the following invariants: cmp-2
                                            TypeReference(Resource)
                                            Is Modifierfalse
                                            Summaryfalse
                                            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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                            • profile @ resolve()
                                            • 222. Composition.section:complications_section.entry:complications_entry
                                              Slice Namecomplications_entry
                                              Definition

                                              A reference to the actual resource from which the narrative in the section is derived.

                                              ShortA reference to data that supports this section
                                              Comments

                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(US Core Condition Profile)
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              224. Composition.section:complications_section.emptyReason
                                              Definition

                                              If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                              ShortWhy the section is empty
                                              Comments

                                              The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                              Control0..1
                                              This element is affected by the following invariants: cmp-2
                                              BindingThe codes SHOULD be taken from ListEmptyReasons
                                              (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                              If a section is empty, why it is empty.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              226. Composition.section:complications_section.section
                                              Definition

                                              A nested sub-section within this section.

                                              ShortNested Section
                                              Comments

                                              Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-1
                                              TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              228. Composition.section:preoperative_diagnosis_section
                                              Slice Namepreoperative_diagnosis_section
                                              Definition

                                              The root of the sections that make up the composition.

                                              ShortPreoperative Diagnosis Section
                                              Control1..1
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              LabelPreoperative Diagnosis Section
                                              Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                              cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              230. Composition.section:preoperative_diagnosis_section.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
                                              232. Composition.section:preoperative_diagnosis_section.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())
                                              234. Composition.section:preoperative_diagnosis_section.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                              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 element that contains them
                                              Summarytrue
                                              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, modifiers
                                              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())
                                              236. Composition.section:preoperative_diagnosis_section.title
                                              Definition

                                              The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                              Shorttitle
                                              Comments

                                              The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                              Control1..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                              Alternate Namesheader, label, caption
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              238. Composition.section:preoperative_diagnosis_section.code
                                              Definition

                                              A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                              ShortPreoperative Diagnosis
                                              Comments

                                              The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                              If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                              Control1..1
                                              BindingFor example codes, see DocumentSectionCodes
                                              (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                              Classification of a section of a composition/document.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Requirements

                                              Provides computable standardized labels to topics within the document.

                                              LabelPreoperative Diagnosis
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "http://loinc.org",
                                                  "code" : "10219-4"
                                                }]
                                              }
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              240. Composition.section:preoperative_diagnosis_section.author
                                              Definition

                                              Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                              ShortWho and/or what authored the section
                                              Control0..*
                                              TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Identifies who is responsible for the content.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              242. Composition.section:preoperative_diagnosis_section.focus
                                              Definition

                                              The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                              ShortWho/what the section is about, when it is not about the subject of composition
                                              Comments

                                              Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                              Control0..1
                                              TypeReference(Resource)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              244. Composition.section:preoperative_diagnosis_section.text
                                              Definition

                                              A human-readable narrative that contains the attested content of the section, 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.

                                              Shorttext
                                              Comments

                                              Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                              Control1..1
                                              This element is affected by the following invariants: cmp-1
                                              TypeNarrative
                                              Is Modifierfalse
                                              Must Supporttrue
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              246. Composition.section:preoperative_diagnosis_section.mode
                                              Definition

                                              How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                              Shortworking | snapshot | changes
                                              Comments

                                              This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                              Control0..1
                                              BindingThe codes SHALL be taken from ListMode
                                              (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                              The processing mode that applies to this section.

                                              Typecode
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summaryfalse
                                              Requirements

                                              Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              248. Composition.section:preoperative_diagnosis_section.orderedBy
                                              Definition

                                              Specifies the order applied to the items in the section entries.

                                              ShortOrder of section entries
                                              Comments

                                              Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                              Control0..1
                                              BindingThe codes SHOULD be taken from ListOrderCodes
                                              (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                              What order applies to the items in the entry.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Requirements

                                              Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              250. Composition.section:preoperative_diagnosis_section.entry
                                              Definition

                                              A reference to the actual resource from which the narrative in the section is derived.

                                              Shortentry
                                              Comments

                                              If there are no entries in the list, an emptyReason SHOULD be provided.

                                              Control0..*
                                              This element is affected by the following invariants: cmp-2
                                              TypeReference(Resource)
                                              Is Modifierfalse
                                              Summaryfalse
                                              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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                              • profile @ resolve()
                                              • 252. Composition.section:preoperative_diagnosis_section.entry:preoperative_diagnosis_entry
                                                Slice Namepreoperative_diagnosis_entry
                                                Definition

                                                A reference to the actual resource from which the narrative in the section is derived.

                                                ShortA reference to data that supports this section
                                                Comments

                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-2
                                                TypeReference(US Core Condition Profile)
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                254. Composition.section:preoperative_diagnosis_section.emptyReason
                                                Definition

                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                ShortWhy the section is empty
                                                Comments

                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                Control0..1
                                                This element is affected by the following invariants: cmp-2
                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                If a section is empty, why it is empty.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                256. Composition.section:preoperative_diagnosis_section.section
                                                Definition

                                                A nested sub-section within this section.

                                                ShortNested Section
                                                Comments

                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-1
                                                TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                258. Composition.section:procedure_estimated_blood_loss_section
                                                Slice Nameprocedure_estimated_blood_loss_section
                                                Definition

                                                The root of the sections that make up the composition.

                                                ShortProcedure Estimated Blood Loss Section
                                                Control1..1
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                LabelProcedure Estimated Blood Loss Section
                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                260. Composition.section:procedure_estimated_blood_loss_section.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
                                                262. Composition.section:procedure_estimated_blood_loss_section.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())
                                                264. Composition.section:procedure_estimated_blood_loss_section.modifierExtension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                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 element that contains them
                                                Summarytrue
                                                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, modifiers
                                                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())
                                                266. Composition.section:procedure_estimated_blood_loss_section.title
                                                Definition

                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                Shorttitle
                                                Comments

                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                Control1..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                Alternate Namesheader, label, caption
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                268. Composition.section:procedure_estimated_blood_loss_section.code
                                                Definition

                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                ShortProcedure Estimated Blood Loss
                                                Comments

                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                Control1..1
                                                BindingFor example codes, see DocumentSectionCodes
                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                Classification of a section of a composition/document.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Provides computable standardized labels to topics within the document.

                                                LabelProcedure Estimated Blood Loss
                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://loinc.org",
                                                    "code" : "59770-8"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                270. Composition.section:procedure_estimated_blood_loss_section.author
                                                Definition

                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                ShortWho and/or what authored the section
                                                Control0..*
                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Identifies who is responsible for the content.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                272. Composition.section:procedure_estimated_blood_loss_section.focus
                                                Definition

                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                Comments

                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                Control0..1
                                                TypeReference(Resource)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                274. Composition.section:procedure_estimated_blood_loss_section.text
                                                Definition

                                                A human-readable narrative that contains the attested content of the section, 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.

