Estonian Terminology Services Implementation Guide
1.0.0 - draft Estonia flag

Estonian Terminology Services Implementation Guide, published by TEHIK. 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/TEHIK-EE/TerminologyServices/ and changes regularly. See the Directory of published versions

Resource Profile: TehikCodeSystem - Detailed Descriptions

Draft as of 2024-10-06

Definitions for the tehikcodesystem resource profile.

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

0. CodeSystem
2. CodeSystem.extension:changeManagementDescription
Slice NamechangeManagementDescription
ShortDescription of change management: change requests, release cycles, etc
Control0..1
TypeExtension(GuidanceMaterial) (Extension Type: markdown)
4. CodeSystem.extension:codingPrinciples
Slice NamecodingPrinciples
ShortDescription of coding principles: structure of codes, hierarchy, etc.
Control0..1
TypeExtension(GuidanceMaterial) (Extension Type: markdown)
6. CodeSystem.extension:otherTitle
Slice NameotherTitle
ShortOther human-readable title for the code system
Control0..*
TypeExtension(Localized Other Name) (Complex Extension)
8. CodeSystem.url
Definition

Follows the pattern 'https://fhir.ee/CodeSystem/[Resource Id]'

10. CodeSystem.identifier
ShortA non-FHIR identifier for the code system (e.g ISO OID)
NoteThis is a business identifier, not a resource identifier (see discussion)
SlicingThis element introduces a set of slices on CodeSystem.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • pattern @ system
  • 12. CodeSystem.identifier:oid
    Slice Nameoid
    Definition

    Follows the pattern: urn:oid:1.2.3. Legacy code lists OID identifiers are assigned to the related FHIR value set, not the code system.

    ShortISO OID identifier represented as URN
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    14. CodeSystem.identifier:oid.system
    Control1..?
    Pattern Valueurn:ietf:rfc:3986
    16. CodeSystem.name
    Definition

    Follows the pattern: ...

    ShortComputer-friendly name/identifier to be used for machine-processing
    Control1..?
    18. CodeSystem.title
    Definition

    Follows the pattern: ...

    ShortName of the code system, a human-readable well understood name
    20. CodeSystem.experimental
    Comments

    In production terminology server, experimental code systems should not exist, and therefore the default value should be 'false'

    22. CodeSystem.publisher
    ShortThe maintainer/publisher of the code system. For international code systems, the publisher might be the national release maintainer.
    Control1..?
    24. CodeSystem.contact
    Control1..?
    26. CodeSystem.description
    ShortShort description of the code system
    28. CodeSystem.useContext
    ShortUsage context: health, social care, work
    30. CodeSystem.useContext.value[x]
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    SlicingThis element introduces a set of slices on CodeSystem.useContext.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 32. CodeSystem.useContext.value[x]:valueCodeableConcept
      Slice NamevalueCodeableConcept
      Control1..1
      TypeCodeableConcept
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      34. CodeSystem.purpose
      ShortOverview of the purpose, content, and usage of the code system
      36. CodeSystem.author
      ShortOwner of the code system. Organisation/group who is responsible for the content of the code system. For international code systems, the owner might be the national release owner.
      Control0..1
      38. CodeSystem.author.name
      ShortName of the organisation/group.
      Control1..?

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

      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
      Must Supportfalse
      Summaryfalse
      Invariantscnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$'))
      csd-1: Within a code system definition, all the codes SHALL be unique (concept.exists() implies concept.code.combine(%resource.concept.descendants().concept.code).isDistinct())
      csd-2: If there is an explicit hierarchy, a hierarchyMeaning should be provided (concept.concept.exists() implies hierarchyMeaning.exists())
      csd-3: If there is an implicit hierarchy, a hierarchyMeaning should be provided (concept.where(property.code = 'parent' or property.code = 'child').exists() implies hierarchyMeaning.exists())
      csd-4: If the code system content = supplement, it must nominate what it's a supplement for (CodeSystem.content = 'supplement' implies CodeSystem.supplements.exists())
      scs-1: If a codesystem contains nested concepts, it must specify hierarchyMeaning (concept.concept.exists() implies hierarchyMeaning.exists())
      scs-2: If a codesystem contains example, fragment, or complete content, it must have at least one concept (content in ( 'example' | 'fragment' | 'complete' ) implies concept.exists())
      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 its 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 its meaning or interpretation
      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()))
      4. CodeSystem.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      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..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      6. CodeSystem.extension:knowledgeRepresentationLevel
      Slice NameknowledgeRepresentationLevel
      Definition

      Defines a knowledge representation level provided by this knowledge artifact.

