Vital Records Mortality and Morbidity Reporting FHIR Implementation Guide
1.0.0 - STU 1

This page is part of the Vital Records Mortality and Morbidity Reporting FHIR IG (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

Resource Profile: Death Certification

Defining URL:http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Certification
Version:1.0.0
Name:DeathCertification
Title:VRDR Death Certification
Status:Draft as of 2020-05-09
Publisher:Health Level Seven International
Source Resource:XML / JSON / Turtle

The official URL for this profile is: 

http://hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Death-Certification

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from USCoreProcedureProfile

Summary

Mandatory: 8 elements
Fixed Value: 3 elements

Structures

This structure refers to these other structures:

This structure is derived from USCoreProcedureProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure 0..*USCoreProcedureProfileAn action that is being or was performed on a patient
... identifier 1..*IdentifierExternal Identifiers for this procedure
... status 1..1codestatus
Fixed Value: completed
... category 1..1CodeableConceptcategory
Fixed Value: As shown
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 103693007
..... display1..1stringRepresentation defined by the system
Fixed Value: Diagnostic procedure
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 308646001
..... display1..1stringRepresentation defined by the system
Fixed Value: Death certification
... performed[x] 1..1dateTimecertificationDatetime
... performer 1..1BackboneElementThe people who performed the procedure
.... function 1..1CodeableConceptType of performance
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.6001 (required)
.... actor 1..1Reference(VRDR Certifier)The reference to the practitioner

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure 0..*USCoreProcedureProfileAn action that is being or was performed on a patient
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ1..*IdentifierExternal Identifiers for this procedure
... instantiatesCanonical Σ0..*canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | ServiceRequest)A request for this procedure
... partOf Σ0..*Reference(Procedure | Observation | MedicationAdministration)Part of referenced event
... status ?!SΣ1..1codestatus
Binding: EventStatus (required)
Fixed Value: completed
... statusReason Σ0..1CodeableConceptReason for current status
Binding: ProcedureNotPerformedReason(SNOMED-CT) (example)
... category Σ1..1CodeableConceptcategory
Binding: ProcedureCategoryCodes(SNOMEDCT) (example)
Fixed Value: As shown
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 103693007
..... display1..1stringRepresentation defined by the system
Fixed Value: Diagnostic procedure
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... code SΣ1..1CodeableConceptcode
Binding: US Core Procedure Codes (extensible)
Fixed Value: As shown
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 308646001
..... display1..1stringRepresentation defined by the system
Fixed Value: Death certification
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who the procedure was performed on
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... performed[x] SΣ1..1dateTimecertificationDatetime
... recorder Σ0..1Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)Who recorded the procedure
... asserter Σ0..1Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)Person who asserts this procedure
... performer Σ1..1BackboneElementThe people who performed the procedure
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function Σ1..1CodeableConceptType of performance
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.6001 (required)
.... actor Σ1..1Reference(VRDR Certifier)The reference to the practitioner
.... onBehalfOf 0..1Reference(Organization)Organization the device or practitioner was acting for
... location Σ0..1Reference(Location)Where the procedure happened
... reasonCode Σ0..*CodeableConceptCoded reason procedure performed
Binding: ProcedureReasonCodes (example)
... reasonReference Σ0..*Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference)The justification that the procedure was performed
... bodySite Σ0..*CodeableConceptTarget body sites
Binding: SNOMEDCTBodyStructures (example)
... outcome Σ0..1CodeableConceptThe result of procedure
Binding: ProcedureOutcomeCodes(SNOMEDCT) (example)
... report 0..*Reference(DiagnosticReport | DocumentReference | Composition)Any report resulting from the procedure
... complication 0..*CodeableConceptComplication following the procedure
Binding: Condition/Problem/DiagnosisCodes (example)
... complicationDetail 0..*Reference(Condition)A condition that is a result of the procedure
... followUp 0..*CodeableConceptInstructions for follow up
Binding: ProcedureFollowUpCodes(SNOMEDCT) (example)
... note 0..*AnnotationAdditional information about the procedure
... focalDevice 0..*BackboneElementManipulated, implanted, or removed device
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... action 0..1CodeableConceptKind of change to device
Binding: ProcedureDeviceActionCodes (preferred)
.... manipulated 1..1Reference(Device)Device that was changed
... usedReference 0..*Reference(Device | Medication | Substance)Items used during procedure
... usedCode 0..*CodeableConceptCoded items used during the procedure
Binding: FHIRDeviceTypes (example)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure 0..*USCoreProcedureProfileAn action that is being or was performed on a patient
... status ?!Σ1..1codestatus
Binding: EventStatus (required)
Fixed Value: completed
... code Σ1..1CodeableConceptcode
Binding: US Core Procedure Codes (extensible)
Fixed Value: As shown
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 308646001
..... display1..1stringRepresentation defined by the system
Fixed Value: Death certification
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... subject Σ1..1Reference(US Core Patient Profile)Who the procedure was performed on

