Terminology Change Set Exchange
1.0.0 - STU1 International flag

Terminology Change Set Exchange, published by HL7 International / Terminology Infrastructure. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/termchangeset-ig/ and changes regularly. See the Directory of published versions

Resource Profile: CodeSystemChangeSet - Detailed Descriptions

Page standards status: Draft Maturity Level: 0

Definitions for the codesystem-change-set resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. 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.

ShortDeclares the existence of and describes a code system or code system supplement
Control10..1*
Is Modifierfalse
Summaryfalse
Invariantscsd-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($this.descendants().concept.code).isDistinct())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
csd-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.matches('[A-Z]([A-Za-z0-9_]){0,254}'))
csd-1: Within a code system definition, all the codes SHALL be unique (concept.code.combine($this.descendants().concept.code).isDistinct())
2. 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.

ShortA set of rules under which this content was created
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.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. CodeSystem.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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.

ShortExtensionAdditional content defined by implementations
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.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-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 areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. CodeSystem.extension:ExtendsCodeSystem
    Slice NameExtendsCodeSystem
    Definition

    Extends CodeSystem contains a reference to a source terminology, for which a CodeSystem resource is intended to contain additional Concepts

    ShortExtends CodeSystem
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Extends CodeSystem) (Extension Type: Reference(CodeSystem))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-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())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. 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).

    ShortExtensions that cannot be ignored
    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Summaryfalse
    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.


    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
    Invariantsele-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.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.


    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.

    ShortCanonical identifier for this code system, represented as a URI (globally unique) (Coding.system). NOTE: Where not specified by an SDO-specific policy (such as SNOMED’s extension process), change sets associated with locally-maintained extensions should include a url clearly identifying the extension as published under the implementer’s authority, and not the SDO.
    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.


    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.

    Control10..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. 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.

    ShortAdditional identifier for the code system (business identifier)
    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.

    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control10..1*
    TypeIdentifier
    Is Modifierfalse
    Summarytrue
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. CodeSystem.identifier.use
    Definition

    The purpose of this identifier.

    Shortusual | official | temp | secondary | old (If known)
    Comments

    Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

    Control0..1
    BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
    (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

    Identifies the purpose for this identifier, if known .

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. CodeSystem.identifier.value
    Definition

    The portion of the identifier typically relevant to the user and which is unique within the context of the system.

    ShortThe value that is unique
    Comments

    If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    ExampleGeneral: 123456
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. 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.


    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.

    ShortBusiness version of the code system (Coding.version). NOTE: where not specified by an SDO-specific policy, it is recommended that implementers consider aligning to HL7 terminology versioning approach.
    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].

    NoteThis is a business version Id, not a resource version Id (see discussion)
    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-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.

    ShortName for this code system (computer friendly). Should clearly identify the CodeSystem as a Change Set and ideally convey both the source terminology from which it was derived and a notion of its contents.
    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.

    Control10..1
    This element is affected by the following invariants: inv-0
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    Support human navigation and code generation.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. CodeSystem.title
    Definition

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

    ShortName for this code system (human friendly). Should clearly identify the CodeSystem as a Change Set and ideally convey both the source terminology from which it was derived and a notion of its contents.
    Comments

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

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. CodeSystem.status
    Definition

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

    Shortdraft | active | retired | unknown
    Comments

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

    Control1..1
    BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

    The lifecycle status of an artifact.

    Typecode
    Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. 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.

    ShortFor testing purposes, not real usage
    Comments

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

    Control10..1
    Typeboolean
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. CodeSystem.publisher
    Definition

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

    ShortName of the publisher (organization or individual)
    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.

    Control10..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

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

    Alternate Namessteward
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. CodeSystem.description
    Definition

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

    ShortNatural language description of the code system. Should provide a robust inventory of the contents of the Change Set
    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).

    Control10..1
    Typemarkdown
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Alternate NamesScope, Purpose, scope
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. 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.

    ShortUse and/or publishing 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.

    Control10..1
    Typemarkdown
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Requirements

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

    Alternate NamesLicense, Restrictions
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. CodeSystem.caseSensitive
    Definition

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

    ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, caseSensitive should not be included.If code comparison is case sensitive
    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.

    Control0..01
    Typeboolean
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. CodeSystem.hierarchyMeaning
    Definition

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

    ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, hierarchyMeaning should not be included.grouped-by | is-a | part-of | classified-with
    Comments

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

    Control0..01
    BindingThe codes SHALL be taken from CodeSystemHierarchyMeaninghttp://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|4.0.1
    (required to http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|4.0.1)

    The meaning of the hierarchy of concepts in a code system.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    38. CodeSystem.compositional
    Definition

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

    ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, compositional should not be included.If code system defines a compositional grammar
    Comments

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

    Control0..01
    Typeboolean
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Alternate Namesgrammar
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    40. CodeSystem.content
    Definition

    This codes system profile contains only those concepts included in an incremental Change Set for a terminology


