Extensions for Using Data Elements from FHIR R4 in FHIR STU3
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Extensions for Using Data Elements from FHIR R4 in FHIR STU3 - Downloaded Version null See the Directory of published versions

Resource Profile: Profile_R4_CodeSystem_R3 - Detailed Descriptions

Page standards status: Trial-use Maturity Level: 0

Definitions for the profile-CodeSystem resource profile.

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

0. CodeSystem
Definition

A code system resource specifies a set of codes drawn from one or more code systems.

ShortA set of codes drawn from one or more code systems
Control0..*
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
csd-1: Within a code system definition, all the codes SHALL be unique ((concept.code | descendants().concept.code).isDistinct())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
csd-1: Within a code system definition, all the codes SHALL be unique ((concept.code | descendants().concept.code).isDistinct())
2. CodeSystem.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.

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.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Control0..1
Typeuri
Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
4. CodeSystem.extension
Definition

An Extension


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

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.

Control0..*
TypeExtension
Alternate Namesextensions, user content
SlicingThis element introduces a set of slices on CodeSystem.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. CodeSystem.extension:supplements
    Slice Namesupplements
    Definition

    R4: CodeSystem.supplements (new:canonical(CodeSystem))

    ShortR4: Canonical URL of Code System this adds designations and properties to (new)
    Comments

    Element CodeSystem.supplements has a context of CodeSystem based on following the parent source element upwards and mapping to CodeSystem. Element CodeSystem.supplements has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The most common use of a code system supplement is to add additional language support.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(R4: Canonical URL of Code System this adds designations and properties to (new)) (Extension Type: uri(Cross-version Profile for R4.CodeSystem for use in FHIR STU3, CodeSystem))
    Is Modifierfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. CodeSystem.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. Usually modifier elements provide negation or qualification. In order 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.

    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 No Modifier Reason provideed in previous versions of FHIR
    Alternate Namesextensions, user content
    10. CodeSystem.status
    Definition

    The status of this code system. Enables tracking the life-cycle of the content.

    Shortdraft | active | retired | unknown
    Comments

    Allows filtering of code systems that are appropriate for use vs. not.
    This is labeled as "Is Modifier" because applications should not use a retired code system without due consideration.

    Control1..1
    BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|3.0.2
    (required to http://hl7.org/fhir/ValueSet/publication-status|3.0.2)

    The lifecycle status of a Value Set or Concept Map.

    Typecode
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    12. CodeSystem.experimental
    Definition

    A boolean value to indicate that this code system 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 code system that are appropriate for use vs. not. This is labeled as "Is Modifier" because applications should not use an experimental code system in production.

    Control0..1
    Typeboolean
    Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
    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 code system.

    14. CodeSystem.content
    Definition

    How much of the content of the code system - the concepts and codes it defines - are represented in this resource.

    Shortnot-present | example | fragment | complete
    Control1..1
    BindingThe codes SHALL be taken from CodeSystemContentMode .http://hl7.org/fhir/ValueSet/codesystem-content-mode|3.0.2
    (required to http://hl7.org/fhir/ValueSet/codesystem-content-mode|3.0.2)

    How much of the content of the code system - the concepts and codes it defines - are represented in a code system resource

    Typecode
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    16. CodeSystem.content.extension
    Definition

    An Extension


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

    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.

    Control0..*
    TypeExtension
    Alternate Namesextensions, user content
    SlicingThis element introduces a set of slices on CodeSystem.content.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. CodeSystem.content.extension:content
      Slice Namecontent
      Definition

      R4: CodeSystem.content

      ShortR4: not-present | example | fragment | complete | supplement
      Comments

      Element CodeSystem.content is mapped to FHIR STU3 element CodeSystem.content as SourceIsBroaderThanTarget.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(R4: not-present | example | fragment | complete | supplement) (Extension Type: code)
      Is Modifierfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (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 foundhere

      0. CodeSystem
      2. CodeSystem.extension
      Control0..*
      SlicingThis element introduces a set of slices on CodeSystem.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 4. CodeSystem.extension:supplements
        Slice Namesupplements
        Definition

        R4: CodeSystem.supplements (new:canonical(CodeSystem))

        ShortR4: Canonical URL of Code System this adds designations and properties to (new)
        Comments

        Element CodeSystem.supplements has a context of CodeSystem based on following the parent source element upwards and mapping to CodeSystem. Element CodeSystem.supplements has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The most common use of a code system supplement is to add additional language support.