      Shortnarrative | semi-structured | structured | executable
      Control0..*
      TypeExtension(CQF knowledge representation level) (Extension Type: code)
      Is Modifierfalse
      Must Supporttrue
      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())
      8. CodeSystem.extension:changeManagementDescription
      Slice NamechangeManagementDescription
      Definition

      Additional guidance material, providing textual guidance and links to other sources

      ShortDescription of change management: change requests, release cycles, etc
      Control0..1
      TypeExtension(GuidanceMaterial) (Extension Type: markdown)
      Is Modifierfalse
      Must Supportfalse
      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())
      10. CodeSystem.extension:codingPrinciples
      Slice NamecodingPrinciples
      Definition

      Additional guidance material, providing textual guidance and links to other sources

      ShortDescription of coding principles: structure of codes, hierarchy, etc.
      Control0..1
      TypeExtension(GuidanceMaterial) (Extension Type: markdown)
      Is Modifierfalse
      Must Supportfalse
      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())
      12. CodeSystem.extension:otherTitle
      Slice NameotherTitle
      Definition

      The name in a given language and of certain type. For example, short name in English (e.g ICD-10).

      ShortOther human-readable title for the code system
      Control0..*
      TypeExtension(Localized Other Name) (Complex Extension)
      Is Modifierfalse
      Must Supportfalse
      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())
      14. 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 managable, 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
      Must Supportfalse
      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
      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())
      16. CodeSystem.url
      Definition

      Follows the pattern 'https://fhir.ee/CodeSystem/[Resource Id]'


      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 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)
      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.

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

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

      Invariantscnl-1: URL should not contain | or # - these characters make processing canonical references problematic (exists() implies matches('^[^|# ]+$'))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      18. CodeSystem.identifier
      Definition

      A formal identifier that is used to identify this code system when it is represented in other formats, or referenced in a specification, model, design or an instance.

      ShortA non-FHIR identifier for the code system (e.g ISO OID)Additional 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)
      Control0..*
      TypeIdentifier
      Is Modifierfalse
      Must Supportfalse
      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()))
      SlicingThis element introduces a set of slices on CodeSystem.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • pattern @ system
      • 20. CodeSystem.identifier:oid
        Slice Nameoid
        Definition

        Follows the pattern: urn:oid:1.2.3. Legacy code lists OID identifiers are assigned to the related FHIR value set, not the code system.


        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.

        ShortISO OID identifier represented as URNAdditional 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)
        Control0..1*
        TypeIdentifier
        Is Modifierfalse
        Must Supportfalse
        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()))
        22. CodeSystem.identifier:oid.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|5.0.0
        (required to http://hl7.org/fhir/ValueSet/identifier-use|5.0.0)

        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()))
        24. CodeSystem.identifier:oid.system
        Definition

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

        ShortThe namespace for the identifier value
        Comments

        Identifier.system is always case sensitive.

        Control10..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.

        Pattern Valueurn:ietf:rfc:3986
        Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. 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)
        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]. The version SHOULD NOT contain a '#' - see Business 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
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. CodeSystem.versionAlgorithm[x]
        Definition

        Indicates the mechanism used to compare versions to determine which CodeSystem is more current.

        ShortHow to compare versions
        Comments

        If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

        Control0..1
        BindingUnless not suitable, these codes SHALL be taken from VersionAlgorithmhttp://hl7.org/fhir/ValueSet/version-algorithm
        (extensible to http://hl7.org/fhir/ValueSet/version-algorithm)
        TypeChoice of: string, Coding
        [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
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. CodeSystem.name
        Definition

        Follows the pattern: ...


        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.

        ShortComputer-friendly name/identifier to be used for machine-processingName for this code system (computer friendly)
        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: cnl-0
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        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()))
        32. CodeSystem.title
        Definition

        Follows the pattern: ...


