Content Management Infrastructure Implementation Guide
0.1.0 - ballot United States of America flag

Content Management Infrastructure Implementation Guide, published by Clinical Decision Support WG. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7/Content-Management-Infrastructure-IG/ and changes regularly. See the Directory of published versions

Resource Profile: CMIPublishableCodeSystem - Detailed Descriptions

Draft as of 2019-06-06

Definitions for the publishable-codesystem-cmi resource profile.

1. CodeSystem
Definition

The CodeSystem resource is used to declare the existence of and describe a code system or code system supplement and its key properties, and optionally define a part or all of its content.

Control1..1
InvariantsDefined on this element
csd-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (: name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
csd-1: Within a code system definition, all the codes SHALL be unique (: concept.code.combine($this.descendants().concept.code).isDistinct())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (: contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (: contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (: text.`div`.exists())
2. CodeSystem.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typestring
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.

3. CodeSystem.meta
Definition

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

Control0..1
TypeMeta
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
4. 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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
5. CodeSystem.language
Definition

The base language in which the resource is written.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
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).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. CodeSystem.text
Definition

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
7. 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.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

8. CodeSystem.extension
Definition

An Extension

Control0..*
TypeExtension
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on CodeSystem.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
9. CodeSystem.extension:approvalDate
SliceNameapprovalDate
Definition

The date on which the asset content was approved by the publisher. Approval happens once when the content is officially approved for usage.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(approvalDate) (Extension Type: date)
Must Supporttrue
Comments

The date may be more recent than the approval date because of minor changes / editorial corrections.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. CodeSystem.extension:effectiveDate
SliceNameeffectiveDate
Definition

This is the first date-time when the value set version becomes active, so this value is present on Inactive value set versions as well. The start Date_time is expected to be as of 0001 UTC of the Effective Date.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(effectiveDate) (Extension Type: date)
Must Supporttrue
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. CodeSystem.extension:expirationDate
SliceNameexpirationDate
Definition

The date when the value set version is no longer expected to be used to create new content. This is the first date-time when the value set version becomes Inactive, so this value MUST present on all Inactive value set versions. The start Date_time is expected to be as of 0001 UTC of the Expiration Date.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(expirationDate) (Extension Type: date)
Must Supporttrue
Comments

Upon reaching the Expiration Date, the value set Activity Status should be consdiered as inactive. An Inactive value set version may no longer be used to create new content, but it may be used to evaluate content created prior to the Expiration Date.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
12. CodeSystem.extension:lastReviewDate
SliceNamelastReviewDate
Definition

The date on which the asset content was last reviewed. Review happens periodically after that, but doesn't change the original approval date.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(lastReviewDate) (Extension Type: date)
Must Supporttrue
Comments

If specified, this is usually after the approval date.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
13. CodeSystem.extension:author
SliceNameauthor
Definition

User or Org actually involved in creating the value set content.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(author) (Extension Type: string)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
14. CodeSystem.extension:keyWord
SliceNamekeyWord
Definition

Word or words used in an information retrieval system to indicate the content of the value set.

Control0..* This element is affected by the following invariants: ele-1
TypeExtension(keyWord) (Extension Type: string)
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
15. CodeSystem.extension:sourceReference
SliceNamesourceReference
Definition

This text is intended to act as a citation to work done elsewhere that is not part of the current stewarding process where the referenced source is in some way a basis of the current value set definition.

Control0..1 This element is affected by the following invariants: ele-1
TypeExtension(sourceReference) (Extension Type: uri)
Must Supporttrue
Comments

This is not intended to be a direct link to another value set. It is only intended to support a link or textual description that indicates related material for the value set.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
16. 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
17. 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; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this code system is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the code system is stored on different servers. This is used in Coding.system.

Control1..1
Typeuri
Requirements

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

Comments

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

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

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
18. 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.

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

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

Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this code system outside of FHIR, where it is not possible to use the logical URI. Note that HL7 defines at least three identifiers for many of its code systems - the FHIR canonical URL, the OID and the V2 Table 0396 mnemonic code.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
19. 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.version.

NoteThis is a business versionId, not a resource version id (see discussion)
Control1..1
Typestring
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 reference to a particular business version of the code system with the format [url]|[version].

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
20. 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.

Control1..1 This element is affected by the following invariants: inv-0
Typestring
Requirements

Support human navigation and code generation.

Comments

The name is not expected to be globally unique. The name should be a simple alphanumeric type name to ensure that it is machine-processing friendly.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
21. CodeSystem.title
Definition

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

Control1..1
Typestring
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. CodeSystem.status
Definition

The date (and optionally time) when the code system resource was created or revised.

Control1..1
BindingThe codes SHALL be taken from PublicationStatus The lifecycle status of an artifact.

Typecode
Is Modifiertrue
Comments

Allows filtering of code systems that are appropriate for use versus not.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
23. 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.

Control1..1
Typeboolean
Requirements

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

Comments

Allows filtering of code systems that are appropriate for use versus not.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. CodeSystem.date
Definition

The date (and optionally time) when the code system was published. The date must change 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.

Control1..1
TypedateTime
Alternate NamesRevision Date
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
25. CodeSystem.publisher
Definition

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

Control1..1
Typestring
Requirements

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

Alternate Namessteward
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. CodeSystem.contact
Definition

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

Control0..*
TypeContactDetail
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. CodeSystem.description
Definition

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

Control1..1
Typemarkdown
Alternate NamesScope, Purpose, scope
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 code system is presumed to be the predominant language in the place the code system was created).

