Release 5 R4 Ballot #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v5.0.0: R5 - STU ). This is the (v3.5.0: R4 Ballot #2). The current published version. version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Terminology Infrastructure Vocabulary Work Group Maturity Level : N 5   Normative (from v4.0.0) Security Category : Anonymous Compartments : No Not linked to any defined compartments

Detailed Descriptions for the elements in the ValueSet resource.

false Summary Standards Status This element has a standards status of "Deprecated" which is different from the status of the whole resource Summary Invariants Defined on this element vsd-11 Rule Must have a value for concept.designation.use if concept.designation.additionalUse is present additionalUse.exists() implies use.exists() Invariants Affect this element vsd-11 Rule Must have a value for concept.designation.use if concept.designation.additionalUse is present additionalUse.exists() implies use.exists() ValueSet.compose.include.concept.designation.additionalUse Element Id ValueSet.compose.include.concept.designation.additionalUse Definition Additional codes that detail how this designation would be used, if there is more than one use. Short Display Additional ways how this designation would be used Cardinality 0..* Terminology Binding Designation Use ( Extensible ) Type Coding Summary false Comments This was added rather than increasing the cardinality of .use to 0..* in order to maintain backward compatibility. Invariants Affect this element vsd-11 Rule Must have a value for concept.designation.use if concept.designation.additionalUse is present additionalUse.exists() implies use.exists() Summary false Comments In case filter.property represents a property of the system, the operation applies to the selected property. In case filter.property represents a filter of the system, the operation SHALL match one of the CodeSystem.filter.operator values. ValueSet.compose.property Summary false ValueSet.expansion.property Element Id ValueSet.expansion.property Definition A property defines an additional slot through which additional information can be provided about a concept. Short Display Additional information supplied about each concept Cardinality 0..* Summary false ValueSet.expansion.property.code Element Id ValueSet.expansion.property.code Definition A code that is used to identify the property. The code is used in ValueSet.expansion.contains.property.code. Short Display Identifies the property on the concepts, and when referred to in operations Cardinality 1..1 Type code Summary false ValueSet.expansion.property.uri Element Id ValueSet.expansion.property.uri Definition Reference to the formal meaning of the property. One possible source of meaning is the Concept Properties code system. Short Display Formal identifier for the property Cardinality 0..1 Type uri Summary false Summary false Invariants Affect this element vsd-10 Rule SHALL have a system if a code is present code.empty() or system.exists() Invariants Affect this element vsd-9 Rule SHALL have a code if not abstract code.exists() or abstract = true ValueSet.scope Element Id ValueSet.scope Definition Description of the semantic space the Value Set Expansion is intended to cover and should further clarify the text in ValueSet.description. Short Display Description of the semantic space the Value Set Expansion is intended to cover and should further clarify the text in ValueSet.description Cardinality 0..1 Summary false ValueSet.scope.inclusionCriteria Element Id ValueSet.scope.inclusionCriteria Definition Criteria describing which concepts or codes should be included and why. Short Display Criteria describing which concepts or codes should be included and why Cardinality 0..1 Type string Summary false ValueSet.scope.exclusionCriteria Element Id ValueSet.scope.exclusionCriteria Definition Criteria describing which concepts or codes should be excluded and why. Short Display Criteria describing which concepts or codes should be excluded and why Cardinality 0..1 Type string Summary false
ValueSet
Element Id ValueSet
Definition

A ValueSet resource instance instances specifies a set of codes drawn from one or more code systems, intended for use in a particular context. Value sets link between CodeSystem definitions and their use in coded elements .

Short Display A set of codes drawn from one or more code systems Cardinality Control 0..* 1..1
Type MetadataResource Summary DomainResource
Invariants
Defined on this element
cnl-0 vsd-0 Warning 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}$') name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
vsd-11 Rule Status must = 'active' if expansion is present and compose is absent status='active' or compose.exists() or expansion.empty()
ValueSet.url
Element Id ValueSet.url
Definition

An absolute URI that is used to identify this value set when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which at which an authoritative instance of this value set is (or will be) published. This URL can be the target of a canonical reference. It SHALL remain the same when the value set is stored on different servers.

Short Display Canonical identifier for this value set, represented as a URI (globally unique) Cardinality Control 0..1
Type uri
Requirements

Allows the value set to be referenced by a single globally unique identifier.