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

        ShortName of the code system, a human-readable well understood nameName for this code system (human friendly)
        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
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. CodeSystem.status
        Definition

        The status of this code system. Enables tracking the life-cycle of the content.

        Shortdraft | active | retired | unknown
        Comments

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

        See guidance around (not) making local changes to elements here.


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

        See guidance around (not) making local changes to elements here.

        Control1..1
        BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|5.0.0
        (required to http://hl7.org/fhir/ValueSet/publication-status|5.0.0)

        The lifecycle status of an artifact.

        Typecode
        Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired CodeSystem without due consideration
        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()))
        36. 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

        In production terminology server, experimental code systems should not exist, and therefore the default value should be 'false'


        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
        Must Supporttrue
        Summarytrue
        Requirements

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

        Meaning if MissingIf absent, this resource is treated as though it is not experimental.
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. CodeSystem.publisher
        Definition

        The name of the organization or individual responsible for the release and ongoing maintenance of the code system.

        ShortThe maintainer/publisher of the code system. For international code systems, the publisher might be the national release maintainer.Name of the publisher/steward (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
        Must Supporttrue
        Summarytrue
        Requirements

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

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. 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.

        See guidance around (not) making local changes to elements here.


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

        See guidance around (not) making local changes to elements here.

        Control10..*
        TypeContactDetail
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. CodeSystem.description
        Definition

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

        ShortShort description of the code systemNatural language description of the code system
        Comments

        This description can be used to capture details such as 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
        Must Supporttrue
        Summaryfalse
        Alternate NamesScope, Purpose
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. 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.

        ShortUsage context: health, social care, workThe 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
        Must Supportfalse
        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()))
        46. CodeSystem.useContext.code
        Definition

        A code that identifies the type of context being specified by this usage context.

        ShortType of context being specified
        Control1..1
        BindingUnless not suitable, these codes SHALL be taken from UsageContextTypehttp://terminology.hl7.org/ValueSet/usage-context-type
        (extensible to http://terminology.hl7.org/ValueSet/usage-context-type)

        A code that specifies a type of context being specified by a usage context.

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. CodeSystem.useContext.value[x]
        Definition

        A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

        ShortValue that defines the context
        Control1..1
        BindingFor example codes, see ContextOfUseValueSethttp://hl7.org/fhir/ValueSet/use-context
        (example to http://hl7.org/fhir/ValueSet/use-context)

        A code that defines the specific value for the context being specified.

        TypeCodeableConcept, Reference(PlanDefinition, ResearchStudy, InsurancePlan, HealthcareService, Group, Location, Organization), Quantity, Range
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        SlicingThis element introduces a set of slices on CodeSystem.useContext.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
        • type @ $this
        • 50. CodeSystem.useContext.value[x]:valueCodeableConcept
          Slice NamevalueCodeableConcept
          Definition

          A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

          ShortValue that defines the context
          Control1..1
          BindingFor example codes, see ContextOfUseValueSethttp://hl7.org/fhir/ValueSet/use-context
          (example to http://hl7.org/fhir/ValueSet/use-context)

          A code that defines the specific value for the context being specified.

          TypeCodeableConcept, Reference(PlanDefinition, ResearchStudy, InsurancePlan, HealthcareService, Group, Location, Organization), Quantity, Range
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          52. CodeSystem.purpose
          Definition

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

          ShortOverview of the purpose, content, and usage of the code systemWhy 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
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          54. CodeSystem.author
          Definition

          An individiual or organization primarily involved in the creation and maintenance of the CodeSystem.

          ShortOwner of the code system. Organisation/group who is responsible for the content of the code system. For international code systems, the owner might be the national release owner.Who authored the CodeSystem
          Control0..1*
          TypeContactDetail
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          56. CodeSystem.author.name
          Definition

          The name of an individual to contact.

          ShortName of the organisation/group.Name of an individual to contact
          Comments

          If there is no named individual, the telecom information is for the organization as a whole.

          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()))
          58. CodeSystem.caseSensitive
          Definition

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

          ShortIf 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.

