Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	A reference to a document Constraints: docRef-1, docRef-2, im-docref-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
Slices for identifier	Σ	1..*	Identifier	Business identifiers for the document Slice: Unordered, Open by value:system
identifier:entry-uuid	Σ	1..1	IheMhdEntryUUIDIdentifier	Business identifiers for the document
status	?!Σ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
modality	Σ	1..*	CodeableConcept	Imaging modality used Binding: https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (required)
type	Σ	1..1	CodeableConcept	Type of Imaging Manifest Binding: HL7 EU Imaging Manifest Types (preferred)
Slices for category	Σ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by value:$this Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
category:class-code	Σ	0..*	CodeableConcept	Categorization of document Binding: XDS Class Codes (preferred)
subject	Σ	1..1	Reference(Resource)	Who/what is the subject of the document
context	C	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
Slices for bodySite	Σ	0..*	CodeableReferenceWithRequiredCoding(BodyStructure)	The concept field is required for all bodySites. Slice: Unordered, Open by value:concept Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
bodySite:anatomical-region	Σ	0..*	CodeableReference(BodyStructure)	The anatomical region of the patient that is the focus of the imaging manifest, concept field is required. Binding: Anatomical Region (required)
practiceSetting	C	0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: Practice Settings (preferred)
custodian		0..1	Reference(Organization)	Organization that manages the Imaging Manifest
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	ΣC	1..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging-manifest-r5/CodeSystem/codesystem-missing-dicom-terminology
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0040E031
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for content	Σ	1..*	BackboneElement	Document referenced Slice: Unordered, Open by value:value
content:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
content:kos	Σ	0..1	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required): BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049) Required Pattern: application/dicom
url	Σ	1..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
Slices for profile	Σ	1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
profile:kos-manifest	Σ	1..1	BackboneElement	Content profile rules for the document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for value[x]	Σ	1..1		Code|uri|canonical Slice: Unordered, Open by type:$this Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
value[x]:valueCoding	Σ	0..1	Coding	Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 113030
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
content:fhir	Σ	0..1	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required): BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049) Required Pattern: application/fhir+json
url	Σ	1..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
Slices for profile	Σ	1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
profile:fhir-manifest	Σ	1..1	BackboneElement	Content profile rules for the document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for value[x]	Σ	1..1		Code|uri|canonical Slice: Unordered, Open by type:$this Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
value[x]:valueCanonical	Σ	0..1	canonical()	Code|uri|canonical Required Pattern: http://hl7.eu/fhir/imaging-manifest-r5/StructureDefinition/ImImagingStudyManifest
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0 From the FHIR Standard
DocumentReference.modality	required	https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
DocumentReference.type	preferred	ImImagingManifestTypesEuVS http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/ImImagingManifestTypesEuVS From this IG
DocumentReference.category	example	ReferencedItemCategoryValueSet http://hl7.org/fhir/ValueSet/referenced-item-category From the FHIR Standard
DocumentReference.category:class-code	preferred	XdsClassCodeVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-xds-class-code-valueset From this IG
DocumentReference.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site From the FHIR Standard
DocumentReference.bodySite:anatomical-region	required	AnatomicalRegionVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-anatomical-region-valueset From this IG
DocumentReference.practiceSetting	preferred	PracticeSettingsVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-practice-settings From this IG
DocumentReference.custodian.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|5.0.0 From the FHIR Standard
DocumentReference.custodian.identifier.type	extensible	Pattern Value: 0040E031 http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DocumentReference.content:kos.attachment.contentType	required	Pattern Value: application/dicom http://hl7.org/fhir/ValueSet/mimetypes|5.0.0 From the FHIR Standard
DocumentReference.content:kos.profile.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:kos.profile:kos-manifest.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:kos.profile:kos-manifest.value[x]:valueCoding	preferred	​Pattern Value: 113030 http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:fhir.attachment.contentType	required	Pattern Value: application/fhir+json http://hl7.org/fhir/ValueSet/mimetypes|5.0.0 From the FHIR Standard
DocumentReference.content:fhir.profile.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:fhir.profile:fhir-manifest.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
docRef-1	warning	DocumentReference	facilityType SHALL only be present if context is not an encounter : facilityType.empty() or context.where(resolve() is Encounter).empty()
