• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-HL7UpdateMode version 2.1.0

  Code	Display	Definition
  A	Add	**Description:**The item was (or is to be) added, having not been present immediately before. (If it is already present, this may be treated as an error condition.)
  AR	Add or Replace	**Description:**The item was (or is to be) either added or replaced.
  D	Remove	**Description:**The item was (or is to be) removed (sometimes referred to as deleted). If the item is part of a collection, delete any matching items.
  K	Key	**Description:**This item is part of the identifying information for this object.
  N	No Change	**Description:**There was (or is to be) no change to the item. This is primarily used when this element has not changed, but other attributes in the instance have changed.
  R	Replace	**Description:**The item existed previously and has (or is to be) revised. (If an item does not already exist, this may be treated as an error condition.)
  REF	Reference	**Description:**This item provides enough information to allow a processing system to locate the full applicable record by identifying the object.
  U	Unknown	**Description:**Description:</b>It is not specified whether or what kind of change has occurred to the item, or whether the item is present as a reference or identifying property.
  ESA	Set Add	Add the message element to the collection of items on the receiving system that correspond to the message element.
  ESAC	Set Add or Change	Change the item on the receiving system that corresponds to this message element; if a matching element does not exist, add a new one created with the values in the message.
  ESC	Set Change	Change the item on the receiving system that corresponds to this message element; do not process if a matching element does not exist.
  ESD	Set Delete	Delete the item on the receiving system that corresponds to this message element.
  AU	Add or Update	**Description:** AU: If this item exists, update it with these values. If it does not exist, create it with these values. If the item is part of the collection, update each item that matches this item, and if no items match, add a new item to the collection.
  I	Ignore	Ignore this role, it is not relevant to the update.
  V	Verify	Verify - this message element must match a value already in the receiving systems database in order to process the message.

This value set expansion contains 15 concepts.