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

    ShortChange Set CodeSystem resources are most appropriately described as a FRAGMENTnot-present | example | fragment | complete | supplement
    Control1..1
    BindingThe codes SHALL be taken from CodeSystemContentModehttp://hl7.org/fhir/ValueSet/codesystem-content-mode|4.0.1
    (required to http://hl7.org/fhir/ValueSet/codesystem-content-mode|4.0.1)

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

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Fixed Valuefragment
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    42. CodeSystem.supplements
    Definition

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

    ShortThe source terminology from which the Change Set was derived should be conveyed via a Provenance resource, not CodeSystem.supplementsCanonical URL of Code System this adds designations and properties to
    Comments

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

    Control0..01
    Typecanonical(CodeSystem)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    44. CodeSystem.property
    Definition

    A property defines additional semantic detail for each concept included in the change set


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

    ShortAdditional information supplied about each concept. Property values should follow the guidance available in the terminology-specific links in the 'Use with HL7 Standards' column within the [HL7 Terminology External Code Systems page](https://terminology.hl7.org/external_terminologies.html).
    Comments

    All properties referenced in the definitions of concepts within the change set must be defined first as a CodeSystem.property

    Control0..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    46. 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).

    ShortExtensions that cannot be ignored even if unrecognized
    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    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.


    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
    Invariantsele-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())
    48. 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.

    ShortIdentifies the property on the concepts, and when referred to in operations
    Control1..1
    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    50. CodeSystem.property.uri
    Definition

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

    ShortFormal identifier for the property
    Control0..1
    Typeuri
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    52. CodeSystem.property.description
    Definition

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

    ShortWhy the property is defined, and/or what it conveys
    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    54. 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 anotherr defined concept).


    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).

    Shortcode | Coding | string | integer | boolean | dateTimecode | Coding | string | integer | boolean | dateTime | decimal
    Control1..1
    BindingThe codes SHALL be taken from PropertyTypehttp://hl7.org/fhir/ValueSet/concept-property-type|4.0.1
    (required to http://hl7.org/fhir/ValueSet/concept-property-type|4.0.1)

    The type of a property value.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Invariantsele-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 meaning of the hierarchical relationships are.


    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.

    ShortConcepts in the change set for the code systemConcepts in the code system
    Comments

    For a change set, concepts must be defined and included in the CodeSystem instance


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

    Control10..*
    TypeBackboneElement
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. 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.

    ShortUnique internal identifier maintained by the entity distributing the change set for the concept represented by the terminology-specific concept.codeUnique id for inter-element referencing
    Control0..1
    Typestring
    Is Modifierfalse
    XML FormatIn the XML format, this property is represented as an attribute.
    Summaryfalse
    60. CodeSystem.concept.extension
    Definition

    An Extension


    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.

    ShortExtensionAdditional content defined by implementations
    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.

    Control0..*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-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.concept.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 62. CodeSystem.concept.extension:OWLExpression
      Slice NameOWLExpression
      Definition

      OWL Expression representing the logical definition of a concept

      ShortOWL Expression
      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension(OWL Expression) (Extension Type: string)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      64. CodeSystem.concept.extension:changeType
      Slice NamechangeType
      Definition

      Coded value indicating the nature of a change made to the parent element

      ShortChange Type
      Control0..1
      This element is affected by the following invariants: ele-1
      TypeExtension(Change Type) (Extension Type: CodeableConcept)
      Is Modifierfalse
      Summaryfalse
      Invariantsele-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())
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      66. 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).

      ShortExtensions that cannot be ignored even if unrecognized
      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.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      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.


      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
      Invariantsele-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())
      68. CodeSystem.concept.code
      Definition

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

      ShortCode that identifies concept
      Control1..1
      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      70. CodeSystem.concept.display
      Definition

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

      ShortText to display to the user representing the concept
      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      72. 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.

      ShortFormal definition
      Control10..1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      74. CodeSystem.concept.designation
      Definition

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

      ShortAdditional representations for the concept
      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.


      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.

      Control0..*
      TypeBackboneElement
      Is Modifierfalse
      Summaryfalse
      Requirements

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

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      76. CodeSystem.concept.designation.extension
      Definition

      An Extension


      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.

      ShortExtensionAdditional content defined by implementations
      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-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.concept.designation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 78. CodeSystem.concept.designation.extension:caseSensitivity
        Slice NamecaseSensitivity
        Definition

        Coded value to identify what case sensitivity is reflected in the designation

        ShortDesignation Case Sensitivity
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Designation Case Sensitivity) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        80. CodeSystem.concept.designation.extension:acceptability
        Slice Nameacceptability
        Definition

        Coded value to convey the acceptability of a designation in the language or dialect specified by that Reference Set . Values include 'preferred' and 'acceptable'.

        ShortDesignation Acceptability
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Designation Acceptability) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        82. CodeSystem.concept.designation.extension:dialect
        Slice Namedialect
        Definition

        Subcategorization of language

        ShortDesignation Dialect
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Designation Dialect) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        84. CodeSystem.concept.designation.extension:changeType
        Slice NamechangeType
        Definition

        Coded value indicating the nature of a change made to the parent element

        ShortChange Type
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Change Type) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-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())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        86. CodeSystem.concept.designation.modifierExtension
        Definition

        An Extension


        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).