docRef-2	warning	DocumentReference	practiceSetting SHALL only be present if context is not present : practiceSetting.empty() or context.where(resolve() is Encounter).empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
im-docref-1	error	DocumentReference	At least a KOS or FHIR manifest needs to be present. : content.value.subsumes( $dcm#113030) or content.value.endsWith('ImManifestDocumentReference')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	A reference to a document Constraints: im-docref-1
modifierExtension		0..0
Slices for identifier		1..*	Identifier	Business identifiers for the document Slice: Unordered, Open by value:system
identifier:entry-uuid		1..1	IheMhdEntryUUIDIdentifier	Business identifiers for the document
modality		1..*	CodeableConcept	Imaging modality used Binding: https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (required)
type		1..1	CodeableConcept	Type of Imaging Manifest Binding: HL7 EU Imaging Manifest Types (preferred)
Slices for category		1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by value:$this
category:class-code		0..*	CodeableConcept	Categorization of document Binding: XDS Class Codes (preferred)
subject		1..1	Reference(Resource)	Who/what is the subject of the document
Slices for bodySite		0..*	CodeableReferenceWithRequiredCoding(BodyStructure)	The concept field is required for all bodySites. Slice: Unordered, Open by value:concept
bodySite:anatomical-region		0..*	CodeableReference(BodyStructure)	The anatomical region of the patient that is the focus of the imaging manifest, concept field is required. Binding: Anatomical Region (required)
practiceSetting		0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: Practice Settings (preferred)
custodian		0..1	Reference(Organization)	Organization that manages the Imaging Manifest
identifier		1..1	Identifier	Logical reference, when literal reference is not known
type		0..1	CodeableConcept	Description of identifier Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging-manifest-r5/CodeSystem/codesystem-missing-dicom-terminology
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0040E031
Slices for content		1..*	BackboneElement	Document referenced Slice: Unordered, Open by value:value
content:kos		0..1	BackboneElement	Document referenced
attachment
contentType		0..1	code	Mime type of the content, with charset etc. Required Pattern: application/dicom
url		1..1	url	Uri where the data can be found
Slices for profile		1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:kos-manifest		1..1	BackboneElement	Content profile rules for the document
Slices for value[x]		1..1	Coding, uri, canonical()	Code|uri|canonical Slice: Unordered, Open by type:$this
value[x]:valueCoding		0..1	Coding	Code|uri|canonical Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 113030
content:fhir		0..1	BackboneElement	Document referenced
attachment
contentType		0..1	code	Mime type of the content, with charset etc. Required Pattern: application/fhir+json
url		1..1	url	Uri where the data can be found
Slices for profile		1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:fhir-manifest		1..1	BackboneElement	Content profile rules for the document
Slices for value[x]		1..1	Coding, uri, canonical()	Code|uri|canonical Slice: Unordered, Open by type:$this
value[x]:valueCanonical		0..1	canonical()	Code|uri|canonical Required Pattern: http://hl7.eu/fhir/imaging-manifest-r5/StructureDefinition/ImImagingStudyManifest
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.modality	required	https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
DocumentReference.type	preferred	ImImagingManifestTypesEuVS http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/ImImagingManifestTypesEuVS From this IG
DocumentReference.category:class-code	preferred	XdsClassCodeVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-xds-class-code-valueset From this IG
DocumentReference.bodySite:anatomical-region	required	AnatomicalRegionVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-anatomical-region-valueset From this IG
DocumentReference.practiceSetting	preferred	PracticeSettingsVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-practice-settings From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
im-docref-1	error	DocumentReference	At least a KOS or FHIR manifest needs to be present. : content.value.subsumes( $dcm#113030) or content.value.endsWith('ImManifestDocumentReference')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	A reference to a document Constraints: docRef-1, docRef-2, im-docref-1
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: AllLanguages (required): IETF language tag for a human language Additional Bindings Purpose CommonLanguages Starter
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
Slices for identifier	Σ	1..*	Identifier	Business identifiers for the document Slice: Unordered, Open by value:system
identifier:entry-uuid	Σ	1..1	IheMhdEntryUUIDIdentifier	Business identifiers for the document
version	Σ	0..1	string	An explicitly assigned identifer of a variation of the content in the DocumentReference
basedOn		0..*	Reference(Appointment | AppointmentResponse | CarePlan | Claim | CommunicationRequest | Contract | CoverageEligibilityRequest | DeviceRequest | EnrollmentRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | RequestOrchestration | ServiceRequest | SupplyRequest | VisionPrescription)	Procedure that caused this media to be created
status	?!Σ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
docStatus	Σ	0..1	code	registered | partial | preliminary | final | amended | corrected | appended | cancelled | entered-in-error | deprecated | unknown Binding: CompositionStatus (required): Status of the underlying document.