                                                ShortThis section contains only human readable content
                                                Comments

                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                Control1..1
                                                This element is affected by the following invariants: cmp-1
                                                TypeNarrative
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                276. Composition.section:procedure_estimated_blood_loss_section.mode
                                                Definition

                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                Shortworking | snapshot | changes
                                                Comments

                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                Control0..1
                                                BindingThe codes SHALL be taken from ListMode
                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                The processing mode that applies to this section.

                                                Typecode
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summaryfalse
                                                Requirements

                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                278. Composition.section:procedure_estimated_blood_loss_section.orderedBy
                                                Definition

                                                Specifies the order applied to the items in the section entries.

                                                ShortOrder of section entries
                                                Comments

                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                Control0..1
                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                What order applies to the items in the entry.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                280. Composition.section:procedure_estimated_blood_loss_section.entry
                                                Definition

                                                A reference to the actual resource from which the narrative in the section is derived.

                                                ShortA reference to data that supports this section
                                                Comments

                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-2
                                                TypeReference(Resource)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                282. Composition.section:procedure_estimated_blood_loss_section.emptyReason
                                                Definition

                                                If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                ShortWhy the section is empty
                                                Comments

                                                The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                Control0..1
                                                This element is affected by the following invariants: cmp-2
                                                BindingThe codes SHOULD be taken from ListEmptyReasons
                                                (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                If a section is empty, why it is empty.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                284. Composition.section:procedure_estimated_blood_loss_section.section
                                                Definition

                                                A nested sub-section within this section.

                                                ShortNested Section
                                                Comments

                                                Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-1
                                                TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                286. Composition.section:procedure_findings_section
                                                Slice Nameprocedure_findings_section
                                                Definition

                                                The root of the sections that make up the composition.

                                                ShortProcedure Findings Section
                                                Control1..1
                                                TypeBackboneElement
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                LabelProcedure Findings Section
                                                Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                288. Composition.section:procedure_findings_section.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
                                                290. Composition.section:procedure_findings_section.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())
                                                292. Composition.section:procedure_findings_section.modifierExtension
                                                Definition

                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                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 element that contains them
                                                Summarytrue
                                                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, modifiers
                                                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())
                                                294. Composition.section:procedure_findings_section.title
                                                Definition

                                                The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                Shorttitle
                                                Comments

                                                The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                Control1..1
                                                Typestring
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                Alternate Namesheader, label, caption
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                296. Composition.section:procedure_findings_section.code
                                                Definition

                                                A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                ShortProcedure Findings
                                                Comments

                                                The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                Control1..1
                                                BindingFor example codes, see DocumentSectionCodes
                                                (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                Classification of a section of a composition/document.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Requirements

                                                Provides computable standardized labels to topics within the document.

                                                LabelProcedure Findings
                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "http://loinc.org",
                                                    "code" : "59776-5"
                                                  }]
                                                }
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                298. Composition.section:procedure_findings_section.author
                                                Definition

                                                Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                ShortWho and/or what authored the section
                                                Control0..*
                                                TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Identifies who is responsible for the content.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                300. Composition.section:procedure_findings_section.focus
                                                Definition

                                                The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                ShortWho/what the section is about, when it is not about the subject of composition
                                                Comments

                                                Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                Control0..1
                                                TypeReference(Resource)
                                                Is Modifierfalse
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                302. Composition.section:procedure_findings_section.text
                                                Definition

                                                A human-readable narrative that contains the attested content of the section, 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.

                                                Shorttext
                                                Comments

                                                Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                Control1..1
                                                This element is affected by the following invariants: cmp-1
                                                TypeNarrative
                                                Is Modifierfalse
                                                Must Supporttrue
                                                Summaryfalse
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                304. Composition.section:procedure_findings_section.mode
                                                Definition

                                                How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                Shortworking | snapshot | changes
                                                Comments

                                                This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                Control0..1
                                                BindingThe codes SHALL be taken from ListMode
                                                (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                The processing mode that applies to this section.

                                                Typecode
                                                Is Modifierfalse
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                Summaryfalse
                                                Requirements

                                                Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                306. Composition.section:procedure_findings_section.orderedBy
                                                Definition

                                                Specifies the order applied to the items in the section entries.

                                                ShortOrder of section entries
                                                Comments

                                                Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                Control0..1
                                                BindingThe codes SHOULD be taken from ListOrderCodes
                                                (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                What order applies to the items in the entry.

                                                TypeCodeableConcept
                                                Is Modifierfalse
                                                Summaryfalse
                                                Requirements

                                                Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                308. Composition.section:procedure_findings_section.entry
                                                Definition

                                                A reference to the actual resource from which the narrative in the section is derived.

                                                Shortentry
                                                Comments

                                                If there are no entries in the list, an emptyReason SHOULD be provided.

                                                Control0..*
                                                This element is affected by the following invariants: cmp-2
                                                TypeReference(Resource)
                                                Is Modifierfalse
                                                Summaryfalse
                                                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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                • profile @ resolve()
                                                • 310. Composition.section:procedure_findings_section.entry:procedure_findings_entry
                                                  Slice Nameprocedure_findings_entry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  ShortA reference to data that supports this section
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(US Core Condition Profile)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  312. Composition.section:procedure_findings_section.emptyReason
                                                  Definition

                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                  ShortWhy the section is empty
                                                  Comments

                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                  Control0..1
                                                  This element is affected by the following invariants: cmp-2
                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                  If a section is empty, why it is empty.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  314. Composition.section:procedure_findings_section.section
                                                  Definition

                                                  A nested sub-section within this section.

                                                  ShortNested Section
                                                  Comments

                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  316. Composition.section:procedure_specimens_taken_section
                                                  Slice Nameprocedure_specimens_taken_section
                                                  Definition

                                                  The root of the sections that make up the composition.

