R5-DocumentReference-element-map-to-R4
type: ConceptMap
node role: treeRoot
id:
  v: R5-DocumentReference-element-map-to-R4
text:
  status:
    v: generated
  div:
    v: Generated Narrative: ConceptMap R5-DocumentReference-element-map-to-R4 Mapping from http://hl7.org/fhir/5.0 to http://hl7.org/fhir/4.0 Group 1 Mapping from http://hl7.org/fhir/StructureDefinition/DocumentReference|5.0.0 to DocumentReferenceversion: 4.0.1) Source Code Relationship Target Code Comment DocumentReference.meta (meta) is equivalent to DocumentReference.meta Element `DocumentReference.meta` is mapped to FHIR R4 element `DocumentReference.meta` as `Equivalent`. Element `DocumentReference.meta` is mapped to FHIR R4 element `Media.meta` as `Equivalent`. DocumentReference.implicitRules (implicitRules) is equivalent to DocumentReference.implicitRules Element `DocumentReference.implicitRules` is mapped to FHIR R4 element `DocumentReference.implicitRules` as `Equivalent`. Element `DocumentReference.implicitRules` is mapped to FHIR R4 element `Media.implicitRules` as `Equivalent`. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc. DocumentReference.language (language) is equivalent to DocumentReference.language Element `DocumentReference.language` is mapped to FHIR R4 element `DocumentReference.language` as `Equivalent`. Element `DocumentReference.language` is mapped to FHIR R4 element `Media.language` as `Equivalent`. 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 resourc…
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-wg
    l: structuredefinition-wg
  value: Code
    v: fhir
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
    l: structuredefinition-fmm
  value: Integer
    v: 0
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4
        l: hl7.fhir.uv.xver-r5.r4
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
    l: structuredefinition-standards-status
  value: Code
    v: trial-use
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r5.r4
        l: hl7.fhir.uv.xver-r5.r4
url:
  v: http://hl7.org/fhir/uv/xver/ConceptMap/R5-DocumentReference-element-map-to-R4
  l: R5-DocumentReference-element-map-to-R4
version:
  v: 0.1.0
name:
  v: R5DocumentReferenceElementMapToR4
title:
  v: Cross-version mapping for FHIR R5 DocumentReference to FHIR R4 DocumentReference
status:
  v: active
experimental:
  v: false
date:
  v: 2026-03-17T16:04:45.166955-05:00
contact:
  name:
    v: FHIR Infrastructure
  telecom:
    system:
      v: url
    value:
      v: http://www.hl7.org/Special/committees/fiwg
description:
  v: This ConceptMap represents cross-version mappings for elements from a FHIR R5 DocumentReference to FHIR R4.
jurisdiction:
  coding:
    system:
      v: http://unstats.un.org/unsd/methods/m49/m49.htm
      l: m49.htm
    code:
      v: 001
    display:
      v: World
source: Canonical
  v: http://hl7.org/fhir/5.0
  l: http://hl7.org/fhir/5.0
target: Uri
  v: http://hl7.org/fhir/4.0
  l: http://hl7.org/fhir/4.0
group:
  source:
    v: http://hl7.org/fhir/StructureDefinition/DocumentReference
    l: DocumentReference
  source version:
    v: 5.0.0
  target:
    v: http://hl7.org/fhir/StructureDefinition/DocumentReference
    l: DocumentReference
  target version:
    v: 4.0.1
  element:
    code:
      v: DocumentReference.meta
    display:
      v: meta
    target:
      code:
        v: DocumentReference.meta
      display:
        v: DocumentReference.meta
      equivalence:
        v: equivalent
      comment:
        v: Element `DocumentReference.meta` is mapped to FHIR R4 element `DocumentReference.meta` as `Equivalent`. Element `DocumentReference.meta` is mapped to FHIR R4 element `Media.meta` as `Equivalent`.
  element:
    code:
      v: DocumentReference.implicitRules
    display:
      v: implicitRules
    target:
      code:
        v: DocumentReference.implicitRules
