The January 2026 Ballot Version adds United States Core Data for Interoperability (USCDI) V6 updates that the Assistant Secretary for Technology Policy (ASTP) published in July 2025. It also addresses over 50 trackers submitted by implementers since the publication of US Core ver 8.0.0. For a detailed list of the changes for this version, see the Change Notes at http://hl7.org/fhir/us/core/2026Jan/changes.html.
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The January 2026 Ballot Version adds United States Core Data for Interoperability (USCDI) V6 updates that the Assistant Secretary for Technology Policy (ASTP) published in July 2025. It also addresses over 50 trackers submitted by implementers since the publication of US Core ver 8.0.0. For a detailed list of the changes for this version, see the Change Notes.
changes
changes.html
RelatedIgs
(None Found)
Proposed path for this publication should usually be the canonical with the version or sequence appended and then some kind of label (typically '-snapshot')
The jira specification file appears to be out of date with the versions, artifacts and pages currently defined in the IG. A proposed revised file to be reviewed and, if appropriate, submitted as a pull request against the XML folder in https://github.com/HL7/JIRA-Spec-Artifacts. To see the differences, perform a file compare on 'template/jira-current.xml' (a normalized view of what is in Github) and 'template/jira-new.xml' (reflects current IG content)
The link 'StructureDefinition-us-core-location.html#profile-specific-implementation-guidance' for "US Core Location" cannot be resolved (valid targets: 277 targets)HTML_LINK_CHECK_FAILED
A definition could not be found for Canonical URL 'http://hl7.org/fhir/us/mcc/StructureDefinition/us-core-familymemberhistory'TYPE_SPECIFIC_CHECKS_DT_CANONICAL_RESOLVE
FamilyMemberHistory.meta.profile[0] (l1/c2)
warning
Profile reference 'http://hl7.org/fhir/us/mcc/StructureDefinition/us-core-familymemberhistory' has not been checked because it could not be found, and the validator is set to not fetch unknown profilesVALIDATION_VAL_PROFILE_UNKNOWN_NOT_POLICY
Wrong Display Name 'iInfluenza, high-dose, quadrivalent, PF' for http://hl7.org/fhir/sid/cvx#197. Valid display is one of 2 choices: 'Influenza, high-dose, quadrivalent, PF' or 'Influenza, high-dose, split virus, quadrivalent, injectable, preservative free' (for the language(s) 'en-US') (from https://tx.fhir.org/r4, see log, or see the servers logic) Display_Name_for__should_be_one_of__instead_of
Unknown code '49281012188' in the CodeSystem 'http://hl7.org/fhir/sid/ndc' version '' (from https://tx.fhir.org/r4, see log, or see the servers logic) Unknown_Code_in_Version
The provided code 'http://snomed.info/sct|http://snomed.info/sct/731000124108#22232009 ('Hospital')' was not found in the value set 'http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType|3.0.0'; The provided code 'https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/hsloc.html#1120-5 ('Medical Clinic')' was not found in the value set 'http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType|3.0.0' (from server, see log, or see the servers logic)
Error from https://tx.fhir.org/r4: The filter "concept = 1206-2" from the value set http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.1.11.20275 was not understood in the context of https://www.cdc.gov/nhsn/cdaportal/terminology/codesystem/hsloc.html (1) (from server, see log)
Reference to draft CodeSystem urn:iso:std:iso:11073:10101|2024-12-05 from fhir.tx.support.r4#0.32.0 (from https://tx.fhir.org/r4, see log, or see the servers logic) MSG_DRAFT
The provided code 'http://loinc.org#59408-5 ('Oxygen saturation in Arterial blood by Pulse oximetry')' was not found in the value set 'http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1'; The provided code 'urn:iso:std:iso:11073:10101#150456 ('MDC_PULS_OXIM_SAT_O2')' was not found in the value set 'http://hl7.org/fhir/ValueSet/observation-vitalsignresult|4.0.1' (from server, see log, or see the servers logic)
The code provided (urn:oid:2.16.840.1.113883.6.238#2184-0) was not found in the value set 'Detailed Ethnicity Including Absence Reasons' (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.4.642.40.2.48.1|20250419), and a code from this value set is required: The provided code 'urn:oid:2.16.840.1.113883.6.238#2184-0 ('Dominican')' was not found in the value set 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.4.642.40.2.48.1|20250419' (from server, see log, or see the servers logic) Terminology_TX_Confirm_4a