                                                  ShortProcedure Specimens Taken Section
                                                  Control1..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  LabelProcedure Specimens Taken Section
                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  318. Composition.section:procedure_specimens_taken_section.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
                                                  320. Composition.section:procedure_specimens_taken_section.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())
                                                  322. Composition.section:procedure_specimens_taken_section.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                  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 element that contains them
                                                  Summarytrue
                                                  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, modifiers
                                                  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())
                                                  324. Composition.section:procedure_specimens_taken_section.title
                                                  Definition

                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                  Shorttitle
                                                  Comments

                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                  Control1..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                  Alternate Namesheader, label, caption
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  326. Composition.section:procedure_specimens_taken_section.code
                                                  Definition

                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                  ShortProcedure Specimens Taken
                                                  Comments

                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                  Control1..1
                                                  BindingFor example codes, see DocumentSectionCodes
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  LabelProcedure Specimens Taken
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "59773-2"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  328. Composition.section:procedure_specimens_taken_section.author
                                                  Definition

                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                  ShortWho and/or what authored the section
                                                  Control0..*
                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Identifies who is responsible for the content.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  330. Composition.section:procedure_specimens_taken_section.focus
                                                  Definition

                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                  Comments

                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                  Control0..1
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  332. Composition.section:procedure_specimens_taken_section.text
                                                  Definition

                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                  ShortThis section contains only human readable content
                                                  Comments

                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                  Control1..1
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  334. Composition.section:procedure_specimens_taken_section.mode
                                                  Definition

                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                  Shortworking | snapshot | changes
                                                  Comments

                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from ListMode
                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                  The processing mode that applies to this section.

                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  336. Composition.section:procedure_specimens_taken_section.orderedBy
                                                  Definition

                                                  Specifies the order applied to the items in the section entries.

                                                  ShortOrder of section entries
                                                  Comments

                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                  Control0..1
                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                  What order applies to the items in the entry.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  338. Composition.section:procedure_specimens_taken_section.entry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  ShortA reference to data that supports this section
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  340. Composition.section:procedure_specimens_taken_section.emptyReason
                                                  Definition

                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                  ShortWhy the section is empty
                                                  Comments

                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                  Control0..1
                                                  This element is affected by the following invariants: cmp-2
                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                  If a section is empty, why it is empty.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  342. Composition.section:procedure_specimens_taken_section.section
                                                  Definition

                                                  A nested sub-section within this section.

                                                  ShortNested Section
                                                  Comments

                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  344. Composition.section:postoperative_diagnosis_section
                                                  Slice Namepostoperative_diagnosis_section
                                                  Definition

                                                  The root of the sections that make up the composition.

                                                  ShortPostoperative Diagnosis Section
                                                  Control1..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  LabelPostoperative Diagnosis Section
                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  346. Composition.section:postoperative_diagnosis_section.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
                                                  348. Composition.section:postoperative_diagnosis_section.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())
                                                  350. Composition.section:postoperative_diagnosis_section.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                  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 element that contains them
                                                  Summarytrue
                                                  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, modifiers
                                                  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())
                                                  352. Composition.section:postoperative_diagnosis_section.title
                                                  Definition

                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                  Shorttitle
                                                  Comments

                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                  Control1..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                  Alternate Namesheader, label, caption
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  354. Composition.section:postoperative_diagnosis_section.code
                                                  Definition

                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                  ShortPostoperative Diagnosis
                                                  Comments

                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                  Control1..1
                                                  BindingFor example codes, see DocumentSectionCodes
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  LabelPostoperative Diagnosis
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "10218-6"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  356. Composition.section:postoperative_diagnosis_section.author
                                                  Definition

                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                  ShortWho and/or what authored the section
                                                  Control0..*
                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Identifies who is responsible for the content.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  358. Composition.section:postoperative_diagnosis_section.focus
                                                  Definition

                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                  Comments

                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                  Control0..1
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  360. Composition.section:postoperative_diagnosis_section.text
                                                  Definition

                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                  ShortThis section contains only human readable content
                                                  Comments

                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                  Control1..1
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  362. Composition.section:postoperative_diagnosis_section.mode
                                                  Definition

                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                  Shortworking | snapshot | changes
                                                  Comments

                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from ListMode
                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                  The processing mode that applies to this section.

                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  364. Composition.section:postoperative_diagnosis_section.orderedBy
                                                  Definition

                                                  Specifies the order applied to the items in the section entries.

                                                  ShortOrder of section entries
                                                  Comments

                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                  Control0..1
                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                  What order applies to the items in the entry.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  366. Composition.section:postoperative_diagnosis_section.entry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  ShortA reference to data that supports this section
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  368. Composition.section:postoperative_diagnosis_section.emptyReason
                                                  Definition

                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                  ShortWhy the section is empty
                                                  Comments

                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                  Control0..1
                                                  This element is affected by the following invariants: cmp-2
                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                  If a section is empty, why it is empty.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  370. Composition.section:postoperative_diagnosis_section.section
                                                  Definition

                                                  A nested sub-section within this section.

                                                  ShortNested Section
                                                  Comments

                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  372. Composition.section:procedure_description_section
                                                  Slice Nameprocedure_description_section
                                                  Definition

                                                  The root of the sections that make up the composition.

                                                  ShortProcedure Description Section
                                                  Control1..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  LabelProcedure Description Section
                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  374. Composition.section:procedure_description_section.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
                                                  376. Composition.section:procedure_description_section.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())
                                                  378. Composition.section:procedure_description_section.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                  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 element that contains them
                                                  Summarytrue
                                                  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, modifiers
                                                  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())
                                                  380. Composition.section:procedure_description_section.title
                                                  Definition

                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                  Shorttitle
                                                  Comments

                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                  Control1..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                  Alternate Namesheader, label, caption
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  382. Composition.section:procedure_description_section.code
                                                  Definition

                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                  ShortProcedure Description
                                                  Comments

                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                  Control1..1
                                                  BindingFor example codes, see DocumentSectionCodes
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  LabelProcedure Description
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "29554-3"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  384. Composition.section:procedure_description_section.author
                                                  Definition

                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                  ShortWho and/or what authored the section
                                                  Control0..*
                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Identifies who is responsible for the content.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  386. Composition.section:procedure_description_section.focus
                                                  Definition

                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                  Comments

                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                  Control0..1
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  388. Composition.section:procedure_description_section.text
                                                  Definition

                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                  ShortThis section contains only human readable content
                                                  Comments

                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                  Control1..1
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  390. Composition.section:procedure_description_section.mode
                                                  Definition

                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                  Shortworking | snapshot | changes
                                                  Comments

                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from ListMode
                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                  The processing mode that applies to this section.

                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  392. Composition.section:procedure_description_section.orderedBy
                                                  Definition

                                                  Specifies the order applied to the items in the section entries.