        Control0..1
        TypeExtension(R4: Canonical URL of Code System this adds designations and properties to (new)) (Extension Type: uri(Cross-version Profile for R4.CodeSystem for use in FHIR STU3, CodeSystem))
        6. CodeSystem.content
        8. CodeSystem.content.extension
        Control0..*
        SlicingThis element introduces a set of slices on CodeSystem.content.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 10. CodeSystem.content.extension:content
          Slice Namecontent
          Definition

          R4: CodeSystem.content

          ShortR4: not-present | example | fragment | complete | supplement
          Comments

          Element CodeSystem.content is mapped to FHIR STU3 element CodeSystem.content as SourceIsBroaderThanTarget.

          Control0..1
          TypeExtension(R4: not-present | example | fragment | complete | supplement) (Extension Type: code)
          12. CodeSystem.property
          14. CodeSystem.property.type
          16. CodeSystem.property.type.extension
          Control0..*
          SlicingThis element introduces a set of slices on CodeSystem.property.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 18. CodeSystem.property.type.extension:type
            Slice Nametype
            Definition

            R4: CodeSystem.property.type

            ShortR4: code | Coding | string | integer | boolean | dateTime | decimal
            Comments

            Element CodeSystem.property.type is mapped to FHIR STU3 element CodeSystem.property.type as SourceIsBroaderThanTarget.

            Control0..1
            TypeExtension(R4: code | Coding | string | integer | boolean | dateTime | decimal) (Extension Type: code)
            20. CodeSystem.concept
            22. CodeSystem.concept.property
            24. CodeSystem.concept.property.extension
            Control0..*
            SlicingThis element introduces a set of slices on CodeSystem.concept.property.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 26. CodeSystem.concept.property.extension:value
              Slice Namevalue
              Definition

              R4: CodeSystem.concept.property.value[x] additional types (decimal)

              ShortR4: value additional types
              Comments

              Element CodeSystem.concept.property.value[x] is mapped to FHIR STU3 element CodeSystem.concept.property.value[x] as SourceIsBroaderThanTarget. The mappings for CodeSystem.concept.property.value[x] do not cover the following types: decimal. The target context CodeSystem.concept.property.value[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element CodeSystem.concept.property.

              Control0..1
              TypeExtension(R4: value additional types) (Extension Type: decimal)

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

              0. CodeSystem
              Definition

              A code system resource specifies a set of codes drawn from one or more code systems.

              ShortA set of codes drawn from one or more code systems
              Control0..*
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.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-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
              csd-1: Within a code system definition, all the codes SHALL be unique ((concept.code | descendants().concept.code).isDistinct())
              2. CodeSystem.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
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              4. CodeSystem.meta
              Definition

              The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Summarytrue
              6. CodeSystem.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.

              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.

              This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

              Control0..1
              Typeuri
              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              8. CodeSystem.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
              BindingUnless not suitable, these codes SHALL be taken from Common Languages
              (extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

              A human language.

              Additional BindingsPurpose
              All LanguagesMax Binding
              Typecode
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              10. CodeSystem.text
              Definition

              A human-readable narrative that contains a summary of the resource, and may 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 in formation is added later.

              Control0..1
              This element is affected by the following invariants: dom-1
              TypeNarrative
              Alternate Namesnarrative, html, xhtml, display
              12. CodeSystem.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.

              Control0..*
              TypeResource
              Alternate Namesinline resources, anonymous resources, contained resources
              14. CodeSystem.extension
              Definition

              An Extension

              ShortExtension
              Control0..*
              TypeExtension
              SlicingThis element introduces a set of slices on CodeSystem.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 16. CodeSystem.extension:supplements
                Slice Namesupplements
                Definition

                R4: CodeSystem.supplements (new:canonical(CodeSystem))

                ShortR4: Canonical URL of Code System this adds designations and properties to (new)
                Comments

                Element CodeSystem.supplements has a context of CodeSystem based on following the parent source element upwards and mapping to CodeSystem. Element CodeSystem.supplements has no mapping targets in FHIR STU3. Typically, this is because the element has been added (is a new element). The most common use of a code system supplement is to add additional language support.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(R4: Canonical URL of Code System this adds designations and properties to (new)) (Extension Type: uri(Cross-version Profile for R4.CodeSystem for use in FHIR STU3, CodeSystem))
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                18. CodeSystem.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. Usually modifier elements provide negation or qualification. In order 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.

