StructureDefinition: PublishableCodeSystem - XML

PublishableCodeSystem

<?xml version="1.0" encoding="UTF-8"?>


<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="publishablecodesystem"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">to do</div> 
  </text> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="3"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="vocab"/> 
  </extension> 
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use"/> 
  </extension> 
  <url value="http://hl7.org/fhir/StructureDefinition/publishablecodesystem"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.5.1129"/> 
  </identifier> 
  

  <version value="6.0.0-ballot3"/> 
  <name value="PublishableCodeSystem"/> 
  <title value="Publishable CodeSystem"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <date value="2020-12-28T16:55:11+11:00"/> 
  <publisher value="HL7"/> 
  Defines and enforces the minimum expectations for publication and distribution
   of a code system, typically as part of an artifact repository or implementation

  <description value="Defines and enforces the minimum expectations for publication and distribution
   of a code system, typically as part of an artifact repository or implementation

   guide publication"/> 
  

  <fhirVersion value="6.0.0-ballot3"/> 
  <mapping> 
    <identity value="rim"/> 
    <uri value="http://hl7.org/v3"/> 
    <name value="RIM Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="workflow"/> 
    <uri value="http://hl7.org/fhir/workflow"/> 
    <name value="Workflow Pattern"/> 
  </mapping> 
  <mapping> 
    <identity value="w5"/> 
    <uri value="http://hl7.org/fhir/fivews"/> 
    <name value="FiveWs Pattern Mapping"/> 
  </mapping> 
  <mapping> 
    <identity value="objimpl"/> 
    <uri value="http://hl7.org/fhir/object-implementation"/> 
    <name value="Object Implementation Information"/> 
  </mapping> 
  <kind value="resource"/> 
  <abstract value="false"/> 
  <type value="CodeSystem"/> 
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> 
  <derivation value="constraint"/> 
  <snapshot> 
    <extension url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
      <valueString value="6.0.0-ballot3"/> 
    </extension> 
    <element id="CodeSystem">
      <path value="CodeSystem"/> 
      <short value="Declares the existence of and describes a code system or code system supplement"/> 
      The CodeSystem resource is used to declare the existence of and describe a code
       system or code system supplement and its key properties, and optionally define

      <definition value="The CodeSystem resource is used to declare the existence of and describe a code
       system or code system supplement and its key properties, and optionally define

       a part or all of its content."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <constraint> 
        <key value="cnl-0"/> 
        <severity value="warning"/> 
        Name should be usable as an identifier for the module by machine processing applications

        <human value="Name should be usable as an identifier for the module by machine processing applications
         such as code generation"/> 
        <expression value="name.exists() implies name.matches('^[A-Z]([A-Za-z0-9_]){1,254}$')"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/> 
      </constraint> 
      <constraint> 
        <key value="csd-1"/> 
        <severity value="error"/> 
        <human value="Within a code system definition, all the codes SHALL be unique"/> 
        concept.exists() implies concept.code.combine(%resource.concept.descendants().concept.code).i

        <expression value="concept.exists() implies concept.code.combine(%resource.concept.descendants().concept.code).i
        sDistinct()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/> 
      </constraint> 
      <constraint> 
        <key value="csd-2"/> 
        <severity value="warning"/> 
        <human value="If there is an explicit hierarchy, a hierarchyMeaning should be provided"/> 
        <expression value="concept.concept.exists() implies hierarchyMeaning.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/> 
      </constraint> 
      <constraint> 
        <key value="csd-3"/> 
        <severity value="warning"/> 
        <human value="If there is an implicit hierarchy, a hierarchyMeaning should be provided"/> 
        concept.where(property.code = 'parent' or property.code = 'child').exists() implies

        <expression value="concept.where(property.code = 'parent' or property.code = 'child').exists() implies
         hierarchyMeaning.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/> 
      </constraint> 
      <constraint> 
        <key value="csd-4"/> 
        <severity value="error"/> 
        If the code system content = supplement, it must nominate what it's a supplement

        <human value="If the code system content = supplement, it must nominate what it's a supplement
         for"/> 
        <expression value="CodeSystem.content = 'supplement' implies CodeSystem.supplements.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/> 
      </constraint> 
      <constraint> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/> 
        </extension> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown value="There is scope for unsafe interpretation of codes if it's not known whether the
           CodeSystem is case sensitive or not"/> 
        </extension>         <key value="csd-7"/>         <severity value="warning"/>         <human value="caseSensitive SHOULD be provided"/>         <expression value="caseSensitive.exists()"/>         <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/>       </constraint>       <constraint> 
        <key value="scs-1"/> 
        <severity value="error"/> 
        <human value="If a codesystem contains nested concepts, it must specify hierarchyMeaning"/> 
        <expression value="concept.concept.exists() implies hierarchyMeaning.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> 
      </constraint> 
      <constraint> 
        <key value="scs-2"/> 
        <severity value="error"/> 
        If a codesystem contains example, fragment, or complete content, it must have at

        <human value="If a codesystem contains example, fragment, or complete content, it must have at
         least one concept"/> 
        <expression value="content in ( 'example' | 'fragment' | 'complete' ) implies concept.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="conformance.behavior,conformance.terminology"/> 
      </mapping> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.id">
      <path value="CodeSystem.id"/> 
      <short value="Logical id of this artifact"/> 
      The logical id of the resource, as used in the URL for the resource. Once assigned,

      <definition value="The logical id of the resource, as used in the URL for the resource. Once assigned,
       this value never changes."/> 
      Within the context of the FHIR RESTful interactions, the resource has an id except
       for cases like the create and conditional update. Otherwise, the use of the resouce

      <comment value="Within the context of the FHIR RESTful interactions, the resource has an id except
       for cases like the create and conditional update. Otherwise, the use of the resouce

       id depends on the given use case."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.meta">
      <path value="CodeSystem.meta"/> 
      <short value="Metadata about the resource"/> 
      The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content might not always be associated with version changes to the

      <definition value="The metadata about the resource. This is content that is maintained by the infrastructure.
       Changes to the content might not always be associated with version changes to the

       resource."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.meta"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Meta"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.implicitRules">
      <path value="CodeSystem.implicitRules"/> 
      <short value="A set of rules under which this content was created"/> 
      A reference to a set of rules that were followed when the resource was constructed,
       and which must be understood when processing the content. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles

      <definition value="A reference to a set of rules that were followed when the resource was constructed,
       and which must be understood when processing the content. Often, this is a reference
       to an implementation guide that defines the special rules along with other profiles

       etc."/> 
      Asserting this rule set restricts the content to be only understood by a limited
       set of trading partners. This inherently limits the usefulness of the data in the
       long term. However, the existing health eco-system is highly fractured, and not
       yet ready to define, collect, and exchange data in a generally computable sense.
       Wherever possible, implementers and/or specification writers should avoid using
       this element. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of its narrative along with other profiles,

      <comment value="Asserting this rule set restricts the content to be only understood by a limited
       set of trading partners. This inherently limits the usefulness of the data in the
       long term. However, the existing health eco-system is highly fractured, and not
       yet ready to define, collect, and exchange data in a generally computable sense.
       Wherever possible, implementers and/or specification writers should avoid using
       this element. Often, when used, the URL is a reference to an implementation guide
       that defines these special rules as part of its narrative along with other profiles,

       value sets, etc."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.implicitRules"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      This element is labeled as a modifier because the implicit rules may provide additional