                                                  ShortOrder of section entries
                                                  Comments

                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                  Control0..1
                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                  What order applies to the items in the entry.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  394. Composition.section:procedure_description_section.entry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  ShortA reference to data that supports this section
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  396. Composition.section:procedure_description_section.emptyReason
                                                  Definition

                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                  ShortWhy the section is empty
                                                  Comments

                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                  Control0..1
                                                  This element is affected by the following invariants: cmp-2
                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                  If a section is empty, why it is empty.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  398. Composition.section:procedure_description_section.section
                                                  Definition

                                                  A nested sub-section within this section.

                                                  ShortNested Section
                                                  Comments

                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  400. Composition.section:operative_note_surgical_procedure_section
                                                  Slice Nameoperative_note_surgical_procedure_section
                                                  Definition

                                                  The root of the sections that make up the composition.

                                                  ShortOperative Note Surgical Procedure Section
                                                  Control0..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  LabelOperative Note Surgical Procedure Section
                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  402. Composition.section:operative_note_surgical_procedure_section.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
                                                  404. Composition.section:operative_note_surgical_procedure_section.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())
                                                  406. Composition.section:operative_note_surgical_procedure_section.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                  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 element that contains them
                                                  Summarytrue
                                                  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, modifiers
                                                  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())
                                                  408. Composition.section:operative_note_surgical_procedure_section.title
                                                  Definition

                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                  Shorttitle
                                                  Comments

                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                  Control1..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                  Alternate Namesheader, label, caption
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  410. Composition.section:operative_note_surgical_procedure_section.code
                                                  Definition

                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                  ShortOperative Note Surgical Procedure
                                                  Comments

                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                  Control1..1
                                                  BindingFor example codes, see DocumentSectionCodes
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  LabelOperative Note Surgical Procedure
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "10223-6"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  412. Composition.section:operative_note_surgical_procedure_section.author
                                                  Definition

                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                  ShortWho and/or what authored the section
                                                  Control0..*
                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Identifies who is responsible for the content.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  414. Composition.section:operative_note_surgical_procedure_section.focus
                                                  Definition

                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                  Comments

                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                  Control0..1
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  416. Composition.section:operative_note_surgical_procedure_section.text
                                                  Definition

                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                  ShortThis section contains only human readable content
                                                  Comments

                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                  Control1..1
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  418. Composition.section:operative_note_surgical_procedure_section.mode
                                                  Definition

                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                  Shortworking | snapshot | changes
                                                  Comments

                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from ListMode
                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                  The processing mode that applies to this section.

                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  420. Composition.section:operative_note_surgical_procedure_section.orderedBy
                                                  Definition

                                                  Specifies the order applied to the items in the section entries.

                                                  ShortOrder of section entries
                                                  Comments

                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                  Control0..1
                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                  What order applies to the items in the entry.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  422. Composition.section:operative_note_surgical_procedure_section.entry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  ShortA reference to data that supports this section
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  424. Composition.section:operative_note_surgical_procedure_section.emptyReason
                                                  Definition

                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                  ShortWhy the section is empty
                                                  Comments

                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                  Control0..1
                                                  This element is affected by the following invariants: cmp-2
                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                  If a section is empty, why it is empty.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  426. Composition.section:operative_note_surgical_procedure_section.section
                                                  Definition

                                                  A nested sub-section within this section.

                                                  ShortNested Section
                                                  Comments

                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  428. Composition.section:operative_note_fluids_section
                                                  Slice Nameoperative_note_fluids_section
                                                  Definition

                                                  The root of the sections that make up the composition.

                                                  ShortOperative Note Fluids Section
                                                  Control0..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  LabelOperative Note Fluids Section
                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  430. Composition.section:operative_note_fluids_section.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
                                                  432. Composition.section:operative_note_fluids_section.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())
                                                  434. Composition.section:operative_note_fluids_section.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                  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 element that contains them
                                                  Summarytrue
                                                  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, modifiers
                                                  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())
                                                  436. Composition.section:operative_note_fluids_section.title
                                                  Definition

                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                  Shorttitle
                                                  Comments

                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                  Control1..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                  Alternate Namesheader, label, caption
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  438. Composition.section:operative_note_fluids_section.code
                                                  Definition

                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                  ShortOperative Note Fluids
                                                  Comments

                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                  Control1..1
                                                  BindingFor example codes, see DocumentSectionCodes
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  LabelOperative Note Fluids
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "10216-0"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  440. Composition.section:operative_note_fluids_section.author
                                                  Definition

                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                  ShortWho and/or what authored the section
                                                  Control0..*
                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Identifies who is responsible for the content.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  442. Composition.section:operative_note_fluids_section.focus
                                                  Definition

                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                  Comments

                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                  Control0..1
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  444. Composition.section:operative_note_fluids_section.text
                                                  Definition

                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                  ShortThis section contains only human readable content
                                                  Comments

                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                  Control1..1
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  446. Composition.section:operative_note_fluids_section.mode
                                                  Definition

                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                  Shortworking | snapshot | changes
                                                  Comments

                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from ListMode
                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                  The processing mode that applies to this section.

                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  448. Composition.section:operative_note_fluids_section.orderedBy
                                                  Definition

                                                  Specifies the order applied to the items in the section entries.

                                                  ShortOrder of section entries
                                                  Comments

                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                  Control0..1
                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                  What order applies to the items in the entry.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  450. Composition.section:operative_note_fluids_section.entry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  ShortA reference to data that supports this section
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  452. Composition.section:operative_note_fluids_section.emptyReason
                                                  Definition

                                                  If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                  ShortWhy the section is empty
                                                  Comments

                                                  The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                  Control0..1
                                                  This element is affected by the following invariants: cmp-2
                                                  BindingThe codes SHOULD be taken from ListEmptyReasons
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                  If a section is empty, why it is empty.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  454. Composition.section:operative_note_fluids_section.section
                                                  Definition

                                                  A nested sub-section within this section.

                                                  ShortNested Section
                                                  Comments

                                                  Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  456. Composition.section:plan_of_treatment_section
                                                  Slice Nameplan_of_treatment_section
                                                  Definition

                                                  The root of the sections that make up the composition.

                                                  ShortPlan of Treatment Section
                                                  Control0..1
                                                  TypeBackboneElement
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  LabelPlan of Treatment Section
                                                  Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                  cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                  ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  458. Composition.section:plan_of_treatment_section.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
                                                  460. Composition.section:plan_of_treatment_section.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())
                                                  462. Composition.section:plan_of_treatment_section.modifierExtension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                  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 element that contains them
                                                  Summarytrue
                                                  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, modifiers
                                                  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())
                                                  464. Composition.section:plan_of_treatment_section.title
                                                  Definition

                                                  The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                  Shorttitle
                                                  Comments

                                                  The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                  Control1..1
                                                  Typestring
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                  Alternate Namesheader, label, caption
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  466. Composition.section:plan_of_treatment_section.code
                                                  Definition

                                                  A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                  ShortPlan of Treatment
                                                  Comments

                                                  The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                  If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                  Control1..1
                                                  BindingFor example codes, see DocumentSectionCodes
                                                  (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                  Classification of a section of a composition/document.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Requirements

                                                  Provides computable standardized labels to topics within the document.

