Vital Records Death Reporting (VRDR) FHIR Implementation Guide
3.0.0 - STU3

Vital Records Death Reporting (VRDR) FHIR Implementation Guide, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IHE/QRPH.VRDR/ and changes regularly. See the Directory of published versions

## : CauseOfDeathCodedContentBundle-Example1 - JSON Representation

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    {
      "resourceType" : "Bundle",
      "id" : "CauseOfDeathCodedContentBundle-Example1",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-cause-of-death-coded-content-bundle"
        ]
      },
      "identifier" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/CertificateNumber",
            "valueString" : "000182"
          },
          {
            "url" : "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/AuxiliaryStateIdentifier1",
            "valueString" : "000000000001"
          },
          {
            "url" : "http://hl7.org/fhir/us/vrdr/StructureDefinition/StateSpecificField",
            "valueString" : "state specific content"
          }
        ],
        "system" : "http://nchs.cdc.gov/vrdr_id",
        "value" : "2020NY000182"
      },
      "type" : "collection",
      "timestamp" : "2020-10-20T14:48:35.401641-04:00",
      "entry" : [
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/ActivityAtTimeOfDeath-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "ActivityAtTimeOfDeath-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-activity-at-time-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_ActivityAtTimeOfDeath-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation ActivityAtTimeOfDeath-Example1</b></p><a name=\"ActivityAtTimeOfDeath-Example1\"> </a><a name=\"hcActivityAtTimeOfDeath-Example1\"> </a><a name=\"ActivityAtTimeOfDeath-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80626-5}\">Activity at time of death [CDC]</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-activity-at-time-of-death-cs 1}\">While engaged in leisure activities.</span></p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80626-5"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-activity-at-time-of-death-cs",
                  "code" : "1",
                  "display" : "While engaged in leisure activities."
                }
              ]
            }
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/ManualUnderlyingCauseOfDeath-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "ManualUnderlyingCauseOfDeath-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-manual-underlying-cause-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_ManualUnderlyingCauseOfDeath-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation ManualUnderlyingCauseOfDeath-Example1</b></p><a name=\"ManualUnderlyingCauseOfDeath-Example1\"> </a><a name=\"hcManualUnderlyingCauseOfDeath-Example1\"> </a><a name=\"ManualUnderlyingCauseOfDeath-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80359-3}\">Cause of death.underlying [Manual]</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 J96.0}\">Acute respiratory failure</span></p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80359-3"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-10",
                  "code" : "J96.0"
                }
              ]
            }
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/AutomatedUnderlyingCauseOfDeath-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "AutomatedUnderlyingCauseOfDeath-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-automated-underlying-cause-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_AutomatedUnderlyingCauseOfDeath-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation AutomatedUnderlyingCauseOfDeath-Example1</b></p><a name=\"AutomatedUnderlyingCauseOfDeath-Example1\"> </a><a name=\"hcAutomatedUnderlyingCauseOfDeath-Example1\"> </a><a name=\"AutomatedUnderlyingCauseOfDeath-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80358-5}\">Cause of death.underlying [Automated]</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 J96.0}\">Acute respiratory failure</span></p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80358-5"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-10",
                  "code" : "J96.0"
                }
              ]
            }
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/RecordAxisCauseOfDeath-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "RecordAxisCauseOfDeath-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-record-axis-cause-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_RecordAxisCauseOfDeath-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation RecordAxisCauseOfDeath-Example1</b></p><a name=\"RecordAxisCauseOfDeath-Example1\"> </a><a name=\"hcRecordAxisCauseOfDeath-Example1\"> </a><a name=\"RecordAxisCauseOfDeath-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80357-7}\">Cause of death record axis code [Automated]</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 J96.0}\">Acute respiratory failure</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs position}\">position</span></td><td>1</td></tr></table></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80357-7"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-10",
                  "code" : "J96.0"
                }
              ]
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "position"
                    }
                  ]
                },
                "valueInteger" : 1
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/EntityAxisCauseOfDeath-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "EntityAxisCauseOfDeath-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-entity-axis-cause-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_EntityAxisCauseOfDeath-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation EntityAxisCauseOfDeath-Example1</b></p><a name=\"EntityAxisCauseOfDeath-Example1\"> </a><a name=\"hcEntityAxisCauseOfDeath-Example1\"> </a><a name=\"EntityAxisCauseOfDeath-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80356-9}\">Cause of death entity axis code [Automated]</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 J96.0}\">Acute respiratory failure</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs lineNumber}\">line number</span></p><p><b>value</b>: 1</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs position}\">position</span></p><p><b>value</b>: 1</p></blockquote></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80356-9"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-10",