      <isModifierReason value="This element is labeled as a modifier because the implicit rules may provide additional
       knowledge about the resource that modifies its meaning or interpretation"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.language">
      <path value="CodeSystem.language"/> 
      <short value="Language of the resource content"/> 
      <definition value="The base language in which the resource is written."/> 
      Language is provided to support indexing and accessibility (typically, services
       such as text to speech use the language tag). The html language tag in the narrative
       applies  to the narrative. The language tag on the resource may be used to specify
       the language of other presentations generated from the data in the resource. Not
       all the content has to be in the base language. The Resource.language should not
       be assumed to apply to the narrative automatically. If a language is specified,
       it should it also be specified on the div element in the html (see rules in HTML5

      <comment value="Language is provided to support indexing and accessibility (typically, services
       such as text to speech use the language tag). The html language tag in the narrative
       applies  to the narrative. The language tag on the resource may be used to specify
       the language of other presentations generated from the data in the resource. Not
       all the content has to be in the base language. The Resource.language should not
       be assumed to apply to the narrative automatically. If a language is specified,
       it should it also be specified on the div element in the html (see rules in HTML5

       for information about the relationship between xml:lang and the html lang attribute)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Resource.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        
          
        

        <strength value="required"/> 
        <description value="IETF language tag for a human language"/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3"/> 
        <additional> 
          <purpose value="starter"/> 
          <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
        </additional> 
      </binding> 
    </element> 
    <element id="CodeSystem.text">
      <path value="CodeSystem.text"/> 
      <short value="Text summary of the resource, for human interpretation"/> 
      A human-readable narrative that contains a summary of the resource and can be used
       to represent the content of the resource to a human. The narrative need not encode
       all the structured data, but is required to contain sufficient detail to make it
       &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
       may define what content should be represented in the narrative to ensure clinical

      <definition value="A human-readable narrative that contains a summary of the resource and can be used
       to represent the content of the resource to a human. The narrative need not encode
       all the structured data, but is required to contain sufficient detail to make it
       &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions
       may define what content should be represented in the narrative to ensure clinical

       safety."/> 
      Contained resources do not have a narrative. Resources that are not contained SHOULD
       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated

      <comment value="Contained resources do not have a narrative. Resources that are not contained SHOULD
       have a narrative. In some cases, a resource may only have text with little or no
       additional discrete data (as long as all minOccurs=1 elements are satisfied). 
       This may be necessary for data from legacy systems where information is captured
       as a &quot;text blob&quot; or where text is additionally entered raw or narrated

       and encoded information is added later."/> 
      <alias value="narrative"/> 
      <alias value="html"/> 
      <alias value="xhtml"/> 
      <alias value="display"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.text"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Narrative"/> 
      </type> 
      <condition value="dom-6"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="Act.text?"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.contained">
      <path value="CodeSystem.contained"/> 
      <short value="Contained, inline Resources"/> 
      These resources do not have an independent existence apart from the resource that
       contains them - they cannot be identified independently, nor can they have their
       own independent transaction scope. This is allowed to be a Parameters resource

      <definition value="These resources do not have an independent existence apart from the resource that
       contains them - they cannot be identified independently, nor can they have their
       own independent transaction scope. This is allowed to be a Parameters resource

       if and only if it is referenced by a resource that provides context/meaning."/> 
      This should never be done when the content can be identified properly, as once
       identification is lost, it is extremely difficult (and context dependent) to restore
       it again. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels.

      <comment value="This should never be done when the content can be identified properly, as once
       identification is lost, it is extremely difficult (and context dependent) to restore
       it again. Contained resources may have profiles and tags in their meta elements,
       but SHALL NOT have security labels. Contained resources may be a resource type
       defined in the FHIR specification, or an [additional resource](resource.html#additional)."/> 

      <alias value="inline resources"/> 
      <alias value="anonymous resources"/> 
      <alias value="contained resources"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.contained"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Resource"/> 
      </type> 
      <condition value="dom-2"/> 
      <condition value="dom-4"/> 
      <condition value="dom-3"/> 
      <condition value="dom-5"/> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.extension">
      <path value="CodeSystem.extension"/> 
      <slicing> 
        <discriminator> 
          <type value="value"/> 
          <path value="url"/> 
        </discriminator> 
        <ordered value="false"/> 
        <rules value="open"/> 
      </slicing> 
      <short value="Extension"/> 
      <definition value="An Extension"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.extension:knowledgeRepresentationLevel">
      <path value="CodeSystem.extension"/> 
      <sliceName value="knowledgeRepresentationLevel"/> 
      <short value="narrative | semi-structured | structured | executable"/> 
      <definition value="Defines a knowledge representation level provided by this knowledge artifact."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeRepresentationLevel"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <constraint> 
        <key value="ext-1"/> 
        <severity value="error"/> 
        <human value="Must have either extensions or value[x], not both"/> 
        <expression value="extension.exists() != value.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
    </element> 
    <element id="CodeSystem.extension:sourceReference">
      <path value="CodeSystem.extension"/> 
      <sliceName value="sourceReference"/> 
      <short value="Where did this content come from"/> 
      This text is intended to act as a citation to work done elsewhere that is not part
       of the current stewarding process where the referenced source is in some way a

      <definition value="This text is intended to act as a citation to work done elsewhere that is not part
       of the current stewarding process where the referenced source is in some way a

       basis of the current value set definition."/> 
      This is not intended to be a direct link to another value set. It is only intended
       to support a link or textual description that indicates related material for the

      <comment value="This is not intended to be a direct link to another value set. It is only intended
       to support a link or textual description that indicates related material for the

       value set."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/codesystem-sourceReference"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.extension:otherName">
      <path value="CodeSystem.extension"/> 
      <sliceName value="otherName"/> 
      <short value="Alternative names"/> 
      <definition value="Human readable names for the codesystem."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/codesystem-otherName"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.modifierExtension">
      <path value="CodeSystem.modifierExtension"/> 
      <short value="Extensions that cannot be ignored"/> 
      May be used to represent additional information that is not part of the basic definition
       of the resource and that modifies the understanding of the element that contains
       it and/or the understanding of the containing element's descendants. Usually modifier
       elements provide negation or qualification. To make the use of extensions safe
       and managable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there
       is a set of requirements that SHALL be met as part of the definition of the extension.

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the resource and that modifies the understanding of the element that contains
       it and/or the understanding of the containing element's descendants. Usually modifier
       elements provide negation or qualification. To make the use of extensions safe
       and managable, there is a strict set of governance applied to the definition and
       use of extensions. Though any implementer is allowed to define an extension, there
       is a set of requirements that SHALL be met as part of the definition of the extension.

       Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or

Modifier extensions SHALL NOT change the meaning of any elements on Resource or

       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="DomainResource.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <mustSupport value="false"/> 
      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       resource that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.url">
      <path value="CodeSystem.url"/> 
      Canonical identifier for this code system, represented as a URI (globally unique)

      <short value="Canonical identifier for this code system, represented as a URI (globally unique)
       (Coding.system)"/> 
      An absolute URI that is used to identify this code system when it is referenced
       in a specification, model, design or an instance; also called its canonical identifier.
       This SHOULD be globally unique and SHOULD be a literal address at which an authoritative
       instance of this code system is (or will be) published. This URL can be the target
       of a canonical reference. It SHALL remain the same when the code system is stored

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

       on different servers. This is used in [Coding](datatypes.html#Coding).system."/> 
      Can be a urn:uuid: or a urn:oid: but real http: addresses are preferred.  Multiple

      <comment value="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](resource.html#versions).