          Control10..1
          Typeboolean
          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()))
          60. CodeSystem.hierarchyMeaning
          Definition

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

          Shortgrouped-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..1
          This element is affected by the following invariants: csd-2, csd-3, scs-1
          BindingThe codes SHALL be taken from CodeSystemHierarchyMeaninghttp://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|5.0.0
          (required to http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|5.0.0)

          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
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          62. CodeSystem.content
          Definition

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

          Shortnot-present | example | fragment | complete | supplement
          Control1..1
          This element is affected by the following invariants: csd-4, scs-2
          BindingThe codes SHALL be taken from CodeSystemContentModehttp://hl7.org/fhir/ValueSet/codesystem-content-mode|5.0.0
          (required to http://hl7.org/fhir/ValueSet/codesystem-content-mode|5.0.0)

          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
          Must Supporttrue
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. CodeSystem.concept
          Definition

          Concepts that are in the code system. The concept definitions are inherently hierarchical, but the definitions must be consulted to determine what the meanings of the hierarchical relationships are.

          ShortConcepts in the code system
          Comments

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

          Control0..*
          This element is affected by the following invariants: csd-1, scs-2
          TypeBackboneElement
          Is Modifierfalse
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          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 managable, 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())
          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
          This element is affected by the following invariants: csd-1
          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          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
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          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
          Control0..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. 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)
          Control0..*
          This element is affected by the following invariants: csd-1, csd-2, scs-1
          TypeSeettp://hl7.org/fhir/StructureDefinition/CodeSystem#CodeSystem.concept
          Is Modifierfalse
          Must Supporttrue
          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 found here

          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
          Must Supportfalse
          Summaryfalse
          Invariantscnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation (name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$'))
          csd-1: Within a code system definition, all the codes SHALL be unique (concept.exists() implies concept.code.combine(%resource.concept.descendants().concept.code).isDistinct())
          csd-2: If there is an explicit hierarchy, a hierarchyMeaning should be provided (concept.concept.exists() implies hierarchyMeaning.exists())
          csd-3: If there is an implicit hierarchy, a hierarchyMeaning should be provided (concept.where(property.code = 'parent' or property.code = 'child').exists() implies hierarchyMeaning.exists())
          csd-4: If the code system content = supplement, it must nominate what it's a supplement for (CodeSystem.content = 'supplement' implies CodeSystem.supplements.exists())
          scs-1: If a codesystem contains nested concepts, it must specify hierarchyMeaning (concept.concept.exists() implies hierarchyMeaning.exists())
          scs-2: If a codesystem contains example, fragment, or complete content, it must have at least one concept (content in ( 'example' | 'fragment' | 'complete' ) implies concept.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

          Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

          Control0..1
          Typeid
          Is Modifierfalse
          Must Supportfalse
          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
          Must Supportfalse
          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 its 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 its meaning or interpretation
          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()))
          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 SHALL be taken from AllLanguages
          (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

          IETF language tag for a human language

          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()))
          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 a 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
          This element is affected by the following invariants: dom-6
          TypeNarrative
          Is Modifierfalse
          Must Supportfalse
          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, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

          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..*
          This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
          TypeResource
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. CodeSystem.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Must Supportfalse
          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:knowledgeRepresentationLevel
            Slice NameknowledgeRepresentationLevel
            Definition

            Defines a knowledge representation level provided by this knowledge artifact.

            Shortnarrative | semi-structured | structured | executable
            Control0..*
            TypeExtension(CQF knowledge representation level) (Extension Type: code)
            Is Modifierfalse
            Must Supporttrue
            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.extension:changeManagementDescription
            Slice NamechangeManagementDescription
            Definition

            Additional guidance material, providing textual guidance and links to other sources

            ShortDescription of change management: change requests, release cycles, etc
            Control0..1
            TypeExtension(GuidanceMaterial) (Extension Type: markdown)
            Is Modifierfalse
            Must Supportfalse
            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())
            20. CodeSystem.extension:codingPrinciples
            Slice NamecodingPrinciples
            Definition

            Additional guidance material, providing textual guidance and links to other sources

            ShortDescription of coding principles: structure of codes, hierarchy, etc.
            Control0..1
            TypeExtension(GuidanceMaterial) (Extension Type: markdown)
            Is Modifierfalse
            Must Supportfalse
            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())
            22. CodeSystem.extension:otherTitle
            Slice NameotherTitle
            Definition

            The name in a given language and of certain type. For example, short name in English (e.g ICD-10).