                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 No Modifier Reason provideed in previous versions of FHIR
                Alternate Namesextensions, user content
                20. CodeSystem.url
                Definition

                An absolute URI that is used to identify this code system when it is referenced in a specification, model, design or an instance. This SHALL be a URL, SHOULD be globally unique, and SHOULD be an address at which this code system is (or will be) published. The URL SHOULD include the major version of the code system. For more information see Technical and Business Versions. This is used in [Coding]{datatypes.html#Coding}.system.

                ShortLogical URI to reference this code system (globally unique) (Coding.system)
                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.

                Control0..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                Allows the code system to be referenced by a single globally unique identifier.

                22. CodeSystem.identifier
                Definition

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

                ShortAdditional identifier for the code system
                Comments

                Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, e.g., to identify this code system 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..1
                TypeIdentifier
                Summarytrue
                Requirements

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

                24. CodeSystem.version
                Definition

                The identifier that is used to identify this version of the code system when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the code system 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. This is used in [Coding]{datatypes.html#Coding}.version.

                ShortBusiness version of the code system (Coding.version)
                Comments

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

                NoteThis is a business version Id, not a resource version Id (see discussion)
                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                26. CodeSystem.name
                Definition

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

                ShortName for this code system (computer friendly)
                Comments

                The name is not expected to be globally unique. The name should be a simple alpha-numeric type name to ensure that it is computable friendly.

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

                Support human navigation and code generation.

                28. CodeSystem.title
                Definition

                A short, descriptive, user-friendly title for the code system.

                ShortName for this code system (human friendly)
                Comments

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

                Control0..1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                30. CodeSystem.status
                Definition

                The status of this code system. Enables tracking the life-cycle of the content.

                Shortdraft | active | retired | unknown
                Comments

                Allows filtering of code systems that are appropriate for use vs. not.
                This is labeled as "Is Modifier" because applications should not use a retired code system without due consideration.

                Control1..1
                BindingThe codes SHALL be taken from PublicationStatus
                (required to http://hl7.org/fhir/ValueSet/publication-status|3.0.2)

                The lifecycle status of a Value Set or Concept Map.

                Typecode
                Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                32. CodeSystem.experimental
                Definition

                A boolean value to indicate that this code system 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 code system that are appropriate for use vs. not. This is labeled as "Is Modifier" because applications should not use an experimental code system in production.

                Control0..1
                Typeboolean
                Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                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 code system.

                34. CodeSystem.date
                Definition

                The date (and optionally time) when the code system was published. The date must change if and when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the code system changes.

                ShortDate this was 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 code system. Additional specific dates may be added as extensions or be found by consulting Provenances associated with past versions of the resource.

                Control0..1
                TypedateTime
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Alternate NamesRevision Date
                36. CodeSystem.publisher
                Definition

                The name of the individual or organization that published the code system.

                ShortName of the publisher (organization or individual)
                Comments

                Usually an organization, but may be an individual. The publisher (or steward) of the code system is the organization or individual primarily responsible for the maintenance and upkeep of the code system. 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 code system. This item SHOULD be populated unless the information is available from context.

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

                Helps establish the "authority/credibility" of the code system. May also allow for contact.

                38. CodeSystem.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
                Summarytrue
                40. CodeSystem.description
                Definition

                A free text natural language description of the code system from a consumer's perspective.

                ShortNatural language description of the code system
                Comments

                This description can be used to capture details such as why the code system 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 code system 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 profile is presumed to be the predominant language in the place the profile was created).

                Control0..1
                Typemarkdown
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Alternate NamesScope, Purpose
                42. CodeSystem.useContext
                Definition

                The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate code system instances.

                ShortContext the content is intended to support
                Comments

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

                Control0..*
                TypeUsageContext
                Summarytrue
                Requirements

                Assist in searching for appropriate content.

                44. CodeSystem.jurisdiction
                Definition

                A legal or geographic region in which the code system is intended to be used.

                ShortIntended jurisdiction for code system (if applicable)
                Comments

                It may be possible for the code system 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|3.0.2)

                Countries and regions within which this artifact is targeted for use

                TypeCodeableConcept
                Summarytrue
                46. CodeSystem.purpose
                Definition

                Explaination of why this code system is needed and why it has been designed as it has.

                ShortWhy this code system is defined
                Comments

                This element does not describe the usage of the code system 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 code system.