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](resource.html#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](resource.html#meta)

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](resource.html#meta)

       element to indicate where the current master source of the resource can be found."/> 
      <requirements value="Allows the code system to be referenced by a single globally unique identifier."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.url"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="cnl-1"/> 
        <severity value="warning"/> 
        URL should not contain | or # - these characters make processing canonical references

        <human value="URL should not contain | or # - these characters make processing canonical references
         problematic"/> 
        <expression value="exists() implies matches('^[^|# ]+$')"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/> 
      </constraint> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.identifier">
      <path value="CodeSystem.identifier"/> 
      <short value="Additional identifier for the code system (business identifier)"/> 
      A formal identifier that is used to identify this code system when it is represented

      <definition value="A formal identifier that is used to identify this code system when it is represented
       in other formats, or referenced in a specification, model, design or an instance."/> 
      Typically, this is used for identifiers that can go in an HL7 V3 II (instance identifier)
       data type, and can then identify this code system outside of FHIR, where it is
       not possible to use the logical URI.  Note that HL7 defines at least three identifiers
       for many of its code systems - the FHIR canonical URL, the OID and the V2 Table
       0396 mnemonic code.
      Allows externally provided and/or usable business identifiers to be easily associated

      <requirements value="Allows externally provided and/or usable business identifiers to be easily associated
       with the module."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.identifier"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Identifier"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.identifier"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.version">
      <path value="CodeSystem.version"/> 
      <short value="Business version of the code system (Coding.version)"/> 
      The identifier that is used to identify this version of the code system when it
       is referenced in a specification, model, design or instance. This is an arbitrary
       value managed by the code system author and is not expected to be globally unique.
       For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not
       available. There is also no expectation that versions can be placed in a lexicographical

      <definition value="The identifier that is used to identify this version of the code system when it
       is referenced in a specification, model, design or instance. This is an arbitrary
       value managed by the code system author and is not expected to be globally unique.
       For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not
       available. There is also no expectation that versions can be placed in a lexicographical

       sequence. This is used in [Coding](datatypes.html#Coding).version."/> 
      There may be different code system instances that have the same identifier but
       different versions.  The version can be appended to the url in a reference to allow
       a reference to a particular business version of the code system with the format
       [url]|[version]. The version SHOULD NOT contain a '#' - see [Business Version](resource.html#

      <comment value="There may be different code system instances that have the same identifier but
       different versions.  The version can be appended to the url in a reference to allow
       a reference to a particular business version of the code system with the format
       [url]|[version]. The version SHOULD NOT contain a '#' - see [Business Version](resource.html#

      bv-format)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.version"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.version"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.versionAlgorithm[x]">
      <path value="CodeSystem.versionAlgorithm[x]"/> 
      <short value="How to compare versions"/> 
      Indicates the mechanism used to compare versions to determine which CodeSystem

      <definition value="Indicates the mechanism used to compare versions to determine which CodeSystem
       is more current."/> 
      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

      <comment value="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."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.versionAlgorithm[x]"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <strength value="extensible"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/version-algorithm"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.name">
      <path value="CodeSystem.name"/> 
      <short value="Name for this code system (computer friendly)"/> 
      A natural language name identifying the code system. This name should be usable
       as an identifier for the module by machine processing applications such as code

      <definition value="A natural language name identifying the code system. This name should be usable
       as an identifier for the module by machine processing applications such as code

       generation."/> 
      The name is not expected to be globally unique. The name should be a simple alphanumeric

      <comment value="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."/> 
      <requirements value="Support human navigation and code generation."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.name"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <condition value="cnl-0"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.title">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      
        
      

      <path value="CodeSystem.title"/> 
      <short value="Name for this code system (human friendly)"/> 
      <definition value="A short, descriptive, user-friendly title for the code system."/> 
      This name does not need to be machine-processing friendly and may contain punctuation,

      <comment value="This name does not need to be machine-processing friendly and may contain punctuation,
       white-space, etc."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.title"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.status">
      <path value="CodeSystem.status"/> 
      <short value="draft | active | retired | unknown"/> 
      <definition value="The status of this code system. Enables tracking the life-cycle of the content."/> 
      <comment value="Allows filtering of code systems that are appropriate for use versus not.
See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

      lization)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.status"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="true"/> 
      This is labeled as &quot;Is Modifier&quot; because applications should not use

      <isModifierReason value="This is labeled as &quot;Is Modifier&quot; because applications should not use
       a retired CodeSystem without due consideration"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PublicationStatus"/> 
        </extension> 
        
          
        

        <strength value="required"/> 
        <description value="The lifecycle status of an artifact."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/publication-status|6.0.0-ballot3"/> 
      </binding> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.status"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.experimental">
      <path value="CodeSystem.experimental"/> 
      
      A Boolean value to indicate that this code system is authored for testing purposes
       (or education/evaluation/marketing) and is not intended to be used for genuine
       usage.
      
      Enables experimental content to be developed following the same lifecycle that

      <short value="For testing only - never for real usage"/> 
      <definition value="A Boolean value to indicate that this code system is authored for testing purposes
       (or education/evaluation/marketing) and no version of this resource will ever be
       intended for genuine usage."/> 
      <comment value="Allows filtering of code systems that are appropriate for use versus not.. Experimental

       resources might include example instances in implementation guides, instances created
       solely for testing purposes, etc. If experimental is 'true' for any version of
       a resource, it should be true for all versions of the resource.  (If experimental
       changes, then it is being misused or a resource that was never intended for real-world
       use has unexpectedly changed its purpose.).
Experimental resources are not expected to be stable and may well have breaking
       changes without a corresponding change to the 'version' element."/> 
      <requirements value="Enables experimental content to be developed following the same lifecycle that
       would be used for a production-level code system."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.experimental"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <meaningWhenMissing value="If absent, this resource is treated as though it is not experimental."/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.class"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.date">
      <path value="CodeSystem.date"/> 
      <short value="Date last changed"/> 
      The date  (and optionally time) when the code system was last significantly changed.
       The date must change when the business version changes and it must change if the
       status code changes. In addition, it should change when the substantive content

      <definition value="The date  (and optionally time) when the code system was last significantly changed.
       The date must change when the business version changes and it must change if the
       status code changes. In addition, it should change when the substantive content

       of the code system changes."/> 
      The date is often not tracked until the resource is published, but may be present
       on draft content. Note that this is not the same as the resource last-modified-date,
       since the resource may be a secondary representation of the code system. Additional
       specific dates may be added as extensions or be found by consulting Provenances

      <comment value="The date is often not tracked until the resource is published, but may be present
       on draft content. Note that this is not the same as the resource last-modified-date,
       since the resource may be a secondary representation of the code system. Additional
       specific dates may be added as extensions or be found by consulting Provenances

       associated with past versions of the resource.
See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

      lization)."/> 
      <alias value="Revision Date"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.date"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.recorded"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.publisher">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      
        