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
28. CodeSystem.useContext
Definition

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

Control0..*
TypeUsageContext
Must Supporttrue
Requirements

Assist in searching for appropriate content.

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. CodeSystem.jurisdiction
Definition

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

Control0..*
BindingThe codes SHALL be taken from Jurisdiction ValueSet; other codes may be used where these codes are not suitable Countries and regions within which this artifact is targeted for use.

TypeCodeableConcept
Must Supporttrue
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. CodeSystem.purpose
Definition

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

Control0..1
Typemarkdown
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. 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.

Control0..1
Typemarkdown
Must Supporttrue
Requirements

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

Alternate NamesLicense, 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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. CodeSystem.caseSensitive
Definition

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

Control1..1
Typeboolean
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. CodeSystem.valueSet
Definition

Canonical reference to the value set that contains the entire code system.

Control0..1
Typecanonical(ValueSet)
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. CodeSystem.hierarchyMeaning
Definition

The meaning of the hierarchy of concepts as represented in this resource.

Control0..1
BindingThe codes SHALL be taken from CodeSystemHierarchyMeaning The meaning of the hierarchy of concepts in a code system.

Typecode
Comments

Note that other representations might have a different hierarchy or none at all, and represent the information using properties.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
35. CodeSystem.compositional
Definition

The code system defines a compositional (post-coordination) grammar.

Control0..1
Typeboolean
Alternate Namesgrammar
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
36. CodeSystem.versionNeeded
Definition

This flag is used to signify that the code system does not commit to concept permanence across versions. If true, a version must be specified when referencing this code system.

Control0..1
Typeboolean
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'.

Most code systems occasionally refine the displays defined for concepts between versions. Contexts in which the concept display values are validated may require that the version be specified for some code systems irrespective of the value of this property.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. CodeSystem.content
Definition

The extent of the content of the code system (the concepts and codes it defines) are represented in this resource instance.

Control1..1
BindingThe codes SHALL be taken from CodeSystemContentMode The extent of the content of the code system (the concepts and codes it defines) are represented in a code system resource.

Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
38. CodeSystem.supplements
Definition

The canonical URL of the code system that this code system supplement is adding designations and properties to.

Control0..1
Typecanonical(CodeSystem)
Comments

The most common use of a code system supplement is to add additional language support.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. CodeSystem.count
Definition

The total number of concepts defined by the code system. Where the code system has a compositional grammar, the basis of this count is defined by the system steward.

Control0..1
TypeunsignedInt
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 element.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. CodeSystem.filter
Definition

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

Control0..*
TypeBackboneElement
Comments

Note that filters defined in code systems usually require custom code on the part of any terminology engine that will make them available for use in value set filters. For this reason, they are generally only seen in high value published terminologies.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. 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.

Control0..1
Typestring
42. CodeSystem.filter.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
43. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
44. CodeSystem.filter.code
Definition

The code that identifies this filter when it is used as a filter in ValueSet.compose.include.filter.

Control1..1
Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
45. CodeSystem.filter.description
Definition

A description of how or why the filter is used.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
46. CodeSystem.filter.operator
Definition

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

Control1..*
BindingThe codes SHALL be taken from FilterOperator The kind of operation to perform as a part of a property based filter.

Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
47. CodeSystem.filter.value
Definition

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

Control1..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
48. CodeSystem.property
Definition

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

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. 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.

Control0..1
Typestring
50. CodeSystem.property.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
51. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
52. 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.

Control1..1
Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
53. CodeSystem.property.uri
Definition

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

Control0..1
Typeuri
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
54. CodeSystem.property.description
Definition

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

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
55. 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 another defined concept).

Control1..1
BindingThe codes SHALL be taken from PropertyType The type of a property value.

Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
56. 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 meanings of the hierarchical relationships are.

Control1..*
TypeBackboneElement
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. 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.

Control0..1
Typestring
58. CodeSystem.concept.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
59. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
60. CodeSystem.concept.code
Definition

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

Control1..1
Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. CodeSystem.concept.display
Definition

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

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
62. 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.

Control0..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. CodeSystem.concept.designation
Definition

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

Control0..*
TypeBackboneElement
Requirements

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

Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
64. 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.

Control0..1
Typestring
65. CodeSystem.concept.designation.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
66. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
67. CodeSystem.concept.designation.language
Definition

The language this designation is defined for.

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
Typecode
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
68. CodeSystem.concept.designation.use
Definition

A code that details how this designation would be used.

Control0..1
BindingThe codes SHALL be taken from DesignationUse; other codes may be used where these codes are not suitable Details of how a designation would be used.

TypeCoding
Comments

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

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
69. CodeSystem.concept.designation.value
Definition

The text value for this designation.

Control1..1
Typestring
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
70. CodeSystem.concept.property
Definition

A property value for this concept.

Control0..*
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
71. 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.

Control0..1
Typestring
72. CodeSystem.concept.property.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
73. 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

Control0..*
TypeExtension
Is Modifiertrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
74. CodeSystem.concept.property.code
Definition

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

Control1..1
Typecode
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
75. CodeSystem.concept.property.value[x]
Definition

The value of this property.

Control1..1
TypeChoice of: code, Coding, string, integer, boolean, dateTime, decimal
[x] NoteSee Choice of Data Types for further information about how to use [x]
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
76. 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.

Control0..*
TypeSee ttp://hl7.org/fhir/StructureDefinition/CodeSystem#CodeSystem.concept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))