HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm
2.1.2 - STU 2 United States of America flag

This page is part of the electronic Case Reporting (eCR) (v2.1.2: STU 2) 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: USPublicHealthExecutableValueSet - Detailed Descriptions

Active as of 2020-10-26

Definitions for the us-ph-executable-valueset resource profile.

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

0. ValueSet
ShortUS Public Health Executable ValueSet
2. ValueSet.extension:usageWarning
Slice NameusageWarning
Control1..1
TypeExtension(US Public Health Usage Warning Extension) (Extension Type: string)
Must Supporttrue
4. ValueSet.extension:usageWarning.value[x]
Control1..1
Typestring
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Fixed ValueThis value set contains a point-in-time expansion enumerating the codes that meet the value set intent. As new versions of the code systems used by the value set are released, the contents of this expansion will need to be updated to incorporate newly defined codes that meet the value set intent. Before, and periodically during production use, the value set expansion contents SHOULD be updated. The value set expansion specifies the timestamp when the expansion was produced, SHOULD contain the parameters used for the expansion, and SHALL contain the codes that are obtained by evaluating the value set definition. If this is ONLY an executable value set, a distributable definition of the value set must be obtained to compute the updated expansion.
6. ValueSet.expansion
Control1..1
Must Supporttrue
8. ValueSet.expansion.parameter
Must Supporttrue
10. ValueSet.expansion.contains
Must Supporttrue

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

0. ValueSet
Definition

A ValueSet resource instance specifies a set of codes drawn from one or more code systems, intended for use in a particular context. Value sets link between CodeSystem definitions and their use in coded elements.


A ValueSet resource instance specifies a set of codes drawn from one or more code systems, intended for use in a particular context. Value sets link between CodeSystem definitions and their use in coded elements.

ShortUS Public Health Executable ValueSetA set of codes drawn from one or more code systems
Control10..1*
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())
vsd-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
vsd-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
2. ValueSet.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. ValueSet.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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.

ShortExtensionAdditional 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.

Control30..*
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())
SlicingThis element introduces a set of slices on ValueSet.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. ValueSet.extension:extensionValueSetSteward
    Slice NameextensionValueSetSteward
    Definition

    The entity or set of entities that create and may modify the Value Set Definition content. The name of a group or an individual, along with contact details.

    ShortValue set steward
    Comments

    The information included should include contact information.

    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(steward) (Extension Type: ContactDetail)
    Is Modifierfalse
    Must Supporttrue
    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. ValueSet.extension:extensionValueSetAuthor
    Slice NameextensionValueSetAuthor
    Definition

    The entity or set of entities that create and may modify the Value Set Definition content. The name of a group or an individual, along with contact details.

    ShortValue set author
    Comments

    This can be any combination of groups or individuals. When known and actively maintained, this should be populated. The information included about the Author may include contact information.

    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(author) (Extension Type: ContactDetail)
    Is Modifierfalse
    Must Supporttrue
    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())
    10. ValueSet.extension:usageWarning
    Slice NameusageWarning
    Definition

    An extra warning about the correct use of the value set.

    ShortUS Public Health Usage Warning Extension
    Control1..1
    TypeExtension(US Public Health Usage Warning Extension) (Extension Type: string)
    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. ValueSet.extension:usageWarning.url
    Definition

    Source of the definition for the extension code - a logical name or a URL.

    Shortidentifies the meaning of the extension
    Comments

    The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

    Control1..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    Fixed Valuehttp://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-usagewarning-extension
    14. ValueSet.extension:usageWarning.value[x]
    Definition

    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

    ShortValue of extension
    Control10..1
    Typestring, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Fixed ValueThis value set contains a point-in-time expansion enumerating the codes that meet the value set intent. As new versions of the code systems used by the value set are released, the contents of this expansion will need to be updated to incorporate newly defined codes that meet the value set intent. Before, and periodically during production use, the value set expansion contents SHOULD be updated. The value set expansion specifies the timestamp when the expansion was produced, SHOULD contain the parameters used for the expansion, and SHALL contain the codes that are obtained by evaluating the value set definition. If this is ONLY an executable value set, a distributable definition of the value set must be obtained to compute the updated expansion.
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. ValueSet.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())
    18. ValueSet.url
    Definition

    An absolute URI that is used to identify this value set when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this value set is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the value set is stored on different servers.

    ShortCanonical identifier for this value set, represented as a URI (globally unique)
    Comments

    Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

    The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

    In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.


    Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

    The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

    In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

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

    Allows the value set to be referenced by a single globally unique identifier.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. ValueSet.identifier
    Definition

    The identifier of the value set.


    A formal identifier that is used to identify this value set when it is represented in other formats, or referenced in a specification, model, design or an instance.

    ShortValue set identifier used by public health (e.g. RCTC OID)Additional identifier for the value set (business identifier)
    Comments

    Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this value set outside of FHIR, where it is not possible to use the logical URI.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Allows externally provided and/or usable business identifiers to be easily associated with the module.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. ValueSet.version
    Definition

    The identifier that is used to identify this version of the value set when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the value set author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

    ShortBusiness version of the value set
    Comments

    There may be different value set instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the value set with the format [url]|[version].

    NoteThis is a business version Id, not a resource version Id (see discussion)
    Control10..1
    Typestring
    Is Modifierfalse
    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()))
    24. ValueSet.name
    Definition

    The name of the value set.


    A natural language name identifying the value set. This name should be usable as an identifier for the module by machine processing applications such as code generation.