      

      <path value="CodeSystem.publisher"/> 
      <short value="Name of the publisher/steward (organization or individual)"/> 
      The name of the organization or individual responsible for the release and ongoing

      <definition value="The name of the organization or individual responsible for the release and ongoing
       maintenance of the code system."/> 
      Usually an organization but may be an individual. The publisher (or steward) of
       the code system is the organization or individual primarily responsible for the
       maintenance and upkeep of the code system. This is not necessarily the same individual
       or organization that developed and initially authored the content. The publisher
       is the primary point of contact for questions or issues with the code system. This

      <comment value="Usually an organization but may be an individual. The publisher (or steward) of
       the code system is the organization or individual primarily responsible for the
       maintenance and upkeep of the code system. This is not necessarily the same individual
       or organization that developed and initially authored the content. The publisher
       is the primary point of contact for questions or issues with the code system. This

       item SHOULD be populated unless the information is available from context."/> 
      Helps establish the &quot;authority/credibility&quot; of the code system.  May

      <requirements value="Helps establish the &quot;authority/credibility&quot; of the code system.  May
       also allow for contact."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.publisher"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.witness"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.contact">
      <path value="CodeSystem.contact"/> 
      <short value="Contact details for the publisher"/> 
      <definition value="Contact details to assist a user in finding and communicating with the publisher."/> 
      <comment value="May be a web site, an email address, a telephone number, etc.
See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

      lization)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.contact"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.description">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      
        
      

      <path value="CodeSystem.description"/> 
      <short value="Natural language description of the code system"/> 
      <definition value="A free text natural language description of the code system from a consumer's perspective."/> 
      This description can be used to capture details such as comments about misuse,
       instructions for clinical use and interpretation, literature references, examples
       from the paper world, etc. It is not a rendering of the code system as conveyed
       in the 'text' field of the resource itself. This item SHOULD be populated unless
       the information is available from context (e.g. the language of the code system

      <comment value="This description can be used to capture details such as comments about misuse,
       instructions for clinical use and interpretation, literature references, examples
       from the paper world, etc. It is not a rendering of the code system as conveyed
       in the 'text' field of the resource itself. This item SHOULD be populated unless
       the information is available from context (e.g. the language of the code system

       is presumed to be the predominant language in the place the code system was created)."/> 
      <alias value="Scope"/> 
      <alias value="Purpose"/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.useContext">
      <path value="CodeSystem.useContext"/> 
      <short value="The context that the content is intended to support"/> 
      The content was developed with a focus and intent of supporting the contexts that
       are listed. These contexts may be general categories (gender, age, ...) or may
       be references to specific programs (insurance plans, studies, ...) and may be used

      <definition value="The content was developed with a focus and intent of supporting the contexts that
       are listed. These contexts may be general categories (gender, age, ...) or may
       be references to specific programs (insurance plans, studies, ...) and may be used

       to assist with indexing and searching for appropriate code system instances."/> 
      When multiple useContexts are specified, there is no expectation that all or any

      <comment value="When multiple useContexts are specified, there is no expectation that all or any
       of the contexts apply."/> 
      <requirements value="Assist in searching for appropriate content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.useContext"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="UsageContext"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.jurisdiction">
      <path value="CodeSystem.jurisdiction"/> 
      <short value="Intended jurisdiction for code system (if applicable)"/> 
      <definition value="A legal or geographic region in which the code system is intended to be used."/> 
      It may be possible for the code system to be used in jurisdictions other than those

      <comment value="It may be possible for the code system to be used in jurisdictions other than those
       for which it was originally designed or intended.
DEPRECATION NOTE: For consistency, implementations are encouraged to migrate to
       using the new 'jurisdiction' code in the useContext element.  (I.e. useContext.code
       indicating http://terminology.hl7.org/CodeSystem/usage-context-type#jurisdiction

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.)"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.jurisdiction"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Jurisdiction"/> 
        </extension> 
        
          
        

        <strength value="extensible"/> 
        <description value="Countries and regions within which this artifact is targeted for use."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/jurisdiction"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.purpose">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      
        
      

      <path value="CodeSystem.purpose"/> 
      <short value="Why this code system is defined"/> 
      Explanation of why this code system is needed and why it has been designed as it

      <definition value="Explanation of why this code system is needed and why it has been designed as it
       has."/> 
      This element does not describe the usage of the code system. Instead, it provides
       traceability of ''why'' the resource is either needed or ''why'' it is defined
       as it is.  This may be used to point to source materials or specifications that

      <comment value="This element does not describe the usage of the code system. Instead, it provides
       traceability of ''why'' the resource is either needed or ''why'' it is defined
       as it is.  This may be used to point to source materials or specifications that

       drove the structure of this code system."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.purpose"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="w5"/> 
        <map value="FiveWs.why[x]"/> 
      </mapping> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.copyright">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      
        
      

      <path value="CodeSystem.copyright"/> 
      <short value="Use and/or publishing restrictions"/> 
      A copyright statement relating to the code system and/or its contents. Copyright
       statements are generally legal restrictions on the use and publishing of the code

      <definition value="A copyright statement relating to the code system and/or its contents. Copyright
       statements are generally legal restrictions on the use and publishing of the code

       system."/> 
      ... Sometimes, the copyright differs between the code system and the codes that
       are included. The copyright statement should clearly differentiate between these

      <comment value="... Sometimes, the copyright differs between the code system and the codes that
       are included. The copyright statement should clearly differentiate between these

       when required."/> 
      Consumers must be able to determine any legal restrictions on the use of the code

      <requirements value="Consumers must be able to determine any legal restrictions on the use of the code
       system and/or its content."/> 
      <alias value="License"/> 
      <alias value="Restrictions"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.copyright"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="markdown"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.copyrightLabel">
      <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/> 
      </extension> 
      
        
      

      <path value="CodeSystem.copyrightLabel"/> 
      <short value="Copyright holder and year(s)"/> 
      A short string (&lt;50 characters), suitable for inclusion in a page footer that
       identifies the copyright holder, effective period, and optionally whether rights

      <definition value="A short string (&lt;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')."/> 
      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,

      <comment value="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."/> 
      <requirements value="Defines the content expected to be rendered in all representations of the artifact."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.copyrightLabel"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.approvalDate">
      <path value="CodeSystem.approvalDate"/> 
      <short value="When the CodeSystem was approved by publisher"/> 
      The date on which the resource content was approved by the publisher. Approval

      <definition value="The date on which the resource content was approved by the publisher. Approval
       happens once when the content is officially approved for usage."/> 
      The 'date' element may be more recent than the approval date because of minor changes

      <comment value="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](canonicalresource.html#loca

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

      lization)."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.approvalDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.lastReviewDate">
      <path value="CodeSystem.lastReviewDate"/> 
      <short value="When the CodeSystem was last reviewed by the publisher"/> 
      The date on which the resource content was last reviewed. Review happens periodically

      <definition value="The date on which the resource content was last reviewed. Review happens periodically
       after approval but does not change the original approval date."/> 
      <comment value="If specified, this date follows the original approval date.
See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

      lization)."/> 
      Gives a sense of how &quot;current&quot; the content is.  Resources that have not