        ShortExtensionExtensions that cannot be ignored even if unrecognized
        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        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
        Invariantsele-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.concept.designation.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 88. CodeSystem.concept.designation.modifierExtension:designationStatus
          Slice NamedesignationStatus
          Definition

          Complex extension to convey the status of a designation (active vs. inactive) and a timestamp for that status.

          ShortDesignation Status
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Designation Status) (Complex Extension)
          Is Modifiertrue because A designation that is not active should not be used by implementers in most cases
          Invariantsele-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())
          90. CodeSystem.concept.designation.language
          Definition

          The language this designation is defined for.

          ShortHuman language of the designation
          Comments

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

          Control0..1
          BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Additional BindingsPurpose
          AllLanguagesMax Binding
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          92. CodeSystem.concept.designation.use
          Definition

          A code that details how this designation would be used.

          ShortDetails how this designation would be used
          Comments

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

          Control0..1
          BindingUnless not suitable, these codes SHALL be taken from DesignationUsehttp://hl7.org/fhir/ValueSet/designation-use
          (extensible to http://hl7.org/fhir/ValueSet/designation-use)

          Details of how a designation would be used.

          TypeCoding
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          94. CodeSystem.concept.designation.value
          Definition

          The text value for this designation.

          ShortThe text value for this designation
          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          96. CodeSystem.concept.property
          Definition

          A property value for this concept.

          ShortProperty value for the concept
          Control0..*
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          98. CodeSystem.concept.property.extension
          Definition

          An Extension


          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.

          ShortExtensionAdditional content defined by implementations
          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.

          Control0..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-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.concept.property.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 100. CodeSystem.concept.property.extension:DefiningRelationshipType
            Slice NameDefiningRelationshipType
            Definition

            Indicator to distinguish between axioms explicitly stated vs. inferred by a reasoner or other logical processes

            ShortDefining Relationship Type
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Defining Relationship Type) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            102. CodeSystem.concept.property.extension:elProfileSetOperator
            Slice NameelProfileSetOperator
            Definition

            EL++ profile to describe the axiom as being part of the Necessary vs. Sufficient set for defining the concept

            ShortEL Profile Set Operator
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(EL Profile Set Operator) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            104. CodeSystem.concept.property.extension:roleGroup
            Slice NameroleGroup
            Definition

            Where multiple property groupings are assigned for a particular concept, this identifies the group to which this property belongs. See also SNOMED concept 609096000 Role group (attribute)

            ShortSNOMED Role Group
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(SNOMED Role Group) (Extension Type: integer)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            106. CodeSystem.concept.property.extension:changeType
            Slice NamechangeType
            Definition

            Coded value indicating the nature of a change made to the parent element

            ShortChange Type
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Change Type) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-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())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            108. 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).

            ShortExtensions that cannot be ignored even if unrecognized
            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            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.


            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
            Invariantsele-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())
            110. CodeSystem.concept.property.code
            Definition

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

            ShortReference to CodeSystem.property.code
            Control1..1
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            112. CodeSystem.concept.property.value[x]
            Definition

            The value of this property.

            ShortValue of the property for this concept
            Control1..1
            TypeChoice of: code, Coding, string, integer, boolean, dateTime, decimal
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            114. 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.

            ShortChild Concepts (is-a/contains/categorizes)
            Comments

            For CodeSystem Change Sets, relationships to child concepts should be done through concept.property values, not concept.concept elements

            Control0..0*
            TypeSeettp://hl7.org/fhir/StructureDefinition/CodeSystem#CodeSystem.concept
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

            Guidance on how to interpret the contents of this table can be foundhere

            0. CodeSystem
            2. CodeSystem.extension
            SlicingThis element introduces a set of slices on CodeSystem.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 4. CodeSystem.extension:ExtendsCodeSystem
              Slice NameExtendsCodeSystem
              Control0..1
              TypeExtension(Extends CodeSystem) (Extension Type: Reference(CodeSystem))
              6. CodeSystem.url
              ShortCanonical identifier for this code system, represented as a URI (globally unique) (Coding.system). NOTE: Where not specified by an SDO-specific policy (such as SNOMED’s extension process), change sets associated with locally-maintained extensions should include a url clearly identifying the extension as published under the implementer’s authority, and not the SDO.
              8. CodeSystem.identifier
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control1..1
              10. CodeSystem.identifier.value
              12. CodeSystem.version
              ShortBusiness version of the code system (Coding.version). NOTE: where not specified by an SDO-specific policy, it is recommended that implementers consider aligning to HL7 terminology versioning approach.
              NoteThis is a business version Id, not a resource version Id (see discussion)
              14. CodeSystem.name
              ShortName for this code system (computer friendly). Should clearly identify the CodeSystem as a Change Set and ideally convey both the source terminology from which it was derived and a notion of its contents.
              16. CodeSystem.title
              ShortName for this code system (human friendly). Should clearly identify the CodeSystem as a Change Set and ideally convey both the source terminology from which it was derived and a notion of its contents.
              Control1..?
              18. CodeSystem.description
              ShortNatural language description of the code system. Should provide a robust inventory of the contents of the Change Set
              20. CodeSystem.copyright
              Control1..?
              22. CodeSystem.caseSensitive
              ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, caseSensitive should not be included.
              Control0..0
              24. CodeSystem.hierarchyMeaning
              ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, hierarchyMeaning should not be included.
              Control0..0
              26. CodeSystem.compositional
              ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, compositional should not be included.
              Control0..0
              28. CodeSystem.content
              Definition

