Validation Results for CARINConsumerDirectedPayerDataExchange

Generated Tue Sep 22 13:44:54 UTC 2026, FHIR version 4.0.1 for hl7.fhir.us.carin-bb#2.2.1 (canonical = http://hl7.org/fhir/us/carin-bb (history)). See Full QA Report & IP

Quality Checks
Publisher Version:	IG Publisher Version: v2.3.4
Publication Code:	carin-bb . PackageId = hl7.fhir.us.carin-bb, Canonical = http://hl7.org/fhir/us/carin-bb
Realm Check for US:	Snomed: The IG doesn't use SNOMED CT Profiles: All OK
Language Info:	Stated Languages: n/a. IG Resource Lang: en. 24 of 135 (17%) of resources have a language. Population Policy: NONE
Publication Request:	package-id hl7.fhir.us.carin-bb version 2.2.1 path http://hl7.org/fhir/us/carin-bb/STU2.2 Pub-Mode milestone status trial-use Release-Label STU 2.2 Sequence (Group) STU 2 (current: 'STU 2', others = 'STU 1') desc CARIN Blue Button Implementation Guide Release 2.2 - US Realm STU RelatedIgs (None Found) A publication already exists at http://hl7.org/fhir/us/carin-bb/STU2.2 Proposed path for this milestone publication should usually be canonical with either sequence or version appended A version of this IG has already been published at http://hl7.org/fhir/us/carin-bb/STU2.2
Supressed Messages:	96 Suppressed Issues
Dependency Checks:	Package Version FHIR Canonical Web Base Comment hl7.fhir.us.carin-bb 2.2.1 R4 http://hl7.org/fhir/us/carin-bb hl7.terminology.r4 7.4.0 M R4 http://terminology.hl7.org http://terminology.hl7.org/7.4.0 hl7.fhir.us.core 7.0.0 O R4 http://hl7.org/fhir/us/core http://hl7.org/fhir/us/core/STU7 Latest Release is 9.0.0 hl7.terminology.r4 5.5.0 O R4 http://terminology.hl7.org http://terminology.hl7.org/5.5.0 Latest Release is 7.4.0 hl7.fhir.uv.smart-app-launch 2.0.0 O R4 http://hl7.org/fhir/smart-app-launch http://hl7.org/fhir/smart-app-launch/STU2 Latest Release is 2.2.0 us.nlm.vsac 0.18.0 O R4 http://fhir.org/packages/us.nlm.vsac http://fhir.org/packages/us.nlm.vsac Latest Release is 0.24.0 hl7.fhir.uv.sdc 3.0.0 O R4 http://hl7.org/fhir/uv/sdc http://hl7.org/fhir/uv/sdc/STU3 Latest Release is 4.0.0 hl7.fhir.r4.examples 4.0.1 O R4 http://hl7.org/fhir http://hl7.org/fhir/R4 Latest Release is 5.0.0 us.cdc.phinvads 0.12.0 M R4 http://fhir.org/packages/us.cdc.phinvads http://fhir.org/packages/us.cdc.phinvads hl7.fhir.uv.extensions 5.1.0-snapshot1 O R5 http://hl7.org/fhir/extensions http://hl7.org/fhir/extensions/5.1.0-snapshot1 FHIR Version Mismatch. Latest Release is 5.3.0 hl7.terminology.r5 5.3.0 O R5 http://terminology.hl7.org http://terminology.hl7.org/5.3.0 FHIR Version Mismatch. Latest Release is 7.4.0 hl7.fhir.us.core.v610 6.1.0 U R4 http://hl7.org/fhir/us/core/v610 http://hl7.org/fhir/us/core/STU6.1 hl7.fhir.us.core 6.1.0 O R4 http://hl7.org/fhir/us/core http://hl7.org/fhir/us/core/STU6.1 Latest Release is 9.0.0 hl7.terminology.r4 5.0.0 O R4 http://terminology.hl7.org http://terminology.hl7.org/5.0.0 Latest Release is 7.4.0 hl7.fhir.uv.extensions.r4 1.0.0 O R4 http://hl7.org/fhir/extensions http://hl7.org/fhir/extensions/1.0.0 Latest Release is 5.3.0 hl7.fhir.uv.bulkdata 2.0.0 O R4 http://hl7.org/fhir/uv/bulkdata http://hl7.org/fhir/uv/bulkdata/STU2 Latest Release is 3.0.0 hl7.fhir.uv.smart-app-launch 2.1.0 O R4 http://hl7.org/fhir/smart-app-launch http://hl7.org/fhir/smart-app-launch/STU2.1 Latest Release is 2.2.0 hl7.terminology.r4 5.0.0 O R4 http://terminology.hl7.org http://terminology.hl7.org/5.0.0 (as above). Latest Release is 7.4.0 us.nlm.vsac 0.11.0 O R4 http://fhir.org/packages/us.nlm.vsac http://fhir.org/packages/us.nlm.vsac Latest Release is 0.24.0 hl7.fhir.uv.sdc 3.0.0 O R4 http://hl7.org/fhir/uv/sdc http://hl7.org/fhir/uv/sdc/STU3 (as above). Latest Release is 4.0.0 us.cdc.phinvads 0.12.0 M R4 