      <requirements value="Gives a sense of how &quot;current&quot; the content is.  Resources that have not
       been reviewed in a long time may have a risk of being less appropriate/relevant."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.lastReviewDate"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="date"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.effectivePeriod">
      <path value="CodeSystem.effectivePeriod"/> 
      <short value="When the CodeSystem is expected to be used"/> 
      The period during which the CodeSystem content was or is planned to be in active

      <definition value="The period during which the CodeSystem content was or is planned to be in active
       use."/> 
      The effective period for a CodeSystem  determines when the content is applicable
       for usage and is independent of publication and review dates. For example, a system

      <comment value="The effective period for a CodeSystem  determines when the content is applicable
       for usage and is independent of publication and review dates. For example, a system

       intended to be used for the year 2016 might be published in 2015.
See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

      lization)."/> 
      Allows establishing a transition before a resource comes into effect and also allows
       for a sunsetting  process when new versions of the CodeSystem are or are expected

      <requirements value="Allows establishing a transition before a resource comes into effect and also allows
       for a sunsetting  process when new versions of the CodeSystem are or are expected

       to be used instead."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.effectivePeriod"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Period"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="objimpl"/> 
        <map value="no-gen-base"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.topic">
      <path value="CodeSystem.topic"/> 
      <short value="E.g. Education, Treatment, Assessment, etc"/> 
      Descriptions related to the content of the CodeSystem. Topics provide a high-level
       categorization as well as keywords for the CodeSystem that can be useful for filtering

      <definition value="Descriptions related to the content of the CodeSystem. Topics provide a high-level
       categorization as well as keywords for the CodeSystem that can be useful for filtering

       and searching."/> 
      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.valueCodeableCo

      <comment value="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.valueCodeableCo

      ncept indicating the topic)"/> 
      Repositories must be able to determine how to categorize the CodeSystem so that

      <requirements value="Repositories must be able to determine how to categorize the CodeSystem so that
       it can be found by topical and keyword searches."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.topic"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="CodeableConcept"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DefinitionTopic"/> 
        </extension> 
        <strength value="example"/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/definition-topic"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.author">
      <path value="CodeSystem.author"/> 
      <short value="Who authored the CodeSystem"/> 
      An individiual or organization primarily involved in the creation and maintenance

      <definition value="An individiual or organization primarily involved in the creation and maintenance
       of the CodeSystem."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.author"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.editor">
      <path value="CodeSystem.editor"/> 
      <short value="Who edited the CodeSystem"/> 
      An individual or organization primarily responsible for internal coherence of the

      <definition value="An individual or organization primarily responsible for internal coherence of the
       CodeSystem."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.editor"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.reviewer">
      <path value="CodeSystem.reviewer"/> 
      <short value="Who reviewed the CodeSystem"/> 
      An individual or organization asserted by the publisher to be primarily responsible

      <definition value="An individual or organization asserted by the publisher to be primarily responsible
       for review of some aspect of the CodeSystem."/> 
      See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

      <comment value="See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.reviewer"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.endorser">
      <path value="CodeSystem.endorser"/> 
      <short value="Who endorsed the CodeSystem"/> 
      An individual or organization asserted by the publisher to be responsible for officially

      <definition value="An individual or organization asserted by the publisher to be responsible for officially
       endorsing the CodeSystem for use in some setting."/> 
      See guidance around (not) making local changes to elements [here](canonicalresource.html#loca

      <comment value="See guidance around (not) making local changes to elements [here](canonicalresource.html#loca
      lization)."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.endorser"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="ContactDetail"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.relatedArtifact">
      <path value="CodeSystem.relatedArtifact"/> 
      <short value="Additional documentation, citations, etc"/> 
      Related artifacts such as additional documentation, justification, dependencies,

      <definition value="Related artifacts such as additional documentation, justification, dependencies,
       bibliographic references, and predecessor and successor artifacts."/> 
      Each related artifact is either an attachment, or a reference to another resource,

      <comment value="Each related artifact is either an attachment, or a reference to another resource,
       but not both."/> 
      A CodeSystem must be able to provide enough information for consumers of the content
       (and/or interventions or results produced by the content) to be able to determine

      <requirements value="A CodeSystem must be able to provide enough information for consumers of the content
       (and/or interventions or results produced by the content) to be able to determine

       and understand the justification for and evidence in support of the content."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.relatedArtifact"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="RelatedArtifact"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.caseSensitive">
      <path value="CodeSystem.caseSensitive"/> 
      <short value="If code comparison is case sensitive"/> 
      If code comparison is case sensitive when codes within this system are compared

      <definition value="If code comparison is case sensitive when codes within this system are compared
       to each other."/> 
      If this value is missing, then it is not specified whether a code system is case
       sensitive or not. When the rule is not known, Postel's law should be followed:
       produce codes with the correct case, and accept codes in any case. This element
       is primarily provided to support validation software.

      <comment value="If this value is missing, then it is not specified whether a code system is case
       sensitive or not. When case sensitivity is not known, systems SHOULD produce codes
       with the correct case, and treat codes as case-sensitive, since this will mean
       any incorrect interpretation of codes is not a silent failure. This element is
       primarily provided to support validation software.  Case-insensitive comparisons
       do not take locale into account, and will result in unsatisfactory results for
       certain locales. Character case definitions and conversions are out of scope for
       the FHIR standard, and the results of such operations are implementation dependent."/> 

      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.caseSensitive"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.valueSet">
      <path value="CodeSystem.valueSet"/> 
      <short value="Canonical reference to the value set with entire code system"/> 
      Canonical reference to the value set that contains all codes in the code system

      <definition value="Canonical reference to the value set that contains all codes in the code system
       independent of code status."/> 
      The definition of the value set SHALL include all codes from this code system,
       independent of concept status, and only codes from this code system. It SHALL be

      <comment value="The definition of the value set SHALL include all codes from this code system,
       independent of concept status, and only codes from this code system. It SHALL be

       immutable, and operations SHOULD support validation of any allowed code compositions."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.valueSet"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/ValueSet"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.hierarchyMeaning">
      <path value="CodeSystem.hierarchyMeaning"/> 
      <short value="grouped-by | is-a | part-of | classified-with"/> 
      <definition value="The meaning of the hierarchy of concepts as represented in this resource."/> 
      Note that other representations might have a different hierarchy or none at all,

      <comment value="Note that other representations might have a different hierarchy or none at all,
       and represent the information using properties."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.hierarchyMeaning"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <condition value="csd-2"/> 
      <condition value="csd-3"/> 
      <condition value="scs-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CodeSystemHierarchyMeaning"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The meaning of the hierarchy of concepts in a code system."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/codesystem-hierarchy-meaning|6.0.0-ballot3"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.compositional">
      <path value="CodeSystem.compositional"/> 
      <short value="If code system defines a compositional grammar"/> 
      <definition value="The code system defines a compositional (post-coordination) grammar."/> 
      Note that the code system resource does not define what the compositional grammar
       is, only whether or not there is one.