            ShortOther human-readable title for the code system
            Control0..*
            TypeExtension(Localized Other Name) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            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())
            24. 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 managable, 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
            Must Supportfalse
            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
            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())
            26. CodeSystem.url
            Definition

            Follows the pattern 'https://fhir.ee/CodeSystem/[Resource Id]'

            ShortCanonical identifier for this code system, represented as a URI (globally unique) (Coding.system)
            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
            Must Supporttrue
            Summarytrue
            Requirements

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

            Invariantscnl-1: URL should not contain | or # - these characters make processing canonical references problematic (exists() implies matches('^[^|# ]+$'))
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. 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.

            ShortA non-FHIR identifier for the code system (e.g ISO OID)
            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)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Must Supportfalse
            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()))
            SlicingThis element introduces a set of slices on CodeSystem.identifier. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • pattern @ system
            • 30. CodeSystem.identifier:oid
              Slice Nameoid
              Definition

              Follows the pattern: urn:oid:1.2.3. Legacy code lists OID identifiers are assigned to the related FHIR value set, not the code system.

              ShortISO OID identifier represented as URN
              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)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Must Supportfalse
              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()))
              32. CodeSystem.identifier:oid.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
              This element is affected by the following invariants: ele-1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              34. CodeSystem.identifier:oid.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 managable, 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
              • 36. CodeSystem.identifier:oid.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|5.0.0)

                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()))
                38. CodeSystem.identifier:oid.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 IdentifierTypeCodes
                (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()))
                40. CodeSystem.identifier:oid.system
                Definition

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

                ShortThe namespace for the identifier value
                Comments

                Identifier.system is always case sensitive.

                Control1..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.

                Pattern Valueurn:ietf:rfc:3986
                Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. CodeSystem.identifier:oid.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 http://hl7.org/fhir/StructureDefinition/rendered-value). 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
                This element is affected by the following invariants: ident-1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Example<br/><b>General</b>:123456
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. CodeSystem.identifier:oid.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()))
                46. CodeSystem.identifier:oid.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()))
                48. 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)
                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]. The version SHOULD NOT contain a '#' - see Business 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
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                50. CodeSystem.versionAlgorithm[x]
                Definition

                Indicates the mechanism used to compare versions to determine which CodeSystem is more current.

                ShortHow to compare versions
                Comments

                If set as a string, this is a FHIRPath expression that has two additional context variables passed in - %version1 and %version2 and will return a negative number if version1 is newer, a positive number if version2 and a 0 if the version ordering can't be successfully be determined.

                Control0..1
                BindingUnless not suitable, these codes SHALL be taken from VersionAlgorithm
                (extensible to http://hl7.org/fhir/ValueSet/version-algorithm)
                TypeChoice of: string, Coding
                [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
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                52. CodeSystem.name
                Definition

                Follows the pattern: ...

                ShortComputer-friendly name/identifier to be used for machine-processing
                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: cnl-0
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                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()))
                54. CodeSystem.title
                Definition

                Follows the pattern: ...

                ShortName of the code system, a human-readable well understood name
                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
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                56. CodeSystem.status
                Definition

                The status of this code system. Enables tracking the life-cycle of the content.

                Shortdraft | active | retired | unknown
                Comments

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

                See guidance around (not) making local changes to elements here.

                Control1..1
                BindingThe codes SHALL be taken from PublicationStatus
                (required to http://hl7.org/fhir/ValueSet/publication-status|5.0.0)

                The lifecycle status of an artifact.

                Typecode
                Is Modifiertrue because This is labeled as "Is Modifier" because applications should not use a retired CodeSystem without due consideration
                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()))
                58. 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

                In production terminology server, experimental code systems should not exist, and therefore the default value should be 'false'

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

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

                Meaning if MissingIf absent, this resource is treated as though it is not experimental.
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. CodeSystem.date
                Definition

                The date (and optionally time) when the code system was last significantly changed. 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

                The date is often not tracked until the resource is published, but may be present on draft content. 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.