                                                  LabelPlan of Treatment
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "http://loinc.org",
                                                      "code" : "18776-5"
                                                    }]
                                                  }
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  468. Composition.section:plan_of_treatment_section.author
                                                  Definition

                                                  Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                  ShortWho and/or what authored the section
                                                  Control0..*
                                                  TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Identifies who is responsible for the content.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  470. Composition.section:plan_of_treatment_section.focus
                                                  Definition

                                                  The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                  ShortWho/what the section is about, when it is not about the subject of composition
                                                  Comments

                                                  Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                  Control0..1
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  472. Composition.section:plan_of_treatment_section.text
                                                  Definition

                                                  A human-readable narrative that contains the attested content of the section, 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.

                                                  Shorttext
                                                  Comments

                                                  Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                  Control1..1
                                                  This element is affected by the following invariants: cmp-1
                                                  TypeNarrative
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  474. Composition.section:plan_of_treatment_section.mode
                                                  Definition

                                                  How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                  Shortworking | snapshot | changes
                                                  Comments

                                                  This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                  Control0..1
                                                  BindingThe codes SHALL be taken from ListMode
                                                  (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                  The processing mode that applies to this section.

                                                  Typecode
                                                  Is Modifierfalse
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summaryfalse
                                                  Requirements

                                                  Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  476. Composition.section:plan_of_treatment_section.orderedBy
                                                  Definition

                                                  Specifies the order applied to the items in the section entries.

                                                  ShortOrder of section entries
                                                  Comments

                                                  Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                  Control0..1
                                                  BindingThe codes SHOULD be taken from ListOrderCodes
                                                  (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                  What order applies to the items in the entry.

                                                  TypeCodeableConcept
                                                  Is Modifierfalse
                                                  Summaryfalse
                                                  Requirements

                                                  Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                  478. Composition.section:plan_of_treatment_section.entry
                                                  Definition

                                                  A reference to the actual resource from which the narrative in the section is derived.

                                                  Shortentry
                                                  Comments

                                                  If there are no entries in the list, an emptyReason SHOULD be provided.

                                                  Control0..*
                                                  This element is affected by the following invariants: cmp-2
                                                  TypeReference(Resource)
                                                  Is Modifierfalse
                                                  Must Supporttrue
                                                  Summaryfalse
                                                  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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                  • profile @ resolve()
                                                  • 480. Composition.section:plan_of_treatment_section.entry:sliceEntry
                                                    Slice NamesliceEntry
                                                    Definition

                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                    ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                    Comments

                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                    Control0..*
                                                    This element is affected by the following invariants: cmp-2
                                                    TypeReference(US Core Goal Profile, US Core MedicationRequest Profile, US Core Encounter Profile, Communication, Appointment, CommunicationRequest, DeviceRequest, NutritionOrder, Task, ServiceRequest, VisionPrescription, RequestGroup)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    482. Composition.section:plan_of_treatment_section.emptyReason
                                                    Definition

                                                    If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                    ShortWhy the section is empty
                                                    Comments

                                                    The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                    Control0..1
                                                    This element is affected by the following invariants: cmp-2
                                                    BindingThe codes SHOULD be taken from ListEmptyReasons
                                                    (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                    If a section is empty, why it is empty.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    484. Composition.section:plan_of_treatment_section.section
                                                    Definition

                                                    A nested sub-section within this section.

                                                    ShortNested Section
                                                    Comments

                                                    Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                    Control0..*
                                                    This element is affected by the following invariants: cmp-1
                                                    TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    486. Composition.section:planned_procedure_section
                                                    Slice Nameplanned_procedure_section
                                                    Definition

                                                    The root of the sections that make up the composition.

                                                    ShortPlanned Procedure Section
                                                    Control0..1
                                                    TypeBackboneElement
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    LabelPlanned Procedure Section
                                                    Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                    cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    488. Composition.section:planned_procedure_section.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
                                                    490. Composition.section:planned_procedure_section.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())
                                                    492. Composition.section:planned_procedure_section.modifierExtension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                    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 element that contains them
                                                    Summarytrue
                                                    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, modifiers
                                                    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())
                                                    494. Composition.section:planned_procedure_section.title
                                                    Definition

                                                    The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                    Shorttitle
                                                    Comments

                                                    The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                    Control1..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

                                                    Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                    Alternate Namesheader, label, caption
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    496. Composition.section:planned_procedure_section.code
                                                    Definition

                                                    A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                    ShortPlanned Procedure
                                                    Comments

                                                    The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                    If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                    Control1..1
                                                    BindingFor example codes, see DocumentSectionCodes
                                                    (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                    Classification of a section of a composition/document.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Requirements

                                                    Provides computable standardized labels to topics within the document.

                                                    LabelPlanned Procedure
                                                    Pattern Value{
                                                      "coding" : [{
                                                        "system" : "http://loinc.org",
                                                        "code" : "59772-4"
                                                      }]
                                                    }
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    498. Composition.section:planned_procedure_section.author
                                                    Definition

                                                    Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                    ShortWho and/or what authored the section
                                                    Control0..*
                                                    TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Identifies who is responsible for the content.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    500. Composition.section:planned_procedure_section.focus
                                                    Definition

                                                    The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                    ShortWho/what the section is about, when it is not about the subject of composition
                                                    Comments

                                                    Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                    Control0..1
                                                    TypeReference(Resource)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    502. Composition.section:planned_procedure_section.text
                                                    Definition

                                                    A human-readable narrative that contains the attested content of the section, 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.

                                                    Shorttext
                                                    Comments

                                                    Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                    Control1..1
                                                    This element is affected by the following invariants: cmp-1
                                                    TypeNarrative
                                                    Is Modifierfalse
                                                    Must Supporttrue
                                                    Summaryfalse
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    504. Composition.section:planned_procedure_section.mode
                                                    Definition

                                                    How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                    Shortworking | snapshot | changes
                                                    Comments

                                                    This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                    Control0..1
                                                    BindingThe codes SHALL be taken from ListMode
                                                    (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                    The processing mode that applies to this section.