      <comment value="Note that the code system resource does not define what the compositional grammar
       is, only whether or not there is one. Note that the code system resource does not
       define what the compositional grammar is, only whether or not there is one. Review
       the Using Code System X with HL7 Standards (where Code System X is a specific code
       system) pages at [terminology.hl7.org](https://terminology.hl7.org/external_terminologies.htm
      l) to learn about a code system's post coordination support. [Coding.code](datatypes-definitio
      ns.html#Coding.code) has some more information about how a post coordinated expression
       may be exchanged in a code element."/> 

      <alias value="grammar"/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.compositional"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.versionNeeded">
      <path value="CodeSystem.versionNeeded"/> 
      <short value="If definitions are not stable"/> 
      This flag is used to signify that the code system does not commit to concept permanence
       across versions. If true, a version must be specified when referencing this code

      <definition value="This flag is used to signify that the code system does not commit to concept permanence
       across versions. If true, a version must be specified when referencing this code

       system."/> 
      Best practice is that code systems do not redefine concepts, or that if concepts
       are redefined, a new code system definition is created. But this is not always

      <comment value="Best practice is that code systems do not redefine concepts, or that if concepts
       are redefined, a new code system definition is created. But this is not always

       possible, so some code systems may be defined as 'versionNeeded'.
Most code systems occasionally refine the displays defined for concepts between
       versions. Contexts in which the concept display values are validated may require
       that the version be specified for some code systems irrespective of the value of

Most code systems occasionally refine the displays defined for concepts between
       versions. Contexts in which the concept display values are validated may require
       that the version be specified for some code systems irrespective of the value of

       this property."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.versionNeeded"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.content">
      <path value="CodeSystem.content"/> 
      <short value="not-present | example | fragment | complete | supplement"/> 
      The extent of the content of the code system (the concepts and codes it defines)

      <definition value="The extent of the content of the code system (the concepts and codes it defines)
       are represented in this resource instance."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.content"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <condition value="csd-4"/> 
      <condition value="scs-2"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="CodeSystemContentMode"/> 
        </extension> 
        <strength value="required"/> 
        The extent of the content of the code system (the concepts and codes it defines)

        <description value="The extent of the content of the code system (the concepts and codes it defines)
         are represented in a code system resource."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/codesystem-content-mode|6.0.0-ballot3"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.supplements">
      
        
      

      <path value="CodeSystem.supplements"/> 
      <short value="Canonical URL of Code System this adds designations and properties to"/> 
      The canonical URL of the code system that this code system supplement is adding

      <definition value="The canonical URL of the code system that this code system supplement is adding
       designations and properties to."/> 
      <comment value="The most common use of a code system supplement is to add additional language support."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.supplements"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="canonical"/> 
        <targetProfile value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/> 
      </type> 
      <condition value="csd-4"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.count">
      <path value="CodeSystem.count"/> 
      <short value="Total concepts in the code system"/> 
      The total number of concepts defined by the code system. Where the code system

      <definition value="The total number of concepts defined by the code system. Where the code system
       has a compositional grammar, the basis of this count is defined by the system steward."/> 
      The count of concepts defined in this resource cannot be more than this value but

      <comment value="The count of concepts defined in this resource cannot be more than this value but
       may be less for several reasons - see the content element."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.count"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="unsignedInt"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.filter">
      <path value="CodeSystem.filter"/> 
      <short value="Filter that can be used in a value set"/> 
      A filter that can be used in a value set compose statement when selecting concepts

      <definition value="A filter that can be used in a value set compose statement when selecting concepts
       using a filter."/> 
      Note that filters defined in code systems usually require custom code on the part
       of any terminology engine that will make them available for use in value set filters.

      <comment value="Note that filters defined in code systems usually require custom code on the part
       of any terminology engine that will make them available for use in value set filters.

       For this reason, they are generally only seen in high value published terminologies."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.filter"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        

        <human value="All FHIR elements must have a @value or children or both"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.filter.id">
      <path value="CodeSystem.filter.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may

      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.filter.extension">
      <path value="CodeSystem.filter.extension"/> 
      <short value="Additional content defined by implementations"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

       of the definition of the extension."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.filter.modifierExtension">
      <path value="CodeSystem.filter.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

       Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or

Modifier extensions SHALL NOT change the meaning of any elements on Resource or

       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.filter.code">
      
        
      

      <path value="CodeSystem.filter.code"/> 
      <short value="Code that identifies the filter"/> 
      The code that identifies this filter when it is used as a filter in [ValueSet](valueset.html#

      <definition value="The code that identifies this filter when it is used as a filter in [ValueSet](valueset.html#
      ).compose.include.filter."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.filter.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.filter.description">
      <path value="CodeSystem.filter.description"/> 
      <short value="How or why the filter is used"/> 
      <definition value="A description of how or why the filter is used."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.filter.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.filter.operator">
      <path value="CodeSystem.filter.operator"/> 
      = | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | child-of

      <short value="= | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | child-of
       | descendent-leaf | exists"/> 
      <definition value="A list of operators that can be used with the filter."/> 
      <min value="1"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.filter.operator"/> 
        <min value="1"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FilterOperator"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The kind of operation to perform as a part of a property based filter."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/filter-operator|6.0.0-ballot3"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.filter.value">
      <path value="CodeSystem.filter.value"/> 
      <short value="What to use for the value"/> 
      <definition value="A description of what the value for the filter should be."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.filter.value"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.property">
      
        
      

      <path value="CodeSystem.property"/> 
      <short value="Additional information supplied about each concept"/> 
      A property defines an additional slot through which additional information can

      <definition value="A property defines an additional slot through which additional information can
       be provided about a concept."/> 
      Multiple occurrences of CodeSystem.concept.property may occur for a CodeSystem.property
       where     CodeSystem.concept.property.code is the same and CodeSystem.concept.property.value

      <comment value="Multiple occurrences of CodeSystem.concept.property may occur for a CodeSystem.property
       where     CodeSystem.concept.property.code is the same and CodeSystem.concept.property.value

       differs. For example: multiple designations for a single concept."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.property"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        

        <human value="All FHIR elements must have a @value or children or both"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.property.id">
      <path value="CodeSystem.property.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may

      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.property.extension">
      <path value="CodeSystem.property.extension"/> 
      <short value="Additional content defined by implementations"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

       of the definition of the extension."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.property.modifierExtension">
      <path value="CodeSystem.property.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

       Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or

Modifier extensions SHALL NOT change the meaning of any elements on Resource or

       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.property.code">
      
        
      

      <path value="CodeSystem.property.code"/> 
      <short value="Identifies the property on the concepts, and when referred to in operations"/> 
      A code that is used to identify the property. The code is used internally (in CodeSystem.conc

      <definition value="A code that is used to identify the property. The code is used internally (in CodeSystem.conc
      ept.property.code) and also externally, such as in property filters."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.property.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.property.uri">
      <path value="CodeSystem.property.uri"/> 
      <short value="Formal identifier for the property"/> 
      Reference to the formal meaning of the property. One possible source of meaning

      <definition value="Reference to the formal meaning of the property. One possible source of meaning
       is the [Concept Properties](codesystem-concept-properties.html) code system."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.property.uri"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="uri"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.property.description">
      <path value="CodeSystem.property.description"/> 
      <short value="Why the property is defined, and/or what it conveys"/> 
      <definition value="A description of the property- why it is defined, and how its value might be used."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.property.description"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
    </element> 
    <element id="CodeSystem.property.type">
      <path value="CodeSystem.property.type"/> 
      <short value="code | Coding | string | integer | boolean | dateTime | decimal"/> 
      The type of the property value. Properties of type &quot;code&quot; contain a code