The code provided (urn:oid:2.16.840.1.113883.6.238#2148-5) was not found in the value set 'Detailed Ethnicity Including Absence Reasons' (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.4.642.40.2.48.1|20250419), and a code from this value set is required: The provided code 'urn:oid:2.16.840.1.113883.6.238#2148-5 ('Mexican')' was not found in the value set 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.4.642.40.2.48.1|20250419' (from server, see log, or see the servers logic) Terminology_TX_Confirm_4a
Slicing cannot be evaluated: Could not match discriminator ($this) for slice ServiceRequest.category:us-core-pmo-category in profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-pmo-servicerequest|9.0.0-ballot - the discriminator [$this] does not have fixed value, binding or existence assertionsSLICING_CANNOT_BE_EVALUATED
ServiceRequest (l1/c2)
information
ServiceRequest.category:us-core-pmo: Found 0 matches, but unable to check minimum required (ServiceRequest.category) due to lack of slicing validation (from http://hl7.org/fhir/us/core/StructureDefinition/us-core-pmo-servicerequest|9.0.0-ballot)Validation_VAL_Profile_NoCheckMin
ServiceRequest.code (l23/c4)
warning
ValueSet 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.35' not foundTerminology_TX_ValueSet_NotFound
Wrong Display Name 'No CPR: Do Not Attempt Resuscitation' for http://loinc.org#LA33471-6. Valid display is 'No CPR: Do Not Attempt Resuscitation.' (en-US) (for the language(s) 'en-US') (from https://tx.fhir.org/r4, see log, or see the servers logic) Display_Name_for__should_be_one_of__instead_of
Wrong Display Name 'Terminal illness' for http://snomed.info/sct#422650009. Valid display is 'Social isolation (finding)' (en) (for the language(s) 'en-US') (from https://tx.fhir.org/r4, see log, or see the servers logic) Display_Name_for__should_be_one_of__instead_of
A definition could not be found for Canonical URL 'https://loinc.org' but a definition can be found for 'http://loinc.org' - change from https: to http:TYPE_SPECIFIC_CHECKS_DT_URL_WRONG_HTTPS
A definition could not be found for Canonical URL 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.34'TYPE_SPECIFIC_CHECKS_DT_CANONICAL_RESOLVE
A definition could not be found for Canonical URL 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.35'TYPE_SPECIFIC_CHECKS_DT_CANONICAL_RESOLVE
A definition could not be found for Canonical URL 'https://loinc.org' but a definition can be found for 'http://loinc.org' - change from https: to http:TYPE_SPECIFIC_CHECKS_DT_URL_WRONG_HTTPS
A definition could not be found for Canonical URL 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.34'TYPE_SPECIFIC_CHECKS_DT_CANONICAL_RESOLVE
A definition could not be found for Canonical URL 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.35'TYPE_SPECIFIC_CHECKS_DT_CANONICAL_RESOLVE
StructureDefinition.snapshot (l1/c109688)
warning
The slice 'us-core-pmo-category' on path 'ServiceRequest.category' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true
Error in constraint 'us-core-27' with expression 'value.matches('^\d{8}$')': Error @1, 25: Unknown FHIRPath character escape \dED_INVARIANT_EXPRESSION_ERROR
StructureDefinition.snapshot (l1/c146684)
warning
The slice 'NCSBNID' on path 'Practitioner.identifier' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true
A definition could not be found for Canonical URL 'https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1115.35/expansion'TYPE_SPECIFIC_CHECKS_DT_CANONICAL_RESOLVE
ValueSet.compose.include[0].valueSet[3]
warning
The value set import https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1115.35/expansion could not be found so cannot be checkedVALUESET_REFERENCE_UNKNOWN
ValueSet.compose.include[0] (l1/c3018)
warning
This value set has a single include with multiple imported value sets. Per issue https://jira.hl7.org/browse/FHIR-25179, there has been confusion in the past whether these value sets are unioned or intersectioned. If this value set is contained in a package published prior to March 31 2022, it will be treated as a union, otherwise it will be treated as an intersection. If want a union, split the value set imports across multiple includes
ValueSet.where(id = 'us-core-pmo-procedure')
error
Unable to find included value set 'https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1115.35/expansion'
A definition could not be found for Canonical URL 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-implantable-device|8.0.0'TYPE_SPECIFIC_CHECKS_DT_CANONICAL_RESOLVE
CapabilityStatement.text.div
error
Hyperlink 'StructureDefinition-us-core-implantable-device.html' at 'div/table/tbody/tr/td/a' for 'US Core Implantable Device Profile' does not resolve
CapabilityStatement.text.div
error
Hyperlink 'StructureDefinition-us-core-implantable-device.html' at 'div/ul/li/a' for 'US Core Implantable Device Profile' does not resolve
Error from https://tx.fhir.org/r4: A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/icd9cm' could not be found, so the value set cannot be expanded (from server, see log)