                  "code" : "J96.0"
                }
              ]
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "lineNumber"
                    }
                  ]
                },
                "valueInteger" : 1
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "position"
                    }
                  ]
                },
                "valueInteger" : 1
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/EntityAxisCauseOfDeath-Example2",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "EntityAxisCauseOfDeath-Example2",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-entity-axis-cause-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_EntityAxisCauseOfDeath-Example2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation EntityAxisCauseOfDeath-Example2</b></p><a name=\"EntityAxisCauseOfDeath-Example2\"> </a><a name=\"hcEntityAxisCauseOfDeath-Example2\"> </a><a name=\"EntityAxisCauseOfDeath-Example2-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80356-9}\">Cause of death entity axis code [Automated]</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 T27.3}\">Burn of respiratory tract, part unspecified</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs lineNumber}\">line number</span></p><p><b>value</b>: 2</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs position}\">position</span></p><p><b>value</b>: 1</p></blockquote></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80356-9"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-10",
                  "code" : "T27.3"
                }
              ]
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "lineNumber"
                    }
                  ]
                },
                "valueInteger" : 2
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "position"
                    }
                  ]
                },
                "valueInteger" : 1
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/EntityAxisCauseOfDeath-Example3",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "EntityAxisCauseOfDeath-Example3",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-entity-axis-cause-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_EntityAxisCauseOfDeath-Example3\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation EntityAxisCauseOfDeath-Example3</b></p><a name=\"EntityAxisCauseOfDeath-Example3\"> </a><a name=\"hcEntityAxisCauseOfDeath-Example3\"> </a><a name=\"EntityAxisCauseOfDeath-Example3-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80356-9}\">Cause of death entity axis code [Automated]</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 X00}\">Exposure to uncontrolled fire in building or structure</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs lineNumber}\">line number</span></p><p><b>value</b>: 2</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs position}\">position</span></p><p><b>value</b>: 2</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs eCodeIndicator}\">e Code Indicator</span></p><p><b>value</b>: true</p></blockquote></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80356-9"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-10",
                  "code" : "X00"
                }
              ]
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "lineNumber"
                    }
                  ]
                },
                "valueInteger" : 2
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "position"
                    }
                  ]
                },
                "valueInteger" : 2
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "eCodeIndicator"
                    }
                  ]
                },
                "valueBoolean" : true
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/EntityAxisCauseOfDeath-Example4",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "EntityAxisCauseOfDeath-Example4",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-entity-axis-cause-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_EntityAxisCauseOfDeath-Example4\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation EntityAxisCauseOfDeath-Example4</b></p><a name=\"EntityAxisCauseOfDeath-Example4\"> </a><a name=\"hcEntityAxisCauseOfDeath-Example4\"> </a><a name=\"EntityAxisCauseOfDeath-Example4-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80356-9}\">Cause of death entity axis code [Automated]</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 T27.2}\">Burn of other parts of respiratory tract</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs lineNumber}\">line number</span></p><p><b>value</b>: 2</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs position}\">position</span></p><p><b>value</b>: 3</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs eCodeIndicator}\">e Code Indicator</span></p><p><b>value</b>: false</p></blockquote></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80356-9"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/sid/icd-10",
                  "code" : "T27.2"
                }
              ]
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "lineNumber"
                    }
                  ]
                },
                "valueInteger" : 2
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "position"
                    }
                  ]
                },
                "valueInteger" : 3
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "eCodeIndicator"
                    }
                  ]
                },
                "valueBoolean" : false