Summary true
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. Invariants Defined on this element cnl-1 Warning URL should not contain | or # - these characters make processing canonical references problematic exists() implies matches('^[^|# ]+$')
ValueSet.identifier
Element Id ValueSet.identifier
Definition

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

Short Display Additional identifier for the value set (business identifier) Note This is a business identifier, identifer, not a resource identifier (see discussion )
Cardinality Control 0..*
Type Identifier
Requirements

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

Summary true
Comments

Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier) data type, and can then identify this value set outside of FHIR, where it is not possible to use the logical URI.

ValueSet.version
Element Id ValueSet.version
Definition

The identifier that is used to identify this version of the value set when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the value set 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.

Short Display Business version of the value set Note This is a business versionId, not a resource version id (see discussion )
Cardinality Control 0..1
Type string
Summary true
Comments

There may be different value set 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 value set with the format [url]|[version]. The version SHOULD NOT contain a '#' - see Business Version . ValueSet.versionAlgorithm[x] Element Id ValueSet.versionAlgorithm[x] Definition Indicates the mechanism used to compare versions to determine which ValueSet is more current. Short Display How to compare versions Cardinality 0..1 Terminology Binding Version Algorithm ( Extensible ) Type string | Coding [x] Note See Choice of Datatypes for further information about how to use [x] Summary true 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.

ValueSet.name
Element Id ValueSet.name
Definition

A natural language name identifying the value set. This name should be usable as an identifier for the module by machine processing applications such as code generation.

Short Display Name for this value set (computer friendly) Cardinality Control 0..1
Type string
Requirements

Support human navigation and code generation.

Summary true
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.A name should be provided unless the value set is a contained resource (e.g. an anonymous value set in a profile). Most registries will require a name.

Invariants
Affect this element
cnl-0 inv-0 Warning 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}$') name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
ValueSet.title
Element Id ValueSet.title
Definition

A short, descriptive, user-friendly title for the value set.

Short Display Name for this value set (human friendly) Cardinality Control 0..1
Type string
Summary true
Comments

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

ValueSet.status
Element Id ValueSet.status
Definition

The status of this value set. Enables tracking the life-cycle of the content. The status of the value set applies to the value set definition (ValueSet.compose) and the associated ValueSet metadata. Expansions do not have a state.

Short Display draft | active | retired | unknown Cardinality Control 1..1
Terminology Binding PublicationStatus ( Required )
Type code
Is Modifier true (Reason: This is labeled as "Is Modifier" because applications should not use a retired {{title}} without due consideration)
Summary true
Comments

Allows filtering of value sets that are appropriate for use versus not.See also the http://hl7.org/fhir/StructureDefinition/valueset-workflowStatusDescription valueset-workflowStatus extension for additional status information related to the editorial process.

See guidance around (not) making local changes to elements here .
Invariants
Affect this element
vsd-11 Rule Status must = 'active' if expansion is present and compose is absent status='active' or compose.exists() or expansion.empty()
ValueSet.experimental
Element Id ValueSet.experimental
Definition

A Boolean value to indicate that this value set is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage.

Short Display For testing purposes, not real usage Cardinality Control 0..1
Type boolean
Meaning if Missing If absent, this resource is treated as though it is not experimental. Requirements

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

Summary true
Comments

Allows filtering of value sets that are appropriate for use versus not.

ValueSet.date
Element Id ValueSet.date
Definition

The date (and optionally time) when the value set metadata or was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the value set changes. (e.g. the 'content logical definition (.compose) was created or revised. definition').

Short Display Date last changed Cardinality Control 0..1
Type dateTime
Alternate Names Revision Date
Summary true
Comments

Note that this is not the same as the meta.lastUpdated which is specific to an instance of a value set resource on last-modified-date, since the resource may be a server. secondary representation of the value set. 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 .
ValueSet.publisher
Element Id ValueSet.publisher
Definition

The name of the organization or individual responsible for the release and ongoing maintenance of that published the value set.

Short Display Name of the publisher/steward (organization or individual) Cardinality Control 0..1
Type string
Requirements

Helps establish the "authority/credibility" of the value set. May also allow for contact.

Summary true
Comments

Usually an organization but may be an individual. The publisher (or steward) of the value set is the organization or individual primarily responsible for the maintenance and upkeep of the value set. 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 value set. This item SHOULD be populated unless the information is available from context.

ValueSet.contact
Element Id ValueSet.contact
Definition

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

Short Display Contact details for the publisher Cardinality Control 0..*
Type ContactDetail
Summary true
Comments

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

See guidance around (not) making local changes to elements here .
ValueSet.description
Element Id ValueSet.description
Definition

A free text natural language description of the value set from a consumer's perspective. The textual description specifies the span of meanings for concepts to be included within the Value Set Expansion, and also may specify the intended use and limitations of the Value Set.