                                                    Typecode
                                                    Is Modifierfalse
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    Summaryfalse
                                                    Requirements

                                                    Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    506. Composition.section:planned_procedure_section.orderedBy
                                                    Definition

                                                    Specifies the order applied to the items in the section entries.

                                                    ShortOrder of section entries
                                                    Comments

                                                    Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                    Control0..1
                                                    BindingThe codes SHOULD be taken from ListOrderCodes
                                                    (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                    What order applies to the items in the entry.

                                                    TypeCodeableConcept
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Requirements

                                                    Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    508. Composition.section:planned_procedure_section.entry
                                                    Definition

                                                    A reference to the actual resource from which the narrative in the section is derived.

                                                    Shortentry
                                                    Comments

                                                    If there are no entries in the list, an emptyReason SHOULD be provided.

                                                    Control0..*
                                                    This element is affected by the following invariants: cmp-2
                                                    TypeReference(Resource)
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                    • profile @ resolve()
                                                    • 510. Composition.section:planned_procedure_section.entry:planned_procedure_entry
                                                      Slice Nameplanned_procedure_entry
                                                      Definition

                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                      ShortThis section contains unprofiled resources not covered by US Core. Please refer to C-CDA R2.1 for guidance on terminology, etc.
                                                      Comments

                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-2
                                                      TypeReference(ServiceRequest)
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      512. Composition.section:planned_procedure_section.emptyReason
                                                      Definition

                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                      ShortWhy the section is empty
                                                      Comments

                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                      Control0..1
                                                      This element is affected by the following invariants: cmp-2
                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                      If a section is empty, why it is empty.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      514. Composition.section:planned_procedure_section.section
                                                      Definition

                                                      A nested sub-section within this section.

                                                      ShortNested Section
                                                      Comments

                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-1
                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      516. Composition.section:procedure_disposition_section
                                                      Slice Nameprocedure_disposition_section
                                                      Definition

                                                      The root of the sections that make up the composition.

                                                      ShortProcedure Disposition Section
                                                      Control0..1
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      LabelProcedure Disposition Section
                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      518. Composition.section:procedure_disposition_section.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
                                                      520. Composition.section:procedure_disposition_section.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())
                                                      522. Composition.section:procedure_disposition_section.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                      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 element that contains them
                                                      Summarytrue
                                                      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, modifiers
                                                      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())
                                                      524. Composition.section:procedure_disposition_section.title
                                                      Definition

                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                      Shorttitle
                                                      Comments

                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                      Control1..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                      Alternate Namesheader, label, caption
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      526. Composition.section:procedure_disposition_section.code
                                                      Definition

                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                      ShortProcedure Disposition
                                                      Comments

                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                      Control1..1
                                                      BindingFor example codes, see DocumentSectionCodes
                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                      Classification of a section of a composition/document.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Provides computable standardized labels to topics within the document.

                                                      LabelProcedure Disposition
                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://loinc.org",
                                                          "code" : "59775-7"
                                                        }]
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      528. Composition.section:procedure_disposition_section.author
                                                      Definition

                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                      ShortWho and/or what authored the section
                                                      Control0..*
                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Identifies who is responsible for the content.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      530. Composition.section:procedure_disposition_section.focus
                                                      Definition

                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                      Comments

                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                      Control0..1
                                                      TypeReference(Resource)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      532. Composition.section:procedure_disposition_section.text
                                                      Definition

                                                      A human-readable narrative that contains the attested content of the section, 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.

                                                      ShortThis section contains only human readable content
                                                      Comments

                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                      Control1..1
                                                      This element is affected by the following invariants: cmp-1
                                                      TypeNarrative
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      534. Composition.section:procedure_disposition_section.mode
                                                      Definition

                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                      Shortworking | snapshot | changes
                                                      Comments

                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                      Control0..1
                                                      BindingThe codes SHALL be taken from ListMode
                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                      The processing mode that applies to this section.

                                                      Typecode
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summaryfalse
                                                      Requirements

                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      536. Composition.section:procedure_disposition_section.orderedBy
                                                      Definition

                                                      Specifies the order applied to the items in the section entries.

                                                      ShortOrder of section entries
                                                      Comments

                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                      Control0..1
                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                      What order applies to the items in the entry.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      538. Composition.section:procedure_disposition_section.entry
                                                      Definition

                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                      ShortA reference to data that supports this section
                                                      Comments

                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-2
                                                      TypeReference(Resource)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      540. Composition.section:procedure_disposition_section.emptyReason
                                                      Definition

                                                      If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                      ShortWhy the section is empty
                                                      Comments

                                                      The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                      Control0..1
                                                      This element is affected by the following invariants: cmp-2
                                                      BindingThe codes SHOULD be taken from ListEmptyReasons
                                                      (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                      If a section is empty, why it is empty.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      542. Composition.section:procedure_disposition_section.section
                                                      Definition

                                                      A nested sub-section within this section.

                                                      ShortNested Section
                                                      Comments

                                                      Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-1
                                                      TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      544. Composition.section:procedure_indications_section
                                                      Slice Nameprocedure_indications_section
                                                      Definition

                                                      The root of the sections that make up the composition.

                                                      ShortProcedure Indications Section
                                                      Control0..1
                                                      TypeBackboneElement
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      LabelProcedure Indications Section
                                                      Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                      cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      546. Composition.section:procedure_indications_section.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
                                                      548. Composition.section:procedure_indications_section.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())
                                                      550. Composition.section:procedure_indications_section.modifierExtension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                      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 element that contains them
                                                      Summarytrue
                                                      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, modifiers
                                                      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())
                                                      552. Composition.section:procedure_indications_section.title
                                                      Definition

                                                      The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                      Shorttitle
                                                      Comments

                                                      The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                      Control1..1
                                                      Typestring
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                      Alternate Namesheader, label, caption
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      554. Composition.section:procedure_indications_section.code
                                                      Definition

                                                      A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                      ShortProcedure Indications
                                                      Comments

                                                      The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                      If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                      Control1..1
                                                      BindingFor example codes, see DocumentSectionCodes
                                                      (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                      Classification of a section of a composition/document.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Requirements

                                                      Provides computable standardized labels to topics within the document.

                                                      LabelProcedure Indications
                                                      Pattern Value{
                                                        "coding" : [{
                                                          "system" : "http://loinc.org",
                                                          "code" : "59768-2"
                                                        }]
                                                      }
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      556. Composition.section:procedure_indications_section.author
                                                      Definition

                                                      Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                      ShortWho and/or what authored the section
                                                      Control0..*
                                                      TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Identifies who is responsible for the content.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      558. Composition.section:procedure_indications_section.focus
                                                      Definition

                                                      The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                      ShortWho/what the section is about, when it is not about the subject of composition
                                                      Comments

                                                      Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                      Control0..1
                                                      TypeReference(Resource)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      560. Composition.section:procedure_indications_section.text
                                                      Definition

                                                      A human-readable narrative that contains the attested content of the section, 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.