              This codes system profile contains only those concepts included in an incremental Change Set for a terminology

              ShortChange Set CodeSystem resources are most appropriately described as a FRAGMENT
              Fixed Valuefragment
              30. CodeSystem.supplements
              ShortThe source terminology from which the Change Set was derived should be conveyed via a Provenance resource, not CodeSystem.supplements
              Control0..0
              32. CodeSystem.property
              Definition

              A property defines additional semantic detail for each concept included in the change set

              ShortAdditional information supplied about each concept. Property values should follow the guidance available in the terminology-specific links in the 'Use with HL7 Standards' column within the [HL7 Terminology External Code Systems page](https://terminology.hl7.org/external_terminologies.html).
              Comments

              All properties referenced in the definitions of concepts within the change set must be defined first as a CodeSystem.property

              Must Supporttrue
              34. CodeSystem.property.uri
              Definition

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

              Must Supportfalse
              36. CodeSystem.property.description
              Must Supporttrue
              38. 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 anotherr defined concept).

              Shortcode | Coding | string | integer | boolean | dateTime
              40. 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 meaning of the hierarchical relationships are.

              ShortConcepts in the change set for the code system
              Comments

              For a change set, concepts must be defined and included in the CodeSystem instance

              42. CodeSystem.concept.id
              ShortUnique internal identifier maintained by the entity distributing the change set for the concept represented by the terminology-specific concept.code
              44. CodeSystem.concept.extension
              SlicingThis element introduces a set of slices on CodeSystem.concept.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 46. CodeSystem.concept.extension:OWLExpression
                Slice NameOWLExpression
                Control0..*
                TypeExtension(OWL Expression) (Extension Type: string)
                48. CodeSystem.concept.extension:changeType
                Slice NamechangeType
                Control0..1
                TypeExtension(Change Type) (Extension Type: CodeableConcept)
                50. CodeSystem.concept.code
                52. CodeSystem.concept.display
                ShortText to display to the user representing the concept
                Control1..?
                54. CodeSystem.concept.definition
                Control1..?
                Must Supportfalse
                56. CodeSystem.concept.designation
                58. CodeSystem.concept.designation.extension
                SlicingThis element introduces a set of slices on CodeSystem.concept.designation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 60. CodeSystem.concept.designation.extension:caseSensitivity
                  Slice NamecaseSensitivity
                  Control0..1
                  TypeExtension(Designation Case Sensitivity) (Extension Type: CodeableConcept)
                  62. CodeSystem.concept.designation.extension:acceptability
                  Slice Nameacceptability
                  Control0..1
                  TypeExtension(Designation Acceptability) (Extension Type: CodeableConcept)
                  64. CodeSystem.concept.designation.extension:dialect
                  Slice Namedialect
                  Control0..1
                  TypeExtension(Designation Dialect) (Extension Type: CodeableConcept)
                  66. CodeSystem.concept.designation.extension:changeType
                  Slice NamechangeType
                  Control0..1
                  TypeExtension(Change Type) (Extension Type: CodeableConcept)
                  68. CodeSystem.concept.designation.modifierExtension
                  SlicingThis element introduces a set of slices on CodeSystem.concept.designation.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 70. CodeSystem.concept.designation.modifierExtension:designationStatus
                    Slice NamedesignationStatus
                    Control0..1
                    TypeExtension(Designation Status) (Complex Extension)
                    72. CodeSystem.concept.designation.language
                    Must Supportfalse
                    74. CodeSystem.concept.designation.use
                    Must Supportfalse
                    76. CodeSystem.concept.designation.value
                    Must Supportfalse
                    78. CodeSystem.concept.property
                    Must Supporttrue
                    80. CodeSystem.concept.property.extension
                    SlicingThis element introduces a set of slices on CodeSystem.concept.property.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 82. CodeSystem.concept.property.extension:DefiningRelationshipType
                      Slice NameDefiningRelationshipType
                      Control0..1
                      TypeExtension(Defining Relationship Type) (Extension Type: CodeableConcept)
                      84. CodeSystem.concept.property.extension:elProfileSetOperator
                      Slice NameelProfileSetOperator
                      Control0..1
                      TypeExtension(EL Profile Set Operator) (Extension Type: CodeableConcept)
                      86. CodeSystem.concept.property.extension:roleGroup
                      Slice NameroleGroup
                      Control0..1
                      TypeExtension(SNOMED Role Group) (Extension Type: integer)
                      88. CodeSystem.concept.property.extension:changeType
                      Slice NamechangeType
                      Control0..1
                      TypeExtension(Change Type) (Extension Type: CodeableConcept)
                      90. CodeSystem.concept.property.code
                      92. CodeSystem.concept.property.value[x]
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      94. CodeSystem.concept.concept
                      Comments