                See guidance around (not) making local changes to elements here.

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

                The name of the organization or individual responsible for the release and ongoing maintenance of the code system.

                ShortThe maintainer/publisher of the code system. For international code systems, the publisher might be the national release maintainer.
                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
                Must Supporttrue
                Summarytrue
                Requirements

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

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. 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.

                See guidance around (not) making local changes to elements here.

                Control1..*
                TypeContactDetail
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. CodeSystem.description
                Definition

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

                ShortShort description of the code system
                Comments

                This description can be used to capture details such as 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
                Must Supporttrue
                Summaryfalse
                Alternate NamesScope, Purpose
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                68. 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.

                ShortUsage context: health, social care, work
                Comments

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

                Control0..*
                TypeUsageContext
                Is Modifierfalse
                Must Supportfalse
                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()))
                70. CodeSystem.useContext.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
                This element is affected by the following invariants: ele-1
                Typeid
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                72. CodeSystem.useContext.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 managable, 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.useContext.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 74. CodeSystem.useContext.code
                  Definition

                  A code that identifies the type of context being specified by this usage context.

                  ShortType of context being specified
                  Control1..1
                  BindingUnless not suitable, these codes SHALL be taken from UsageContextType
                  (extensible to http://terminology.hl7.org/ValueSet/usage-context-type)

                  A code that specifies a type of context being specified by a usage context.

                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. CodeSystem.useContext.value[x]
                  Definition

                  A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

                  ShortValue that defines the context
                  Control1..1
                  BindingFor example codes, see ContextOfUseValueSet
                  (example to http://hl7.org/fhir/ValueSet/use-context)

                  A code that defines the specific value for the context being specified.

                  TypeCodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on CodeSystem.useContext.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 78. CodeSystem.useContext.value[x]:valueCodeableConcept
                    Slice NamevalueCodeableConcept
                    Definition

                    A value that defines the context specified in this context of use. The interpretation of the value is defined by the code.

                    ShortValue that defines the context
                    Control1..1
                    BindingFor example codes, see ContextOfUseValueSet
                    (example to http://hl7.org/fhir/ValueSet/use-context)

                    A code that defines the specific value for the context being specified.

                    TypeCodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    80. 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.

                    DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'jurisdiction' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction and useContext.valueCodeableConcept indicating the jurisdiction.)

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

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

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

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

                    ShortOverview of the purpose, content, and usage of the code system
                    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
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    84. 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.

                    Control0..1
                    Typemarkdown
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supportfalse
                    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()))
                    86. CodeSystem.copyrightLabel
                    Definition

                    A short string (<50 characters), suitable for inclusion in a page footer that identifies the copyright holder, effective period, and optionally whether rights are resctricted. (e.g. 'All rights reserved', 'Some rights reserved').

                    ShortCopyright holder and year(s)
                    Comments

                    The (c) symbol should NOT be included in this string. It will be added by software when rendering the notation. Full details about licensing, restrictions, warrantees, etc. goes in the more general 'copyright' element.

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supportfalse
                    Summaryfalse
                    Requirements

                    Defines the content expected to be rendered in all representations of the artifact.

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

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

                    ShortWhen the CodeSystem was approved by publisher
                    Comments

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

                    See guidance around (not) making local changes to elements here.

                    Control0..1
                    Typedate
                    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()))
                    90. CodeSystem.lastReviewDate
                    Definition

                    The date on which the resource content was last reviewed. Review happens periodically after approval but does not change the original approval date.

                    ShortWhen the CodeSystem was last reviewed by the publisher
                    Comments

                    If specified, this date follows the original approval date.

                    See guidance around (not) making local changes to elements here.

                    Control0..1
                    Typedate
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supportfalse
                    Summaryfalse
                    Requirements

                    Gives a sense of how "current" the content is. Resources that have not been reviewed in a long time may have a risk of being less appropriate/relevant.

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

                    The period during which the CodeSystem content was or is planned to be in active use.

                    ShortWhen the CodeSystem is expected to be used
                    Comments

                    The effective period for a CodeSystem determines when the content is applicable for usage and is independent of publication and review dates. For example, a system intended to be used for the year 2016 might be published in 2015.