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/PlaceOfInjury-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "PlaceOfInjury-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-place-of-injury"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_PlaceOfInjury-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation PlaceOfInjury-Example1</b></p><a name=\"PlaceOfInjury-Example1\"> </a><a name=\"hcPlaceOfInjury-Example1\"> </a><a name=\"PlaceOfInjury-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 11376-1}\">Injury location</span></p><p><b>subject</b>: NCHS generated</p><p><b>value</b>: <span title=\"Codes:{http://loinc.org LA14084-0}\">Home</span></p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "11376-1"
                }
              ]
            },
            "subject" : {
              "display" : "NCHS generated"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "LA14084-0",
                  "display" : "Home"
                }
              ]
            }
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Parameter/CodingStatusValues-Example1",
          "resource" : {
            "resourceType" : "Parameters",
            "id" : "CodingStatusValues-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-coding-status-values"
              ]
            },
            "parameter" : [
              {
                "name" : "shipmentNumber",
                "valueString" : "A2B2"
              },
              {
                "name" : "receiptDate",
                "valueDate" : "2021-12-12"
              },
              {
                "name" : "coderStatus",
                "valueInteger" : 5
              },
              {
                "name" : "intentionalReject",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-intentional-reject-cs",
                      "code" : "1",
                      "display" : "Reject1"
                    }
                  ]
                }
              },
              {
                "name" : "acmeSystemReject",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-system-reject-cs",
                      "code" : "0",
                      "display" : "Not Rejected"
                    }
                  ]
                }
              },
              {
                "name" : "transaxConversion",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-transax-conversion-cs",
                      "code" : "3",
                      "display" : "Conversion using non-ambivalent table entries"
                    }
                  ]
                }
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/DecedentPregnancyStatus-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "DecedentPregnancyStatus-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-decedent-pregnancy-status"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_DecedentPregnancyStatus-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation DecedentPregnancyStatus-Example1</b></p><a name=\"DecedentPregnancyStatus-Example1\"> </a><a name=\"hcDecedentPregnancyStatus-Example1\"> </a><a name=\"DecedentPregnancyStatus-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69442-2}\">Timing of recent pregnancy in relation to death</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>value</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/CodeSystem-death-pregnancy-status 2}\">Pregnant at time of death</span></p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "69442-2"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "valueCodeableConcept" : {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/us/vr-common-library/StructureDefinition/BypassEditFlag",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://hl7.org/fhir/us/vr-common-library/CodeSystem/CodeSystem-vr-edit-flags",
                        "code" : "2",
                        "display" : "Edit Failed, Data Queried, but not Verified"
                      }
                    ]
                  }
                }
              ],
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/CodeSystem-death-pregnancy-status",
                  "code" : "2",
                  "display" : "Pregnant at time of death"
                }
              ]
            }
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/TobaccoUseContributedToDeath-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "TobaccoUseContributedToDeath-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-tobacco-use-contributed-to-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_TobaccoUseContributedToDeath-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation TobaccoUseContributedToDeath-Example1</b></p><a name=\"TobaccoUseContributedToDeath-Example1\"> </a><a name=\"hcTobaccoUseContributedToDeath-Example1\"> </a><a name=\"TobaccoUseContributedToDeath-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69443-0}\">Did tobacco use contribute to death</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>value</b>: <span title=\"Codes:{http://snomed.info/sct 373066001}\">Yes</span></p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "69443-0",
                  "display" : "Did tobacco use contribute to death"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "373066001",
                  "display" : "Yes"
                }
              ]
            }
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/SurgeryDate-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "SurgeryDate-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-surgery-date"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_SurgeryDate-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation SurgeryDate-Example1</b></p><a name=\"SurgeryDate-Example1\"> </a><a name=\"hcSurgeryDate-Example1\"> </a><a name=\"SurgeryDate-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 80992-1}\">Date and time of surgery</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>effective</b>: 2019-11-12</p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "80992-1"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "effectiveDateTime" : "2019-11-12"