http://fhir.org/packages/us.cdc.phinvads http://fhir.org/packages/us.cdc.phinvads (as above) ihe.formatcode.fhir 1.1.0 O R4 https://profiles.ihe.net/fhir/ihe.formatcode.fhir https://profiles.ihe.net/fhir/ihe.formatcode.fhir/1.1.0 Latest Release is 1.6.0 hl7.fhir.uv.smart-app-launch 2.0.0 O R4 http://hl7.org/fhir/smart-app-launch http://hl7.org/fhir/smart-app-launch/STU2 (as above). Latest Release is 2.2.0 hl7.fhir.uv.extensions.r4 5.2.0 O R4 http://hl7.org/fhir/extensions http://hl7.org/fhir/extensions/5.2.0 Latest Release is 5.3.0 us.nlm.vsac 0.24.0 M R4 http://fhir.org/packages/us.nlm.vsac http://fhir.org/packages/us.nlm.vsac hl7.fhir.uv.tools.r4 1.1.2 O R4 http://hl7.org/fhir/tools http://hl7.org/fhir/tools/1.1.2 Internal Dependency. Latest Release is 1.2.0 Templates: hl7.fhir.template#current -> hl7.base.template#current -> fhir2.base.template#current
Related IGs:	n/a
Dependent IGs:	no references
Global Profiles:	(none declared)
Terminology Server(s):	http://tx.fhir.org/r4, https://tx-nordics.fhir.org/fhir/r4, https://tx.fhir.org/r4 (details)
HTA Analysis:	1 issue
R5 Dependencies:	http://hl7.org/fhir/5.0/StructureDefinition/extension-ImplementationGuide.dependsOn.reason
Draft Dependencies:	hl7.fhir.r4.core#4.0.1: GuideParameterCode (16 uses), payor (1 uses), care-team (1 uses), coverage (1 uses), identifier (1 uses), patient (1 uses), provider (1 uses), organization (1 uses), practitioner (1 uses), CommonTags (16 uses), CommonLanguages (29 uses), Organization (40 uses), FinancialResourceStatusCodes (1 uses), RelatedPerson (3 uses), SubscriberRelationshipCodes (2 uses), CoverageClassCodes (3 uses), CoverageCopayTypeCodes (1 uses), ExampleCoverageFinancialExceptionCodes (1 uses), Contract (1 uses), ExplanationOfBenefitStatus (11 uses), ClaimTypeCodes (10 uses), Use (11 uses), Practitioner (23 uses), PractitionerRole (23 uses), ProcessPriorityCodes (12 uses), Funds Reservation Codes (22 uses), Claim (22 uses), MedicationRequest (22 uses), VisionPrescription (11 uses), ServiceRequest (11 uses), Location (40 uses), ClaimResponse (11 uses), ClaimProcessingCodes (11 uses), ExampleProviderQualificationCodes (5 uses), ExceptionCodes (67 uses), MissingToothReasonCodes (95 uses), ExampleDiagnosisRelatedGroupCodes (11 uses), Device (44 uses), BenefitCategoryCodes (44 uses), ExampleProgramReasonCodes (44 uses), ExampleServicePlaceCodes (18 uses), OralSiteCodes (20 uses), SurfaceCodes (20 uses), Encounter (11 uses), AdjudicationReasonCodes (36 uses), ExampleRevenueCenterCodes (29 uses), USCLSCodes (54 uses), ModifierTypeCodes (58 uses), ExplanationOfBenefit (57 uses), AdjudicationValueCodes (8 uses), PaymentAdjustmentReasonCodes (11 uses), Form Codes (11 uses), NoteType (11 uses), NetworkTypeCodes (11 uses), UnitTypeCodes (11 uses), BenefitTermCodes (11 uses), BenefitTypeCodes (11 uses), ExampleClaimSubTypeCodes (7 uses), ExampleDiagnosisOnAdmissionCodes (9 uses), ExampleProcedureTypeCodes (9 uses), Procedure (9 uses), ICD-10ProcedureCodes (9 uses), Condition (3 uses), ICD-10Codes (3 uses), ExampleDiagnosisTypeCodes (3 uses), ClaimCareTeamRoleCodes (1 uses), OrganizationType (1 uses), ContactEntityType (1 uses), Endpoint (1 uses), PatientRelationshipType (1 uses), _id (6 uses), _lastUpdated (6 uses) hl7.fhir.uv.extensions.r4#5.2.0: SDStatusDerivation (171 uses), SDcompliesWithProfile (5 uses)
Modifier Extensions:	(none)
Previous Version Comparison:	Comparison with version 2.2.0
IPA Comparison:	n/a
IPS Comparison:	n/a
Validation Flags:	On: autoLoad; Off: hintAboutNonMustSupport, anyExtensionsAllowed, checkAggregation, showReferenceMessages, noExperimentalContent, displayWarnings
Summary:	errors = 0, warn = 15, info = 11, broken links = 1, pinned = n/a. Show Message Ids