01. === Added this STU NOTE: This profile is technically non-conformant with the base FHIR ver 4.0.1 vitals profile, which defines a required binding that excludes the concept for L/min for Observation.component.value(x). This is a known issue, which means validation errors may occur when validating against this version of the US Core Pulse Oximetry Profile. This issue has been corrected in base FHIR ver 4.3.0 ("Release 4B"), which will correct this error when this guide is based on a newer version of FHIR. ===
ERROR: Observation/satO2-fiO2: Observation.component[0].value.ofType(Quantity): The code provided (http://unitsofmeasure.org#L/min) was not found in the value set' Vital Signs Units' (http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1), and a code from this value set is required: The provided code 'http://unitsofmeasure.org#L/min' was not found in the value set 'http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1' (0 uses)
ERROR: US Core Vital Signs Profile.Observation.component.value[x]: illegal attempt to change the binding on Observation.component.value[x] from required to extensible (0 uses)
04. === Several examples derived from this profile are provided in this guide (1) ===
WARNING: StructureDefinition.where(URL = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs'): The Implementation Guide contains no examples for this profile (1 uses)
05. === These questionnaires are created using NLM tooling based on LOINC LFORMs. They use standard FHIR Questionnaire Extensions that "extend" the base SDC profile ===
This element does not match any known slice defined in the profile http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire|3.0.0 (10 uses)
06. === The code is from the US Core defined NUCC binding and not from base FHIR preferred c80-practice-codes value set (updated text from 7.0.0) ===
None of the codings provided are in the value set 'Practice Setting Code Value Set' (http://hl7.org/fhir/ValueSet/c80-practice-codes|4.0.1), and a coding is recommended to come from this value set (codes = http://nucc.org/provider-taxonomy#208D00000X) (1 uses)
INFORMATION: StructureDefinition.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole'): The Implementation Guide contains no explicitly linked examples for this profile (1 uses)
08. ==== The following content is inherited from the base standard and cannot be changed ====
The string value contains text that looks like embedded HTML tags. If this content is rendered to HTML without appropriate post-processing, it may be a security risk (1 uses)
09. ==== The pattern is set in a repeating slice. The pattern is expected to hold for all repetitions of that slice. (It's fixing the 'system' for the identifier.) ====
The repeating element has a pattern. The pattern will apply to all the repeats (this has not been clear to all users) (5 uses)
10. ==== The self-link for these searchset bundles is to the $docref operation and not to a FHIR search string====
No types could be determined from the search string, so the types can't be checked (2 uses)
11. === Using the extension US Core Extension Questionnaire URI pointing to a pdf form of the Questionnaire for this example. Regarding the message: "No questionnaire is identified, so no validation can be performed against the base questionnaire" ===
INFORMATION: QuestionnaireResponse/glascow-coma-score: QuestionnaireResponse: No questionnaire is identified, so no validation can be performed against the base questionnaire (1 uses)
15. === This Search Parameter expression `Goal.target.due as date` is inherited from the FHIR base. Since US Core inherits from the FHIR R4 base, this warning is acknowledged as an issue with the base specification. In R5, this expression has been updated to `(Goal.target.due.ofType(date))`. ===
WARNING: SearchParameter/us-core-goal-target-date: SearchParameter.expression: The left side is inherently a collection, and so the expression 'Goal.target.due as date' may fail or return false if there is more than one item in the content being evaluated (1 uses)
17. === The 'no-narrative' parameter is used for these resources instances because they are displayed as inline JSON examples to illustrate transactions, and the narrative degrades human readability ===
WARNING: Bundle/docref-example-1: Bundle.entry[0].resource/*DocumentReference/ccd123*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (1 uses)
WARNING: Bundle/docref-example-2: Bundle.entry[0].resource/*DocumentReference/procedure-note123*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (1 uses)
WARNING: Bundle/docref-example-2: Bundle.entry[1].resource/*DocumentReference/procedure-note456*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (1 uses)