doco Documentation for this format

This structure is derived from USCoreProcedureProfile

Summary

Mandatory: 8 elements
Fixed Value: 3 elements

Structures

This structure refers to these other structures:

Differential View

This structure is derived from USCoreProcedureProfile

NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure 0..*USCoreProcedureProfileAn action that is being or was performed on a patient
... identifier 1..*IdentifierExternal Identifiers for this procedure
... status 1..1codestatus
Fixed Value: completed
... category 1..1CodeableConceptcategory
Fixed Value: As shown
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 103693007
..... display1..1stringRepresentation defined by the system
Fixed Value: Diagnostic procedure
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 308646001
..... display1..1stringRepresentation defined by the system
Fixed Value: Death certification
... performed[x] 1..1dateTimecertificationDatetime
... performer 1..1BackboneElementThe people who performed the procedure
.... function 1..1CodeableConceptType of performance
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.6001 (required)
.... actor 1..1Reference(VRDR Certifier)The reference to the practitioner

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Procedure 0..*USCoreProcedureProfileAn action that is being or was performed on a patient
... id Σ0..1stringLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ1..*IdentifierExternal Identifiers for this procedure
... instantiatesCanonical Σ0..*canonical(PlanDefinition | ActivityDefinition | Measure | OperationDefinition | Questionnaire)Instantiates FHIR protocol or definition
... instantiatesUri Σ0..*uriInstantiates external protocol or definition
... basedOn Σ0..*Reference(CarePlan | ServiceRequest)A request for this procedure
... partOf Σ0..*Reference(Procedure | Observation | MedicationAdministration)Part of referenced event
... status ?!SΣ1..1codestatus
Binding: EventStatus (required)
Fixed Value: completed
... statusReason Σ0..1CodeableConceptReason for current status
Binding: ProcedureNotPerformedReason(SNOMED-CT) (example)
... category Σ1..1CodeableConceptcategory
Binding: ProcedureCategoryCodes(SNOMEDCT) (example)
Fixed Value: As shown
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 103693007
..... display1..1stringRepresentation defined by the system
Fixed Value: Diagnostic procedure
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... code SΣ1..1CodeableConceptcode
Binding: US Core Procedure Codes (extensible)
Fixed Value: As shown
.... id0..0stringUnique id for inter-element referencing
.... extension0..0ExtensionAdditional content defined by implementations
.... coding1..1CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..0stringUnique id for inter-element referencing
..... extension0..0ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version0..0stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 308646001
..... display1..1stringRepresentation defined by the system
Fixed Value: Death certification
..... userSelected0..0booleanIf this coding was chosen directly by the user
.... text0..0stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who the procedure was performed on
... encounter Σ0..1Reference(Encounter)Encounter created as part of
... performed[x] SΣ1..1dateTimecertificationDatetime
... recorder Σ0..1Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)Who recorded the procedure
... asserter Σ0..1Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)Person who asserts this procedure
... performer Σ1..1BackboneElementThe people who performed the procedure
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... function Σ1..1CodeableConceptType of performance
Binding: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.6001 (required)
.... actor Σ1..1Reference(VRDR Certifier)The reference to the practitioner
.... onBehalfOf 0..1Reference(Organization)Organization the device or practitioner was acting for
... location Σ0..1Reference(Location)Where the procedure happened
... reasonCode Σ0..*CodeableConceptCoded reason procedure performed
Binding: ProcedureReasonCodes (example)
... reasonReference Σ0..*Reference(Condition | Observation | Procedure | DiagnosticReport | DocumentReference)The justification that the procedure was performed
... bodySite Σ0..*CodeableConceptTarget body sites
Binding: SNOMEDCTBodyStructures (example)
... outcome Σ0..1CodeableConceptThe result of procedure
Binding: ProcedureOutcomeCodes(SNOMEDCT) (example)
... report 0..*Reference(DiagnosticReport | DocumentReference | Composition)Any report resulting from the procedure
... complication 0..*CodeableConceptComplication following the procedure
Binding: Condition/Problem/DiagnosisCodes (example)
... complicationDetail 0..*Reference(Condition)A condition that is a result of the procedure
... followUp 0..*CodeableConceptInstructions for follow up
Binding: ProcedureFollowUpCodes(SNOMEDCT) (example)
... note 0..*AnnotationAdditional information about the procedure
... focalDevice 0..*BackboneElementManipulated, implanted, or removed device
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... action 0..1CodeableConceptKind of change to device
Binding: ProcedureDeviceActionCodes (preferred)
.... manipulated 1..1Reference(Device)Device that was changed
... usedReference 0..*Reference(Device | Medication | Substance)Items used during procedure
... usedCode 0..*CodeableConceptCoded items used during the procedure
Binding: FHIRDeviceTypes (example)