n/a Show Validation Information

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional-Basis.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Oral-Basis.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional-Basis.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy-Basis.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.json Show Validation Information (1)

fsh-generated/resources/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician-Basis.json Show Validation Information (1)

fsh-generated/resources/ValueSet-AMACPTCMSHCPCSModifiers.json Show Validation Information (1)

fsh-generated/resources/ValueSet-AMACPTCMSHCPCSProcedureCodes.json Show Validation Information (1)

fsh-generated/resources/ValueSet-C4BBEOBInstitutionalProcedureCodes.json Show Validation Information (1)

Suppressed Messages (Warnings, hints, broken links)

01. === INFORMATION: Previously defined CodeSystems currently in use by implementers. Will leave for an STU Update with the intent to make the change during a major version ===

• INFORMATION: CodeSystem/C4BBAdjudication: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBAdjudicationDiscriminator: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBClaimCareTeamRole: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBClaimDiagnosisType: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBClaimProcedureType: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBCompoundLiteral: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBIdentifierType: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBInstitutionalClaimSubType: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBPayeeType: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBPayerAdjudicationStatus: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBRelatedClaimRelationshipCodes: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)
• INFORMATION: CodeSystem/C4BBSupportingInfoType: CodeSystem: Most code systems defined in HL7 IGs will need to move to THO later during the process. Consider giving this code system a THO URL now (See https://confluence.hl7.org/display/TSMG/Terminology+Play+Book, and/or talk to TSMG) (1 uses)

02. === INFORMATION: The following code systems are external and not supported by terminology server, and cannot be validated in examples. Wild card matching because terminology servers are providing different messages ===