modality	Σ	1..*	CodeableConcept	Imaging modality used Binding: https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (required)
type	Σ	1..1	CodeableConcept	Type of Imaging Manifest Binding: HL7 EU Imaging Manifest Types (preferred)
Slices for category	Σ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by value:$this Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
category:class-code	Σ	0..*	CodeableConcept	Categorization of document Binding: XDS Class Codes (preferred)
subject	Σ	1..1	Reference(Resource)	Who/what is the subject of the document
context	C	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
event		0..*	CodeableReference()	Main clinical acts documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
Slices for bodySite	Σ	0..*	CodeableReferenceWithRequiredCoding(BodyStructure)	The concept field is required for all bodySites. Slice: Unordered, Open by value:concept Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
bodySite:anatomical-region	Σ	0..*	CodeableReference(BodyStructure)	The anatomical region of the patient that is the focus of the imaging manifest, concept field is required. Binding: Anatomical Region (required)
facilityType	C	0..1	CodeableConcept	Kind of facility where patient was seen Binding: FacilityTypeCodeValueSet (example): XDS Facility Type.
practiceSetting	C	0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: Practice Settings (preferred)
period	Σ	0..1	Period	Time of service that is being documented
date	Σ	0..1	instant	When this document reference was created
author	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | Device | Patient | RelatedPerson | CareTeam)	Who and/or what authored the document
attester		0..*	BackboneElement	Attests to accuracy of the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
mode		1..1	CodeableConcept	personal | professional | legal | official Binding: CompositionAttestationMode (preferred): The way in which a person authenticated a document.
time		0..1	dateTime	When the document was attested
party		0..1	Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization)	Who attested the document
custodian		0..1	Reference(Organization)	Organization that manages the Imaging Manifest
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") - must be a resource in resources Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	1..1	Identifier	Logical reference, when literal reference is not known
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging-manifest-r5/CodeSystem/codesystem-missing-dicom-terminology
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0040E031
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	ΣC	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	ΣC	0..1	string	Text alternative for the resource
relatesTo	Σ	0..*	BackboneElement	Relationships to other documents
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	The relationship type with another document Binding: DocumentRelationshipType (extensible): The type of relationship between the documents.
target	Σ	1..1	Reference(DocumentReference)	Target of the relationship
description	Σ	0..1	markdown	Human-readable description
securityLabel	Σ	0..*	CodeableConcept	Document security-tags Binding: SecurityLabelExamples (example): Example Security Labels from the Healthcare Privacy and Security Classification System.