    ShortValue set nameName for this value set (computer friendly)
    Comments

    The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.A name should be provided unless the value set is a contained resource (e.g. an anonymous value set in a profile). Most registries will require a name.

    Control10..1
    This element is affected by the following invariants: inv-0
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Support human navigation and code generation.

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

    The title of the value set.


    A short, descriptive, user-friendly title for the value set.

    ShortValue set titleName for this value set (human friendly)
    Comments

    This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. ValueSet.status
    Definition

    The value set definition version.


    The status of this value set. Enables tracking the life-cycle of the content. The status of the value set applies to the value set definition (ValueSet.compose) and the associated ValueSet metadata. Expansions do not have a state.

    ShortValue set definition versiondraft | active | retired | unknown
    Comments

    Allows filtering of value sets that are appropriate for use versus not.See also the valueset-workflowStatus extension for additional status information related to the editorial process.


    Allows filtering of value sets that are appropriate for use versus not.See also the valueset-workflowStatus extension for additional status information related to the editorial process.

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

    The lifecycle status of an artifact.

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. ValueSet.experimental
    Definition

    A Boolean value to indicate that this value set is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

    ShortFor testing purposes, not real usage
    Comments

    Allows filtering of value sets that are appropriate for use versus not.

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

    Enables experimental content to be developed following the same lifecycle that would be used for a production-level value set.

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

    The name of the organization or individual that published the value set.

    ShortThe entity that is responsible for the content of the Value Set DefinitionName of the publisher (organization or individual)
    Comments

    Usually an organization but may be an individual. The publisher (or steward) of the value set is the organization or individual primarily responsible for the maintenance and upkeep of the value set. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the value set. This item SHOULD be populated unless the information is available from context.

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

    Helps establish the "authority/credibility" of the value set. May also allow for contact.

    Alternate Namessteward
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. ValueSet.description
    Definition

    The value set definition (depending on source, could be a concatenation of the value set fields Clinical Focus, Data Element Scope, Inclusion Criteria, Exclusion Criteria, and Note).


    A free text natural language description of the value set from a consumer's perspective. The textual description specifies the span of meanings for concepts to be included within the Value Set Expansion, and also may specify the intended use and limitations of the Value Set.

    ShortValue set descriptionNatural language description of the value set
    Comments

    This description can be used to capture details such as why the value set was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the value set as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the value set is presumed to be the predominant language in the place the value set was created).The description is not intended to describe the semantics of the Value Set - there are no intrinsic semantics separate from the codes contained in its expansion. The description should capture its intended use, which is needed for ensuring integrity for its use in models across future changes. A description should be provided unless the value set is a contained resource (e.g. an anonymous value set in a profile). Most registries will require a description.

    Control10..1
    Typemarkdown
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summaryfalse
    Alternate NamesScope, Purpose, scope
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. ValueSet.useContext
    Definition

    The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate value set instances.

    ShortThe context that the content is intended to support
    Comments

    When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

    Control10..*
    TypeUsageContext
    Is Modifierfalse
    Summarytrue
    Requirements

    Assist in searching for appropriate 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 ValueSet.useContext. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • pattern @ code
    • 38. ValueSet.useContext:priorityContext
      Slice NamepriorityContext
      Definition

      The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate value set instances.

      ShortThe context that the content is intended to support
      Comments

      When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

      Control10..1*
      TypeUsageContext
      Is Modifierfalse
      Summarytrue
      Requirements

      Assist in searching for appropriate content.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. ValueSet.useContext:priorityContext.code
      Definition

      A code that identifies the type of context being specified by this usage context.

      ShortType of context being specified
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from UsageContextTypehttp://hl7.org/fhir/ValueSet/usage-context-type
      (extensible to http://hl7.org/fhir/ValueSet/usage-context-type)

      A code that specifies a type of context being specified by a usage context.

      TypeCoding
      Is Modifierfalse
      Summarytrue
      Pattern Value{
        "system" : "http://hl7.org/fhir/us/ecr/CodeSystem/us-ph-usage-context-type",
        "code" : "priority"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. ValueSet.useContext:priorityContext.value[x]
      Definition

      The US Public Health release priority of the value set.


      A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

      ShortRelease priority of the ValueSetValue that defines the context
      Control1..1
      BindingThe codes SHALL be taken from For example codes, see US Public Health ValueSet Priorityhttp://hl7.org/fhir/ValueSet/use-context
      (required to http://hl7.org/fhir/us/ecr/ValueSet/us-ph-valueset-priority)

      US PH ValueSet Release Priority Codes.


      A code that defines the specific value for the context being specified.

      TypeCodeableConcept, Reference(PlanDefinition, ResearchStudy, InsurancePlan, HealthcareService, Group, Location, Organization), Quantity, Range
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      44. ValueSet.useContext:focusConditionContext
      Slice NamefocusConditionContext
      Definition

      The clinical condition that is the focus of the codes in this value set.


      The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate value set instances.

      ShortThe context that the content is intended to support
      Comments

      When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

      Control0..*
      TypeUsageContext
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Assist in searching for appropriate content.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      46. ValueSet.useContext:focusConditionContext.code
      Definition

      A code that identifies the type of context being specified by this usage context.

      ShortType of context being specified
      Control1..1
      BindingUnless not suitable, these codes SHALL be taken from UsageContextTypehttp://hl7.org/fhir/ValueSet/usage-context-type
      (extensible to http://hl7.org/fhir/ValueSet/usage-context-type)

      A code that specifies a type of context being specified by a usage context.