      display:
        v: DocumentReference.implicitRules
      equivalence:
        v: equivalent
      comment:
        v: Element `DocumentReference.implicitRules` is mapped to FHIR R4 element `DocumentReference.implicitRules` as `Equivalent`. Element `DocumentReference.implicitRules` is mapped to FHIR R4 element `Media.implicitRules` as `Equivalent`. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
  element:
    code:
      v: DocumentReference.language
    display:
      v: language
    target:
      code:
        v: DocumentReference.language
      display:
        v: DocumentReference.language
      equivalence:
        v: equivalent
      comment:
        v: Element `DocumentReference.language` is mapped to FHIR R4 element `DocumentReference.language` as `Equivalent`. Element `DocumentReference.language` is mapped to FHIR R4 element `Media.language` as `Equivalent`. 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).
  element:
    code:
      v: DocumentReference.text
    display:
      v: text
    target:
      code:
        v: DocumentReference.text
      display:
        v: DocumentReference.text
      equivalence:
        v: equivalent
      comment:
        v: Element `DocumentReference.text` is mapped to FHIR R4 element `DocumentReference.text` as `Equivalent`. Element `DocumentReference.text` is mapped to FHIR R4 element `Media.text` as `Equivalent`. Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
  element:
    code:
      v: DocumentReference.contained
    display:
      v: contained
    target:
      code:
        v: DocumentReference.contained
      display:
        v: DocumentReference.contained
      equivalence:
        v: equivalent
      comment:
        v: Element `DocumentReference.contained` is mapped to FHIR R4 element `DocumentReference.contained` as `Equivalent`. Element `DocumentReference.contained` is mapped to FHIR R4 element `Media.contained` as `Equivalent`. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
  element:
    code:
      v: DocumentReference.identifier
    display:
      v: identifier
    target:
      code:
        v: DocumentReference.identifier
      display:
        v: DocumentReference.identifier
      equivalence:
        v: equivalent
      comment:
        v: Element `DocumentReference.identifier` is mapped to FHIR R4 element `DocumentReference.identifier` as `Equivalent`. Element `DocumentReference.identifier` is mapped to FHIR R4 element `Media.identifier` as `Equivalent`. The structure and format of this identifier would be consistent with the specification corresponding to the format of the document. (e.g. for a DICOM standard document, a 64-character numeric UID; for an HL7 CDA format, the CDA Document Id root and extension).
  element:
    code:
      v: DocumentReference.status
    display:
      v: status
    target:
      code:
        v: DocumentReference.status
      display:
        v: DocumentReference.status
      equivalence:
        v: equivalent
      comment:
        v: Element `DocumentReference.status` is mapped to FHIR R4 element `DocumentReference.status` as `Equivalent`. Element `DocumentReference.status` is mapped to FHIR R4 element `Media.status` as `Equivalent`. This is the status of the DocumentReference object, which might be independent from the docStatus element. This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid.
  element:
    code:
      v: DocumentReference.docStatus
    display:
      v: docStatus
    target:
      code:
        v: DocumentReference.docStatus
      display:
        v: DocumentReference.docStatus
      equivalence:
        v: relatedto
      comment:
        v: Element `DocumentReference.docStatus` is mapped to FHIR R4 element `DocumentReference.docStatus` as `SourceIsBroaderThanTarget`. The document that is pointed to might be in various lifecycle states.