                Control0..1
                Typemarkdown
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                48. CodeSystem.copyright
                Definition

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

                ShortUse and/or publishing restrictions
                Comments

                ... Sometimes, the copyright differs between the code system and the codes that are included. The copyright statement should clearly differentiate between these when required.

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

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

                Alternate NamesLicense, Restrictions
                50. CodeSystem.caseSensitive
                Definition

                If code comparison is case sensitive when codes within this system are compared to each other.

                ShortIf code comparison is case sensitive
                Comments

                If this value is missing, then it is not specified whether a code system is case sensitive or not. When the rule is not known, Postel's law should be followed: produce codes with the correct case, and accept codes in any case. This element is primarily provided to support validation software.

                Control0..1
                Typeboolean
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                52. CodeSystem.valueSet
                Definition

                Canonical URL of value set that contains the entire code system.

                ShortCanonical URL for value set with entire code system
                Comments

                The definition of the value set SHALL include all codes from this code system, and it SHALL be immutable.

                Control0..1
                Typeuri
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                54. CodeSystem.hierarchyMeaning
                Definition

                The meaning of the hierarchy of concepts.

                Shortgrouped-by | is-a | part-of | classified-with
                Control0..1
                BindingThe codes SHALL be taken from CodeSystemHierarchyMeaning
                (required to http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|3.0.2)

                The meaning of the hierarchy of concepts in a code system

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                56. CodeSystem.compositional
                Definition

                True If code system defines a post-composition grammar.

                ShortIf code system defines a post-composition grammar
                Comments

                Note that the code system resource does not define what the compositional grammar is, only whether or not there is one.

                Control0..1
                Typeboolean
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Alternate Namesgrammar
                58. CodeSystem.versionNeeded
                Definition

                This flag is used to signify that the code system has not (or does not) maintain the definitions, and a version must be specified when referencing this code system.

                ShortIf definitions are not stable
                Comments

                Best practice is that code systems do not redefine concepts, or that if concepts are redefined, a new code system definition is created. But this is not always possible, so some code systems may be defined as 'versionNeeded'.

                Control0..1
                Typeboolean
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                60. CodeSystem.content
                Definition

                How much of the content of the code system - the concepts and codes it defines - are represented in this resource.

                Shortnot-present | example | fragment | complete
                Control1..1
                BindingThe codes SHALL be taken from CodeSystemContentMode .
                (required to http://hl7.org/fhir/ValueSet/codesystem-content-mode|3.0.2)

                How much of the content of the code system - the concepts and codes it defines - are represented in a code system resource

                Typecode
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                62. CodeSystem.content.id
                Definition

                unique id for the element within a resource (for internal references)

                Shortxml:id (or equivalent in JSON)
                Control0..1
                Typestring
                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.
                64. CodeSystem.content.extension
                Definition

                An Extension

                ShortExtension
                Control0..*
                TypeExtension
                SlicingThis element introduces a set of slices on CodeSystem.content.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 66. CodeSystem.content.extension:content
                  Slice Namecontent
                  Definition

                  R4: CodeSystem.content

                  ShortR4: not-present | example | fragment | complete | supplement
                  Comments

                  Element CodeSystem.content is mapped to FHIR STU3 element CodeSystem.content as SourceIsBroaderThanTarget.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeExtension(R4: not-present | example | fragment | complete | supplement) (Extension Type: code)
                  Is Modifierfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  68. CodeSystem.content.value
                  Definition

                  Primitive value for code

                  ShortPrimitive value for code
                  Control0..1
                  Typecode
                  XML FormatIn the XML format, this property is represented as an attribute.
                  70. CodeSystem.count
                  Definition

                  The total number of concepts defined by the code system. Where the code system has a compositional grammar, the count refers to the number of base (primitive) concepts.

                  ShortTotal concepts in the code system
                  Comments

                  The count of concepts defined in this resource cannot be more than this value, but may be less for several reasons - see the content value.

                  Control0..1
                  TypeunsignedInt
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  72. CodeSystem.filter
                  Definition

                  A filter that can be used in a value set compose statement when selecting concepts using a filter.

                  ShortFilter that can be used in a value set
                  Control0..*
                  TypeBackboneElement
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  74. CodeSystem.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.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  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.
                  76. CodeSystem.filter.extension
                  Definition

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

                  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
                  Alternate Namesextensions, user content
                  78. CodeSystem.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                  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 No Modifier Reason provideed in previous versions of FHIR
                  Summarytrue
                  Alternate Namesextensions, user content, modifiers
                  80. CodeSystem.filter.code
                  Definition

                  The code that identifies this filter when it is used in the instance.