      TypeCoding
      Is Modifierfalse
      Summarytrue
      Pattern Value{
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. ValueSet.useContext:focusConditionContext.value[x]
      Definition

      The clinical condition that is the focus of the codes in this value set.


      A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

      ShortClinical condition that is the focus of the codes in this value setValue that defines the context
      Control1..1
      BindingFor example codes, see Condition/Problem/DiagnosisCodeshttp://hl7.org/fhir/ValueSet/use-context
      (example to http://hl7.org/fhir/ValueSet/condition-code)

      Condition/Problem/Diagnosis Codes.


      A code that defines the specific value for the context being specified.

      TypeCodeableConcept, Reference(PlanDefinition, ResearchStudy, InsurancePlan, HealthcareService, Group, Location, Organization), Quantity, Range
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. ValueSet.expansion
      Definition

      A value set can also be "expanded", where the value set is turned into a simple collection of enumerated codes. This element holds the expansion, if it has been performed.

      ShortUsed when the value set is "expanded"
      Comments

      Expansion is performed to produce a collection of codes that are ready to use for data entry or validation. Value set expansions are always considered to be stateless - they are a record of the set of codes in the value set at a point in time under a given set of conditions, and are not subject to ongoing maintenance.

      Expansion.parameter is a simplified list of parameters - a subset of the features of the Parameters resource.


      Expansion is performed to produce a collection of codes that are ready to use for data entry or validation. Value set expansions are always considered to be stateless - they are a record of the set of codes in the value set at a point in time under a given set of conditions, and are not subject to ongoing maintenance.

      Expansion.parameter is a simplified list of parameters - a subset of the features of the Parameters resource.

      Control10..1
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. ValueSet.expansion.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. ValueSet.expansion.timestamp
      Definition

      The time at which the expansion was produced by the expanding system.

      ShortTime ValueSet expansion happened
      Comments

      This SHOULD be a fully populated instant, but in some circumstances, value sets are expanded by hand, and the expansion is published without that precision.

      Control1..1
      TypedateTime
      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()))
      56. ValueSet.expansion.parameter
      Definition

      A parameter that controlled the expansion process. These parameters may be used by users of expanded value sets to check whether the expansion is suitable for a particular purpose, or to pick the correct expansion.

      ShortParameter that controlled the expansion process
      Comments

      The server decides which parameters to include here, but at a minimum, the list SHOULD include all of the parameters that affect the $expand operation. If the expansion will be persisted all of these parameters SHALL be included. If the codeSystem on the server has a specified version then this version SHALL be provided as a parameter in the expansion (note that not all code systems have a version).

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      58. ValueSet.expansion.parameter.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())
      60. ValueSet.expansion.parameter.name
      Definition

      Name of the input parameter to the $expand operation; may be a server-assigned name for additional default or other server-supplied parameters used to control the expansion process.

      ShortName as assigned by the client or server
      Comments

      The names are assigned at the discretion of the server.

      Control1..1
      Typestring
      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()))
      62. ValueSet.expansion.contains
      Definition

      The codes that are contained in the value set expansion.

      ShortCodes in the value set
      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      vsd-6: SHALL have a code or a display (code.exists() or display.exists())
      vsd-9: Must have a code if not abstract (code.exists() or abstract = true)
      vsd-10: Must have a system if a code is present (code.empty() or system.exists())
      vsd-6: SHALL have a code or a display (code.exists() or display.exists())
      vsd-9: Must have a code if not abstract (code.exists() or abstract = true)
      vsd-10: Must have a system if a code is present (code.empty() or system.exists())
      64. ValueSet.expansion.contains.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())

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

      0. ValueSet
      Definition

      A ValueSet resource instance specifies a set of codes drawn from one or more code systems, intended for use in a particular context. Value sets link between CodeSystem definitions and their use in coded elements.

      ShortUS Public Health Executable ValueSet
      Control1..1
      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())
      vsd-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
      2. ValueSet.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. ValueSet.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. ValueSet.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. ValueSet.language
      Definition

      The base language in which the resource is written.

      ShortLanguage 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).

      Control0..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
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. ValueSet.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. ValueSet.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. ValueSet.extension
      Definition

      An Extension

      ShortExtension
      Control3..*
      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 ValueSet.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. ValueSet.extension:extensionValueSetSteward
        Slice NameextensionValueSetSteward
        Definition

        The entity or set of entities that create and may modify the Value Set Definition content. The name of a group or an individual, along with contact details.

        ShortValue set steward
        Comments

        The information included should include contact information.

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(steward) (Extension Type: ContactDetail)
        Is Modifierfalse
        Must Supporttrue
        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. ValueSet.extension:extensionValueSetAuthor
        Slice NameextensionValueSetAuthor
        Definition

        The entity or set of entities that create and may modify the Value Set Definition content. The name of a group or an individual, along with contact details.

        ShortValue set author
        Comments

        This can be any combination of groups or individuals. When known and actively maintained, this should be populated. The information included about the Author may include contact information.

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeExtension(author) (Extension Type: ContactDetail)
        Is Modifierfalse
        Must Supporttrue
        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. ValueSet.extension:usageWarning
        Slice NameusageWarning
        Definition

        An extra warning about the correct use of the value set.