• A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/ADAAreaOralCavitySystem' could not be found, so the code cannot be validated (2 uses)
• A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPBrandGenericIndicator' could not be found, so the code cannot be validated (2 uses)
• A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPCompoundCode' could not be found, so the code cannot be validated (2 uses)
• A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPDispensedAsWrittenOrProductSelectionCode' could not be found, so the code cannot be validated (2 uses)
• A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPPrescriptionOriginCode' could not be found, so the code cannot be validated (2 uses)
• A definition for CodeSystem 'http://www.ada.org/cdt' could not be found, so the code cannot be validated (6 uses)
• A definition for CodeSystem 'https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets' could not be found, so the code cannot be validated (4 uses)
• A definition for CodeSystem 'https://www.nubc.org/CodeSystem/PatDischargeStatus' could not be found, so the code cannot be validated (4 uses)
• A definition for CodeSystem 'https://www.nubc.org/CodeSystem/PointOfOrigin' could not be found, so the code cannot be validated (4 uses)
• A definition for CodeSystem 'https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit' could not be found, so the code cannot be validated (4 uses)
• A definition for CodeSystem 'https://www.nubc.org/CodeSystem/RevenueCodes' could not be found, so the code cannot be validated (34 uses)
• A definition for CodeSystem 'https://www.nubc.org/CodeSystem/TypeOfBill' could not be found, so the code cannot be validated (4 uses)
• Resolved system https://x12.org/codesystem.x12.org/ambulance-transport-reason-codes (v1.0.0), but the definition doesn't include any codes, so the code has not been validated (2 uses)
• The definition for the Code System with URI 'https://x12.org/codesystem.x12.org/ambulance-transport-reason-codes' from 'non-package source' doesn't provide any codes so the code cannot be validated (2 uses)

03. === Suggestion to pin canonical for an artifact that is inherited by this guide. Cannot be directly addressed by this guide. ===

• There are multiple different potential matches for the url 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '20250419', found versions: 20221118 (from us.nlm.vsac#0.18.0), 20250419 (from us.nlm.vsac#0.24.0). Suggested fix: change the canonical reference from 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591' to 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591|20250419' (1 uses)
• There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|7.0.0' (1 uses)
• There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|7.0.0' (3 uses)
• There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|7.0.0' (2 uses)
• There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson|7.0.0' (1 uses)
• There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state' to 'http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0' (2 uses)
• There are multiple different potential matches for the url 'http://terminology.hl7.org/ValueSet/v3-ActIncidentCode'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '3.0.0', found versions: 2.0.0 (from hl7.terminology.r4#5.0.0), 3.0.0 (from hl7.terminology.r4#7.3.0). Suggested fix: change the canonical reference from 'http://terminology.hl7.org/ValueSet/v3-ActIncidentCode' to 'http://terminology.hl7.org/ValueSet/v3-ActIncidentCode|3.0.0' (0 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[104].binding.valueSet: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/ValueSet/simple-language'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/ValueSet/simple-language' to 'http://hl7.org/fhir/us/core/ValueSet/simple-language|7.0.0' (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[16].type[0].profile[0]: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race|7.0.0' (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[17].type[0].profile[0]: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity|7.0.0' (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[18].type[0].profile[0]: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-tribal-affiliation|7.0.0' (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[19].type[0].profile[0]: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex|7.0.0' (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[20].type[0].profile[0]: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex|7.0.0' (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[21].type[0].profile[0]: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-genderIdentity|7.0.0' (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[51].constraint[1].source: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient' to 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0' (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot.element[82].binding.valueSet: There are multiple different potential matches for the url 'http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state'. It might be a good idea to fix to the correct version to reduce the likelihood of a wrong version being selected by an implementation/implementer, or use the [IG Parameter `pin-canonicals`](https://hl7.org/fhir/tools/CodeSystem-ig-parameters.html). Using version '7.0.0', found versions: 6.1.0 (from hl7.fhir.us.core#6.1.0), 7.0.0 (from hl7.fhir.us.core#7.0.0). Suggested fix: change the canonical reference from 'http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state' to 'http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state|7.0.0' (1 uses)

04. === Message regarding Issues inherited by the US Core version this IG is based on. ===