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/MannerOfDeath-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "MannerOfDeath-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-manner-of-death"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_MannerOfDeath-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation MannerOfDeath-Example1</b></p><a name=\"MannerOfDeath-Example1\"> </a><a name=\"hcMannerOfDeath-Example1\"> </a><a name=\"MannerOfDeath-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69449-7}\">Manner of death</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>performer</b>: <a href=\"Practitioner-Certifier-Example1.html\">Practitioner Jim Black (official)</a></p><p><b>value</b>: <span title=\"Codes:{http://snomed.info/sct 38605008}\">Natural death</span></p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "69449-7"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "performer" : [
              {
                🔗 "reference" : "Practitioner/Certifier-Example1"
              }
            ],
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "38605008",
                  "display" : "Natural death"
                }
              ]
            }
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/InjuryIncident-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "InjuryIncident-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-injury-incident"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_InjuryIncident-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation InjuryIncident-Example1</b></p><a name=\"InjuryIncident-Example1\"> </a><a name=\"hcInjuryIncident-Example1\"> </a><a name=\"InjuryIncident-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 11374-6}\">Injury incident description Narrative</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>effective</b>: 2019-11-02 13:00:00-0500</p><p><b>value</b>: <span title=\"Codes:\">drug toxicity</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69444-8}\">Did death result from injury at work</span></p><p><b>value</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0136 N}\">No</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69450-5}\">Place of injury Facility</span></p><p><b>value</b>: <span title=\"Codes:\">Home</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69451-3}\">Transportation role of decedent</span></p><p><b>value</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor OTH}\">Hoverboard Rider</span></p></blockquote></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "11374-6"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "effectiveDateTime" : "2019-11-02T13:00:00-05:00",
            "valueCodeableConcept" : {
              "text" : "drug toxicity"
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "69444-8"
                    }
                  ]
                },
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/v2-0136",
                      "code" : "N",
                      "display" : "No"
                    }
                  ]
                }
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "69450-5"
                    }
                  ]
                },
                "valueCodeableConcept" : {
                  "text" : "Home"
                }
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "69451-3"
                    }
                  ]
                },
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/v3-NullFlavor",
                      "code" : "OTH",
                      "display" : "Other"
                    }
                  ],
                  "text" : "Hoverboard Rider"
                }
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Procedure/DeathCertification-Example2",
          "resource" : {
            "resourceType" : "Procedure",
            "id" : "DeathCertification-Example2",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-death-certification"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Procedure_DeathCertification-Example2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Procedure DeathCertification-Example2</b></p><a name=\"DeathCertification-Example2\"> </a><a name=\"hcDeathCertification-Example2\"> </a><a name=\"DeathCertification-Example2-en-US\"> </a><p><b>identifier</b>: 180</p><p><b>status</b>: Completed</p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 308646001}\">Death certification</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>performed</b>: 2020-11-14 16:39:40-0500</p><h3>Performers</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Function</b></td><td><b>Actor</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://snomed.info/sct 434641000124105}\">Death certification and verification by physician (procedure)</span></td><td><a href=\"Practitioner-Certifier-Example1.html\">Practitioner Jim Black (official)</a></td></tr></table></div>"
            },
            "identifier" : [
              {
                "value" : "180"
              }
            ],
            "status" : "completed",
            "code" : {
              "coding" : [
                {
                  "system" : "http://snomed.info/sct",
                  "code" : "308646001",
                  "display" : "Death certification"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "performedDateTime" : "2020-11-14T16:39:40-05:00",
            "performer" : [
              {
                "function" : {
                  "coding" : [
                    {
                      "system" : "http://snomed.info/sct",
                      "code" : "434641000124105",
                      "display" : "Death certification and verification by physician (procedure)"
                    }
                  ]
                },
                "actor" : {
                  🔗 "reference" : "Practitioner/Certifier-Example1"
                }
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "CauseOfDeathPart1-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-cause-of-death-part1"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_CauseOfDeathPart1-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation CauseOfDeathPart1-Example1</b></p><a name=\"CauseOfDeathPart1-Example1\"> </a><a name=\"hcCauseOfDeathPart1-Example1\"> </a><a name=\"CauseOfDeathPart1-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69453-9}\">Cause of death [US Standard Certificate of Death]</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>performer</b>: <a href=\"Practitioner-Certifier-Example1.html\">Practitioner Jim Black (official)</a></p><p><b>value</b>: <span title=\"Codes:\">Cardiopulmonary arrest</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs lineNumber}\">line number</span></p><p><b>value</b>: 1</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69440-6}\">Disease onset to death interval</span></p><p><b>value</b>: 4 hours</p></blockquote></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "69453-9"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "performer" : [