        ShortUS Public Health Usage Warning Extension
        Control1..1
        TypeExtension(US Public Health Usage Warning Extension) (Extension Type: string)
        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. ValueSet.extension:usageWarning.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
        24. ValueSet.extension:usageWarning.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())
        SlicingThis element introduces a set of slices on ValueSet.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 26. ValueSet.extension:usageWarning.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-usagewarning-extension
          28. ValueSet.extension:usageWarning.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control1..1
          Typestring
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Fixed ValueThis value set contains a point-in-time expansion enumerating the codes that meet the value set intent. As new versions of the code systems used by the value set are released, the contents of this expansion will need to be updated to incorporate newly defined codes that meet the value set intent. Before, and periodically during production use, the value set expansion contents SHOULD be updated. The value set expansion specifies the timestamp when the expansion was produced, SHOULD contain the parameters used for the expansion, and SHALL contain the codes that are obtained by evaluating the value set definition. If this is ONLY an executable value set, a distributable definition of the value set must be obtained to compute the updated expansion.
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          30. ValueSet.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())
          32. ValueSet.url
          Definition

          An absolute URI that is used to identify this value set when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this value set is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the value set is stored on different servers.

          ShortCanonical identifier for this value set, represented as a URI (globally unique)
          Comments

          Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred. Multiple instances may share the same URL if they have a distinct version.

          The determination of when to create a new version of a resource (same url, new version) vs. defining a new artifact is up to the author. Considerations for making this decision are found in Technical and Business Versions.

          In some cases, the resource can no longer be found at the stated url, but the url itself cannot change. Implementations can use the meta.source element to indicate where the current master source of the resource can be found.

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

          Allows the value set to be referenced by a single globally unique identifier.

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

          The identifier of the value set.

          ShortValue set identifier used by public health (e.g. RCTC OID)
          Comments

          Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this value set outside of FHIR, where it is not possible to use the logical URI.

          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          TypeIdentifier
          Is Modifierfalse
          Must Supporttrue
          Summarytrue
          Requirements

          Allows externally provided and/or usable business identifiers to be easily associated with the module.

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

          The identifier that is used to identify this version of the value set when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the value set author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequence.

          ShortBusiness version of the value set
          Comments

          There may be different value set instances that have the same identifier but different versions. The version can be appended to the url in a reference to allow a reference to a particular business version of the value set with the format [url]|[version].

          NoteThis is a business version Id, not a resource version Id (see discussion)
          Control1..1
          Typestring
          Is Modifierfalse
          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()))
          38. ValueSet.name
          Definition

          The name of the value set.

          ShortValue set name
          Comments

          The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.A name should be provided unless the value set is a contained resource (e.g. an anonymous value set in a profile). Most registries will require a name.

          Control1..1
          This element is affected by the following invariants: inv-0
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          Support human navigation and code generation.

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

          The title of the value set.

          ShortValue set title
          Comments

          This name does not need to be machine-processing friendly and may contain punctuation, white-space, etc.

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

          The value set definition version.

          ShortValue set definition version
          Comments

          Allows filtering of value sets that are appropriate for use versus not.See also the valueset-workflowStatus extension for additional status information related to the editorial process.

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

          The lifecycle status of an artifact.

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          44. ValueSet.experimental
          Definition

          A Boolean value to indicate that this value set is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

          ShortFor testing purposes, not real usage
          Comments

          Allows filtering of value sets that are appropriate for use versus not.

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

          Enables experimental content to be developed following the same lifecycle that would be used for a production-level value set.

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

          The date (and optionally time) when the value set was created or revised (e.g. the 'content logical definition').

          ShortDate last changed
          Comments

          Note that this is not the same as the resource last-modified-date, since the resource may be a secondary representation of the value set. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

          Control0..1
          TypedateTime
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Alternate NamesRevision Date
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          48. ValueSet.publisher
          Definition

          The name of the organization or individual that published the value set.

          ShortThe entity that is responsible for the content of the Value Set Definition
          Comments

          Usually an organization but may be an individual. The publisher (or steward) of the value set is the organization or individual primarily responsible for the maintenance and upkeep of the value set. This is not necessarily the same individual or organization that developed and initially authored the content. The publisher is the primary point of contact for questions or issues with the value set. This item SHOULD be populated unless the information is available from context.

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

          Helps establish the "authority/credibility" of the value set. May also allow for contact.

          Alternate Namessteward
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          50. ValueSet.contact
          Definition

          Contact details to assist a user in finding and communicating with the publisher.

          ShortContact details for the publisher
          Comments

          May be a web site, an email address, a telephone number, etc.

          Control0..*
          TypeContactDetail
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. ValueSet.description
          Definition

          The value set definition (depending on source, could be a concatenation of the value set fields Clinical Focus, Data Element Scope, Inclusion Criteria, Exclusion Criteria, and Note).

          ShortValue set description
          Comments

          This description can be used to capture details such as why the value set was built, comments about misuse, instructions for clinical use and interpretation, literature references, examples from the paper world, etc. It is not a rendering of the value set as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context (e.g. the language of the value set is presumed to be the predominant language in the place the value set was created).The description is not intended to describe the semantics of the Value Set - there are no intrinsic semantics separate from the codes contained in its expansion. The description should capture its intended use, which is needed for ensuring integrity for its use in models across future changes. A description should be provided unless the value set is a contained resource (e.g. an anonymous value set in a profile). Most registries will require a description.

          Control1..1
          Typemarkdown
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Alternate NamesScope, Purpose, scope
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. ValueSet.useContext
          Definition

          The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate value set instances.

          ShortThe context that the content is intended to support
          Comments

          When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

          Control1..*
          TypeUsageContext
          Is Modifierfalse
          Summarytrue
          Requirements

          Assist in searching for appropriate 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 ValueSet.useContext. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • pattern @ code
          • 56. ValueSet.useContext:priorityContext
            Slice NamepriorityContext
            Definition

            The content was developed with a focus and intent of supporting the contexts that are listed. These contexts may be general categories (gender, age, ...) or may be references to specific programs (insurance plans, studies, ...) and may be used to assist with indexing and searching for appropriate value set instances.