      <definition value="The type of the property value. Properties of type &quot;code&quot; contain a code
       defined by the code system (e.g. a reference to another defined concept)."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.property.type"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="true"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="PropertyType"/> 
        </extension> 
        <strength value="required"/> 
        <description value="The type of a property value."/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/concept-property-type|6.0.0-ballot3"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.concept">
      
        
      

      <path value="CodeSystem.concept"/> 
      <short value="Concepts in the code system"/> 
      Concepts that are in the code system. The concept definitions are inherently hierarchical,
       but the definitions must be consulted to determine what the meanings of the hierarchical

      <definition value="Concepts that are in the code system. The concept definitions are inherently hierarchical,
       but the definitions must be consulted to determine what the meanings of the hierarchical

       relationships are."/> 
      If this is empty, it means that the code system resource does not represent the

      <comment value="If this is empty, it means that the code system resource does not represent the
       content of the code system."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.concept"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      

      <condition value="scs-2"/> 
      <constraint> 
        <key value="csd-6"/> 
        <severity value="error"/> 
        <human value="If a concept identifies an alternate, there must be a reciprocal relationship"/> 
        <expression value="defineVariable('sc', code).property.all((code = 'alternateCode') implies defineVariable('ac',
         value).%resource.repeat(concept).where(code = %ac).exists(property.where(code =
         'alternateCode').value = %sc))"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/>       </constraint>       <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        

        <human value="All FHIR elements must have a @value or children or both"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.id">
      <path value="CodeSystem.concept.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may

      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.extension">
      <path value="CodeSystem.concept.extension"/> 
      <short value="Additional content defined by implementations"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

       of the definition of the extension."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.modifierExtension">
      <path value="CodeSystem.concept.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

       Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or

Modifier extensions SHALL NOT change the meaning of any elements on Resource or

       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.code">
      
        
      

      <path value="CodeSystem.concept.code"/> 
      <short value="Code that identifies concept"/> 
      <definition value="A code - a text symbol - that uniquely identifies the concept within the code system."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.concept.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <condition value="csd-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.display">
      <path value="CodeSystem.concept.display"/> 
      <short value="Text to display to the user"/> 
      A human readable string that is the recommended default way to present this concept

      <definition value="A human readable string that is the recommended default way to present this concept
       to a user."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.concept.display"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.definition">
      <path value="CodeSystem.concept.definition"/> 
      <short value="Formal definition"/> 
      The formal definition of the concept. The code system resource does not make formal
       definitions required, because of the prevalence of legacy systems. However, they
       are highly recommended, as without them there is no formal meaning associated with

      <definition value="The formal definition of the concept. The code system resource does not make formal
       definitions required, because of the prevalence of legacy systems. However, they
       are highly recommended, as without them there is no formal meaning associated with

       the concept."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.concept.definition"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.designation">
      <path value="CodeSystem.concept.designation"/> 
      <short value="Additional representations for the concept"/> 
      Additional representations for the concept - other languages, aliases, specialized

      <definition value="Additional representations for the concept - other languages, aliases, specialized
       purposes, used for particular purposes, etc."/> 
      Concepts have both a ```display``` and an array of ```designation```. The display
       is equivalent to a special designation with an implied ```designation.use``` of
       &quot;primary code&quot; and a language equal to the [Resource Language](resource.html#langua
      ge).
      Many concept definition systems support multiple representations, in multiple languages,

      <comment value="Concepts have both a ```display``` and an array of ```designation```. The display
       is equivalent to a special designation with an implied ```designation.use``` of
       &quot;primary designation&quot; and a language equal to the [Resource Language](resource.html
      #language)."/> 
      <requirements value="Many concept definition systems support multiple representations, in multiple languages,
       and for multiple purposes."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.concept.designation"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="csd-5"/> 
        <severity value="error"/> 
        Must have a value for concept.designation.use if concept.designation.additionalUse

        <human value="Must have a value for concept.designation.use if concept.designation.additionalUse
         is present"/> 
        <expression value="additionalUse.exists() implies use.exists()"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/CodeSystem"/> 
      </constraint> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        

        <human value="All FHIR elements must have a @value or children or both"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.designation.id">
      <path value="CodeSystem.concept.designation.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may

      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.designation.extension">
      <path value="CodeSystem.concept.designation.extension"/> 
      <short value="Additional content defined by implementations"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

       of the definition of the extension."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.designation.modifierExtension">
      <path value="CodeSystem.concept.designation.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

       Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or

Modifier extensions SHALL NOT change the meaning of any elements on Resource or

       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.designation.language">
      <path value="CodeSystem.concept.designation.language"/> 
      <short value="Human language of the designation"/> 
      <definition value="The language this designation is defined for."/> 
      <comment value="In the absence of a language, the resource language applies."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.concept.designation.language"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/> 
        </extension> 
        
          
        

        <strength value="required"/> 
        <description value="IETF language tag for a human language"/> 
        

        <valueSet value="http://hl7.org/fhir/ValueSet/all-languages|6.0.0-ballot3"/> 
        <additional> 
          <purpose value="starter"/> 
          <valueSet value="http://hl7.org/fhir/ValueSet/languages"/> 
        </additional> 
      </binding> 
    </element> 
    <element id="CodeSystem.concept.designation.use">
      <path value="CodeSystem.concept.designation.use"/> 
      <short value="Details how this designation would be used"/> 
      <definition value="A code that details how this designation would be used."/> 
      If no use is provided, the designation can be assumed to be suitable for general

      <comment value="If no use is provided, the designation can be assumed to be suitable for general
       display to a human user."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.concept.designation.use"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <condition value="csd-5"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConceptDesignationUse"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Details of how a designation would be used."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/designation-use"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.concept.designation.additionalUse">
      
        
      

      <path value="CodeSystem.concept.designation.additionalUse"/> 
      <short value="Additional ways how this designation would be used"/> 
      Additional codes that detail how this designation would be used, if there is more

      <definition value="Additional codes that detail how this designation would be used, if there is more
       than one use."/> 
      This was added rather than increasing the cardinality of .use to 0..* in order

      <comment value="This was added rather than increasing the cardinality of .use to 0..* in order
       to maintain backward compatibility."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.concept.designation.additionalUse"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <condition value="csd-5"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <binding> 
        <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="ConceptDesignationUse"/> 
        </extension> 
        <strength value="extensible"/> 
        <description value="Details of how a designation would be used."/> 
        <valueSet value="http://hl7.org/fhir/ValueSet/designation-use"/> 
      </binding> 
    </element> 
    <element id="CodeSystem.concept.designation.value">
      <path value="CodeSystem.concept.designation.value"/> 
      <short value="The text value for this designation"/> 
      <definition value="The text value for this designation."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.concept.designation.value"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="string"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.property">
      
        
      

      <path value="CodeSystem.concept.property"/> 
      <short value="Property value for the concept"/> 
      <definition value="A property value for this concept."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.concept.property"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="BackboneElement"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        

        <human value="All FHIR elements must have a @value or children or both"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.property.id">
      <path value="CodeSystem.concept.property.id"/> 
      <representation value="xmlAttr"/> 
      <short value="Unique id for inter-element referencing"/> 
      Unique id for the element within a resource (for internal references). This may