Slices for content	Σ	1..*	BackboneElement	Document referenced Slice: Unordered, Open by value:value
content:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
profile	Σ	0..*	BackboneElement	Content profile rules for the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
content:kos	Σ	0..1	BackboneElement	Document referenced
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required): BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049) Required Pattern: application/dicom
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: AllLanguages (required): IETF language tag for a human language. Additional Bindings Purpose CommonLanguages Starter Example General: en-AU
data	C	0..1	base64Binary	Data inline, base64ed
url	Σ	1..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	integer64	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	Σ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	Σ	0..1	dateTime	Date attachment was first created
height		0..1	positiveInt	Height of the image in pixels (photo/video)
width		0..1	positiveInt	Width of the image in pixels (photo/video)
frames		0..1	positiveInt	Number of frames if > 1 (photo)
duration		0..1	decimal	Length in seconds (audio / video)
pages		0..1	positiveInt	Number of printed pages
Slices for profile	Σ	1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
profile:kos-manifest	Σ	1..1	BackboneElement	Content profile rules for the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for value[x]	Σ	1..1		Code|uri|canonical Slice: Unordered, Open by type:$this Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
value[x]:valueCoding	Σ	0..1	Coding	Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 113030
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
content:fhir	Σ	0..1	BackboneElement	Document referenced
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required): BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049) Required Pattern: application/fhir+json
language	Σ	0..1	code	Human language of the content (BCP-47) Binding: AllLanguages (required): IETF language tag for a human language. Additional Bindings Purpose CommonLanguages Starter Example General: en-AU
data	C	0..1	base64Binary	Data inline, base64ed
url	Σ	1..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
size	Σ	0..1	integer64	Number of bytes of content (if url provided)
hash	Σ	0..1	base64Binary	Hash of the data (sha-1, base64ed)
title	Σ	0..1	string	Label to display in place of the data Example General: Official Corporate Logo
creation	Σ	0..1	dateTime	Date attachment was first created
height		0..1	positiveInt	Height of the image in pixels (photo/video)
width		0..1	positiveInt	Width of the image in pixels (photo/video)
frames		0..1	positiveInt	Number of frames if > 1 (photo)
duration		0..1	decimal	Length in seconds (audio / video)
pages		0..1	positiveInt	Number of printed pages
Slices for profile	Σ	1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
profile:fhir-manifest	Σ	1..1	BackboneElement	Content profile rules for the document
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for value[x]	Σ	1..1		Code|uri|canonical Slice: Unordered, Open by type:$this Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
value[x]:valueCanonical	Σ	0..1	canonical()	Code|uri|canonical Required Pattern: http://hl7.eu/fhir/imaging-manifest-r5/StructureDefinition/ImImagingStudyManifest
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DocumentReference.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 From the FHIR Standard
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0 From the FHIR Standard
DocumentReference.docStatus	required	CompositionStatus http://hl7.org/fhir/ValueSet/composition-status|5.0.0 From the FHIR Standard
DocumentReference.modality	required	https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
DocumentReference.type	preferred	ImImagingManifestTypesEuVS http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/ImImagingManifestTypesEuVS From this IG
DocumentReference.category	example	ReferencedItemCategoryValueSet http://hl7.org/fhir/ValueSet/referenced-item-category From the FHIR Standard
DocumentReference.category:class-code	preferred	XdsClassCodeVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-xds-class-code-valueset From this IG
DocumentReference.event	example	ActCode http://terminology.hl7.org/ValueSet/v3-ActCode
DocumentReference.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site From the FHIR Standard
DocumentReference.bodySite:anatomical-region	required	AnatomicalRegionVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-anatomical-region-valueset From this IG