code:
  v: DocumentReference.type
display:
  v: type
target:
  code:
    v: DocumentReference.type
  display:
    v: DocumentReference.type
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.type` is mapped to FHIR R4 element `DocumentReference.type` as `Equivalent`. Element `DocumentReference.type` is mapped to FHIR R4 element `Media.type` as `Equivalent`. Key metadata element describing the document that describes he exact type of document. Helps humans to assess whether the document is of interest when viewing a list of documents.

code:
  v: DocumentReference.category
display:
  v: category
target:
  code:
    v: DocumentReference.category
  display:
    v: DocumentReference.category
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.category` is mapped to FHIR R4 element `DocumentReference.category` as `Equivalent`. Key metadata element describing the the category or classification of the document. This is a broader perspective that groups similar documents based on how they would be used. This is a primary key used in searching.

code:
  v: DocumentReference.subject
display:
  v: subject
target:
  code:
    v: DocumentReference.subject
  display:
    v: DocumentReference.subject
  equivalence:
    v: relatedto
  comment:
    v: Element `DocumentReference.subject` is mapped to FHIR R4 element `DocumentReference.subject` as `SourceIsBroaderThanTarget`. Element `DocumentReference.subject` is mapped to FHIR R4 element `Media.subject` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.subject` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DocumentReference.subject` with unmapped reference targets: Resource.

code:
  v: DocumentReference.context
display:
  v: context
target:
  code:
    v: DocumentReference.context
  display:
    v: DocumentReference.context
  equivalence:
    v: relatedto
  comment:
    v: Element `DocumentReference.context` is mapped to FHIR R4 element `DocumentReference.context` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.context` do not cover the following types: Reference.

code:
  v: DocumentReference.event
display:
  v: event
target:
  code:
    v: DocumentReference.context.event
  display:
    v: DocumentReference.context.event
  equivalence:
    v: relatedto
  comment:
    v: Element `DocumentReference.event` is mapped to FHIR R4 element `DocumentReference.context.event` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.event` do not cover the following types: CodeableReference. The mappings for `DocumentReference.event` do not cover the following types based on type expansion: reference. An event can further specialize the act inherent in the type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation.

code:
  v: DocumentReference.facilityType
display:
  v: facilityType
target:
  code:
    v: DocumentReference.context.facilityType
  display:
    v: DocumentReference.context.facilityType
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.facilityType` is mapped to FHIR R4 element `DocumentReference.context.facilityType` as `Equivalent`.

code:
  v: DocumentReference.practiceSetting
display:
  v: practiceSetting
target:
  code:
    v: DocumentReference.context.practiceSetting
  display:
    v: DocumentReference.context.practiceSetting
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.practiceSetting` is mapped to FHIR R4 element `DocumentReference.context.practiceSetting` as `Equivalent`. This element should be based on a coarse classification system for the class of specialty practice. Recommend the use of the classification system for Practice Setting, such as that described by the Subject Matter Domain in LOINC.

code:
  v: DocumentReference.period
display:
  v: period
target:
  code:
    v: DocumentReference.context.period
  display:
    v: DocumentReference.context.period
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.period` is mapped to FHIR R4 element `DocumentReference.context.period` as `Equivalent`.

code:
  v: DocumentReference.date
display:
  v: date
target:
  code:
    v: DocumentReference.date
  display:
    v: DocumentReference.date
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.date` is mapped to FHIR R4 element `DocumentReference.date` as `Equivalent`. Referencing/indexing time is used for tracking, organizing versions and searching.

code:
  v: DocumentReference.author
display:
  v: author
target:
  code:
    v: DocumentReference.author
  display:
    v: DocumentReference.author
  equivalence:
    v: relatedto
  comment:
    v: Element `DocumentReference.author` is mapped to FHIR R4 element `DocumentReference.author` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DocumentReference.author` with unmapped reference targets: CareTeam. Not necessarily who did the actual data entry (i.e. typist) or who was the source (informant).

code:
  v: DocumentReference.custodian
display:
  v: custodian
target:
  code:
    v: DocumentReference.custodian
  display:
    v: DocumentReference.custodian
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.custodian` is mapped to FHIR R4 element `DocumentReference.custodian` as `Equivalent`. Identifies the logical organization (software system, vendor, or department) to go to find the current version, where to report issues, etc. This is different from the physical location (URL, disk drive, or server) of the document, which is the technical location of the document, which host may be delegated to the management of some other organization.

code:
  v: DocumentReference.relatesTo
display:
  v: relatesTo
target:
  code:
    v: DocumentReference.relatesTo
  display:
    v: DocumentReference.relatesTo
  equivalence:
    v: relatedto
  comment:
    v: Element `DocumentReference.relatesTo` is mapped to FHIR R4 element `DocumentReference.relatesTo` as `Equivalent`. This element is labeled as a modifier because documents that append to other documents are incomplete on their own.