              {
                🔗 "reference" : "Practitioner/Certifier-Example1"
              }
            ],
            "valueCodeableConcept" : {
              "text" : "Cardiopulmonary arrest"
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "lineNumber"
                    }
                  ]
                },
                "valueInteger" : 1
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "69440-6"
                    }
                  ]
                },
                "valueString" : "4 hours"
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/CauseOfDeathPart1-Example2",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "CauseOfDeathPart1-Example2",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-cause-of-death-part1"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_CauseOfDeathPart1-Example2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation CauseOfDeathPart1-Example2</b></p><a name=\"CauseOfDeathPart1-Example2\"> </a><a name=\"hcCauseOfDeathPart1-Example2\"> </a><a name=\"CauseOfDeathPart1-Example2-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69453-9}\">Cause of death [US Standard Certificate of Death]</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>performer</b>: <a href=\"Practitioner-Certifier-Example1.html\">Practitioner Jim Black (official)</a></p><p><b>value</b>: <span title=\"Codes:\">Eclampsia</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs lineNumber}\">line number</span></p><p><b>value</b>: 2</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69440-6}\">Disease onset to death interval</span></p><p><b>value</b>: 3 months</p></blockquote></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "69453-9"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "performer" : [
              {
                🔗 "reference" : "Practitioner/Certifier-Example1"
              }
            ],
            "valueCodeableConcept" : {
              "text" : "Eclampsia"
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/vrdr/CodeSystem/vrdr-component-cs",
                      "code" : "lineNumber"
                    }
                  ]
                },
                "valueInteger" : 2
              },
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "69440-6"
                    }
                  ]
                },
                "valueString" : "3 months"
              }
            ]
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/CauseOfDeathPart2-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "CauseOfDeathPart2-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-cause-of-death-part2"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_CauseOfDeathPart2-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation CauseOfDeathPart2-Example1</b></p><a name=\"CauseOfDeathPart2-Example1\"> </a><a name=\"hcCauseOfDeathPart2-Example1\"> </a><a name=\"CauseOfDeathPart2-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 69441-4}\">Other significant causes or conditions of death</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>performer</b>: <a href=\"Practitioner-Certifier-Example1.html\">Practitioner Jim Black (official)</a></p><p><b>value</b>: <span title=\"Codes:\">hypertensive heart disease</span></p></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "69441-4"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "performer" : [
              {
                🔗 "reference" : "Practitioner/Certifier-Example1"
              }
            ],
            "valueCodeableConcept" : {
              "text" : "hypertensive heart disease"
            }
          }
        },
        {
          "fullUrl" : "http://www.example.org/fhir/Observation/AutopsyPerformedIndicator-Example1",
          "resource" : {
            "resourceType" : "Observation",
            "id" : "AutopsyPerformedIndicator-Example1",
            "meta" : {
              "profile" : [
                🔗 "http://hl7.org/fhir/us/vrdr/StructureDefinition/vrdr-autopsy-performed-indicator"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_AutopsyPerformedIndicator-Example1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation AutopsyPerformedIndicator-Example1</b></p><a name=\"AutopsyPerformedIndicator-Example1\"> </a><a name=\"hcAutopsyPerformedIndicator-Example1\"> </a><a name=\"AutopsyPerformedIndicator-Example1-en-US\"> </a><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 85699-7}\">Autopsy was performed</span></p><p><b>subject</b>: <a href=\"Patient-Decedent-Example1.html\">Madelyn Patel (official) Female, DoB: 1978-03-12 ( Social Beneficiary Identifier: SSN#987654321)</a></p><p><b>value</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0136 Y}\">Yes</span></p><h3>Components</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://loinc.org 69436-4}\">Autopsy results available</span></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v2-0136 Y}\">Yes</span></td></tr></table></div>"
            },
            "status" : "final",
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "85699-7"
                }
              ]
            },
            "subject" : {
              🔗 "reference" : "Patient/Decedent-Example1"
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0136",
                  "code" : "Y",
                  "display" : "Yes"
                }
              ]
            },
            "component" : [
              {
                "code" : {
                  "coding" : [
                    {
                      "system" : "http://loinc.org",
                      "code" : "69436-4"
                    }
                  ]
                },
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/v2-0136",
                      "code" : "Y",
                      "display" : "Yes"
                    }
                  ]
                }
              }
            ]
          }
        }
      ]
    }