            ShortThe context that the content is intended to support
            Comments

            When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

            Control1..1
            TypeUsageContext
            Is Modifierfalse
            Summarytrue
            Requirements

            Assist in searching for appropriate content.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. ValueSet.useContext:priorityContext.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. ValueSet.useContext:priorityContext.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())
            SlicingThis element introduces a set of slices on ValueSet.useContext.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 62. ValueSet.useContext:priorityContext.code
              Definition

              A code that identifies the type of context being specified by this usage context.

              ShortType of context being specified
              Control1..1
              BindingUnless not suitable, these codes SHALL be taken from UsageContextType
              (extensible to http://hl7.org/fhir/ValueSet/usage-context-type)

              A code that specifies a type of context being specified by a usage context.

              TypeCoding
              Is Modifierfalse
              Summarytrue
              Pattern Value{
                "system" : "http://hl7.org/fhir/us/ecr/CodeSystem/us-ph-usage-context-type",
                "code" : "priority"
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              64. ValueSet.useContext:priorityContext.value[x]
              Definition

              The US Public Health release priority of the value set.

              ShortRelease priority of the ValueSet
              Control1..1
              BindingThe codes SHALL be taken from US Public Health ValueSet Priority
              (required to http://hl7.org/fhir/us/ecr/ValueSet/us-ph-valueset-priority)

              US PH ValueSet Release Priority Codes.

              TypeCodeableConcept
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              66. ValueSet.useContext:focusConditionContext
              Slice NamefocusConditionContext
              Definition

              The clinical condition that is the focus of the codes in this value set.

              ShortThe context that the content is intended to support
              Comments

              When multiple useContexts are specified, there is no expectation that all or any of the contexts apply.

              Control0..*
              TypeUsageContext
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Assist in searching for appropriate content.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              68. ValueSet.useContext:focusConditionContext.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
              70. ValueSet.useContext:focusConditionContext.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())
              SlicingThis element introduces a set of slices on ValueSet.useContext.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 72. ValueSet.useContext:focusConditionContext.code
                Definition

                A code that identifies the type of context being specified by this usage context.

                ShortType of context being specified
                Control1..1
                BindingUnless not suitable, these codes SHALL be taken from UsageContextType
                (extensible to http://hl7.org/fhir/ValueSet/usage-context-type)

                A code that specifies a type of context being specified by a usage context.

                TypeCoding
                Is Modifierfalse
                Summarytrue
                Pattern Value{
                  "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
                  "code" : "focus"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                74. ValueSet.useContext:focusConditionContext.value[x]
                Definition

                The clinical condition that is the focus of the codes in this value set.

                ShortClinical condition that is the focus of the codes in this value set
                Control1..1
                BindingFor example codes, see Condition/Problem/DiagnosisCodes
                (example to http://hl7.org/fhir/ValueSet/condition-code)

                Condition/Problem/Diagnosis Codes.

                TypeCodeableConcept
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                76. ValueSet.jurisdiction
                Definition

                A legal or geographic region in which the value set is intended to be used.

                ShortIntended jurisdiction for value set (if applicable)
                Comments

                It may be possible for the value set to be used in jurisdictions other than those for which it was originally designed or intended.

                Control0..*
                BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
                (extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

                Countries and regions within which this artifact is targeted for use.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                78. ValueSet.immutable
                Definition

                If this is set to 'true', then no new versions of the content logical definition can be created. Note: Other metadata might still change.

                ShortIndicates whether or not any change to the content logical definition may occur
                Comments

                Normally immutability is set to 'false', which is the default assumption if it is not populated. Note that the implication is that if this is set to 'true', there may be only one ValueSet version for this definition. Immutability tends to be set to 'true' in one of two cases: - Where the value set, by the nature of its usage, cannot change. For example "All specializations of ACT in ActClassCode" - Where there's no safe way to express the "Purpose" such that someone else could safely make changes to the value set definition. Source workflow control must guarantee that the same URI always yields the same definition.

                Control0..1
                Typeboolean
                Is Modifierfalse
                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()))
                80. ValueSet.purpose
                Definition

                Explanation of why this value set is needed and why it has been designed as it has.

                ShortWhy this value set is defined
                Comments

                This element does not describe the usage of the value set. Instead, it provides traceability of ''why'' the resource is either needed or ''why'' it is defined as it is. This may be used to point to source materials or specifications that drove the structure of this value set.

                Control0..1
                Typemarkdown
                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()))
                82. ValueSet.copyright
                Definition

                A copyright statement relating to the value set and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the value set.

                ShortUse and/or publishing restrictions
                Comments

                nullFrequently, the copyright differs between the value set and the codes that are included. The copyright statement should clearly differentiate between these when required.

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

                Consumers must be able to determine any legal restrictions on the use of the value set and/or its content.

                Alternate NamesLicense, Restrictions
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                84. ValueSet.compose
                Definition

                A set of criteria that define the contents of the value set by including or excluding codes selected from the specified code system(s) that the value set draws from. This is also known as the Content Logical Definition (CLD).

                ShortContent logical definition of the value set (CLD)
                Control0..1
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Alternate NamesContent Logical Definition, CLD
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                86. ValueSet.compose.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. ValueSet.compose.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. ValueSet.compose.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. ValueSet.compose.lockedDate
                Definition

                The Locked Date is the effective date that is used to determine the version of all referenced Code Systems and Value Set Definitions included in the compose that are not already tied to a specific version.