code:
  v: DocumentReference.relatesTo.code
display:
  v: code
target:
  code:
    v: DocumentReference.relatesTo.code
  display:
    v: DocumentReference.relatesTo.code
  equivalence:
    v: relatedto
  comment:
    v: Element `DocumentReference.relatesTo.code` is mapped to FHIR R4 element `DocumentReference.relatesTo.code` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.relatesTo.code` do not cover the following types: CodeableConcept. The mappings for `DocumentReference.relatesTo.code` do not cover the following types based on type expansion: coding. If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

code:
  v: DocumentReference.relatesTo.target
display:
  v: target
target:
  code:
    v: DocumentReference.relatesTo.target
  display:
    v: DocumentReference.relatesTo.target
  equivalence:
    v: relatedto
  comment:
    v: Element `DocumentReference.relatesTo.target` is mapped to FHIR R4 element `DocumentReference.relatesTo.target` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.relatesTo.target` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DocumentReference.relatesTo.target` with unmapped reference targets: DocumentReference.

code:
  v: DocumentReference.description
display:
  v: description
target:
  code:
    v: DocumentReference.description
  display:
    v: DocumentReference.description
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.description` is mapped to FHIR R4 element `DocumentReference.description` as `Equivalent`. What the document is about, a terse summary of the document.

code:
  v: DocumentReference.securityLabel
display:
  v: securityLabel
target:
  code:
    v: DocumentReference.securityLabel
  display:
    v: DocumentReference.securityLabel
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.securityLabel` is mapped to FHIR R4 element `DocumentReference.securityLabel` as `Equivalent`. The confidentiality codes can carry multiple vocabulary items. HL7 has developed an understanding of security and privacy tags that might be desirable in a Document Sharing environment, called HL7 Healthcare Privacy and Security Classification System (HCS). The following specification is recommended but not mandated, as the vocabulary bindings are an administrative domain responsibility. The use of this method is up to the policy domain such as the XDS Affinity Domain or other Trust Domain where all parties including sender and recipients are trusted to appropriately tag and enforce. In the HL7 Healthcare Privacy and Security Classification (HCS) there are code systems specific to Confidentiality, Sensitivity, Integrity, and Handling Caveats. Some values would come from a local vocabulary as they are related to workflow roles and special projects.

code:
  v: DocumentReference.content
display:
  v: content
target:
  code:
    v: DocumentReference.content
  display:
    v: DocumentReference.content
  equivalence:
    v: relatedto
  comment:
    v: Element `DocumentReference.content` is mapped to FHIR R4 element `DocumentReference.content` as `Equivalent`. Element `DocumentReference.content` is mapped to FHIR R4 element `Media.content` as `SourceIsBroaderThanTarget`. content element shall not contain different versions of the same content. For version handling use multiple DocumentReference with .relatesTo.

code:
  v: DocumentReference.content.attachment
display:
  v: attachment
target:
  code:
    v: DocumentReference.content.attachment
  display:
    v: DocumentReference.content.attachment
  equivalence:
    v: equivalent
  comment:
    v: Element `DocumentReference.content.attachment` is mapped to FHIR R4 element `DocumentReference.content.attachment` as `Equivalent`.