                      For CodeSystem Change Sets, relationships to child concepts should be done through concept.property values, not concept.concept elements

                      Control0..0
                      Must Supportfalse

                      Guidance on how to interpret the contents of this table can be foundhere

                      0. 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.

                      ShortDeclares the existence of and describes a code system or code system supplement
                      Control1..1
                      Is Modifierfalse
                      Summaryfalse
                      Invariantscsd-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.

                      ShortLogical id of this artifact
                      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.

                      Control0..1
                      Typeid
                      Is Modifierfalse
                      Summarytrue
                      4. 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.

                      ShortMetadata about the resource
                      Control0..1
                      TypeMeta
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      6. 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.

                      ShortA set of rules under which this content was created
                      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.

                      Control0..1
                      Typeuri
                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      8. CodeSystem.language
                      Definition

                      The base language in which the resource is written.

                      ShortLanguage of the resource content
                      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).

                      Control0..1
                      BindingThe codes SHOULD be taken from CommonLanguages
                      (preferred to http://hl7.org/fhir/ValueSet/languages)

                      A human language.

                      Additional BindingsPurpose
                      AllLanguagesMax Binding
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      10. 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.

                      ShortText summary of the resource, for human interpretation
                      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.

                      Control0..1
                      TypeNarrative
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesnarrative, html, xhtml, display
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      12. 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.

                      ShortContained, inline 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.

                      Control0..*
                      TypeResource
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesinline resources, anonymous resources, contained resources
                      14. CodeSystem.extension
                      Definition

                      An Extension

                      ShortExtension
                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-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 areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 16. CodeSystem.extension:ExtendsCodeSystem
                        Slice NameExtendsCodeSystem
                        Definition

                        Extends CodeSystem contains a reference to a source terminology, for which a CodeSystem resource is intended to contain additional Concepts

                        ShortExtends CodeSystem
                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeExtension(Extends CodeSystem) (Extension Type: Reference(CodeSystem))
                        Is Modifierfalse
                        Summaryfalse
                        Invariantsele-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())
                        18. 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).

                        ShortExtensions that cannot be ignored
                        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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                        Summaryfalse
                        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
                        Invariantsele-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())
                        20. 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.

                        ShortCanonical identifier for this code system, represented as a URI (globally unique) (Coding.system). NOTE: Where not specified by an SDO-specific policy (such as SNOMED’s extension process), change sets associated with locally-maintained extensions should include a url clearly identifying the extension as published under the implementer’s authority, and not the SDO.
                        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.

                        Control1..1
                        Typeuri
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        22. 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.

                        ShortAdditional identifier for the code system (business identifier)
                        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.

                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control1..1
                        TypeIdentifier
                        Is Modifierfalse
                        Summarytrue
                        Requirements

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

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        24. CodeSystem.identifier.id
                        Definition

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        ShortUnique id for inter-element referencing
                        Control0..1
                        Typestring
                        Is Modifierfalse
                        XML FormatIn the XML format, this property is represented as an attribute.
                        Summaryfalse
                        26. CodeSystem.identifier.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.

                        ShortAdditional content defined by implementations
                        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.

                        Control0..*
                        TypeExtension
                        Is Modifierfalse
                        Summaryfalse
                        Alternate Namesextensions, user content
                        Invariantsele-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.identifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 28. CodeSystem.identifier.use
                          Definition

                          The purpose of this identifier.

                          Shortusual | official | temp | secondary | old (If known)
                          Comments

                          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                          Control0..1
                          BindingThe codes SHALL be taken from IdentifierUse
                          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                          Identifies the purpose for this identifier, if known .

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          30. CodeSystem.identifier.type
                          Definition

                          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                          ShortDescription of identifier
                          Comments

                          This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                          Control0..1
                          BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes
                          (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                          A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Allows users to make use of identifiers when the identifier system is not known.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          32. CodeSystem.identifier.system
                          Definition

                          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                          ShortThe namespace for the identifier value
                          Comments

                          Identifier.system is always case sensitive.

                          Control0..1
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                          ExampleGeneral: http://www.acme.com/identifiers/patient
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          34. CodeSystem.identifier.value
                          Definition

                          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                          ShortThe value that is unique
                          Comments

                          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          ExampleGeneral: 123456
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          36. CodeSystem.identifier.period
                          Definition

                          Time period during which identifier is/was valid for use.