Short Display Natural language description of the value set Cardinality Control 0..1
Type markdown
Alternate Names false Scope; Purpose
Comments

Description SHOULD contain This description can be used to capture details such as why the value set was built, comments about misuse, instructions for clinical or administrative use and interpretation and information about misuse. Description interpretation, literature references, examples from the paper world, etc. It is not a rendering of the value set as conveyed in the 'text' field of the resource itself. This item SHOULD be populated unless the information is available from context. Description SHOULD context (e.g. the language of the value set is presumed to be populated the predominant language in the place the value set was created).The description is not intended to describe the semantics of the Value Set - there are no intrinsic semantics separate from the codes contained in its expansion. The description should capture its intended use, which is needed for ensuring integrity for its use in models across future changes. A description should be provided unless the value set is a contained resource (e.g. a an anonymous value set defined solely in the context of a profile). Most registries will require a description.

ValueSet.useContext
Element Id ValueSet.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 terms may be used to assist with indexing and searching for appropriate value set instances.

Short Display The context that the content is intended to support Cardinality Control 0..*
Type UsageContext
Requirements

Assist in searching for appropriate content.

Summary true
Comments

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

ValueSet.jurisdiction
Element Id ValueSet.jurisdiction
Definition

A legal or geographic region in which the value set is intended to be used.

Short Display Intended jurisdiction for value set (if applicable) Cardinality Control 0..*
Terminology Binding Jurisdiction ValueSet ( Extensible )
Type CodeableConcept
Summary true
Comments

It may be possible for the value set 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.)
ValueSet.immutable
Element Id ValueSet.immutable
Definition

If this is set to 'true', then no new versions of the content logical definition can be created. Note: Other metadata might still change.

Short Display Indicates whether or not any change to the content logical definition may occur Cardinality Control 0..1
Type boolean
Summary true
Comments

Normally immutability is set to 'false', which is the default assumption if it is not populated. Note that the implication is that if this is set to 'true', there may be only one ValueSet version for this definition. Immutability tends to be set to 'true' in one of two cases: - Where the value set, by the nature of its usage, cannot change. For example "All specializations of ACT in ActClassCode" - Where there's no safe way to express the "Purpose" such that someone else could safely make changes to the value set definition. Source workflow control must guarantee that the same URI always yields the same definition.

ValueSet.purpose
Element Id ValueSet.purpose
Definition

Explanation of why this value set is needed and why it has been designed as it has.

Short Display Why this value set is defined Cardinality Control 0..1
Type markdown
Summary false Comments

This element does not describe the usage of the value set. 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 value set.

ValueSet.copyright
Element Id ValueSet.copyright
Definition

A copyright statement relating to the value set and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the value set.

Short Display Use and/or publishing restrictions Cardinality Control 0..1
Type markdown
Requirements

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

Alternate Names License; Restrictions
Summary false Comments

Frequently, nullFrequently, the copyright differs between the value set and the codes that are included. The copyright statement should clearly differentiate between these when required.

ValueSet.copyrightLabel Element Id ValueSet.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'). Short Display Copyright holder and year(s) Cardinality 0..1 Type string Requirements Defines the content expected to be rendered in all representations of the artifact. Summary false 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. ValueSet.approvalDate Element Id ValueSet.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. Short Display When the ValueSet was approved by publisher Cardinality 0..1 Type date Summary false 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 . ValueSet.lastReviewDate Element Id ValueSet.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. Short Display When the ValueSet was last reviewed by the publisher Cardinality 0..1 Type date 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. Summary false Comments If specified, this date follows the original approval date. See guidance around (not) making local changes to elements here . ValueSet.effectivePeriod Element Id ValueSet.effectivePeriod Definition The period during which the ValueSet content was or is planned to be in active use. Short Display When the ValueSet is expected to be used Cardinality 0..1 Type Period Requirements Allows establishing a transition before a resource comes into effect and also allows for a sunsetting process when new versions of the ValueSet are or are expected to be used instead. Summary true Comments The effective period for a ValueSet determines when the content is applicable for usage and is independent of publication and review dates. For example, a valueset intended to be used for the year 2016 might be published in 2015. See guidance around (not) making local changes to elements here . ValueSet.topic Standards Status This element has a standards status of "Deprecated" which is different from the status of the whole resource Element Id ValueSet.topic Definition Descriptions related to the content of the ValueSet. Topics provide a high-level categorization as well as keywords for the ValueSet that can be useful for filtering and searching. Short Display E.g. Education, Treatment, Assessment, etc Cardinality 0..* Terminology Binding Definition Topic ( Example ) Type CodeableConcept Requirements Repositories must be able to determine how to categorize the ValueSet so that it can be found by topical and keyword searches. Summary false 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) ValueSet.author Element Id ValueSet.author Definition An individiual or organization primarily involved in the creation and maintenance of the ValueSet. Short Display Who authored the ValueSet Cardinality 0..* Type ContactDetail Summary false ValueSet.editor Element Id ValueSet.editor Definition An individual or organization primarily responsible for internal coherence of the ValueSet. Short Display Who edited the ValueSet Cardinality 0..* Type ContactDetail Summary false ValueSet.reviewer Element Id ValueSet.reviewer Definition An individual or organization asserted by the publisher to be primarily responsible for review of some aspect of the ValueSet. Short Display Who reviewed the ValueSet Cardinality 0..* Type ContactDetail Summary false Comments See guidance around (not) making local changes to elements here . ValueSet.endorser Element Id ValueSet.endorser Definition An individual or organization asserted by the publisher to be responsible for officially endorsing the ValueSet for use in some setting. Short Display Who endorsed the ValueSet Cardinality 0..* Type ContactDetail Summary false Comments See guidance around (not) making local changes to elements here . ValueSet.relatedArtifact Element Id ValueSet.relatedArtifact Definition Related artifacts such as additional documentation, justification, dependencies, bibliographic references, and predecessor and successor artifacts. Short Display Additional documentation, citations, etc Cardinality 0..* Type RelatedArtifact Requirements A ValueSet 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. Summary false Comments Each related artifact is either an attachment, or a reference to another resource, but not both. ValueSet.compose
Element Id ValueSet.compose
Definition