DocumentReference.facilityType	example	FacilityTypeCodeValueSet http://hl7.org/fhir/ValueSet/c80-facilitycodes From the FHIR Standard
DocumentReference.practiceSetting	preferred	PracticeSettingsVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-practice-settings From this IG
DocumentReference.attester.mode	preferred	CompositionAttestationMode http://hl7.org/fhir/ValueSet/composition-attestation-mode From the FHIR Standard
DocumentReference.custodian.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types From the FHIR Standard
DocumentReference.custodian.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|5.0.0 From the FHIR Standard
DocumentReference.custodian.identifier.type	extensible	Pattern Value: 0040E031 http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DocumentReference.relatesTo.code	extensible	DocumentRelationshipType http://hl7.org/fhir/ValueSet/document-relationship-type From the FHIR Standard
DocumentReference.securityLabel	example	SecurityLabelExamples http://hl7.org/fhir/ValueSet/security-label-examples From the FHIR Standard
DocumentReference.content.profile.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:kos.attachment.contentType	required	Pattern Value: application/dicom http://hl7.org/fhir/ValueSet/mimetypes|5.0.0 From the FHIR Standard
DocumentReference.content:kos.attachment.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 From the FHIR Standard
DocumentReference.content:kos.profile.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:kos.profile:kos-manifest.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:kos.profile:kos-manifest.value[x]:valueCoding	preferred	​Pattern Value: 113030 http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:fhir.attachment.contentType	required	Pattern Value: application/fhir+json http://hl7.org/fhir/ValueSet/mimetypes|5.0.0 From the FHIR Standard
DocumentReference.content:fhir.attachment.language	required	AllLanguages http://hl7.org/fhir/ValueSet/all-languages|5.0.0 From the FHIR Standard
DocumentReference.content:fhir.profile.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:fhir.profile:fhir-manifest.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
docRef-1	warning	DocumentReference	facilityType SHALL only be present if context is not an encounter : facilityType.empty() or context.where(resolve() is Encounter).empty()
docRef-2	warning	DocumentReference	practiceSetting SHALL only be present if context is not present : practiceSetting.empty() or context.where(resolve() is Encounter).empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
im-docref-1	error	DocumentReference	At least a KOS or FHIR manifest needs to be present. : content.value.subsumes( $dcm#113030) or content.value.endsWith('ImManifestDocumentReference')

Summary

Mandatory: 6 elements(7 nested mandatory elements)
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Placeholder for IHE MHD Entry UUID Identifier in FHIR R5. (http://hl7.eu/fhir/imaging-manifest-r5/StructureDefinition/IheMhdEntryUUIDIdentifier)
• CodeableReferenceWithRequiredCoding (http://hl7.eu/fhir/imaging-manifest-r5/StructureDefinition/CodeableReferenceWithRequiredCoding)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of DocumentReference.identifier
• The element 1 is sliced based on the value of DocumentReference.category
• The element 1 is sliced based on the value of DocumentReference.bodySite
• The element 1 is sliced based on the value of DocumentReference.content
• The element 1 is sliced based on the value of DocumentReference.content.profile
• The element 1 is sliced based on the value of DocumentReference.content.profile.value[x]

Maturity: 1

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	A reference to a document Constraints: docRef-1, docRef-2, im-docref-1
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
contained		0..*	Resource	Contained, inline Resources
Slices for identifier	Σ	1..*	Identifier	Business identifiers for the document Slice: Unordered, Open by value:system
identifier:entry-uuid	Σ	1..1	IheMhdEntryUUIDIdentifier	Business identifiers for the document
status	?!Σ	1..1	code	current | superseded | entered-in-error Binding: DocumentReferenceStatus (required): The status of the document reference.
modality	Σ	1..*	CodeableConcept	Imaging modality used Binding: https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (required)
type	Σ	1..1	CodeableConcept	Type of Imaging Manifest Binding: HL7 EU Imaging Manifest Types (preferred)
Slices for category	Σ	1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by value:$this Binding: ReferencedItemCategoryValueSet (example): High-level kind of document at a macro level.