                ShortFixed date for references with no specified version (transitive)
                Comments

                With a defined lockedDate the value set is considered "Locked". Otherwise, the value set may have different expansions as underlying code systems and/or value sets evolve. The interpretation of lockedDate is often dependent on the context - e.g. a SNOMED CT derived value set with a lockedDate will have a different expansion in USA than in UK. If a value set specifies a version for include and exclude statements, and also specifies a locked date, the specified versions need to be available that date, or the value set will not be usable.

                Control0..1
                Typedate
                Is Modifierfalse
                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()))
                94. ValueSet.compose.inactive
                Definition

                Whether inactive codes - codes that are not approved for current use - are in the value set. If inactive = true, inactive codes are to be included in the expansion, if inactive = false, the inactive codes will not be included in the expansion. If absent, the behavior is determined by the implementation, or by the applicable $expand parameters (but generally, inactive codes would be expected to be included).

                ShortWhether inactive codes are in the value set
                Comments

                Note that in the FHIR terminology framework, "deprecated" does not mean inactive, but in some code systems, e.g. LOINC, "deprecated" does mean inactive. Code systems should define what codes are considered to be inactive. If this is not clearly defined (including in the FHIR code system resource), then all codes are assumed to be active.

                The Value Set Definition specification defines an ActiveOnly element, which is the reverse of this element e.g. (ValueSet.compose.inactive=FALSE) is the same as (VSD.ActiveOnly=TRUE).

                Control0..1
                Typeboolean
                Is Modifierfalse
                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()))
                96. ValueSet.compose.include
                Definition

                Include one or more codes from a code system or other value set(s).

                ShortInclude one or more codes from a code system or other value set(s)
                Comments

                All the conditions in an include must be true. If a system is listed, all the codes from the system are listed. If one or more filters are listed, all of the filters must apply. If one or more value sets are listed, the codes must be in all the value sets. E.g. each include is 'include all the codes that meet all these conditions'.

                Control1..*
                TypeBackboneElement
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                vsd-1: A value set include/exclude SHALL have a value set or a system (valueSet.exists() or system.exists())
                vsd-2: A value set with concepts or filters SHALL include a system ((concept.exists() or filter.exists()) implies system.exists())
                vsd-3: Cannot have both concept and filter (concept.empty() or filter.empty())
                98. ValueSet.compose.include.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
                100. ValueSet.compose.include.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())
                102. ValueSet.compose.include.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())
                104. ValueSet.compose.include.system
                Definition

                An absolute URI which is the code system from which the selected codes come from.

                ShortThe system the codes come from
                Comments

                If there are no codes or filters, the entire code system is included. Note that the set of codes that are included may contain abstract codes. See ''Coding.system'' for further documentation about the correct value for the system element.

                Control0..1
                This element is affected by the following invariants: vsd-1, vsd-2
                Typeuri
                Is Modifierfalse
                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()))
                106. ValueSet.compose.include.version
                Definition

                The version of the code system that the codes are selected from, or the special version '*' for all versions.

                ShortSpecific version of the code system referred to
                Comments

                This is used when selecting the descendants of a concept - they may change between versions. If no version is specified, then the exact contents of the value set might not be known until a context of use binds it to a particular version. The special value '*' means all versions; It is at server discretion regarding expansions and which versions must be supported.

                NoteThis is a business version Id, not a resource version Id (see discussion)
                Control0..1
                Typestring
                Is Modifierfalse
                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()))
                108. ValueSet.compose.include.concept
                Definition

                Specifies a concept to be included or excluded.

                ShortA concept defined in the system
                Comments

                The list of concepts is considered ordered, though the order might not have any particular significance. Typically, the order of an expansion follows that defined in the compose element.

                Control0..*
                This element is affected by the following invariants: vsd-3
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                110. ValueSet.compose.include.concept.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
                112. ValueSet.compose.include.concept.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())
                114. ValueSet.compose.include.concept.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())
                116. ValueSet.compose.include.concept.code
                Definition

                Specifies a code for the concept to be included or excluded.

                ShortCode or expression from system
                Comments

                Expressions are allowed if defined by the underlying code system.

                Control1..1
                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()))
                118. ValueSet.compose.include.concept.display
                Definition

                The text to display to the user for this concept in the context of this valueset. If no display is provided, then applications using the value set use the display specified for the code by the system.

                ShortText to display for this code for this value set in this valueset
                Comments

                The value set resource allows for an alternative display to be specified for when this concept is used in this particular value set. See notes in the value set narrative about the correct use of this element.

                Control0..1
                Typestring
                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()))
                120. ValueSet.compose.include.concept.designation
                Definition

                Additional representations for this concept when used in this value set - other languages, aliases, specialized purposes, used for particular purposes, etc.

                ShortAdditional representations for this concept
                Comments

                Concepts have both a display and an array of designation. The display is equivalent to a special designation with an implied designation.use of "primary code" and a language equal to the Resource Language.

                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                122. ValueSet.compose.include.concept.designation.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
                124. ValueSet.compose.include.concept.designation.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())
                126. ValueSet.compose.include.concept.designation.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())
                128. ValueSet.compose.include.concept.designation.language
                Definition

                The language this designation is defined for.

                ShortHuman language of the designation
                Comments

                In the absence of a language, the resource language applies.

                Control0..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
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                130. ValueSet.compose.include.concept.designation.use
                Definition

                A code that represents types of uses of designations.