WARNING: Bundle/docref-example-2: Bundle.entry[2].resource/*DocumentReference/discharge*/: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (1 uses)
WARNING: DocumentReference/discharge-summary: DocumentReference: Constraint failed: dom-6: 'A resource should have narrative for robust management' (defined in http://hl7.org/fhir/StructureDefinition/DomainResource) (Best Practice Recommendation) (1 uses)
18. === The following code system and value set are in FHIR Core/THO and not under the direct control of US Core editors ===
Reference to draft CodeSystem http://hl7.org/fhir/narrative-status|4.0.1 (4 uses)
Reference to draft CodeSystem urn:iso:std:iso:11073:10101|2024-12-05 from fhir.tx.support.r4#0.31.0 (0 uses)
Reference to draft ValueSet http://hl7.org/fhir/ValueSet/servicerequest-category|4.0.1 (3 uses)
There are multiple different potential matches for the url 'http://terminology.hl7.org/ValueSet/v3-PurposeOfUse'. 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 '3.1.0', found versions: 3.0.0, 3.1.0. Suggested fix: change the canonical reference from 'http://terminology.hl7.org/ValueSet/v3-PurposeOfUse' to 'http://terminology.hl7.org/ValueSet/v3-PurposeOfUse|3.1.0' (1 uses)
19. ==== The following code systems are not discoverable because they are code systems in THO, but THO doesn't define the codes. They have been checked, and the identifiers are correct (updated text from 7.0.0) ===========
A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/PHOccupationalDataForHealthODH' could not be found, so the code cannot be validated (4 uses)
The definition for the Code System with URI 'urn:oid:2.16.840.1.113883.6.238' doesn't provide any codes so the code cannot be validated (15 uses)
Unable to check whether the code is in the value set 'http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.7900|1' because the code system http://terminology.hl7.org/CodeSystem/PHOccupationalDataForHealthODH was not found (0 uses)
Unable to check whether the code is in the value set 'http://phinvads.cdc.gov/fhir/ValueSet/2.16.840.1.114222.4.11.7901|1' because the code system http://terminology.hl7.org/CodeSystem/PHOccupationalDataForHealthODH was not found (0 uses)
WARNING: ValueSet.where(id = 'us-core-condition-code'): Error from https://tx.fhir.org/r4: Unable to provide support for code system http://terminology.hl7.org/CodeSystem/icd9cm (0 uses)
21. === The following code system is not discoverable because they are code systems in THO, but THO doesn't define the codes due to AHA NUBC Patient Discharge Status Codes IP issues. These codes were checked manually (updated text from 7.0.0)===
A definition for CodeSystem 'http://terminology.hl7.org/CodeSystem/nubc-UB92' could not be found, so the code cannot be validated (1 uses)
Unable to check whether the code is in the value set 'http://terminology.hl7.org/ValueSet/v3-USEncounterDischargeDisposition|3.0.0' because the code system http://terminology.hl7.org/CodeSystem/nubc-UB92 was not found (0 uses)
22. ====FHIR R4 http://hl7.org/fhir/ValueSet/formatcodes is in error which has been corrected in the FHIR R5. The guide is referencing the "HL7 ValueSet of Format Codes for use with Document Sharing" that is used in R5 (updated text from 7.0.0) ===
INFORMATION: Bundle/docref-example-1: Bundle.entry[0].resource/*DocumentReference/ccd123*/.content[0].format: The Coding provided (http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes#urn:hl7-org:sdwg:ccda-structuredBody:2.1) was not found in the value set 'DocumentReference Format Code Set' (http://hl7.org/fhir/ValueSet/formatcodes|4.0.1), and a code is recommended to come from this value set. (error message = The provided code 'http://terminology.hl7.org/CodeSystem/v3-HL7DocumentFormatCodes#urn:hl7-org:sdwg:ccda-structuredBody:2.1: 'ccda-structuredBody:2.1'' was not found in the value set 'http://hl7.org/fhir/ValueSet/formatcodes|4.0.1') (1 uses)
23. ==== The US Core Team is aware of this and will budget and move these values to THO in a future publication cycle ===
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) (5 uses)
24. ==== Understood and note that this is rendered by the ig-publisher in the ig ====
The value set expansion is too large, and only a subset has been displayed (3 uses)
26. === Using the standard CapabilityStatementExpectation extension in additional contexts to fully express intended capabilities: see FHIR-12419 (115) (updated text from 7.0.0-ballot) ===
This element does not match any known slice defined in the profile http://hl7.org/fhir/StructureDefinition/capabilitystatement-search-parameter-combination|5.2.0 (this may not be a problem, but you should check that it's not intended to match a slice) (139 uses)
27. === These Examples demonstrate the use of additional Codes or Identifiers not defined in US Core profiles Updated in 9.0.0-ballot ===