                                                      ShortThis section contains only human readable content
                                                      Comments

                                                      Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                      Control1..1
                                                      This element is affected by the following invariants: cmp-1
                                                      TypeNarrative
                                                      Is Modifierfalse
                                                      Must Supporttrue
                                                      Summaryfalse
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      562. Composition.section:procedure_indications_section.mode
                                                      Definition

                                                      How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                      Shortworking | snapshot | changes
                                                      Comments

                                                      This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                      Control0..1
                                                      BindingThe codes SHALL be taken from ListMode
                                                      (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                      The processing mode that applies to this section.

                                                      Typecode
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summaryfalse
                                                      Requirements

                                                      Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      564. Composition.section:procedure_indications_section.orderedBy
                                                      Definition

                                                      Specifies the order applied to the items in the section entries.

                                                      ShortOrder of section entries
                                                      Comments

                                                      Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                      Control0..1
                                                      BindingThe codes SHOULD be taken from ListOrderCodes
                                                      (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                      What order applies to the items in the entry.

                                                      TypeCodeableConcept
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      Requirements

                                                      Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      566. Composition.section:procedure_indications_section.entry
                                                      Definition

                                                      A reference to the actual resource from which the narrative in the section is derived.

                                                      Shortentry
                                                      Comments

                                                      If there are no entries in the list, an emptyReason SHOULD be provided.

                                                      Control0..*
                                                      This element is affected by the following invariants: cmp-2
                                                      TypeReference(Resource)
                                                      Is Modifierfalse
                                                      Summaryfalse
                                                      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 Composition.section.entry. The slices are unordered and Open, and can be differentiated using the following discriminators:
                                                      • profile @ resolve()
                                                      • 568. Composition.section:procedure_indications_section.entry:problem_entry
                                                        Slice Nameproblem_entry
                                                        Definition

                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                        ShortA reference to data that supports this section
                                                        Comments

                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-2
                                                        TypeReference(US Core Condition Profile)
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        570. Composition.section:procedure_indications_section.emptyReason
                                                        Definition

                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                        ShortWhy the section is empty
                                                        Comments

                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                        Control0..1
                                                        This element is affected by the following invariants: cmp-2
                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                        If a section is empty, why it is empty.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        572. Composition.section:procedure_indications_section.section
                                                        Definition

                                                        A nested sub-section within this section.

                                                        ShortNested Section
                                                        Comments

                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-1
                                                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        574. Composition.section:procedure_implants_section
                                                        Slice Nameprocedure_implants_section
                                                        Definition

                                                        The root of the sections that make up the composition.

                                                        ShortProcedure Implants Section
                                                        Control0..1
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        LabelProcedure Implants Section
                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        576. Composition.section:procedure_implants_section.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
                                                        578. Composition.section:procedure_implants_section.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())
                                                        580. Composition.section:procedure_implants_section.modifierExtension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                        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 element that contains them
                                                        Summarytrue
                                                        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, modifiers
                                                        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())
                                                        582. Composition.section:procedure_implants_section.title
                                                        Definition

                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                        Shorttitle
                                                        Comments

                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                        Control1..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Requirements

                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                        Alternate Namesheader, label, caption
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        584. Composition.section:procedure_implants_section.code
                                                        Definition

                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                        ShortProcedure Implants
                                                        Comments

                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                        Control1..1
                                                        BindingFor example codes, see DocumentSectionCodes
                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                        Classification of a section of a composition/document.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Requirements

                                                        Provides computable standardized labels to topics within the document.

                                                        LabelProcedure Implants
                                                        Pattern Value{
                                                          "coding" : [{
                                                            "system" : "http://loinc.org",
                                                            "code" : "59771-6"
                                                          }]
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        586. Composition.section:procedure_implants_section.author
                                                        Definition

                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                        ShortWho and/or what authored the section
                                                        Control0..*
                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Identifies who is responsible for the content.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        588. Composition.section:procedure_implants_section.focus
                                                        Definition

                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                        Comments

                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                        Control0..1
                                                        TypeReference(Resource)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        590. Composition.section:procedure_implants_section.text
                                                        Definition

                                                        A human-readable narrative that contains the attested content of the section, 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.

                                                        ShortThis section contains only human readable content
                                                        Comments

                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                        Control1..1
                                                        This element is affected by the following invariants: cmp-1
                                                        TypeNarrative
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        592. Composition.section:procedure_implants_section.mode
                                                        Definition

                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                        Shortworking | snapshot | changes
                                                        Comments

                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                        Control0..1
                                                        BindingThe codes SHALL be taken from ListMode
                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                        The processing mode that applies to this section.

                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summaryfalse
                                                        Requirements

                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        594. Composition.section:procedure_implants_section.orderedBy
                                                        Definition

                                                        Specifies the order applied to the items in the section entries.

                                                        ShortOrder of section entries
                                                        Comments

                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                        Control0..1
                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                        What order applies to the items in the entry.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        596. Composition.section:procedure_implants_section.entry
                                                        Definition

                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                        ShortA reference to data that supports this section
                                                        Comments

                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-2
                                                        TypeReference(Resource)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        598. Composition.section:procedure_implants_section.emptyReason
                                                        Definition

                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                        ShortWhy the section is empty
                                                        Comments

                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                        Control0..1
                                                        This element is affected by the following invariants: cmp-2
                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                        If a section is empty, why it is empty.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        600. Composition.section:procedure_implants_section.section
                                                        Definition

                                                        A nested sub-section within this section.

                                                        ShortNested Section
                                                        Comments

                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-1
                                                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        602. Composition.section:surgical_drains_section
                                                        Slice Namesurgical_drains_section
                                                        Definition

                                                        The root of the sections that make up the composition.

                                                        ShortSurgical Drains Section
                                                        Control0..1
                                                        TypeBackboneElement
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        LabelSurgical Drains Section
                                                        Invariantscmp-1: A section must contain at least one of text, entries, or sub-sections (text.exists() or entry.exists() or section.exists())
                                                        cmp-2: A section can only have an emptyReason if it is empty (emptyReason.empty() or entry.empty())
                                                        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        604. Composition.section:surgical_drains_section.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
                                                        606. Composition.section:surgical_drains_section.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())
                                                        608. Composition.section:surgical_drains_section.modifierExtension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained 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 can 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 even if unrecognized
                                                        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 element that contains them
                                                        Summarytrue
                                                        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, modifiers
                                                        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())
                                                        610. Composition.section:surgical_drains_section.title
                                                        Definition

                                                        The label for this particular section. This will be part of the rendered content for the document, and is often used to build a table of contents.