• INFORMATION: StructureDefinition/C4BB-Coverage: StructureDefinition.snapshot.element[12].binding.extension[0]: The extension http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet|5.2.0 is deprecated (1 uses)
• INFORMATION: StructureDefinition/C4BB-Coverage: StructureDefinition.snapshot.element[17].slicing.discriminator[0]: The discriminator type 'pattern' is deprecated in R5+. For future compatibility, you could consider using type=value with a pattern[x] instead (if this is not an inherited slicing) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Coverage: StructureDefinition.snapshot.element[37].slicing.discriminator[0]: The discriminator type 'pattern' is deprecated in R5+. For future compatibility, you could consider using type=value with a pattern[x] instead (if this is not an inherited slicing) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Organization: StructureDefinition.snapshot.element[17].slicing.discriminator[0]: The discriminator type 'pattern' is deprecated in R5+. For future compatibility, you could consider using type=value with a pattern[x] instead (if this is not an inherited slicing) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Organization: StructureDefinition.snapshot.element[18].pattern.ofType(Identifier): The repeating element has a pattern. The pattern will apply to all the repeats (this has not been clear to all users) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Organization: StructureDefinition.snapshot.element[19].pattern.ofType(Identifier): The repeating element has a pattern. The pattern will apply to all the repeats (this has not been clear to all users) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Organization: StructureDefinition.snapshot.element[20].pattern.ofType(Identifier): The repeating element has a pattern. The pattern will apply to all the repeats (this has not been clear to all users) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Organization: StructureDefinition.snapshot.element[21].pattern.ofType(Identifier): The repeating element has a pattern. The pattern will apply to all the repeats (this has not been clear to all users) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Organization: StructureDefinition.snapshot.element[22].pattern.ofType(Identifier): The repeating element has a pattern. The pattern will apply to all the repeats (this has not been clear to all users) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Practitioner: StructureDefinition.snapshot.element[17].slicing.discriminator[0]: The discriminator type 'pattern' is deprecated in R5+. For future compatibility, you could consider using type=value with a pattern[x] instead (if this is not an inherited slicing) (1 uses)
• INFORMATION: StructureDefinition/C4BB-Practitioner: StructureDefinition.snapshot.element[19].pattern.ofType(Identifier): The repeating element has a pattern. The pattern will apply to all the repeats (this has not been clear to all users) (1 uses)
• WARNING: StructureDefinition/C4BB-Organization: StructureDefinition.snapshot: The slice 'CLIA' on path 'Organization.identifier' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true (1 uses)
• WARNING: StructureDefinition/C4BB-Organization: StructureDefinition.snapshot: The slice 'NAIC' on path 'Organization.identifier' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true (1 uses)
• WARNING: StructureDefinition/C4BB-Patient: StructureDefinition.snapshot: The slice 'deceasedDateTime' on path 'Patient.deceased[x]' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true (1 uses)

05. === Conformance Verbs not marked as being in a conformance clause. Will address in next non-TC update ===

