{
  "description": null,
  "_filename": "StructureDefinition-icd-10-gm-diagnosesicherheit.json",
  "package_name": "rs/de.basisprofil.r4",
  "date": "2025-06-16",
  "derivation": "constraint",
  "publisher": "HL7 Deutschland e.V. (Technisches Komitee FHIR)",
  "fhirVersion": "4.0.1",
  "name": "ExtensionICD10GMDiagnosesicherheit",
  "abstract": false,
  "copyright": "HL7 Deutschland e.V.",
  "type": "Extension",
  "experimental": "false",
  "resourceType": "StructureDefinition",
  "title": "Extension zur Erfassung der Diagnosesicherheit gemäß KBV-Kodierrichtlinien",
  "package_version": "1.5.4",
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Extension",
      "min": 0,
      "definition": "Optional Extension Element - found in all resources.",
      "isModifier": false,
      "short": "Optional Extensions Element",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
        "valueCode": "normative"
      }, {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
        "valueCode": "4.0.0"
      } ],
      "max": "*",
      "id": "Extension",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Extension"
      }
    }, {
      "path": "Extension.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Extension.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Extension.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, 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.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Extension.extension",
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "isModifier": false,
      "short": "identifies the meaning of the extension",
      "fixedUri": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "uri"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Extension.url",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "icd-4",
        "human": "Wenn die Diagnosesicherheit \"A (Ausschluss)\" verwendet wird, dann muss clinicalStatus leer bleiben und verificationStaus auf \"refuted\" gesetzt werden.",
        "source": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
        "severity": "warning",
        "expression": "code!='A' or (%resource.verificationStatus.coding.where(code='refuted').exists() and %resource.clinicalStatus.empty())"
      }, {
        "key": "icd-5",
        "human": "Wenn die Diagnosesicherheit \"G (Gesichert)\" verwendet wird, dann muss clinicalStatus auf \"active\" und verificationStatus auf \"confirmed\" gesetzt werden.",
        "source": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
        "severity": "warning",
        "expression": "code!='G' or (%resource.clinicalStatus.coding.where(code='active').exists() and %resource.verificationStatus.coding.where(code='confirmed').exists())"
      }, {
        "key": "icd-6",
        "human": "Wenn die Diagnosesicherheit \"V (Verdacht auf)\" verwendet wird, dann muss clinicalStatus auf \"active\" und verificationStatus auf \"provisional\" oder \"differential\" gesetzt werden.",
        "source": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
        "severity": "warning",
        "expression": "code!='V' or (%resource.clinicalStatus.coding.where(code='active').exists() and (%resource.verificationStatus.coding.where(code='provisional').exists() or %resource.verificationStatus.coding.where(code='differential').exists()))"
      }, {
        "key": "icd-7",
        "human": "Wenn die Diagnosesicherheit \"Z (Zustand nach)\" verwendet wird, dann muss clinicalStatus auf \"resolved\" und verificationStatus auf \"confirmed\" gesetzt werden.",
        "source": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
        "severity": "warning",
        "expression": "code!='Z' or (%resource.clinicalStatus.coding.where(code='resolved').exists() and %resource.verificationStatus.coding.where(code='confirmed').exists())"
      } ],
      "path": "Extension.value[x]",
      "min": 1,
      "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
      "isModifier": false,
      "short": "Value of extension",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT"
      },
      "max": "1",
      "id": "Extension.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    } ]
  },
  "status": "active",
  "id": "1c89216c-237a-4430-9a38-41478639e24d",
  "kind": "complex-type",
  "url": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
  "context": [ {
    "type": "element",
    "expression": "Condition.code.coding"
  } ],
  "version": "1.5.4",
  "differential": {
    "element": [ {
      "id": "Extension.extension",
      "max": "0",
      "path": "Extension.extension"
    }, {
      "id": "Extension.url",
      "path": "Extension.url",
      "fixedUri": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit"
    }, {
      "id": "Extension.value[x]",
      "min": 1,
      "path": "Extension.value[x]",
      "type": [ {
        "code": "Coding"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "https://fhir.kbv.de/ValueSet/KBV_VS_SFHIR_ICD_DIAGNOSESICHERHEIT"
      },
      "constraint": [ {
        "key": "icd-4",
        "human": "Wenn die Diagnosesicherheit \"A (Ausschluss)\" verwendet wird, dann muss clinicalStatus leer bleiben und verificationStaus auf \"refuted\" gesetzt werden.",
        "source": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
        "severity": "warning",
        "expression": "code!='A' or (%resource.verificationStatus.coding.where(code='refuted').exists() and %resource.clinicalStatus.empty())"
      }, {
        "key": "icd-5",
        "human": "Wenn die Diagnosesicherheit \"G (Gesichert)\" verwendet wird, dann muss clinicalStatus auf \"active\" und verificationStatus auf \"confirmed\" gesetzt werden.",
        "source": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
        "severity": "warning",
        "expression": "code!='G' or (%resource.clinicalStatus.coding.where(code='active').exists() and %resource.verificationStatus.coding.where(code='confirmed').exists())"
      }, {
        "key": "icd-6",
        "human": "Wenn die Diagnosesicherheit \"V (Verdacht auf)\" verwendet wird, dann muss clinicalStatus auf \"active\" und verificationStatus auf \"provisional\" oder \"differential\" gesetzt werden.",
        "source": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
        "severity": "warning",
        "expression": "code!='V' or (%resource.clinicalStatus.coding.where(code='active').exists() and (%resource.verificationStatus.coding.where(code='provisional').exists() or %resource.verificationStatus.coding.where(code='differential').exists()))"
      }, {
        "key": "icd-7",
        "human": "Wenn die Diagnosesicherheit \"Z (Zustand nach)\" verwendet wird, dann muss clinicalStatus auf \"resolved\" und verificationStatus auf \"confirmed\" gesetzt werden.",
        "source": "http://fhir.de/StructureDefinition/icd-10-gm-diagnosesicherheit",
        "severity": "warning",
        "expression": "code!='Z' or (%resource.clinicalStatus.coding.where(code='resolved').exists() and %resource.verificationStatus.coding.where(code='confirmed').exists())"
      } ]
    } ]
  },
  "contact": [ {
    "telecom": [ {
      "value": "http://hl7.de/technische-komitees/fhir/",
      "system": "url"
    } ]
  } ],
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension"
}