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

PathConformanceValueSet / Code
Procedure.languagepreferredCommonLanguages
Max Binding: AllLanguages
Procedure.statusrequiredFixed Value: completed
Procedure.statusReasonexampleProcedureNotPerformedReason(SNOMED-CT)
Procedure.categoryexampleFixed Value: SNOMED CT code 103693007("Diagnostic procedure")
Procedure.codeextensibleFixed Value: SNOMED CT code 308646001("Death certification")
Procedure.performer.functionrequiredhttps://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.6001
Procedure.reasonCodeexampleProcedureReasonCodes
Procedure.bodySiteexampleSNOMEDCTBodyStructures
Procedure.outcomeexampleProcedureOutcomeCodes(SNOMEDCT)
Procedure.complicationexampleCondition/Problem/DiagnosisCodes
Procedure.followUpexampleProcedureFollowUpCodes(SNOMEDCT)
Procedure.focalDevice.actionpreferredProcedureDeviceActionCodes
Procedure.usedCodeexampleFHIRDeviceTypes

Constraints

IdPathDetailsRequirements
dom-2ProcedureIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3ProcedureIf 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-4ProcedureIf 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-5ProcedureIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6ProcedureA resource should have narrative for robust management
: text.`div`.exists()
ele-1Procedure.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Procedure.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Procedure.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Procedure.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Procedure.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.instantiatesCanonicalAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.instantiatesUriAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.basedOnAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.partOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.statusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.statusReasonAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.subjectAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.performed[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.recorderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.asserterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.performerAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.performer.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Procedure.performer.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Procedure.performer.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Procedure.performer.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Procedure.performer.functionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.performer.actorAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.performer.onBehalfOfAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.locationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.reasonCodeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.reasonReferenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.bodySiteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.outcomeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.reportAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.complicationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.complicationDetailAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.followUpAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.focalDeviceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.focalDevice.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Procedure.focalDevice.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Procedure.focalDevice.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1Procedure.focalDevice.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1Procedure.focalDevice.actionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.focalDevice.manipulatedAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.usedReferenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1Procedure.usedCodeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())