A set of criteria that define the contents of the value set by including or excluding codes selected from the specified code system(s) that the value set draws from. This is also known as the Content Logical Definition (CLD).

Short Display Content logical definition of the value set (CLD) Cardinality Control 0..1
Alternate Names Content Logical Definition; CLD
Invariants
Affect this element
vsd-11 Rule Status must = 'active' if expansion is present and compose is absent false status='active' or compose.exists() or expansion.empty()
ValueSet.compose.lockedDate
Element Id ValueSet.compose.lockedDate
Definition

The Locked Date is the effective If a locked date that is used to determine defined, then the Content Logical Definition must be evaluated using the current version as of all the locked date for referenced Code Systems code system(s) and Value Set Definitions included in the compose that are value set instances where ValueSet.compose.include.version is not already tied to a specific version. defined.

Short Display Fixed date for references with no specified version (transitive) Cardinality Control 0..1
Type date
Summary true
Comments

With a defined lockedDate the value set is considered "Locked". Otherwise, the value set may have different expansions as underlying code systems and/or value sets evolve. The interpretation of lockedDate is often dependent on the context - e.g. a SNOMED CT derived value set with a lockedDate will have a different expansion in USA than in UK. If a value set specifies a version for include and exclude statements, and also specifies a locked date, the specified versions need to be available that date, or the value set will not be usable.

ValueSet.compose.inactive
Element Id ValueSet.compose.inactive
Definition

Whether inactive codes - codes that are not approved for current use - are in the value set. If inactive = true, inactive codes are to be included in the expansion, if inactive = false, the inactive codes will not be included in the expansion. If absent, the behavior is determined by the implementation, or by the applicable $expand parameters (but generally, inactive codes would be expected to be included).

Short Display Whether inactive codes are in the value set Cardinality Control 0..1
Type boolean
Summary true
Comments

Note that in the FHIR terminology framework, "deprecated" does not mean inactive, but in some code systems, e.g. systems (e.g. LOINC, "deprecated" does mean inactive. deprecated means inactive). Code systems should define what codes are considered to be inactive. If this is not clearly defined (including in the FHIR code system resource), then all codes are assumed to be active.

The Value Set Definition specification defines an ActiveOnly element, which is the reverse of this element e.g. (ValueSet.compose.inactive=FALSE) is the same as (VSD.ActiveOnly=TRUE).
ValueSet.compose.include
Element Id ValueSet.compose.include
Definition

Include one or more codes from a code system or other value set(s).

Short Display Include one or more codes from a code system or other value set(s) Cardinality Control 1..*
Summary true
Comments

All the conditions in an include must be true. If a system is listed, all the codes from the system are listed. If one or more filters are listed, all of the filters must apply. If one or more value sets are listed, the codes must be in all the value sets. E.g. each include is 'include all the codes that meet all these conditions'.