A definition for CodeSystem 'http://example.org/fhir/michigan.gov/lara/license-type' could not be found, so the code cannot be validated (1 uses)
This element does not match any known slice defined in the profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-average-blood-pressure|9.0.0-ballot (1 uses)
This element does not match any known slice defined in the profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|9.0.0-ballot (2 uses)
This element does not match any known slice defined in the profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|9.0.0-ballot (5 uses)
This element does not match any known slice defined in the profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry|9.0.0-ballot (1 uses)
28. === In this example, representing the concept clearly with human-readable annotations {pack-years} is not misleading. It clearly illustrates how to use the Observation with the code and demonstrates a clinical need outweighing concerns about using annotations. ===
WARNING: Observation/pack-years-example: Observation.value.ofType(Quantity): UCUM Codes that contain human readable annotations like {pack-years} can be misleading (e.g. they are ignored when comparing units). Best Practice is not to depend on annotations in the UCUM code, so this usage should be checked (1 uses)
29. === US Core thoroughly documents its Must Support expectations for the must supports, including how they apply to the choice of target references. See this chat https://chat.fhir.org/#narrow/channel/179252-IG-creation/topic/Must.20Support.20Target.20Error.20for.20Reference.20type.20Element ===
The element Procedure.performer.actor has types/profiles/targets that are marked as must support, but the element itself is not marked as must-support (1 uses)
30. === Two Bundle examples use this profile and one non-validated inline example that conforms to it as well - when the publisher understands versioned examples, we will create a published example to replace it. ===
INFORMATION: StructureDefinition.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance'): The Implementation Guide contains no explicitly linked examples for this profile (1 uses)
31. === The binding applies to the Quantity data type for US Core Vitals Signs Profile. It inherits the structure from Core, and a change request to correct this has been applied to the base FHIR ver 4.3.0 ("Release 4B"). Will need to slice value[x] in future (updated text from 7.0.0) ===
The element Observation.component.value[x] has a binding, and has multiple types subject to bindings ([dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept]). The binding will apply to all the types (1 uses)
The element Observation.value[x] has a binding, and has multiple types subject to bindings ([dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept]). The binding will apply to all the types (1 uses)
33. === To comply with Executive Order 14168, the following changes were made: 1)Removed USCDI mapping, guidance, and examples for the US Core Observation Sexual Orientation Profile 2) Removed the US Core Birth Sex Extension, guidance, and examples from the US Core Patient Profile 3) Deprecated the US Core Gender Identity and US Core Sex Extensions and removed them from the US Core Profile, USCDI mapping, guidance, and examples. Although the profiles and extensions will remain in this version of US Core to allow for backward compatibility - no examples will be supplied. ===
WARNING: StructureDefinition.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex'): The Implementation Guide contains no examples for this extension (1 uses)
WARNING: StructureDefinition.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-sexual-orientation'): The Implementation Guide contains no examples for this profile (1 uses)
WARNING: StructureDefinition/us-core-genderIdentity: StructureDefinition: The resource status 'active' and the standards status 'deprecated' are not consistent (1 uses)
WARNING: StructureDefinition/us-core-sex: StructureDefinition: The resource status 'active' and the standards status 'deprecated' are not consistent (1 uses)
34. === US Core provides IG-specific guidance on interpreting Must Support for slices at `~/must-support.html#must-support---slices`. Where we state: "...the slicer's Must Support property only defines the element level Must Support/Additional USCDI property. In other words, the slicer's Must Support/Additional USCDI is not inherited by the slices, and each slice must be explicitly tagged with the Must Support/Additional USCDI property to define that slice's conformance strength. If no Must Support/Additional USCDI property is defined for the slice, this lengthy chat: https://chat.fhir.org/#narrow/channel/179252-IG-creation/topic/Slices.20not.20inheriting.20preferred.20bindings.20from.20root/with/514257770 and the resulting tracker FHIR-50391. ===