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/StructureDefinition/Media
  l: Media
target version:
  v: 4.0.1
element:
  code:
    v: DocumentReference.meta
  display:
    v: meta
  target:
    code:
      v: Media.meta
    display:
      v: Media.meta
    equivalence:
      v: equivalent
    comment:
      v: Element `DocumentReference.meta` is mapped to FHIR R4 element `DocumentReference.meta` as `Equivalent`. Element `DocumentReference.meta` is mapped to FHIR R4 element `Media.meta` as `Equivalent`.
element:
  code:
    v: DocumentReference.implicitRules
  display:
    v: implicitRules
  target:
    code:
      v: Media.implicitRules
    display:
      v: Media.implicitRules
    equivalence:
      v: equivalent
    comment:
      v: Element `DocumentReference.implicitRules` is mapped to FHIR R4 element `DocumentReference.implicitRules` as `Equivalent`. Element `DocumentReference.implicitRules` is mapped to FHIR R4 element `Media.implicitRules` as `Equivalent`. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
element:
  code:
    v: DocumentReference.language
  display:
    v: language
  target:
    code:
      v: Media.language
    display:
      v: Media.language
    equivalence:
      v: equivalent
    comment:
      v: Element `DocumentReference.language` is mapped to FHIR R4 element `DocumentReference.language` as `Equivalent`. Element `DocumentReference.language` is mapped to FHIR R4 element `Media.language` as `Equivalent`. 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).
element:
  code:
    v: DocumentReference.text
  display:
    v: text
  target:
    code:
      v: Media.text
    display:
      v: Media.text
    equivalence:
      v: equivalent
    comment:
      v: Element `DocumentReference.text` is mapped to FHIR R4 element `DocumentReference.text` as `Equivalent`. Element `DocumentReference.text` is mapped to FHIR R4 element `Media.text` as `Equivalent`. Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
element:
  code:
    v: DocumentReference.contained
  display:
    v: contained
  target:
    code:
      v: Media.contained
    display:
      v: Media.contained
    equivalence:
      v: equivalent
    comment:
      v: Element `DocumentReference.contained` is mapped to FHIR R4 element `DocumentReference.contained` as `Equivalent`. Element `DocumentReference.contained` is mapped to FHIR R4 element `Media.contained` as `Equivalent`. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
element:
  code:
    v: DocumentReference.identifier
  display:
    v: identifier
  target:
    code:
      v: Media.identifier
    display:
      v: Media.identifier
    equivalence:
      v: equivalent
    comment:
      v: Element `DocumentReference.identifier` is mapped to FHIR R4 element `DocumentReference.identifier` as `Equivalent`. Element `DocumentReference.identifier` is mapped to FHIR R4 element `Media.identifier` as `Equivalent`. The structure and format of this identifier would be consistent with the specification corresponding to the format of the document. (e.g. for a DICOM standard document, a 64-character numeric UID; for an HL7 CDA format, the CDA Document Id root and extension).
element:
  code:
    v: DocumentReference.basedOn
  display:
    v: basedOn
  target:
    code:
      v: Media.basedOn
    display:
      v: Media.basedOn
    equivalence:
      v: relatedto
    comment:
      v: Element `DocumentReference.basedOn` is mapped to FHIR R4 element `Media.basedOn` as `SourceIsBroaderThanTarget`. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DocumentReference.basedOn` with unmapped reference targets: Appointment, AppointmentResponse, Claim, CommunicationRequest, Contract, CoverageEligibilityRequest, DeviceRequest, EnrollmentRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, RequestOrchestration, SupplyRequest, VisionPrescription.
element:
  code:
    v: DocumentReference.status
  display:
    v: status
  target:
    code:
      v: Media.status
    display:
      v: Media.status
    equivalence:
      v: equivalent
    comment:
      v: Element `DocumentReference.status` is mapped to FHIR R4 element `DocumentReference.status` as `Equivalent`. Element `DocumentReference.status` is mapped to FHIR R4 element `Media.status` as `Equivalent`. This is the status of the DocumentReference object, which might be independent from the docStatus element. This element is labeled as a modifier because the status contains the codes that mark the document or reference as not currently valid.
element:
  code:
    v: DocumentReference.modality
  display:
    v: modality
  target:
    code:
      v: Media.modality
    display:
      v: Media.modality
    equivalence:
      v: relatedto
    comment:
      v: Element `DocumentReference.modality` is mapped to FHIR R4 element `Media.modality` as `SourceIsBroaderThanTarget`.
element:
  code:
    v: DocumentReference.type
  display:
    v: type
  target:
    code:
      v: Media.type
    display:
      v: Media.type
    equivalence:
      v: equivalent
    comment:
      v: Element `DocumentReference.type` is mapped to FHIR R4 element `DocumentReference.type` as `Equivalent`. Element `DocumentReference.type` is mapped to FHIR R4 element `Media.type` as `Equivalent`. Key metadata element describing the document that describes he exact type of document. Helps humans to assess whether the document is of interest when viewing a list of documents.
element:
  code:
    v: DocumentReference.subject
  display:
    v: subject
  target:
    code:
      v: Media.subject
    display:
      v: Media.subject
    equivalence:
      v: relatedto
    comment:
      v: Element `DocumentReference.subject` is mapped to FHIR R4 element `DocumentReference.subject` as `SourceIsBroaderThanTarget`. Element `DocumentReference.subject` is mapped to FHIR R4 element `Media.subject` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.subject` do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension `alternate-reference` has been mapped as the representation of FHIR R5 element `DocumentReference.subject` with unmapped reference targets: Resource.
element:
  code:
    v: DocumentReference.bodySite
  display:
    v: bodySite
  target:
    code:
      v: Media.bodySite
    display:
      v: Media.bodySite
    equivalence:
      v: relatedto
    comment:
      v: Element `DocumentReference.bodySite` is mapped to FHIR R4 element `Media.bodySite` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.bodySite` do not cover the following types: CodeableReference. The mappings for `DocumentReference.bodySite` do not cover the following types based on type expansion: reference.
element:
  code:
    v: DocumentReference.content
  display:
    v: content
  target:
    code:
      v: Media.content
    display:
      v: Media.content
    equivalence:
      v: relatedto
    comment:
      v: Element `DocumentReference.content` is mapped to FHIR R4 element `DocumentReference.content` as `Equivalent`. Element `DocumentReference.content` is mapped to FHIR R4 element `Media.content` as `SourceIsBroaderThanTarget`. content element shall not contain different versions of the same content. For version handling use multiple DocumentReference with .relatesTo.