category:class-code	Σ	0..*	CodeableConcept	Categorization of document Binding: XDS Class Codes (preferred)
subject	Σ	1..1	Reference(Resource)	Who/what is the subject of the document
context	C	0..*	Reference(Appointment | Encounter | EpisodeOfCare)	Context of the document content
Slices for bodySite	Σ	0..*	CodeableReferenceWithRequiredCoding(BodyStructure)	The concept field is required for all bodySites. Slice: Unordered, Open by value:concept Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
bodySite:anatomical-region	Σ	0..*	CodeableReference(BodyStructure)	The anatomical region of the patient that is the focus of the imaging manifest, concept field is required. Binding: Anatomical Region (required)
practiceSetting	C	0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: Practice Settings (preferred)
custodian		0..1	Reference(Organization)	Organization that manages the Imaging Manifest
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	ΣC	1..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging-manifest-r5/CodeSystem/codesystem-missing-dicom-terminology
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0040E031
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for content	Σ	1..*	BackboneElement	Document referenced Slice: Unordered, Open by value:value
content:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
content:kos	Σ	0..1	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required): BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049) Required Pattern: application/dicom
url	Σ	1..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
Slices for profile	Σ	1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
profile:kos-manifest	Σ	1..1	BackboneElement	Content profile rules for the document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for value[x]	Σ	1..1		Code|uri|canonical Slice: Unordered, Open by type:$this Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
value[x]:valueCoding	Σ	0..1	Coding	Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 113030
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
content:fhir	Σ	0..1	BackboneElement	Document referenced
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
attachment	Σ	1..1	Attachment	Where to access the document
contentType	ΣC	0..1	code	Mime type of the content, with charset etc. Binding: MimeTypes (required): BCP 13 (RFCs 2045, 2046, 2047, 4288, 4289 and 2049) Required Pattern: application/fhir+json
url	Σ	1..1	url	Uri where the data can be found Example General: http://www.acme.com/logo-small.png
Slices for profile	Σ	1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
value[x]	Σ	1..1		Code|uri|canonical Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
profile:fhir-manifest	Σ	1..1	BackboneElement	Content profile rules for the document
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Slices for value[x]	Σ	1..1		Code|uri|canonical Slice: Unordered, Open by type:$this Binding: HL7 ValueSet of Format Codes for use with Document Sharing (preferred): Document Format Codes.
valueCoding			Coding
valueUri			uri
valueCanonical			canonical(Any)
value[x]:valueCanonical	Σ	0..1	canonical()	Code|uri|canonical Required Pattern: http://hl7.eu/fhir/imaging-manifest-r5/StructureDefinition/ImImagingStudyManifest
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
DocumentReference.status	required	DocumentReferenceStatus http://hl7.org/fhir/ValueSet/document-reference-status|5.0.0 From the FHIR Standard
DocumentReference.modality	required	https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
DocumentReference.type	preferred	ImImagingManifestTypesEuVS http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/ImImagingManifestTypesEuVS From this IG
DocumentReference.category	example	ReferencedItemCategoryValueSet http://hl7.org/fhir/ValueSet/referenced-item-category From the FHIR Standard
DocumentReference.category:class-code	preferred	XdsClassCodeVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-xds-class-code-valueset From this IG
DocumentReference.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site From the FHIR Standard
DocumentReference.bodySite:anatomical-region	required	AnatomicalRegionVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-anatomical-region-valueset From this IG
DocumentReference.practiceSetting	preferred	PracticeSettingsVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-practice-settings From this IG
DocumentReference.custodian.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|5.0.0 From the FHIR Standard
DocumentReference.custodian.identifier.type	extensible	Pattern Value: 0040E031 http://hl7.org/fhir/ValueSet/identifier-type From the FHIR Standard
DocumentReference.content:kos.attachment.contentType	required	Pattern Value: application/dicom http://hl7.org/fhir/ValueSet/mimetypes|5.0.0 From the FHIR Standard
DocumentReference.content:kos.profile.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:kos.profile:kos-manifest.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:kos.profile:kos-manifest.value[x]:valueCoding	preferred	​Pattern Value: 113030 http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:fhir.attachment.contentType	required	Pattern Value: application/fhir+json http://hl7.org/fhir/ValueSet/mimetypes|5.0.0 From the FHIR Standard
DocumentReference.content:fhir.profile.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes
DocumentReference.content:fhir.profile:fhir-manifest.value[x]	preferred	HL7FormatCodes http://terminology.hl7.org/ValueSet/v3-HL7FormatCodes