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)
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)
The slice 'screening-assessment' on path 'Condition.category' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true (1 uses)
The slice 'screening-assessment' on path 'Observation.category' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true (1 uses)
The slice 'us-core' on path 'Observation.category' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true (1 uses)
The slice 'uscore' on path 'DocumentReference.category' is not marked as 'must-support' which is not consistent with the element that defines the slicing, where 'must-support' is true (1 uses)
35. ==== These messages have been acknowledged for this release. After reviewing the implications for conformant systems and downstream publications, we will consider updating and/or adopting the recommended replacement in a future release. ====
The concept 'urn:hl7-org:sdwg:ccda-structuredBody:1.1' is deprecated and its use should be reviewed (2 uses)
The concept 'urn:hl7-org:sdwg:ccda-structuredBody:2.1' is deprecated and its use should be reviewed (1 uses)
The extension http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet|5.2.0 is deprecated (1 uses)
The extension http://hl7.org/fhir/StructureDefinition/elementdefinition-minValueSet|5.2.0 is deprecated (1 uses)
The extension http://hl7.org/fhir/StructureDefinition/ordinalValue|5.2.0 is deprecated with the note: 'Replaced by [[[http://hl7.org/fhir/StructureDefinition/itemWeight]]]' (1 uses)
The extension http://hl7.org/fhir/StructureDefinition/regex|5.2.0 is deprecated with the note: 'This was deprecated in favor of using a constraint on the element using FHIRPath, since constraints allow for the provision of a human readable message associated with the regex' (1 uses)
36. === These Extension StructureDefinitions were examined, and there are no substantive changes between versions and thus no reason to specify a version ===
There are multiple different potential matches for the url 'http://hl7.org/fhir/StructureDefinition/condition-assertedDate'. 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 '5.2.0', found versions: 1.0.0, 4.0.1, 5.1.0, 5.2.0. Suggested fix: change the canonical reference from 'http://hl7.org/fhir/StructureDefinition/condition-assertedDate' to 'http://hl7.org/fhir/StructureDefinition/condition-assertedDate|5.2.0' (2 uses)
There are multiple different potential matches for the url 'http://hl7.org/fhir/StructureDefinition/ordinalValue'. 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 '5.2.0', found versions: 4.0.1, 5.2.0. Suggested fix: change the canonical reference from 'http://hl7.org/fhir/StructureDefinition/ordinalValue' to 'http://hl7.org/fhir/StructureDefinition/ordinalValue|5.2.0' (1 uses)
There are multiple different potential matches for the url 'http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo'. 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 '5.2.0', found versions: 1.0.0, 4.0.1, 5.1.0, 5.2.0. Suggested fix: change the canonical reference from 'http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo' to 'http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo|5.2.0' (2 uses)
37. === The following Extensions are in SDC, a dependent IG, or the FHIR R4 specification and not under the direct control of US Core editors ===
There are multiple different potential matches for the url 'http://hl7.org/fhir/StructureDefinition/display'. 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 '5.2.0', found versions: 1.0.0, 4.0.1, 5.1.0, 5.2.0. Suggested fix: change the canonical reference from 'http://hl7.org/fhir/StructureDefinition/display' to 'http://hl7.org/fhir/StructureDefinition/display|5.2.0' (1 uses)
There are multiple different potential matches for the url 'http://hl7.org/fhir/StructureDefinition/questionnaireresponse-completionMode'. 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 '5.2.0', found versions: 1.0.0, 4.0.1, 5.1.0, 5.2.0. Suggested fix: change the canonical reference from 'http://hl7.org/fhir/StructureDefinition/questionnaireresponse-completionMode' to 'http://hl7.org/fhir/StructureDefinition/questionnaireresponse-completionMode|5.2.0' (1 uses)
There are multiple different potential matches for the url 'http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature'. 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 '5.2.0', found versions: 1.0.0, 4.0.1, 5.1.0, 5.2.0. Suggested fix: change the canonical reference from 'http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature' to 'http://hl7.org/fhir/StructureDefinition/questionnaireresponse-signature|5.2.0' (2 uses)