Invariants
Defined on this element
vsd-1 Rule A value set include/exclude SHALL have a value set or a system valueSet.exists() or system.exists()
vsd-2 Rule A value set with concepts or filters SHALL include a system (concept.exists() or filter.exists()) implies system.exists()
vsd-3 Rule Cannot have both concept and filter concept.empty() or filter.empty()
ValueSet.compose.include.system
Element Id ValueSet.compose.include.system
Definition

An absolute URI which is the code system from which the selected codes come from.

Short Display The system the codes come from Cardinality Control 0..1
Type uri
Summary true
Comments

If there are no codes or filters, the entire code system is included. Note that the set of codes that are included may contain abstract codes. See ''Coding.system'' for further documentation about the correct value for the system element.

Invariants
Affect this element
vsd-2 vsd-1 Rule A value set with concepts or filters include/exclude SHALL include have a value set or a system (concept.exists() valueSet.exists() or filter.exists()) implies system.exists()
vsd-1 vsd-2 Rule A value set include/exclude SHALL have a value set with concepts or filters SHALL include a system valueSet.exists() (concept.exists() or filter.exists()) implies system.exists()
ValueSet.compose.include.version
Element Id ValueSet.compose.include.version
Definition

The version of the code system that the codes are selected from, or the special version '*' "*" for all versions.

Short Display Specific version of the code system referred to Note This is a business versionId, not a resource version id (see discussion )
Cardinality Control 0..1
Type string
Summary true
Comments

This is used when selecting the descendants of a concept - they may change between versions. If no version is specified, then the exact contents of the value set might not be known until a context of use binds it to a particular version. The special value '*' "*" means all versions; version; It is at server discretion discrection regarding expansions and which versions must be supported.

ValueSet.compose.include.concept
Element Id ValueSet.compose.include.concept
Definition

Specifies a concept to be included or excluded.

Short Display A concept defined in the system Cardinality Control 0..*
Summary false Comments

The list of concepts is considered ordered, though the order might not have any particular significance. Typically, the order of an expansion follows that defined in the compose element.

Invariants
Affect this element
vsd-2 Rule A value set with concepts or filters SHALL include a system (concept.exists() or filter.exists()) implies system.exists() vsd-3 Rule Cannot have both concept and filter concept.empty() or filter.empty()
ValueSet.compose.include.concept.code
Element Id ValueSet.compose.include.concept.code
Definition

Specifies a code for the concept to be included or excluded.

Short Display Code or expression from system Cardinality Control 1..1
Type code
Summary false Comments

Expressions are allowed if defined by the underlying code system.

ValueSet.compose.include.concept.display
Element Id ValueSet.compose.include.concept.display
Definition

The text to display to the user for this concept in the context of this valueset. If no display is provided, then applications using the value set use the display specified for the code by the system.

Short Display Text to display for this code for this value set in this valueset Cardinality Control 0..1
Type string
Summary false Comments

The value set resource allows for an alternative display to be specified for when this concept is used in this particular value set. See notes in the value set narrative about the correct use of this element.

ValueSet.compose.include.concept.designation
Element Id ValueSet.compose.include.concept.designation
Definition

Additional representations for this concept when used in this value set - other languages, aliases, specialized purposes, used for particular purposes, etc.

Short Display Additional representations for this concept Cardinality Control 0..*
Summary false Comments

Concepts have both a display and an array of designation . The display is equivalent to a special designation with an a n implied designation.use of "primary code" and a language equal to the Resource Language .

ValueSet.compose.include.concept.designation.language
Element Id ValueSet.compose.include.concept.designation.language
Definition

The language this designation is defined for.

Short Display Human language of the designation Cardinality Control 0..1
Terminology Binding All Languages Language ( Required ) Additional Bindings Purpose Common Languages Preferred Starter Set but limited to Language )
Type code
Summary false Comments

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

ValueSet.compose.include.concept.designation.use
Element Id ValueSet.compose.include.concept.designation.use
Definition

A code that represents types of uses of designations.

Short Display Types of uses of designations Cardinality Control 0..1
Terminology Binding Designation Use ( Extensible )
Type Coding
Summary false Comments

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

ValueSet.compose.include.concept.designation.value
Element Id ValueSet.compose.include.concept.designation.value
Definition

The text value for this designation.

Short Display The text value for this designation Cardinality Control 1..1
Type string
ValueSet.compose.include.filter
Element Id ValueSet.compose.include.filter
Definition

Select concepts by specifying specify a matching criterion criteria based on the properties (including relationships) defined by the system, or on filters defined by the system. If multiple filters are specified within the include, specified, they SHALL all be true.