                    See guidance around (not) making local changes to elements here.

                    Control0..1
                    TypePeriod
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Requirements

                    Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the CodeSystem are or are expected to be used instead.

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

                    Descriptions related to the content of the CodeSystem. Topics provide a high-level categorization as well as keywords for the CodeSystem that can be useful for filtering and searching.

                    ShortE.g. Education, Treatment, Assessment, etc
                    Comments

                    DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to using the new 'topic' code in the useContext element. (I.e. useContext.code indicating http://terminology.hl7.org/CodeSystem/usage-context-type#topic and useContext.valueCodeableConcept indicating the topic)

                    Control0..*
                    BindingFor example codes, see DefinitionTopic
                    (example to http://hl7.org/fhir/ValueSet/definition-topic)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Requirements

                    Repositories must be able to determine how to categorize the CodeSystem so that it can be found by topical and keyword searches.

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

                    An individiual or organization primarily involved in the creation and maintenance of the CodeSystem.

                    ShortOwner of the code system. Organisation/group who is responsible for the content of the code system. For international code systems, the owner might be the national release owner.
                    Control0..1
                    TypeContactDetail
                    Is Modifierfalse
                    Must Supportfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    98. CodeSystem.author.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
                    This element is affected by the following invariants: ele-1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    100. CodeSystem.author.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 managable, 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.author.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 102. CodeSystem.author.name
                      Definition

                      The name of an individual to contact.

                      ShortName of the organisation/group.
                      Comments

                      If there is no named individual, the telecom information is for the organization as a whole.

                      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()))
                      104. CodeSystem.author.telecom
                      Definition

                      The contact details for the individual (if a name was provided) or the organization.

                      ShortContact details for individual or organization
                      Control0..*
                      TypeContactPoint
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      106. CodeSystem.editor
                      Definition

                      An individual or organization primarily responsible for internal coherence of the CodeSystem.

                      ShortWho edited the CodeSystem
                      Control0..*
                      TypeContactDetail
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      108. CodeSystem.reviewer
                      Definition

                      An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the CodeSystem.

                      ShortWho reviewed the CodeSystem
                      Comments

                      See guidance around (not) making local changes to elements here.

                      Control0..*
                      TypeContactDetail
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      110. CodeSystem.endorser
                      Definition

                      An individual or organization asserted by the publisher to be responsible for officially endorsing the CodeSystem for use in some setting.

                      ShortWho endorsed the CodeSystem
                      Comments

                      See guidance around (not) making local changes to elements here.

                      Control0..*
                      TypeContactDetail
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      112. CodeSystem.relatedArtifact
                      Definition

                      Related artifacts such as additional documentation, justification, dependencies, bibliographic references, and predecessor and successor artifacts.

                      ShortAdditional documentation, citations, etc
                      Comments

                      Each related artifact is either an attachment, or a reference to another resource, but not both.

                      Control0..*
                      TypeRelatedArtifact
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Requirements

                      A CodeSystem must be able to provide enough information for consumers of the content (and/or interventions or results produced by the content) to be able to determine and understand the justification for and evidence in support of the content.

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

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

                      ShortIf 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.

                      Control1..1
                      Typeboolean
                      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()))
                      116. CodeSystem.valueSet
                      Definition

                      Canonical reference to the value set that contains all codes in the code system independent of code status.

                      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, independent of concept status, and only codes from this code system. It SHALL be immutable, and operations SHOULD support validation of any allowed code compositions.

                      Control0..1
                      Typecanonical(ValueSet)
                      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()))
                      118. CodeSystem.hierarchyMeaning
                      Definition

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

                      Shortgrouped-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..1
                      This element is affected by the following invariants: csd-2, csd-3, scs-1
                      BindingThe codes SHALL be taken from CodeSystemHierarchyMeaning
                      (required to http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|5.0.0)

                      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
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      120. CodeSystem.compositional
                      Definition

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

                      ShortIf 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..1
                      Typeboolean
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Alternate Namesgrammar
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      122. 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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      124. CodeSystem.content
                      Definition