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.version
  l: extension-DocumentReference.version
target version:
  v: 0.1.0
element:
  code:
    v: DocumentReference.version
  display:
    v: version
  target:
    code:
      v: Extension
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.version` has a context of DocumentReference based on following the parent source element upwards and mapping to `DocumentReference`. Element `DocumentReference.version` has a context of Media based on following the parent source element upwards and mapping to `Media`. Element `DocumentReference.version` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). While each resource, including the DocumentReference itself, has its own version identifier, this is a formal identifier for the logical version of the DocumentReference as a whole. It would remain constant if the resources were moved to a new server, and all got new individual resource versions, for example.

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.docStatus
  l: extension-DocumentReference.docStatus
target version:
  v: 0.1.0
element:
  code:
    v: DocumentReference.docStatus
  display:
    v: docStatus
  target:
    code:
      v: Extension
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.docStatus` is mapped to FHIR R4 element `DocumentReference.docStatus` as `SourceIsBroaderThanTarget`. The document that is pointed to might be in various lifecycle states.

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.context
  l: extension-DocumentReference.context
target version:
  v: 0.1.0
element:
  code:
    v: DocumentReference.context
  display:
    v: context
  target:
    code:
      v: Extension
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.context` is mapped to FHIR R4 element `DocumentReference.context` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.context` do not cover the following types: Reference.

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.event
  l: extension-DocumentReference.event
target version:
  v: 0.1.0
element:
  code:
    v: DocumentReference.event
  display:
    v: event
  target:
    code:
      v: Extension
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.event` is mapped to FHIR R4 element `DocumentReference.context.event` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.event` do not cover the following types: CodeableReference. The mappings for `DocumentReference.event` do not cover the following types based on type expansion: reference. An event can further specialize the act inherent in the type, such as where it is simply "Procedure Report" and the procedure was a "colonoscopy". If one or more event codes are included, they shall not conflict with the values inherent in the class or type elements as such a conflict would create an ambiguous situation.

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.bodySite
  l: extension-DocumentReference.bodySite
target version:
  v: 0.1.0
element:
  code:
    v: DocumentReference.bodySite
  display:
    v: bodySite
  target:
    code:
      v: Extension
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.bodySite` is mapped to FHIR R4 element `Media.bodySite` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.bodySite` do not cover the following types: CodeableReference. The mappings for `DocumentReference.bodySite` do not cover the following types based on type expansion: reference.