Short Display Select codes/concepts by their properties (including relationships) Cardinality Control 0..*
Summary true
Comments

Selecting codes by specifying filters based on properties is only possible where the underlying code system defines appropriate properties. Note that in some cases, the underlying code system defines the logical concepts but not the literal codes for the concepts. In such cases, the literal definitions may be provided by a third party.

Invariants
Affect this element
vsd-2 Rule A value set with concepts or filters SHALL include a system (concept.exists() or filter.exists()) implies system.exists() vsd-3 Rule Cannot have both concept and filter concept.empty() or filter.empty()
ValueSet.compose.include.filter.property
Element Id ValueSet.compose.include.filter.property
Definition

A code that identifies a property or a filter defined in the code system.

Short Display A property/filter defined by the code system Cardinality Control 1..1
Type code
Summary true
ValueSet.compose.include.filter.op
Element Id ValueSet.compose.include.filter.op
Definition

The kind of operation to perform as a part of the filter criteria.

Short Display = | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | child-of | descendent-leaf | exists Cardinality Control 1..1
Terminology Binding Filter Operator FilterOperator ( Required )
Type code
Summary true
ValueSet.compose.include.filter.value
Element Id ValueSet.compose.include.filter.value
Definition

The match value may be either a code defined by the system, or a string value, which is a regex match on the literal string of the property value (if the filter represents a property defined in CodeSystem) or of the system filter value (if the filter represents a filter defined in CodeSystem) when the operation is 'regex', or one of the values (true and false), when the operation is 'exists'.

Short Display Code from the system, or regex criteria, or boolean value for exists Cardinality Control 1..1
Type string
Summary true
Comments

Use regex matching with care - full regex matching on every SNOMED CT term is prohibitive, for example.

ValueSet.compose.include.valueSet
Element Id ValueSet.compose.include.valueSet
Definition

Selects the concepts found in this value set (based on its value set definition). This is an absolute URI that is a reference to ValueSet.url. If multiple value sets are specified this includes the intersection union of the contents of all of the referenced value sets.

Short Display Select the contents included in this value set Cardinality Control 0..*
Type canonical ( ValueSet )
Summary true
Comments

The value set URI is either a logical reference to a defined value set such as a SNOMED CT reference set , or a direct reference to a value set definition using ValueSet.url. The reference might not refer to an actual FHIR ValueSet resource; in this case, whatever is referred to is an implicit definition of a value set that needs to be clear about how versions are resolved.

Invariants
Affect this element
vsd-1 Rule A value set include/exclude SHALL have a value set or a system valueSet.exists() or system.exists()
ValueSet.compose.include.copyright Element Id ValueSet.compose.include.copyright Definition A copyright statement for the specific code system asserted by the containing ValueSet.compose.include element's system value (if the associated ValueSet.compose.include.version element is not present); or the code system and version combination (if the associated ValueSet.compose.include.version element is present). Short Display A copyright statement for the specific code system included in the value set Cardinality 0..1 Type string Summary false ValueSet.compose.exclude
Element Id ValueSet.compose.exclude
Definition

Exclude one or more codes from the value set based on code system filters and/or other value sets.

Short Display Explicitly exclude codes from a code system or other value sets Cardinality Control 0..*
Type See ValueSet.compose.include
Summary false Comments

Usually this is used to selectively exclude codes that were included by subsumption in the inclusions. Any display names specified for the codes are ignored.

Element Id Invariants ValueSet.compose.property Definition A property to return in the expansion, if the client doesn't ask for any particular properties. May be either a code from the code system definition (convenient) or a the formal URI that refers to the property. The special value '*' means all properties known to the server. Cardinality Comments Note that property names can clash, so using a URI is recommended.
Short Display Affect this element Property to return if client doesn't override
vsd-2 0..* Type Rule string A value set with concepts or filters SHALL include a system Summary (concept.exists() or filter.exists()) implies system.exists() false
ValueSet.expansion
Element Id ValueSet.expansion
Definition

A value set can also be "expanded", where the value set is turned into a simple collection of enumerated codes. This element holds the expansion, if it has been performed.

Short Display Used when the value set is "expanded" Cardinality Control 0..1
Summary false Comments

Expansion is performed to produce a collection of codes that are ready to use for data entry or validation. Value set expansions are always considered to be stateless - they are a record of the set of codes in the value set at a point in time under a given set of conditions, and are not subject to ongoing maintenance.

Expansion.parameter is a simplified list of parameters - a subset of the features of the Parameters
Invariants
Affect this element
vsd-11 Rule resource. Status must = 'active' if expansion is present and compose is absent status='active' or compose.exists() or expansion.empty()
ValueSet.expansion.identifier
Element Id ValueSet.expansion.identifier
Definition

An identifier that uniquely identifies this expansion of the valueset, based on a unique combination of the provided parameters, the system default parameters, and the underlying system code system versions etc. Systems may re-use the same identifier as long as those factors remain the same, and the expansion is the same, but are not required to do so. This is a business identifier.