                ShortTypes of uses of designations
                Comments

                If no use is provided, the designation can be assumed to be suitable for general display to a human user.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from DesignationUse
                (extensible to http://hl7.org/fhir/ValueSet/designation-use)

                Details of how a designation would be used.

                TypeCoding
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                132. ValueSet.compose.include.concept.designation.value
                Definition

                The text value for this designation.

                ShortThe text value for this designation
                Control1..1
                Typestring
                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()))
                134. ValueSet.compose.include.filter
                Definition

                Select concepts by specify a matching criterion based on the properties (including relationships) defined by the system, or on filters defined by the system. If multiple filters are specified, they SHALL all be true.

                ShortSelect codes/concepts by their properties (including relationships)
                Comments

                Selecting codes by specifying filters based on properties is only possible where the underlying code system defines appropriate properties. Note that in some cases, the underlying code system defines the logical concepts but not the literal codes for the concepts. In such cases, the literal definitions may be provided by a third party.

                Control0..*
                This element is affected by the following invariants: vsd-3
                TypeBackboneElement
                Is Modifierfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                136. ValueSet.compose.include.filter.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
                138. ValueSet.compose.include.filter.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())
                140. ValueSet.compose.include.filter.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())
                142. ValueSet.compose.include.filter.property
                Definition

                A code that identifies a property or a filter defined in the code system.

                ShortA property/filter defined by the code system
                Control1..1
                Typecode
                Is Modifierfalse
                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()))
                144. ValueSet.compose.include.filter.op
                Definition

                The kind of operation to perform as a part of the filter criteria.

                Short= | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists
                Comments

                In case filter.property represents a property of the system, the operation applies to the selected property. In case filter.property represents a filter of the system, the operation SHALL match one of the CodeSystem.filter.operator values.

                Control1..1
                BindingThe codes SHALL be taken from FilterOperator
                (required to http://hl7.org/fhir/ValueSet/filter-operator|4.0.1)

                The kind of operation to perform as a part of a property based filter.

                Typecode
                Is Modifierfalse
                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()))
                146. ValueSet.compose.include.filter.value
                Definition

                The match value may be either a code defined by the system, or a string value, which is a regex match on the literal string of the property value (if the filter represents a property defined in CodeSystem) or of the system filter value (if the filter represents a filter defined in CodeSystem) when the operation is 'regex', or one of the values (true and false), when the operation is 'exists'.

                ShortCode from the system, or regex criteria, or boolean value for exists
                Comments

                Use regex matching with care - full regex matching on every SNOMED CT term is prohibitive, for example.

                Control1..1
                Typestring
                Is Modifierfalse
                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()))
                148. ValueSet.compose.include.valueSet
                Definition

                Selects the concepts found in this value set (based on its value set definition). This is an absolute URI that is a reference to ValueSet.url. If multiple value sets are specified this includes the union of the contents of all of the referenced value sets.

                ShortSelect the contents included in this value set
                Comments

                The value set URI is either a logical reference to a defined value set such as a SNOMED CT reference set, or a direct reference to a value set definition using ValueSet.url. The reference might not refer to an actual FHIR ValueSet resource; in this case, whatever is referred to is an implicit definition of a value set that needs to be clear about how versions are resolved.

                Control0..*
                This element is affected by the following invariants: vsd-1
                Typecanonical(ValueSet)
                Is Modifierfalse
                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()))
                150. ValueSet.compose.exclude
                Definition

                Exclude one or more codes from the value set based on code system filters and/or other value sets.

                ShortExplicitly exclude codes from a code system or other value sets
                Comments

                Usually this is used to selectively exclude codes that were included by subsumption in the inclusions. Any display names specified for the codes are ignored.

                Control0..*
                This element is affected by the following invariants: vsd-2
                TypeSeettp://hl7.org/fhir/StructureDefinition/ValueSet#ValueSet.compose.include
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                152. ValueSet.expansion
                Definition

                A value set can also be "expanded", where the value set is turned into a simple collection of enumerated codes. This element holds the expansion, if it has been performed.

                ShortUsed when the value set is "expanded"
                Comments

                Expansion is performed to produce a collection of codes that are ready to use for data entry or validation. Value set expansions are always considered to be stateless - they are a record of the set of codes in the value set at a point in time under a given set of conditions, and are not subject to ongoing maintenance.

                Expansion.parameter is a simplified list of parameters - a subset of the features of the Parameters resource.

                Control1..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                154. ValueSet.expansion.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
                156. ValueSet.expansion.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())
                158. ValueSet.expansion.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())
                160. ValueSet.expansion.identifier
                Definition

                An identifier that uniquely identifies this expansion of the valueset, based on a unique combination of the provided parameters, the system default parameters, and the underlying system code system versions etc. Systems may re-use the same identifier as long as those factors remain the same, and the expansion is the same, but are not required to do so. This is a business identifier.

                ShortIdentifies the value set expansion (business identifier)
                Comments

                Typically, this uri is a UUID (e.g. urn:uuid:8230ff20-c97a-4167-a59d-dc2cb9df16dd).

                NoteThis is a business identifier, not a resource identifier (see discussion)
                Control0..1
                Typeuri
                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()))
                162. ValueSet.expansion.timestamp
                Definition

                The time at which the expansion was produced by the expanding system.

                ShortTime ValueSet expansion happened
                Comments

                This SHOULD be a fully populated instant, but in some circumstances, value sets are expanded by hand, and the expansion is published without that precision.