                                                        Shorttitle
                                                        Comments

                                                        The title identifies the section for a human reader. The title must be consistent with the narrative of the resource that is the target of the section.content reference. Generally, sections SHOULD have titles, but in some documents, it is unnecessary or inappropriate. Typically, this is where a section has subsections that have their own adequately distinguishing title, or documents that only have a single section. Most Implementation Guides will make section title to be a required element.

                                                        Control1..1
                                                        Typestring
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Requirements

                                                        Section headings are often standardized for different types of documents. They give guidance to humans on how the document is organized.

                                                        Alternate Namesheader, label, caption
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        612. Composition.section:surgical_drains_section.code
                                                        Definition

                                                        A code identifying the kind of content contained within the section. This must be consistent with the section title.

                                                        ShortSurgical Drains
                                                        Comments

                                                        The code identifies the section for an automated processor of the document. This is particularly relevant when using profiles to control the structure of the document.

                                                        If the section has content (instead of sub-sections), the section.code does not change the meaning or interpretation of the resource that is the content of the section in the comments for the section.code.

                                                        Control1..1
                                                        BindingFor example codes, see DocumentSectionCodes
                                                        (example to http://hl7.org/fhir/ValueSet/doc-section-codes)

                                                        Classification of a section of a composition/document.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Requirements

                                                        Provides computable standardized labels to topics within the document.

                                                        LabelSurgical Drains
                                                        Pattern Value{
                                                          "coding" : [{
                                                            "system" : "http://loinc.org",
                                                            "code" : "11537-8"
                                                          }]
                                                        }
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        614. Composition.section:surgical_drains_section.author
                                                        Definition

                                                        Identifies who is responsible for the information in this section, not necessarily who typed it in.

                                                        ShortWho and/or what authored the section
                                                        Control0..*
                                                        TypeReference(Practitioner, PractitionerRole, Device, Patient, RelatedPerson, Organization)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Identifies who is responsible for the content.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        616. Composition.section:surgical_drains_section.focus
                                                        Definition

                                                        The actual focus of the section when it is not the subject of the composition, but instead represents something or someone associated with the subject such as (for a patient subject) a spouse, parent, fetus, or donor. If not focus is specified, the focus is assumed to be focus of the parent section, or, for a section in the Composition itself, the subject of the composition. Sections with a focus SHALL only include resources where the logical subject (patient, subject, focus, etc.) matches the section focus, or the resources have no logical subject (few resources).

                                                        ShortWho/what the section is about, when it is not about the subject of composition
                                                        Comments

                                                        Typically, sections in a doument are about the subject of the document, whether that is a patient, or group of patients, location, or device, or whatever. For some kind of documents, some sections actually contain data about related entities. Typical examples are a section in a newborn discharge summary concerning the mother, or family history documents, with a section about each family member, though there are many other examples.

                                                        Control0..1
                                                        TypeReference(Resource)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        618. Composition.section:surgical_drains_section.text
                                                        Definition

                                                        A human-readable narrative that contains the attested content of the section, 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.

                                                        ShortThis section contains only human readable content
                                                        Comments

                                                        Document profiles may define what content should be represented in the narrative to ensure clinical safety.

                                                        Control1..1
                                                        This element is affected by the following invariants: cmp-1
                                                        TypeNarrative
                                                        Is Modifierfalse
                                                        Must Supporttrue
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        620. Composition.section:surgical_drains_section.mode
                                                        Definition

                                                        How the entry list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.

                                                        Shortworking | snapshot | changes
                                                        Comments

                                                        This element is labeled as a modifier because a change list must not be misunderstood as a complete list.

                                                        Control0..1
                                                        BindingThe codes SHALL be taken from ListMode
                                                        (required to http://hl7.org/fhir/ValueSet/list-mode|4.0.1)

                                                        The processing mode that applies to this section.

                                                        Typecode
                                                        Is Modifierfalse
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summaryfalse
                                                        Requirements

                                                        Sections are used in various ways, and it must be known in what way it is safe to use the entries in them.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        622. Composition.section:surgical_drains_section.orderedBy
                                                        Definition

                                                        Specifies the order applied to the items in the section entries.

                                                        ShortOrder of section entries
                                                        Comments

                                                        Applications SHOULD render ordered lists in the order provided, but MAY allow users to re-order based on their own preferences as well. If there is no order specified, the order is unknown, though there may still be some order.

                                                        Control0..1
                                                        BindingThe codes SHOULD be taken from ListOrderCodes
                                                        (preferred to http://hl7.org/fhir/ValueSet/list-order)

                                                        What order applies to the items in the entry.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Important for presentation and rendering. Lists may be sorted to place more important information first or to group related entries.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        624. Composition.section:surgical_drains_section.entry
                                                        Definition

                                                        A reference to the actual resource from which the narrative in the section is derived.

                                                        ShortA reference to data that supports this section
                                                        Comments

                                                        If there are no entries in the list, an emptyReason SHOULD be provided.

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-2
                                                        TypeReference(Resource)
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        626. Composition.section:surgical_drains_section.emptyReason
                                                        Definition

                                                        If the section is empty, why the list is empty. An empty section typically has some text explaining the empty reason.

                                                        ShortWhy the section is empty
                                                        Comments

                                                        The various reasons for an empty section make a significant interpretation to its interpretation. Note that this code is for use when the entire section content has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.

                                                        Control0..1
                                                        This element is affected by the following invariants: cmp-2
                                                        BindingThe codes SHOULD be taken from ListEmptyReasons
                                                        (preferred to http://hl7.org/fhir/ValueSet/list-empty-reason)

                                                        If a section is empty, why it is empty.

                                                        TypeCodeableConcept
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Requirements

                                                        Allows capturing things like "none exist" or "not asked" which can be important for most lists.

                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        628. Composition.section:surgical_drains_section.section
                                                        Definition

                                                        A nested sub-section within this section.

                                                        ShortNested Section
                                                        Comments

                                                        Nested sections are primarily used to help human readers navigate to particular portions of the document.

                                                        Control0..*
                                                        This element is affected by the following invariants: cmp-1
                                                        TypeSee ttp://hl7.org/fhir/StructureDefinition/Composition#Composition.section
                                                        Is Modifierfalse
                                                        Summaryfalse
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))