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

                      Shortnot-present | example | fragment | complete | supplement
                      Control1..1
                      This element is affected by the following invariants: csd-4, scs-2
                      BindingThe codes SHALL be taken from CodeSystemContentMode
                      (required to http://hl7.org/fhir/ValueSet/codesystem-content-mode|5.0.0)

                      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
                      Must Supporttrue
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      126. CodeSystem.supplements
                      Definition

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

                      ShortCanonical 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..1
                      This element is affected by the following invariants: csd-4
                      Typecanonical(CodeSystem)
                      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()))
                      128. 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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      130. 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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      132. 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
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      134. 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 managable, 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())
                      136. 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 managable, 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())
                      138. 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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      140. 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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      142. 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 | child-of | descendent-leaf | exists
                      Control1..*
                      BindingThe codes SHALL be taken from FilterOperator
                      (required to http://hl7.org/fhir/ValueSet/filter-operator|5.0.0)

                      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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      144. 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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      146. CodeSystem.property
                      Definition

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

                      ShortAdditional information supplied about each concept
                      Comments

                      Multiple occurrences of CodeSystem.concept.property may occur for a CodeSystem.property where CodeSystem.concept.property.code is the same and CodeSystem.concept.property.value differs. For example: multiple designations for a single concept.

                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      148. 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
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      150. 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 managable, 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())
                      152. 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 managable, 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())
                      154. 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
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      156. 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()))
                      158. 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 Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      160. CodeSystem.property.type
                      Definition

                      The type of the property value. Properties of type "code" contain a code defined by the code system (e.g. a reference to another defined concept).

                      Shortcode | Coding | string | integer | boolean | dateTime | decimal
                      Control1..1
                      BindingThe codes SHALL be taken from PropertyType
                      (required to http://hl7.org/fhir/ValueSet/concept-property-type|5.0.0)

                      The type of a property value.

                      Typecode
                      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()))
                      162. CodeSystem.concept
                      Definition

                      Concepts that are in the code system. The concept definitions are inherently hierarchical, but the definitions must be consulted to determine what the meanings of the hierarchical relationships are.

                      ShortConcepts in the code system
                      Comments

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

                      Control0..*
                      This element is affected by the following invariants: csd-1, scs-2
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      164. 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 id for inter-element referencing
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      166. CodeSystem.concept.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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())
                      168. 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 managable, 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())
                      170. CodeSystem.concept.code
                      Definition

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

                      ShortCode that identifies concept
                      Control1..1
                      This element is affected by the following invariants: csd-1
                      Typecode
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      172. 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
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      174. 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
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      176. 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
                      Must Supportfalse
                      Summaryfalse
                      Requirements

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

                      Invariantscsd-5: Must have a value for concept.designation.use if concept.designation.additionalUse is present (additionalUse.exists() implies use.exists())
                      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      178. 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
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      180. CodeSystem.concept.designation.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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())
                      182. CodeSystem.concept.designation.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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())
                      184. 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 SHALL be taken from AllLanguages
                      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

                      IETF language tag for a human language

                      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()))
                      186. 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
                      This element is affected by the following invariants: csd-5
                      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()))
                      188. CodeSystem.concept.designation.additionalUse
                      Definition

                      Additional codes that detail how this designation would be used, if there is more than one use.

                      ShortAdditional ways how this designation would be used
                      Comments

                      This was added rather than increasing the cardinality of .use to 0..* in order to maintain backward compatibility.

                      Control0..*
                      This element is affected by the following invariants: csd-5
                      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()))
                      190. 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()))
                      192. CodeSystem.concept.property
                      Definition

                      A property value for this concept.

                      ShortProperty value for the concept
                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      194. 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
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      196. CodeSystem.concept.property.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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())
                      198. 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 managable, 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())
                      200. CodeSystem.concept.property.code
                      Definition

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

                      ShortReference to CodeSystem.property.code
                      Control1..1
                      This element is affected by the following invariants: csd-3
                      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()))
                      202. 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
                      Must Supportfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      204. 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)
                      Control0..*
                      This element is affected by the following invariants: csd-1, csd-2, scs-1
                      TypeSeettp://hl7.org/fhir/StructureDefinition/CodeSystem#CodeSystem.concept
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))