                  ShortCode that identifies the filter
                  Control1..1
                  Typecode
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  82. CodeSystem.filter.description
                  Definition

                  A description of how or why the filter is used.

                  ShortHow or why the filter is used
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  84. CodeSystem.filter.operator
                  Definition

                  A list of operators that can be used with the filter.

                  ShortOperators that can be used with filter
                  Control1..*
                  BindingThe codes SHALL be taken from FilterOperator
                  (required to http://hl7.org/fhir/ValueSet/filter-operator|3.0.2)

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

                  Typecode
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  86. CodeSystem.filter.value
                  Definition

                  A description of what the value for the filter should be.

                  ShortWhat to use for the value
                  Control1..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  88. CodeSystem.property
                  Definition

                  A property defines an additional slot through which additional information can be provided about a concept.

                  ShortAdditional information supplied about each concept
                  Control0..*
                  TypeBackboneElement
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                  90. CodeSystem.property.id
                  Definition

                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  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.
                  92. CodeSystem.property.extension
                  Definition

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

                  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
                  Alternate Namesextensions, user content
                  94. CodeSystem.property.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                  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 No Modifier Reason provideed in previous versions of FHIR
                  Summarytrue
                  Alternate Namesextensions, user content, modifiers
                  96. CodeSystem.property.code
                  Definition

                  A code that is used to identify the property. The code is used internally (in CodeSystem.concept.property.code) and also externally, such as in property filters.

                  ShortIdentifies the property on the concepts, and when referred to in operations
                  Control1..1
                  Typecode
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  98. CodeSystem.property.uri
                  Definition

                  Reference to the formal meaning of the property. One possible source of meaning is the Concept Properties code system.

                  ShortFormal identifier for the property
                  Control0..1
                  Typeuri
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  100. CodeSystem.property.description
                  Definition

                  A description of the property- why it is defined, and how its value might be used.

                  ShortWhy the property is defined, and/or what it conveys
                  Control0..1
                  Typestring
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  102. CodeSystem.property.type
                  Definition

                  The type of the property value. Properties of type "code" contain a code defined by the code system (e.g. a reference to anotherr defined concept).

                  Shortcode | Coding | string | integer | boolean | dateTime
                  Control1..1
                  BindingThe codes SHALL be taken from PropertyType .
                  (required to http://hl7.org/fhir/ValueSet/concept-property-type|3.0.2)

                  The type of a property value

                  Typecode
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  104. CodeSystem.property.type.id
                  Definition

                  unique id for the element within a resource (for internal references)

                  Shortxml:id (or equivalent in JSON)
                  Control0..1
                  Typestring
                  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.
                  106. CodeSystem.property.type.extension
                  Definition

                  An Extension

                  ShortExtension
                  Control0..*
                  TypeExtension
                  SlicingThis element introduces a set of slices on CodeSystem.property.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 108. CodeSystem.property.type.extension:type
                    Slice Nametype
                    Definition

                    R4: CodeSystem.property.type

                    ShortR4: code | Coding | string | integer | boolean | dateTime | decimal
                    Comments

                    Element CodeSystem.property.type is mapped to FHIR STU3 element CodeSystem.property.type as SourceIsBroaderThanTarget.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeExtension(R4: code | Coding | string | integer | boolean | dateTime | decimal) (Extension Type: code)
                    Is Modifierfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    110. CodeSystem.property.type.value
                    Definition

                    Primitive value for code

                    ShortPrimitive value for code
                    Control0..1
                    Typecode
                    XML FormatIn the XML format, this property is represented as an attribute.
                    112. CodeSystem.concept
                    Definition

                    Concepts that are in the code system. The concept definitions are inherently hierarchical, but the definitions must be consulted to determine what the meaning of the hierarchical relationships are.

                    ShortConcepts in the code system
                    Comments

                    If this is empty, it means that the code system resource does not represent the content of the code system.

                    Control0..*
                    TypeBackboneElement
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                    114. CodeSystem.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.