• INFORMATION: en/CapabilityStatement-c4bb.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: ' This Section describes the expected capabilities of the C4BB Server actor which is responsible for providing responses to the queries submitted by the C4BB Requestors. The EOB Resource is the focal Consumer-Directed Payer Data Exchange (CDPDE) Resource. Several Reference Resources are defined directly/indirectly from the EOB: Coverage, Patient, Organization (Payer ID), Practioner, and Organization (Facility). The Coverage Reference Resource SHALL be returned with data that was effective as of the date of service of the claim; for example, the data will reflect the employer name in effect at that time. However, for other reference resources, payers MAY decide to provide either the data that was in effect as of the date of service or the current data. All reference resources within the EOB will have meta.lastUpdated flagged as must support. Payers SHALL provide the last time the data was updated or the date of creation in the payers system of record, whichever comes last. Apps will use the meta.lastUpdated values to determine if the reference resources are as of the current date or date of service. ' (1 uses)
• INFORMATION: en/Common_Payer_Consumer_Data_Set.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: '' (1 uses)
• INFORMATION: en/Conformance_Requirements.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: 'The conformance verbs - SHALL, SHOULD, MAY - used in this guide are defined in FHIR Conformance Rules.' (1 uses)
• INFORMATION: en/General_Guidance.html: The html source contains the word 'MAY' but it is not in a text phrase marked as a conformance clause: 'Many of the codes used in this guide are proprietary with licensing requirements. While it is recommended that consumer apps acquire the necessary licenses to show descriptions for these codes, not all app developers may be in a position to do so. Because of this, payers MAY choose to provide a concept text [CodeableConcept].text or the coding display `[CodeableConcept].coding.display. It is the responsibility of the payer to make sure that the descriptions provided are correct.' (1 uses)
• INFORMATION: en/Security_And_Privacy_Considerations.html: The html source contains the word 'MAY' but it is not in a text phrase marked as a conformance clause: 'However, to meet the statutes, regulations, and guiding principles above, consent directives and security labels MAY be considered and used.' (1 uses)
• INFORMATION: en/StructureDefinition-C4BB-ExplanationOfBenefit-Oral-Basis.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: 'The line item primary body site (tooth or oral cavity) SHALL be specified in the .item.bodySite. Additional body sites (tooth or oral cavity) SHALL be specified in supportingInfo[additionalbodysite] repetitions with supportingInfo[additionalbodysite].sequence matching the line items .item.informationSequence' (1 uses)
• INFORMATION: en/StructureDefinition-C4BB-ExplanationOfBenefit-Oral.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: 'The line item primary body site (tooth or oral cavity) SHALL be specified in the .item.bodySite. Additional body sites (tooth or oral cavity) SHALL be specified in supportingInfo[additionalbodysite] repetitions with supportingInfo[additionalbodysite].sequence matching the line items .item.informationSequence' (1 uses)
• INFORMATION: en/StructureDefinition-C4BB-ExplanationOfBenefit.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: '.meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last.' (0 uses)
• INFORMATION: en/StructureDefinition-C4BB-Organization.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: '.meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last. Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service. ' (0 uses)
• INFORMATION: en/StructureDefinition-C4BB-Patient.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: '.meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last. Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service. ' (0 uses)
• INFORMATION: en/StructureDefinition-C4BB-Practitioner.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: '.meta.lastUpdated: Payers SHALL provide the last time the data was updated or the date of creation in the payer’s system of record, whichever comes last. Apps will use the meta.lastUpdated value to determine if the Reference resources are as of the current date or date of service. ' (0 uses)
• INFORMATION: en/Terminology_Licensure.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: 'This HL7 specification contains and references intellectual property owned by third parties ("Third Party IP"). Implementers and testers of this specification SHALL abide by the license requirements for each terminology content artifact utilized within a functioning implementation. Terminology licenses SHALL be obtained from the Third Party IP owner for each code system and/or other specified artifact used. It is the sole responsibility of each organization deploying or testing this specification to ensure their implementations comply with licensing requirements of each Third Party IP.' (1 uses)
• INFORMATION: en/searchparameters.html: The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause: 'A Server SHALL be capable of supporting the following _includes: Coverage:payor - GET [base]/Coverage?_include=Coverage:payor' (1 uses)

06. === Reference to a draft CodeSystem which will be reviewed for the next breaking change balloted update. ===

• INFORMATION: ValueSet/C4BBRelatedClaimRelationshipCodes: ValueSet.compose.include[0].concept[0]: Reference to draft CodeSystem http://terminology.hl7.org/CodeSystem/ex-relatedclaimrelationship|1.0.0 (1 uses)
• Reference to draft CodeSystem http://terminology.hl7.org/CodeSystem/claimcareteamrole|1.0.0 (6 uses)

07. === Code is deprecated, but included in a historical record from a time when it was not. The use of this code is proper. ===

• The concept '0777-3105-02' has a status of inactive and its use should be reviewed (2 uses)

08. === WARNING about US Core and other IGs not being the latest. This was done on purpose to keep US Core and other dependent IGs in line with the base regulation specification requirements ===

• WARNING: ImplementationGuide/hl7.fhir.us.carin-bb: ImplementationGuide.dependsOn[1]: The ImplementationGuide uses package hl7.fhir.us.core#7.0.0 released on 2024-05-08, but the most recent appropriate version is 9.0.0. This reference is getting old and the more recent version should be considered (1 uses)
• WARNING: ImplementationGuide/hl7.fhir.us.carin-bb: ImplementationGuide.dependsOn[3]: The ImplementationGuide uses package hl7.fhir.uv.smart-app-launch#2.0.0 released on 2021-11-26, but the most recent appropriate version is 2.2.0. This reference is getting old and the more recent version should be considered (1 uses)
• WARNING: ImplementationGuide/hl7.fhir.us.carin-bb: ImplementationGuide.dependsOn[4]: The ImplementationGuide uses package hl7.fhir.uv.extensions.r4#5.2.0 released on 2025-02-10, but the most recent appropriate version is 5.3.0. This reference is getting old and the more recent version should be considered (1 uses)