      <definition value="Unique id for the element within a resource (for internal references). This may
       be any string value that does not contain spaces."/> 
      <min value="0"/> 
      <max value="1"/> 
      <base> 
        <path value="Element.id"/> 
        <min value="0"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/> 
        </extension> 
        <code value="http://hl7.org/fhirpath/System.String"/> 
      </type> 
      <condition value="ele-1"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.property.extension">
      <path value="CodeSystem.concept.property.extension"/> 
      <short value="Additional content defined by implementations"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element. To make the use of extensions safe and managable, there is a strict
       set of governance applied to the definition and use of extensions. Though any implementer
       can define an extension, there is a set of requirements that SHALL be met as part

       of the definition of the extension."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="Element.extension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="false"/> 
      <isSummary value="false"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="n/a"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.property.modifierExtension">
      <path value="CodeSystem.concept.property.modifierExtension"/> 
      <short value="Extensions that cannot be ignored even if unrecognized"/> 
      May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

      <definition value="May be used to represent additional information that is not part of the basic definition
       of the element and that modifies the understanding of the element in which it is
       contained and/or the understanding of the containing element's descendants. Usually
       modifier elements provide negation or qualification. To make the use of extensions
       safe and managable, there is a strict set of governance applied to the definition
       and use of extensions. Though any implementer can define an extension, there is
       a set of requirements that SHALL be met as part of the definition of the extension.

       Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or

Modifier extensions SHALL NOT change the meaning of any elements on Resource or

       DomainResource (including cannot change the meaning of modifierExtension itself)."/> 
      There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

      <comment value="There can be no stigma associated with the use of extensions by any application,
       project, or standard - regardless of the institution or jurisdiction that uses
       or defines the extensions.  The use of extensions is what allows the FHIR specification

       to retain a core level of simplicity for everyone."/> 
      Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

      <requirements value="Modifier extensions allow for extensions that *cannot* be safely ignored to be
       clearly distinguished from the vast majority of extensions which can be safely
       ignored.  This promotes interoperability by eliminating the need for implementers
       to prohibit the presence of extensions. For further information, see the [definition

       of modifier extensions](extensibility.html#modifierExtension)."/> 
      <alias value="extensions"/> 
      <alias value="user content"/> 
      <alias value="modifiers"/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="BackboneElement.modifierExtension"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <type> 
        <code value="Extension"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      
        
        
        
        
        
      

      <isModifier value="true"/> 
      Modifier extensions are expected to modify the meaning or interpretation of the

      <isModifierReason value="Modifier extensions are expected to modify the meaning or interpretation of the
       element that contains them"/> 
      <isSummary value="true"/> 
      <mapping> 
        <identity value="rim"/> 
        <map value="N/A"/> 
      </mapping> 
    </element> 
    <element id="CodeSystem.concept.property.code">
      
        
      

      <path value="CodeSystem.concept.property.code"/> 
      <short value="Reference to CodeSystem.property.code"/> 
      <definition value="A code that is a reference to CodeSystem.property.code."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.concept.property.code"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <condition value="csd-3"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.property.value[x]">
      <path value="CodeSystem.concept.property.value[x]"/> 
      <short value="Value of the property for this concept"/> 
      <definition value="The value of this property."/> 
      <min value="1"/> 
      <max value="1"/> 
      <base> 
        <path value="CodeSystem.concept.property.value[x]"/> 
        <min value="1"/> 
        <max value="1"/> 
      </base> 
      <type> 
        <code value="code"/> 
      </type> 
      <type> 
        <code value="Coding"/> 
      </type> 
      <type> 
        <code value="string"/> 
      </type> 
      <type> 
        <code value="integer"/> 
      </type> 
      <type> 
        <code value="boolean"/> 
      </type> 
      <type> 
        <code value="dateTime"/> 
      </type> 
      <type> 
        <code value="decimal"/> 
      </type> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="false"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
    <element id="CodeSystem.concept.concept">
      <path value="CodeSystem.concept.concept"/> 
      <short value="Child Concepts (is-a/contains/categorizes)"/> 
      Defines children of a concept to produce a hierarchy of concepts. The nature of

      <definition value="Defines children of a concept to produce a hierarchy of concepts. The nature of
       the relationships is variable (is-a/contains/categorizes) - see hierarchyMeaning."/> 
      <min value="0"/> 
      <max value="*"/> 
      <base> 
        <path value="CodeSystem.concept.concept"/> 
        <min value="0"/> 
        <max value="*"/> 
      </base> 
      <contentReference value="http://hl7.org/fhir/StructureDefinition/CodeSystem#CodeSystem.concept"/> 
      
      

      <condition value="scs-1"/> 
      <constraint> 
        <key value="ele-1"/> 
        <severity value="error"/> 
        <human value="All FHIR elements must have a @value or children"/> 
        <expression value="hasValue() or (children().count() &gt; id.count())"/> 
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/> 
      </constraint> 
      <mustSupport value="true"/> 
      <isModifier value="false"/> 
      <isSummary value="false"/> 
    </element> 
  </snapshot> 
  <differential> 
    <element id="CodeSystem">
      <path value="CodeSystem"/> 
      <min value="1"/> 
      <max value="1"/> 
    </element> 
    <element id="CodeSystem.extension:sourceReference">
      <path value="CodeSystem.extension"/> 
      <sliceName value="sourceReference"/> 
      <min value="0"/> 
      <max value="1"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/codesystem-sourceReference"/> 
      </type> 
    </element> 
    <element id="CodeSystem.extension:otherName">
      <path value="CodeSystem.extension"/> 
      <sliceName value="otherName"/> 
      <min value="0"/> 
      <max value="*"/> 
      <type> 
        <code value="Extension"/> 
        <profile value="http://hl7.org/fhir/StructureDefinition/codesystem-otherName"/> 
      </type> 
    </element> 
    <element id="CodeSystem.identifier">
      <path value="CodeSystem.identifier"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.date">
      <path value="CodeSystem.date"/> 
      <min value="1"/> 
      <max value="1"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.contact">
      <path value="CodeSystem.contact"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.useContext">
      <path value="CodeSystem.useContext"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.jurisdiction">
      <path value="CodeSystem.jurisdiction"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.purpose">
      <path value="CodeSystem.purpose"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.copyright">
      <path value="CodeSystem.copyright"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.copyrightLabel">
      <path value="CodeSystem.copyrightLabel"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.approvalDate">
      <path value="CodeSystem.approvalDate"/> 
    </element> 
    <element id="CodeSystem.lastReviewDate">
      <path value="CodeSystem.lastReviewDate"/> 
    </element> 
    <element id="CodeSystem.effectivePeriod">
      <path value="CodeSystem.effectivePeriod"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.topic">
      <path value="CodeSystem.topic"/> 
      <mustSupport value="true"/> 
    </element> 
    <element id="CodeSystem.author">
      <path value="CodeSystem.author"/> 
    </element> 
    <element id="CodeSystem.editor">
      <path value="CodeSystem.editor"/> 
    </element> 
    <element id="CodeSystem.reviewer">
      <path value="CodeSystem.reviewer"/> 
    </element> 
    <element id="CodeSystem.endorser">
      <path value="CodeSystem.endorser"/> 
    </element> 
    <element id="CodeSystem.relatedArtifact">
      <path value="CodeSystem.relatedArtifact"/> 
    </element> 
  </differential> 


</

StructureDefinition

>