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    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.
                    116. CodeSystem.concept.extension
                    Definition

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

                    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
                    Alternate Namesextensions, user content
                    118. CodeSystem.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                    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 No Modifier Reason provideed in previous versions of FHIR
                    Summarytrue
                    Alternate Namesextensions, user content, modifiers
                    120. CodeSystem.concept.code
                    Definition

                    A code - a text symbol - that uniquely identifies the concept within the code system.

                    ShortCode that identifies concept
                    Control1..1
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    122. CodeSystem.concept.display
                    Definition

                    A human readable string that is the recommended default way to present this concept to a user.

                    ShortText to display to the user
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    124. CodeSystem.concept.definition
                    Definition

                    The formal definition of the concept. The code system resource does not make formal definitions required, because of the prevalence of legacy systems. However, they are highly recommended, as without them there is no formal meaning associated with the concept.

                    ShortFormal definition
                    Control0..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    126. CodeSystem.concept.designation
                    Definition

                    Additional representations for the concept - other languages, aliases, specialized purposes, used for particular purposes, etc.

                    ShortAdditional representations for the concept
                    Control0..*
                    TypeBackboneElement
                    Requirements

                    Many concept definition systems support multiple representations, in multiple languages, and for multiple purposes.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                    128. CodeSystem.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.

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    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.
                    130. CodeSystem.concept.designation.extension
                    Definition

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

                    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
                    Alternate Namesextensions, user content
                    132. CodeSystem.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                    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 No Modifier Reason provideed in previous versions of FHIR
                    Summarytrue
                    Alternate Namesextensions, user content, modifiers
                    134. CodeSystem.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
                    BindingUnless not suitable, these codes SHALL be taken from Common Languages
                    (extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

                    A human language.

                    Additional BindingsPurpose
                    All LanguagesMax Binding
                    Typecode
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    136. CodeSystem.concept.designation.use
                    Definition

                    A code that details how this designation would be used.

                    ShortDetails how this designation would be used
                    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 Designation Use
                    (extensible to http://hl7.org/fhir/ValueSet/designation-use|3.0.2)

                    Details of how a designation would be used.

                    TypeCoding
                    138. CodeSystem.concept.designation.value
                    Definition

                    The text value for this designation.

                    ShortThe text value for this designation
                    Control1..1
                    Typestring
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    140. CodeSystem.concept.property
                    Definition

                    A property value for this concept.

                    ShortProperty value for the concept
                    Control0..*
                    TypeBackboneElement
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                    142. CodeSystem.concept.property.id
                    Definition

                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    Shortxml:id (or equivalent in JSON)
                    Control0..1
                    Typestring
                    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.
                    144. CodeSystem.concept.property.extension
                    Definition

                    An Extension

                    ShortExtension
                    Control0..*
                    TypeExtension
                    SlicingThis element introduces a set of slices on CodeSystem.concept.property.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 146. CodeSystem.concept.property.extension:value
                      Slice Namevalue
                      Definition

                      R4: CodeSystem.concept.property.value[x] additional types (decimal)

                      ShortR4: value additional types
                      Comments

                      Element CodeSystem.concept.property.value[x] is mapped to FHIR STU3 element CodeSystem.concept.property.value[x] as SourceIsBroaderThanTarget. The mappings for CodeSystem.concept.property.value[x] do not cover the following types: decimal. The target context CodeSystem.concept.property.value[x] is a choice-type element and cannot directly hold extensions. The context is moved up to parent element CodeSystem.concept.property.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeExtension(R4: value additional types) (Extension Type: decimal)
                      Is Modifierfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      148. CodeSystem.concept.property.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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                      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 No Modifier Reason provideed in previous versions of FHIR
                      Summarytrue
                      Alternate Namesextensions, user content, modifiers
                      150. CodeSystem.concept.property.code
                      Definition

                      A code that is a reference to CodeSystem.property.code.

                      ShortReference to CodeSystem.property.code
                      Control1..1
                      Typecode
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      152. CodeSystem.concept.property.value[x]
                      Definition

                      The value of this property.

                      ShortValue of the property for this concept
                      Control1..1
                      TypeChoice of: code, Coding, string, integer, boolean, dateTime
                      [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
                      154. CodeSystem.concept.concept
                      Definition

                      Defines children of a concept to produce a hierarchy of concepts. The nature of the relationships is variable (is-a/contains/categorizes) - see hierarchyMeaning.

                      ShortChild Concepts (is-a/contains/categorizes)
                      Control0..*
                      TypeSeettp://hl7.org/fhir/StructureDefinition/CodeSystem#CodeSystem.concept