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	DocumentReference	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	DocumentReference	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	DocumentReference	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	DocumentReference	A resource should have narrative for robust management : text.`div`.exists()
docRef-1	warning	DocumentReference	facilityType SHALL only be present if context is not an encounter : facilityType.empty() or context.where(resolve() is Encounter).empty()
docRef-2	warning	DocumentReference	practiceSetting SHALL only be present if context is not present : practiceSetting.empty() or context.where(resolve() is Encounter).empty()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
im-docref-1	error	DocumentReference	At least a KOS or FHIR manifest needs to be present. : content.value.subsumes( $dcm#113030) or content.value.endsWith('ImManifestDocumentReference')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
DocumentReference	C	0..*	DocumentReference	A reference to a document Constraints: im-docref-1
modifierExtension		0..0
Slices for identifier		1..*	Identifier	Business identifiers for the document Slice: Unordered, Open by value:system
identifier:entry-uuid		1..1	IheMhdEntryUUIDIdentifier	Business identifiers for the document
modality		1..*	CodeableConcept	Imaging modality used Binding: https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html (required)
type		1..1	CodeableConcept	Type of Imaging Manifest Binding: HL7 EU Imaging Manifest Types (preferred)
Slices for category		1..*	CodeableConcept	Categorization of document Slice: Unordered, Open by value:$this
category:class-code		0..*	CodeableConcept	Categorization of document Binding: XDS Class Codes (preferred)
subject		1..1	Reference(Resource)	Who/what is the subject of the document
Slices for bodySite		0..*	CodeableReferenceWithRequiredCoding(BodyStructure)	The concept field is required for all bodySites. Slice: Unordered, Open by value:concept
bodySite:anatomical-region		0..*	CodeableReference(BodyStructure)	The anatomical region of the patient that is the focus of the imaging manifest, concept field is required. Binding: Anatomical Region (required)
practiceSetting		0..1	CodeableConcept	Additional details about where the content was created (e.g. clinical specialty) Binding: Practice Settings (preferred)
custodian		0..1	Reference(Organization)	Organization that manages the Imaging Manifest
identifier		1..1	Identifier	Logical reference, when literal reference is not known
type		0..1	CodeableConcept	Description of identifier Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://hl7.eu/fhir/imaging-manifest-r5/CodeSystem/codesystem-missing-dicom-terminology
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 0040E031
Slices for content		1..*	BackboneElement	Document referenced Slice: Unordered, Open by value:value
content:kos		0..1	BackboneElement	Document referenced
attachment
contentType		0..1	code	Mime type of the content, with charset etc. Required Pattern: application/dicom
url		1..1	url	Uri where the data can be found
Slices for profile		1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:kos-manifest		1..1	BackboneElement	Content profile rules for the document
Slices for value[x]		1..1	Coding, uri, canonical()	Code|uri|canonical Slice: Unordered, Open by type:$this
value[x]:valueCoding		0..1	Coding	Code|uri|canonical Required Pattern: At least the following
system		1..1	uri	Identity of the terminology system Fixed Value: http://dicom.nema.org/resources/ontology/DCM
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 113030
content:fhir		0..1	BackboneElement	Document referenced
attachment
contentType		0..1	code	Mime type of the content, with charset etc. Required Pattern: application/fhir+json
url		1..1	url	Uri where the data can be found
Slices for profile		1..*	BackboneElement	Content profile rules for the document Slice: Unordered, Open by value:value
profile:fhir-manifest		1..1	BackboneElement	Content profile rules for the document
Slices for value[x]		1..1	Coding, uri, canonical()	Code|uri|canonical Slice: Unordered, Open by type:$this
value[x]:valueCanonical		0..1	canonical()	Code|uri|canonical Required Pattern: http://hl7.eu/fhir/imaging-manifest-r5/StructureDefinition/ImImagingStudyManifest
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
DocumentReference.modality	required	https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html https://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html
DocumentReference.type	preferred	ImImagingManifestTypesEuVS http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/ImImagingManifestTypesEuVS From this IG
DocumentReference.category:class-code	preferred	XdsClassCodeVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-xds-class-code-valueset From this IG
DocumentReference.bodySite:anatomical-region	required	AnatomicalRegionVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-anatomical-region-valueset From this IG
DocumentReference.practiceSetting	preferred	PracticeSettingsVs http://hl7.eu/fhir/imaging-manifest-r5/ValueSet/im-practice-settings From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
im-docref-1	error	DocumentReference	At least a KOS or FHIR manifest needs to be present. : content.value.subsumes( $dcm#113030) or content.value.endsWith('ImManifestDocumentReference')