                          ShortTime period when id is/was valid for use
                          Control0..1
                          TypePeriod
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          38. CodeSystem.identifier.assigner
                          Definition

                          Organization that issued/manages the identifier.

                          ShortOrganization that issued id (may be just text)
                          Comments

                          The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                          Control0..1
                          TypeReference(Organization)
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          40. 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.

                          ShortBusiness version of the code system (Coding.version). NOTE: where not specified by an SDO-specific policy, it is recommended that implementers consider aligning to HL7 terminology versioning approach.
                          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].

                          NoteThis is a business version Id, not a resource version Id (see discussion)
                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          42. 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.

                          ShortName for this code system (computer friendly). Should clearly identify the CodeSystem as a Change Set and ideally convey both the source terminology from which it was derived and a notion of its contents.
                          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.

                          Control1..1
                          This element is affected by the following invariants: inv-0
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          Support human navigation and code generation.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          44. CodeSystem.title
                          Definition

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

                          ShortName for this code system (human friendly). Should clearly identify the CodeSystem as a Change Set and ideally convey both the source terminology from which it was derived and a notion of its contents.
                          Comments

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

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          46. CodeSystem.status
                          Definition

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

                          Shortdraft | active | retired | unknown
                          Comments

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

                          Control1..1
                          BindingThe codes SHALL be taken from PublicationStatus
                          (required to http://hl7.org/fhir/ValueSet/publication-status|4.0.1)

                          The lifecycle status of an artifact.

                          Typecode
                          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          48. 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.

                          ShortFor testing purposes, not real usage
                          Comments

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

                          Control1..1
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

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

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          50. 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.

                          ShortDate last changed
                          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.

                          Control0..1
                          TypedateTime
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Alternate NamesRevision Date
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          52. CodeSystem.publisher
                          Definition

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

                          ShortName of the publisher (organization or individual)
                          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.

                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

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

                          Alternate Namessteward
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          54. CodeSystem.contact
                          Definition

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

                          ShortContact details for the publisher
                          Comments

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

                          Control0..*
                          TypeContactDetail
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          56. CodeSystem.description
                          Definition

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

                          ShortNatural language description of the code system. Should provide a robust inventory of the contents of the Change Set
                          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).

                          Control1..1
                          Typemarkdown
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Alternate NamesScope, Purpose, scope
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          58. 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.

                          ShortThe context that the content is intended to support
                          Comments

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

                          Control0..*
                          TypeUsageContext
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Assist in searching for appropriate content.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          60. CodeSystem.jurisdiction
                          Definition

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

                          ShortIntended jurisdiction for code system (if applicable)
                          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.

                          Control0..*
                          BindingUnless not suitable, these codes SHALL be taken from Jurisdiction ValueSet
                          (extensible to http://hl7.org/fhir/ValueSet/jurisdiction)

                          Countries and regions within which this artifact is targeted for use.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          62. CodeSystem.purpose
                          Definition

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

                          ShortWhy this code system is defined
                          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.

                          Control0..1
                          Typemarkdown
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          64. 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.

                          ShortUse and/or publishing 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.

                          Control1..1
                          Typemarkdown
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Requirements

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

                          Alternate NamesLicense, Restrictions
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          66. CodeSystem.caseSensitive
                          Definition

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

                          ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, caseSensitive should not be included.
                          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.

                          Control0..0
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          68. CodeSystem.valueSet
                          Definition

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

                          ShortCanonical reference to the value set with entire code system
                          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.

                          Control0..1
                          Typecanonical(ValueSet)
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          70. CodeSystem.hierarchyMeaning
                          Definition

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

                          ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, hierarchyMeaning should not be included.
                          Comments

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

                          Control0..0
                          BindingThe codes SHALL be taken from CodeSystemHierarchyMeaning
                          (required to http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|4.0.1)

                          The meaning of the hierarchy of concepts in a code system.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          72. CodeSystem.compositional
                          Definition

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

                          ShortNOTE: As a CodeSystem Change Set should not be fundamentally altering the design and operation of the terminology as a whole therefore, compositional should not be included.
                          Comments

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

                          Control0..0
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Alternate Namesgrammar
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          74. 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.

                          ShortIf definitions are not stable
                          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.

                          Control0..1
                          Typeboolean
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          76. CodeSystem.content
                          Definition

                          This codes system profile contains only those concepts included in an incremental Change Set for a terminology

                          ShortChange Set CodeSystem resources are most appropriately described as a FRAGMENT
                          Control1..1
                          BindingThe codes SHALL be taken from CodeSystemContentMode
                          (required to http://hl7.org/fhir/ValueSet/codesystem-content-mode|4.0.1)

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

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Fixed Valuefragment
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          78. CodeSystem.supplements
                          Definition

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

                          ShortThe source terminology from which the Change Set was derived should be conveyed via a Provenance resource, not CodeSystem.supplements
                          Comments

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

                          Control0..0
                          Typecanonical(CodeSystem)
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          80. 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.

                          ShortTotal concepts in the code system
                          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.