                Control1..1
                TypedateTime
                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()))
                164. ValueSet.expansion.total
                Definition

                The total number of concepts in the expansion. If the number of concept nodes in this resource is less than the stated number, then the server can return more using the offset parameter.

                ShortTotal number of codes in the expansion
                Comments

                Paging only applies to flat expansions.

                Control0..1
                Typeinteger
                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()))
                166. ValueSet.expansion.offset
                Definition

                If paging is being used, the offset at which this resource starts. I.e. this resource is a partial view into the expansion. If paging is not being used, this element SHALL NOT be present.

                ShortOffset at which this resource starts
                Comments

                Paging only applies to flat expansions. If a filter is applied, the count is the number of concepts that matched the filter, not the number of concepts in an unfiltered view of the expansion.

                Control0..1
                Typeinteger
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Meaning if MissingPaging is not being used
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                168. ValueSet.expansion.parameter
                Definition

                A parameter that controlled the expansion process. These parameters may be used by users of expanded value sets to check whether the expansion is suitable for a particular purpose, or to pick the correct expansion.

                ShortParameter that controlled the expansion process
                Comments

                The server decides which parameters to include here, but at a minimum, the list SHOULD include all of the parameters that affect the $expand operation. If the expansion will be persisted all of these parameters SHALL be included. If the codeSystem on the server has a specified version then this version SHALL be provided as a parameter in the expansion (note that not all code systems have a version).

                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                170. ValueSet.expansion.parameter.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. ValueSet.expansion.parameter.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. ValueSet.expansion.parameter.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. ValueSet.expansion.parameter.name
                Definition

                Name of the input parameter to the $expand operation; may be a server-assigned name for additional default or other server-supplied parameters used to control the expansion process.

                ShortName as assigned by the client or server
                Comments

                The names are assigned at the discretion of the server.

                Control1..1
                Typestring
                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()))
                178. ValueSet.expansion.parameter.value[x]
                Definition

                The value of the parameter.

                ShortValue of the named parameter
                Control0..1
                TypeChoice of: string, boolean, integer, decimal, uri, code, dateTime
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                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()))
                180. ValueSet.expansion.contains
                Definition

                The codes that are contained in the value set expansion.

                ShortCodes in the value set
                Control0..*
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                vsd-6: SHALL have a code or a display (code.exists() or display.exists())
                vsd-9: Must have a code if not abstract (code.exists() or abstract = true)
                vsd-10: Must have a system if a code is present (code.empty() or system.exists())
                182. ValueSet.expansion.contains.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
                184. ValueSet.expansion.contains.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())
                186. ValueSet.expansion.contains.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())
                188. ValueSet.expansion.contains.system
                Definition

                An absolute URI which is the code system in which the code for this item in the expansion is defined.

                ShortSystem value for the code
                Control0..1
                Typeuri
                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()))
                190. ValueSet.expansion.contains.abstract
                Definition

                If true, this entry is included in the expansion for navigational purposes, and the user cannot select the code directly as a proper value.

                ShortIf user cannot select this entry
                Comments

                This should not be understood to exclude its use for searching (e.g. by subsumption testing). The client should know whether it is appropriate for the user to select an abstract code or not.

                Control0..1
                Typeboolean
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summaryfalse
                Meaning if MissingIf this is not populated, systems can assume that the concept it not abstract. This SHALL always be populated for abstract concepts
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                192. ValueSet.expansion.contains.inactive
                Definition

                If the concept is inactive in the code system that defines it. Inactive codes are those that are no longer to be used, but are maintained by the code system for understanding legacy data. It might not be known or specified whether an concept is inactive (and it may depend on the context of use).

                ShortIf concept is inactive in the code system
                Comments

                This should only have a value if the concept is inactive.

                Control0..1
                Typeboolean
                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()))
                194. ValueSet.expansion.contains.version
                Definition

                The version of the code system from this code was taken. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                ShortVersion in which this code/display is defined
                Comments

                The exact value of the version string is specified by the system from which the code is derived.

                NoteThis is a business version Id, not a resource version Id (see discussion)
                Control0..1
                Typestring
                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()))
                196. ValueSet.expansion.contains.code
                Definition

                The code for this item in the expansion hierarchy. If this code is missing the entry in the hierarchy is a place holder (abstract) and does not represent a valid code in the value set.

                ShortCode - if blank, this is not a selectable code
                Control0..1
                This element is affected by the following invariants: vsd-6
                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()))
                198. ValueSet.expansion.contains.display
                Definition

                The recommended display for this item in the expansion.

                ShortUser display for the concept
                Control0..1
                This element is affected by the following invariants: vsd-6
                Typestring
                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()))
                200. ValueSet.expansion.contains.designation
                Definition

                Additional representations for this item - other languages, aliases, specialized purposes, used for particular purposes, etc. These are relevant when the conditions of the expansion do not fix to a single correct representation.

                ShortAdditional representations for this item
                Comments

                The designations provided must be based on the value set and code system definitions.

                Control0..*
                TypeSeettp://hl7.org/fhir/StructureDefinition/ValueSet#ValueSet.compose.include.concept.designation
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                202. ValueSet.expansion.contains.contains
                Definition

                Other codes and entries contained under this entry in the hierarchy.

                ShortCodes contained under this entry
                Comments

                If the expansion uses this element, there is no implication about the logical relationship between them, and the structure cannot be used for logical inferencing. The structure exists to provide navigational assistance for helping human users to locate codes in the expansion.

                Control0..*
                TypeSeettp://hl7.org/fhir/StructureDefinition/ValueSet#ValueSet.expansion.contains
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))