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.attester
  l: extension-DocumentReference.attester
target version:
  v: 0.1.0
element:
  code:
    v: DocumentReference.attester
  display:
    v: attester
  target:
    code:
      v: Extension
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.attester` has a context of DocumentReference based on following the parent source element upwards and mapping to `DocumentReference`. Element `DocumentReference.attester` has a context of Media based on following the parent source element upwards and mapping to `Media`. Element `DocumentReference.attester` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Only list each attester once.
element:
  code:
    v: DocumentReference.attester.mode
  display:
    v: mode
  target:
    code:
      v: Extension.extension:mode
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.attester.mode` is part of an existing definition because parent element `DocumentReference.attester` requires a cross-version extension. Element `DocumentReference.attester.mode` has a context of DocumentReference based on following the parent source element upwards and mapping to `DocumentReference`. Element `DocumentReference.attester.mode` has a context of Media based on following the parent source element upwards and mapping to `Media`. Element `DocumentReference.attester.mode` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
element:
  code:
    v: DocumentReference.attester.time
  display:
    v: time
  target:
    code:
      v: Extension.extension:time
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.attester.time` is part of an existing definition because parent element `DocumentReference.attester` requires a cross-version extension. Element `DocumentReference.attester.time` has a context of DocumentReference based on following the parent source element upwards and mapping to `DocumentReference`. Element `DocumentReference.attester.time` has a context of Media based on following the parent source element upwards and mapping to `Media`. Element `DocumentReference.attester.time` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
element:
  code:
    v: DocumentReference.attester.party
  display:
    v: party
  target:
    code:
      v: Extension.extension:party
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.attester.party` is part of an existing definition because parent element `DocumentReference.attester` requires a cross-version extension. Element `DocumentReference.attester.party` has a context of DocumentReference based on following the parent source element upwards and mapping to `DocumentReference`. Element `DocumentReference.attester.party` has a context of Media based on following the parent source element upwards and mapping to `Media`. Element `DocumentReference.attester.party` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.relatesTo.code
  l: extension-DocumentReference.relatesTo.code
target version:
  v: 0.1.0
element:
  code:
    v: DocumentReference.relatesTo.code
  display:
    v: code
  target:
    code:
      v: Extension
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.relatesTo.code` is mapped to FHIR R4 element `DocumentReference.relatesTo.code` as `SourceIsBroaderThanTarget`. The mappings for `DocumentReference.relatesTo.code` do not cover the following types: CodeableConcept. The mappings for `DocumentReference.relatesTo.code` do not cover the following types based on type expansion: coding. If this document appends another document, then the document cannot be fully understood without also accessing the referenced document.

source:
  v: http://hl7.org/fhir/StructureDefinition/DocumentReference
  l: DocumentReference
source version:
  v: 5.0.0
target:
  v: http://hl7.org/fhir/5.0/StructureDefinition/extension-DocumentReference.content.profile
  l: extension-DocumentReference.content.profile
target version:
  v: 0.1.0
element:
  code:
    v: DocumentReference.content.profile
  display:
    v: profile
  target:
    code:
      v: Extension
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.content.profile` has a context of DocumentReference.content based on following the parent source element upwards and mapping to `DocumentReference`. Element `DocumentReference.content.profile` has a context of Media.content based on following the parent source element upwards and mapping to `Media`. Element `DocumentReference.content.profile` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element). Note that IHE often issues URNs for formatCode codes, not all documents can be identified by a URI. For FHIR content, .profile should indicate the structureDefinition profile canonical URI(s) that the content complies with.
element:
  code:
    v: DocumentReference.content.profile.value[x]
  display:
    v: value[x]
  target:
    code:
      v: Extension.extension:value
    equivalence:
      v: wider
    comment:
      v: Element `DocumentReference.content.profile.value[x]` is part of an existing definition because parent element `DocumentReference.content.profile` requires a cross-version extension. Element `DocumentReference.content.profile.value[x]` has a context of DocumentReference.content based on following the parent source element upwards and mapping to `DocumentReference`. Element `DocumentReference.content.profile.value[x]` has a context of Media.content based on following the parent source element upwards and mapping to `Media`. Element `DocumentReference.content.profile.value[x]` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).