                          Control0..1
                          TypeunsignedInt
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          82. CodeSystem.filter
                          Definition

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

                          ShortFilter that can be used in a value set
                          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.

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          84. 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.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          86. 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.

                          ShortAdditional content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-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())
                          88. 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).

                          ShortExtensions that cannot be ignored even if unrecognized
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          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
                          Invariantsele-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())
                          90. CodeSystem.filter.code
                          Definition

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

                          ShortCode that identifies the filter
                          Control1..1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          92. CodeSystem.filter.description
                          Definition

                          A description of how or why the filter is used.

                          ShortHow or why the filter is used
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          94. CodeSystem.filter.operator
                          Definition

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

                          Short= | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists
                          Control1..*
                          BindingThe codes SHALL be taken from FilterOperator
                          (required to http://hl7.org/fhir/ValueSet/filter-operator|4.0.1)

                          The kind of operation to perform as a part of a property based filter.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          96. CodeSystem.filter.value
                          Definition

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

                          ShortWhat to use for the value
                          Control1..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          98. CodeSystem.property
                          Definition

                          A property defines additional semantic detail for each concept included in the change set

                          ShortAdditional information supplied about each concept. Property values should follow the guidance available in the terminology-specific links in the 'Use with HL7 Standards' column within the [HL7 Terminology External Code Systems page](https://terminology.hl7.org/external_terminologies.html).
                          Comments

                          All properties referenced in the definitions of concepts within the change set must be defined first as a CodeSystem.property

                          Control0..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          100. 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.

                          ShortUnique id for inter-element referencing
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          102. 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.

                          ShortAdditional content defined by implementations
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesextensions, user content
                          Invariantsele-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())
                          104. 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).

                          ShortExtensions that cannot be ignored even if unrecognized
                          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.

                          Control0..*
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          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
                          Invariantsele-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())
                          106. 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.

                          ShortIdentifies the property on the concepts, and when referred to in operations
                          Control1..1
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          108. CodeSystem.property.uri
                          Definition

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

                          ShortFormal identifier for the property
                          Control0..1
                          Typeuri
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supportfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          110. CodeSystem.property.description
                          Definition

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

                          ShortWhy the property is defined, and/or what it conveys
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Must Supporttrue
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          112. 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 anotherr defined concept).

                          Shortcode | Coding | string | integer | boolean | dateTime
                          Control1..1
                          BindingThe codes SHALL be taken from PropertyType
                          (required to http://hl7.org/fhir/ValueSet/concept-property-type|4.0.1)

                          The type of a property value.

                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          114. 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 meaning of the hierarchical relationships are.

                          ShortConcepts in the change set for the code system
                          Comments

                          For a change set, concepts must be defined and included in the CodeSystem instance

                          Control1..*
                          TypeBackboneElement
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          116. 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.

                          ShortUnique internal identifier maintained by the entity distributing the change set for the concept represented by the terminology-specific concept.code
                          Control0..1
                          Typestring
                          Is Modifierfalse
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Summaryfalse
                          118. CodeSystem.concept.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-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.concept.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 120. CodeSystem.concept.extension:OWLExpression
                            Slice NameOWLExpression
                            Definition

                            OWL Expression representing the logical definition of a concept

                            ShortOWL Expression
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension(OWL Expression) (Extension Type: string)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-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())
                            122. CodeSystem.concept.extension:changeType
                            Slice NamechangeType
                            Definition

                            Coded value indicating the nature of a change made to the parent element

                            ShortChange Type
                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Change Type) (Extension Type: CodeableConcept)
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-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())
                            124. 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).

                            ShortExtensions that cannot be ignored even if unrecognized
                            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.

                            Control0..*
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            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
                            Invariantsele-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())
                            126. CodeSystem.concept.code
                            Definition

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

                            ShortCode that identifies concept
                            Control1..1
                            Typecode
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. CodeSystem.concept.display
                            Definition

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

                            ShortText to display to the user representing the concept
                            Control1..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            130. 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.

                            ShortFormal definition
                            Control1..1
                            Typestring
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Must Supportfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            132. CodeSystem.concept.designation
                            Definition

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

                            ShortAdditional representations for the concept
                            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.

                            Control0..*
                            TypeBackboneElement
                            Is Modifierfalse
                            Summaryfalse
                            Requirements

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

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            134. 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.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            136. CodeSystem.concept.designation.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..*
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-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.concept.designation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 138. CodeSystem.concept.designation.extension:caseSensitivity
                              Slice NamecaseSensitivity
                              Definition

                              Coded value to identify what case sensitivity is reflected in the designation

                              ShortDesignation Case Sensitivity
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Designation Case Sensitivity) (Extension Type: CodeableConcept)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-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())
                              140. CodeSystem.concept.designation.extension:acceptability
                              Slice Nameacceptability
                              Definition

                              Coded value to convey the acceptability of a designation in the language or dialect specified by that Reference Set . Values include 'preferred' and 'acceptable'.