Short Display Identifies the value set expansion (business identifier) Note This is a business identifier, identifer, not a resource identifier (see discussion )
Cardinality Control 0..1
Type uri
Summary false Comments

Typically, this uri is a UUID (e.g. urn:uuid:8230ff20-c97a-4167-a59d-dc2cb9df16dd).

ValueSet.expansion.next Element Id ValueSet.expansion.next Definition As per paging Search results, the next URLs are opaque to the client, have no dictated structure, and only the server understands them. Short Display Opaque urls for paging through expansion results Cardinality 0..1 Type uri Summary false Comments Clients SHOULD use the next link, if present, to page through expansion results in preference to using the offset and count parameters. Due to the optional nature of the next link, its absence does not necessarily indicate that it is the last page of results. Instead, as the offset and count parameters SHALL be populated when paging, clients can reliably use the count/offset parameters to determine whether the whole expansion is returned. ValueSet.expansion.timestamp
Element Id ValueSet.expansion.timestamp
Definition

The time at which the expansion was produced by the expanding system.

Short Display Time ValueSet expansion happened Cardinality Control 1..1
Type dateTime
Summary false Comments

This SHOULD be a fully populated instant, but in some circumstances, value sets are expanded by hand, and the expansion is published without that precision.

ValueSet.expansion.total
Element Id ValueSet.expansion.total
Definition

The total number of concepts in the expansion. If the number of concept nodes in this resource is less than the stated number, then the server can return more using the offset parameter.

Short Display Total number of codes in the expansion Cardinality Control 0..1
Type integer
Summary false Comments

Paging only applies to flat expansions.

ValueSet.expansion.offset
Element Id ValueSet.expansion.offset
Definition

If paging is being used, the offset at which this resource starts. I.e. this resource is a partial view into the expansion. If paging is not being used, this element SHALL NOT be present.

Short Display Offset at which this resource starts Cardinality Control 0..1
Type integer
Meaning if Missing Paging is not being used
Summary false Comments

Paging only applies to flat expansions. If a filter is applied, the count is the number of concepts that matched the filter, not the number of concepts in an unfiltered view of the expansion.

ValueSet.expansion.parameter
Element Id ValueSet.expansion.parameter
Definition

A parameter that controlled the expansion process. These parameters may be used by users of expanded value sets to check whether the expansion is suitable for a particular purpose, or to pick the correct expansion.

Short Display Parameter that controlled the expansion process Cardinality Control 0..*
Summary false Comments

The server decides which parameters to include here, but at a minimum, the list SHOULD include all of the parameters that affect the $expand operation. If the expansion will be persisted all of these parameters SHALL be included. If the codeSystem on the server has a specified version then this version SHALL be provided as a parameter in the expansion (note that not all code systems have a version).

ValueSet.expansion.parameter.name
Element Id ValueSet.expansion.parameter.name
Definition

Name of the input parameter to the $expand operation; may be a server-assigned name for additional default or other server-supplied parameters used to control the expansion process.

Short Display Name as assigned by the client or server Cardinality Control 1..1
Type string
Summary false Comments

The names are assigned at the discretion of the server.

ValueSet.expansion.parameter.value[x]
Element Id ValueSet.expansion.parameter.value[x]
Definition

The value of the parameter.

Short Display Value of the named parameter Cardinality Control 0..1
Type string | boolean | integer | decimal | uri | code | dateTime
[x] Note See Choice of Datatypes Data Types for further information about how to use [x]
ValueSet.expansion.contains
Element Id ValueSet.expansion.contains
Definition

The codes that are contained in the value set expansion.

Short Display Codes in the value set Cardinality Control 0..*
Summary false Invariants
Defined on this element
vsd-6 Rule SHALL have a code or a display code.exists() or display.exists()
vsd-9 Rule SHALL Must have a code if not abstract code.exists() or abstract = true
vsd-10 Rule SHALL Must have a system if a code is present code.empty() or system.exists()
ValueSet.expansion.contains.system
Element Id ValueSet.expansion.contains.system
Definition

An absolute URI which is the code system in which the code for this item in the expansion is defined.

Short Display System value for the code Cardinality Control 0..1
Type uri
ValueSet.expansion.contains.abstract
Element Id ValueSet.expansion.contains.abstract
Definition

If true, this entry is included in the expansion for navigational purposes, and the user cannot select the code directly as a proper value.