38. === The differences between these code system versions have been evaluated, and there no differences or there are non breaking changes (forward compatible)
There are multiple different potential matches for the url 'http://terminology.hl7.org/CodeSystem/condition-category'. 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 '1.0.1', found versions: 1.0.0, 1.0.1. Suggested fix: change the canonical reference from 'http://terminology.hl7.org/CodeSystem/condition-category' to 'http://terminology.hl7.org/CodeSystem/condition-category|1.0.1' (1 uses)
There are multiple different potential matches for the url 'http://terminology.hl7.org/CodeSystem/observation-category'. 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 '1.0.1', found versions: 1.0.0, 1.0.1. Suggested fix: change the canonical reference from 'http://terminology.hl7.org/CodeSystem/observation-category' to 'http://terminology.hl7.org/CodeSystem/observation-category|1.0.1' (5 uses)
There are multiple different potential matches for the url 'http://terminology.hl7.org/CodeSystem/provenance-participant-type'. 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 '1.1.0', found versions: 1.0.0, 1.1.0. Suggested fix: change the canonical reference from 'http://terminology.hl7.org/CodeSystem/provenance-participant-type' to 'http://terminology.hl7.org/CodeSystem/provenance-participant-type|1.1.0' (1 uses)
40 === Similar to the base FHIR specification the Guide states in the introductory paragraph of the Conformance section's General Requirmenets page "The conformance verbs - SHALL, SHOULD, MAY - used in this guide are defined in FHIR Conformance Rules, and these conventions are strictly adhered to throughout the guide. ===
The html source contains the word 'SHALL' but it is not in a text phrase marked as a conformance clause (178 uses)
The html source contains the word 'SHOULD' but it is not in a text phrase marked as a conformance clause (31 uses)
Wrong Display Name 'iInfluenza, high-dose, quadrivalent, PF' for http://hl7.org/fhir/sid/cvx#197. Valid display is one of 2 choices: 'Influenza, high-dose, quadrivalent, PF' or 'Influenza, high-dose, split virus, quadrivalent, injectable, preservative free' (for the language(s) 'en-US')
Wrong Display Name 'No CPR: Do Not Attempt Resuscitation' for http://loinc.org#LA33471-6. Valid display is 'No CPR: Do Not Attempt Resuscitation.' (en-US) (for the language(s) 'en-US')
Wrong Display Name 'Terminal illness' for http://snomed.info/sct#422650009. Valid display is 'Social isolation (finding)' (en) (for the language(s) 'en-US')
Slicing cannot be evaluated: Could not match discriminator ($this) for slice ServiceRequest.category:us-core-pmo-category in profile http://hl7.org/fhir/us/core/StructureDefinition/us-core-pmo-servicerequest|9.0.0-ballot - the discriminator [$this] does not have fixed value, binding or existence assertions
A definition could not be found for Canonical URL 'https://loinc.org' but a definition can be found for 'http://loinc.org' - change from https: to http:
A definition could not be found for Canonical URL 'https://loinc.org' but a definition can be found for 'http://loinc.org' - change from https: to http:
The code provided (urn:oid:2.16.840.1.113883.6.238#2184-0) was not found in the value set 'Detailed Ethnicity Including Absence Reasons' (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.4.642.40.2.48.1|20250419), and a code from this value set is required: The provided code 'urn:oid:2.16.840.1.113883.6.238#2184-0 ('Dominican')' was not found in the value set 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.4.642.40.2.48.1|20250419'
The code provided (urn:oid:2.16.840.1.113883.6.238#2148-5) was not found in the value set 'Detailed Ethnicity Including Absence Reasons' (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.4.642.40.2.48.1|20250419), and a code from this value set is required: The provided code 'urn:oid:2.16.840.1.113883.6.238#2148-5 ('Mexican')' was not found in the value set 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.4.642.40.2.48.1|20250419'
None of the codings provided are in the value set 'Practice Setting Code Value Set' (http://hl7.org/fhir/ValueSet/c80-practice-codes|4.0.1) specified in an additional binding, and a coding is recommended to come from this value set (codes = http://nucc.org/provider-taxonomy#208D00000X)
Profile reference 'http://hl7.org/fhir/us/mcc/StructureDefinition/us-core-familymemberhistory' has not been checked because it could not be found, and the validator is set to not fetch unknown profiles
ServiceRequest.category:us-core-pmo: Found 0 matches, but unable to check minimum required (ServiceRequest.category) due to lack of slicing validation (from http://hl7.org/fhir/us/core/StructureDefinition/us-core-pmo-servicerequest|9.0.0-ballot)
hl7.fhir.us.core
hl7.fhir.uv.extensions