                              ShortDesignation Acceptability
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Designation Acceptability) (Extension Type: CodeableConcept)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-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())
                              142. CodeSystem.concept.designation.extension:dialect
                              Slice Namedialect
                              Definition

                              Subcategorization of language

                              ShortDesignation Dialect
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Designation Dialect) (Extension Type: CodeableConcept)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-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())
                              144. CodeSystem.concept.designation.extension:changeType
                              Slice NamechangeType
                              Definition

                              Coded value indicating the nature of a change made to the parent element

                              ShortChange Type
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(Change Type) (Extension Type: CodeableConcept)
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-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())
                              146. CodeSystem.concept.designation.modifierExtension
                              Definition

                              An Extension

                              ShortExtension
                              Control0..*
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Invariantsele-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.concept.designation.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • value @ url
                              • 148. CodeSystem.concept.designation.modifierExtension:designationStatus
                                Slice NamedesignationStatus
                                Definition

                                Complex extension to convey the status of a designation (active vs. inactive) and a timestamp for that status.

                                ShortDesignation Status
                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypeExtension(Designation Status) (Complex Extension)
                                Is Modifiertrue because A designation that is not active should not be used by implementers in most cases
                                Invariantsele-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())
                                150. CodeSystem.concept.designation.language
                                Definition

                                The language this designation is defined for.

                                ShortHuman language of the designation
                                Comments

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

                                Control0..1
                                BindingThe codes SHOULD be taken from CommonLanguages
                                (preferred to http://hl7.org/fhir/ValueSet/languages)

                                A human language.

                                Additional BindingsPurpose
                                AllLanguagesMax Binding
                                Typecode
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                152. CodeSystem.concept.designation.use
                                Definition

                                A code that details how this designation would be used.

                                ShortDetails how this designation would be used
                                Comments

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

                                Control0..1
                                BindingUnless not suitable, these codes SHALL be taken from DesignationUse
                                (extensible to http://hl7.org/fhir/ValueSet/designation-use)

                                Details of how a designation would be used.

                                TypeCoding
                                Is Modifierfalse
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                154. CodeSystem.concept.designation.value
                                Definition

                                The text value for this designation.

                                ShortThe text value for this designation
                                Control1..1
                                Typestring
                                Is Modifierfalse
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Must Supportfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                156. CodeSystem.concept.property
                                Definition

                                A property value for this concept.

                                ShortProperty value for the concept
                                Control0..*
                                TypeBackboneElement
                                Is Modifierfalse
                                Must Supporttrue
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                158. 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.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                160. CodeSystem.concept.property.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..*
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-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.concept.property.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 162. CodeSystem.concept.property.extension:DefiningRelationshipType
                                  Slice NameDefiningRelationshipType
                                  Definition

                                  Indicator to distinguish between axioms explicitly stated vs. inferred by a reasoner or other logical processes

                                  ShortDefining Relationship Type
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(Defining Relationship Type) (Extension Type: CodeableConcept)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-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())
                                  164. CodeSystem.concept.property.extension:elProfileSetOperator
                                  Slice NameelProfileSetOperator
                                  Definition

                                  EL++ profile to describe the axiom as being part of the Necessary vs. Sufficient set for defining the concept

                                  ShortEL Profile Set Operator
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(EL Profile Set Operator) (Extension Type: CodeableConcept)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-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())
                                  166. CodeSystem.concept.property.extension:roleGroup
                                  Slice NameroleGroup
                                  Definition

                                  Where multiple property groupings are assigned for a particular concept, this identifies the group to which this property belongs. See also SNOMED concept 609096000 Role group (attribute)

                                  ShortSNOMED Role Group
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(SNOMED Role Group) (Extension Type: integer)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-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())
                                  168. CodeSystem.concept.property.extension:changeType
                                  Slice NamechangeType
                                  Definition

                                  Coded value indicating the nature of a change made to the parent element

                                  ShortChange Type
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(Change Type) (Extension Type: CodeableConcept)
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-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())
                                  170. 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).

                                  ShortExtensions that cannot be ignored even if unrecognized
                                  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.

                                  Control0..*
                                  TypeExtension
                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                  Summarytrue
                                  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
                                  Invariantsele-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())
                                  172. CodeSystem.concept.property.code
                                  Definition

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

                                  ShortReference to CodeSystem.property.code
                                  Control1..1
                                  Typecode
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  174. CodeSystem.concept.property.value[x]
                                  Definition

                                  The value of this property.

                                  ShortValue of the property for this concept
                                  Control1..1
                                  TypeChoice of: code, Coding, string, integer, boolean, dateTime, decimal
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  176. 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.

                                  ShortChild Concepts (is-a/contains/categorizes)
                                  Comments

                                  For CodeSystem Change Sets, relationships to child concepts should be done through concept.property values, not concept.concept elements

                                  Control0..0
                                  TypeSeettp://hl7.org/fhir/StructureDefinition/CodeSystem#CodeSystem.concept
                                  Is Modifierfalse
                                  Must Supportfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))