Short Display If user cannot select this entry Cardinality Control 0..1
Type boolean
Meaning if Missing If this is not populated, systems can assume that the concept it not abstract. This SHALL always be populated for abstract concepts
Summary false Comments

This should not be understood to exclude its use for searching (e.g. by subsumption testing). The client should know whether it is appropriate for the user to select an abstract code or not.

ValueSet.expansion.contains.inactive
Element Id ValueSet.expansion.contains.inactive
Definition

If the concept is inactive in the code system that defines it. Inactive codes are those that are no longer to be used, but are maintained by the code system for understanding legacy data. It might not be known or specified whether a an concept is inactive (and it may depend on the context of use).

Short Display If concept is inactive in the code system Cardinality Control 0..1
Type boolean
Summary false Comments

This should only have a value if the concept is inactive.

ValueSet.expansion.contains.version
Element Id ValueSet.expansion.contains.version
Definition

The version of the code system from this code was taken. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Short Display Version in which this code/display is defined Note This is a business versionId, not a resource version id (see discussion )
Cardinality Control 0..1
Type string
Summary false Comments

The exact value of the version string is specified by the system from which the code is derived.

ValueSet.expansion.contains.code
Element Id ValueSet.expansion.contains.code
Definition

The code for this item in the expansion hierarchy. If this code is missing the entry in the hierarchy is a place holder (abstract) and does not represent a valid code in the value set.

Short Display Code - if blank, this is not a selectable code Cardinality Control 0..1
Type code
Summary false Invariants vsd-9 Rule SHALL have a code if not abstract code.exists() or abstract = true vsd-10 Rule SHALL have a system if a code is present code.empty() or system.exists()
Affect this element
vsd-6 Rule SHALL have a code or a display code.exists() or display.exists()
ValueSet.expansion.contains.display
Element Id ValueSet.expansion.contains.display
Definition

The recommended display for this item in the expansion.

Short Display User display for the concept Cardinality Control 0..1
Type string
Summary false Invariants
Affect this element
vsd-6 Rule SHALL have a code or a display code.exists() or display.exists()
ValueSet.expansion.contains.designation
Element Id ValueSet.expansion.contains.designation
Definition

Additional representations for this item - other languages, aliases, specialized purposes, used for particular purposes, etc. These are relevant when the conditions of the expansion do not fix to a single correct representation.

Short Display Additional representations for this item Cardinality Control 0..*
Type See ValueSet.compose.include.concept.designation
Summary false Comments

The designations provided must be based on the value set and code system definitions.

ValueSet.expansion.contains.property Element Id ValueSet.expansion.contains.property Definition A property value for this concept. Short Display Property value for the concept Cardinality 0..* Summary false ValueSet.expansion.contains.property.code Element Id ValueSet.expansion.contains.property.code Definition A code that is a reference to ValueSet.expansion.property.code. Short Display Reference to ValueSet.expansion.property.code Cardinality 1..1 Type code Summary false ValueSet.expansion.contains.property.value[x] Element Id ValueSet.expansion.contains.property.value[x] Definition The value of this property. Short Display Value of the property for this concept Cardinality 1..1 Type code | Coding | string | integer | boolean | dateTime | decimal [x] Note See Choice of Datatypes for further information about how to use [x] Summary false ValueSet.expansion.contains.property.subProperty Element Id ValueSet.expansion.contains.property.subProperty Definition A subproperty value for this concept. Short Display SubProperty value for the concept Cardinality 0..* Summary false ValueSet.expansion.contains.property.subProperty.code Element Id ValueSet.expansion.contains.property.subProperty.code Definition A code that is a reference to ValueSet.expansion.property.code. Short Display Reference to ValueSet.expansion.property.code Cardinality 1..1 Type code Summary false ValueSet.expansion.contains.property.subProperty.value[x] Element Id ValueSet.expansion.contains.property.subProperty.value[x] Definition The value of this subproperty. Short Display Value of the subproperty for this concept Cardinality 1..1 Type code | Coding | string | integer | boolean | dateTime | decimal [x] Note See Choice of Datatypes for further information about how to use [x] Summary false ValueSet.expansion.contains.contains
Element Id ValueSet.expansion.contains.contains
Definition

Other codes and entries contained under this entry in the hierarchy.

Short Display Codes contained under this entry Cardinality Control 0..*
Type See ValueSet.expansion.contains
Summary false Comments

If the expansion uses this element, there is no implication about the logical relationship between them, and the structure cannot be used for logical inferencing. The structure exists to provide navigational assistance for helping human users to locate codes in the expansion.