09. - INFORMATION: The following code systems are external or are otherwise not supported by terminology server, and cannot be validated in examples

• Error from https://tx.fhir.org/r4: Error: The code System "http://www.ama-assn.org/go/cpt" has a grammar, and cannot be enumerated directly (0 uses)
• WARNING: ValueSet.where(id = 'ADADentalProcedureCode'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'http://www.ada.org/cdt' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'AHANUBCPatientDischargeStatus'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'https://www.nubc.org/CodeSystem/PatDischargeStatus' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'AHANUBCPointOfOriginForAdmissionOrVisit'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'https://www.nubc.org/CodeSystem/PointOfOrigin' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'AHANUBCPriorityTypeOfAdmissionOrVisit'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'AHANUBCRevenueCodes'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'https://www.nubc.org/CodeSystem/RevenueCodes' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'AHANUBCTypeOfBill'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'https://www.nubc.org/CodeSystem/TypeOfBill' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'AMACPTCMSHCPCSModifiers'): Error from https://tx.fhir.org/r4: Error: The code System "http://www.ama-assn.org/go/cpt" has a grammar, and cannot be enumerated directly (0 uses)
• WARNING: ValueSet.where(id = 'AMACPTCMSHCPCSProcedureCodes'): Error from https://tx.fhir.org/r4: Error: The code System "http://www.ama-assn.org/go/cpt" has a grammar, and cannot be enumerated directly (0 uses)
• WARNING: ValueSet.where(id = 'C4BBAmbulanceTransportReasonCodes'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'https://x12.org/codesystem.x12.org/ambulance-transport-reason-codes' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'CMSMS3MAPAPRDRG'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'NCPDPBrandGenericIndicator'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPBrandGenericIndicator' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'NCPDPCompoundCode'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPCompoundCode' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'NCPDPDispensedAsWrittenOrProductSelectionCode'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPDispensedAsWrittenOrProductSelectionCode' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'NCPDPPrescriptionOriginCode'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPPrescriptionOriginCode' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'NCPDPRejectCode'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/NCPDPRejectCode' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'OralBodySite'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/ADAAreaOralCavitySystem' could not be found, so the value set cannot be expanded (2 uses)
• WARNING: ValueSet.where(id = 'X12ClaimAdjustmentReasonCodesCMSRemittanceAdviceRemarkCodes'): Error from https://tx.fhir.org/r4: Error: A definition for CodeSystem 'https://x12.org/codes/claim-adjustment-reason-codes' could not be found, so the value set cannot be expanded (2 uses)

10. - Information about a valueSet Fragment

• The value set references CodeSystem 'http://hl7.org/fhir/sid/icd-9-cm' which has status 'fragment' (0 uses)

11. - INFORMATION: Asserted the 'pin-canonicals' parameter, ignoring associated comments

• INFORMATION: ValueSet.compose.include[0]: Pinned the version of http://terminology.hl7.org/CodeSystem/claim-type to 1.0.1 from choices of 0.1.0 (hl7.terminology.r4#5.0.0), 1.0.0 (hl7.terminology.r4#5.5.0), 1.0.1 (hl7.terminology.r4#7.3.0) (0 uses)
• INFORMATION: ValueSet.compose.include[0]: Pinned the version of http://terminology.hl7.org/CodeSystem/v2-0203 to 5.0.0 from choices of 2.9.0 (hl7.terminology.r4#5.0.0), 4.0.0 (hl7.terminology.r4#5.5.0), 5.0.0 (hl7.terminology.r4#7.3.0) (0 uses)

Errors sorted by type

PIN_VERSION

TYPE_SPECIFIC_CHECKS_DT_CANONICAL_MULTIPLE_POSSIBLE_VERSIONS