PackagesCanonicalsLogsProblems
    Packages
    de.medizininformatikinitiative.kerndatensatz.onkologie@2025.0.3
    https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-operation
{
  "description": "Operation nach OPS inklusive Intention, Datum und Komplikationen:",
  "_filename": "StructureDefinition-mii-pr-onko-operation.json",
  "package_name": "de.medizininformatikinitiative.kerndatensatz.onkologie",
  "date": null,
  "derivation": "constraint",
  "publisher": "Medizininformatik Initiative",
  "fhirVersion": "4.0.1",
  "name": "MII_PR_Onko_Operation",
  "mapping": [ {
    "name": "Mapping FHIR zu oBDS",
    "identity": "oBDS"
  } ],
  "abstract": false,
  "type": "Procedure",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": "MII PR Onkologie Operation",
  "package_version": "2025.0.3",
  "extension": [ {
    "url": "https://www.medizininformatik-initiative.de/fhir/modul-meta/StructureDefinition/mii-ex-meta-license-codeable",
    "valueCodeableConcept": {
      "coding": [ {
        "code": "CC-BY-4.0",
        "system": "http://hl7.org/fhir/spdx-license",
        "display": "Creative Commons Attribution 4.0 International"
      } ]
    }
  } ],
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-3",
        "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
        "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"
      }, {
        "key": "dom-6",
        "human": "A resource should have narrative for robust management",
        "xpath": "exists(f:text/h:div)",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "warning",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
          "valueBoolean": true
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
          "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
        } ],
        "expression": "text.`div`.exists()"
      }, {
        "key": "dom-5",
        "human": "If a resource is contained in another resource, it SHALL NOT have a security label",
        "xpath": "not(exists(f:contained/*/f:meta/f:security))",
        "source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
        "severity": "error",
        "expression": "contained.meta.security.empty()"
      }, {
        "key": "proc-mii-1",
        "human": "Falls die Prozedur per OPS kodiert wird, MUSS eine SNOMED-CT kodierte Category abgebildet werden",
        "source": "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Procedure",
        "severity": "error",
        "expression": "code.coding.where(system = 'http://fhir.de/CodeSystem/bfarm/ops').exists() implies category.coding.where(system = 'http://snomed.info/sct').exists()"
      } ],
      "path": "Procedure",
      "min": 0,
      "definition": "An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long term services, counseling, or hypnotherapy.",
      "short": "An action that is being or was performed on a patient",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "Event",
        "identity": "workflow"
      }, {
        "map": "Procedure[moodCode=EVN]",
        "identity": "rim"
      }, {
        "map": "13",
        "comment": "Operation",
        "identity": "oBDS"
      } ],
      "max": "*",
      "id": "Procedure",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure"
      }
    }, {
      "path": "Procedure.id",
      "min": 0,
      "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "short": "Logical id of this artifact",
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.id",
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.meta",
      "min": 0,
      "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
      "short": "Metadata about the resource",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Meta"
      } ],
      "mustSupport": true,
      "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": "1",
      "id": "Procedure.meta",
      "condition": [ "ele-1" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "path": "Procedure.meta.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.",
      "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": "Procedure.meta.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.meta.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.meta.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.meta.versionId",
      "min": 0,
      "definition": "The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.",
      "short": "Version specific identifier",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "Procedure.meta.versionId",
      "condition": [ "ele-1" ],
      "comment": "The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.versionId"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.meta.lastUpdated",
      "min": 0,
      "definition": "When the resource last changed - e.g. when the version changed.",
      "short": "When the resource version last changed",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "instant"
      } ],
      "max": "1",
      "id": "Procedure.meta.lastUpdated",
      "condition": [ "ele-1" ],
      "comment": "This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a [read](http.html#read) interaction.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.lastUpdated"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.meta.source",
      "min": 0,
      "definition": "A uri that identifies the source system of the resource. This provides a minimal amount of [Provenance](provenance.html#) information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.",
      "short": "Identifies where the resource comes from",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.meta.source",
      "condition": [ "ele-1" ],
      "comment": "In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. \n\nThis element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Meta.source"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.meta.profile",
      "min": 0,
      "definition": "A list of profiles (references to [StructureDefinition](structuredefinition.html#) resources) that this resource claims to conform to. The URL is a reference to [StructureDefinition.url](structuredefinition-definitions.html#StructureDefinition.url).",
      "short": "Profiles this resource claims to conform to",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "canonical",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/StructureDefinition" ]
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Procedure.meta.profile",
      "condition": [ "ele-1" ],
      "comment": "It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time.  The list of profile URLs is a set.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.profile"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.meta.security",
      "min": 0,
      "definition": "Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.",
      "short": "Security Labels applied to this resource",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/security-labels",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "SecurityLabels"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "Security Labels from the Healthcare Privacy and Security Classification System."
      },
      "max": "*",
      "id": "Procedure.meta.security",
      "condition": [ "ele-1" ],
      "comment": "The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.security"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.meta.tag",
      "min": 0,
      "definition": "Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.",
      "short": "Tags applied to this resource",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/common-tags",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Tags"
        } ],
        "description": "Codes that represent various types of tags, commonly workflow-related; e.g. \"Needs review by Dr. Jones\"."
      },
      "max": "*",
      "id": "Procedure.meta.tag",
      "condition": [ "ele-1" ],
      "comment": "The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Meta.tag"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.implicitRules",
      "min": 0,
      "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Procedure.implicitRules",
      "condition": [ "ele-1" ],
      "comment": "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 it's narrative along with other profiles, value sets, etc.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "short": "Language of the resource content",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/languages",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language."
      },
      "max": "1",
      "id": "Procedure.language",
      "condition": [ "ele-1" ],
      "comment": "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).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.text",
      "min": 0,
      "definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      }, {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "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"
      } ],
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "Procedure.text",
      "condition": [ "ele-1" ],
      "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      }
    }, {
      "path": "Procedure.contained",
      "min": 0,
      "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "Procedure.contained",
      "comment": "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.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      }
    }, {
      "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": "Procedure.extension",
      "min": 1,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource. 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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "mustSupport": true,
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.extension",
      "condition": [ "ele-1" ],
      "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": "DomainResource.extension"
      }
    }, {
      "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": "Procedure.extension",
      "min": 0,
      "definition": "Dokumentationsdatum der Prozedur, falls abweichend vom Durchführungsdatum",
      "short": "Dokumentationsdatum",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Dokumentationsdatum der Prozedur, falls abweichend vom Durchführungsdatum"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "The date the procedure was documented, if different from the performed date"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://fhir.de/StructureDefinition/ProzedurDokumentationsdatum" ]
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Dokumentationsdatum"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Recorded date"
          } ]
        } ]
      },
      "sliceName": "Dokumentationsdatum",
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Procedure.extension:Dokumentationsdatum",
      "condition": [ "ele-1" ],
      "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": "DomainResource.extension"
      }
    }, {
      "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": "Procedure.extension",
      "min": 0,
      "definition": "therapeutisch | palliativ | diagnostisch | präventiv | rehabilitativ | andere",
      "short": "Durchführungsabsicht",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "therapeutisch | palliativ | diagnostisch | präventiv | rehabilitativ | andere"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "therapeutic | palliative | diagnostic | preventive | rehabilitative | other"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Durchfuehrungsabsicht" ]
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Durchführungsabsicht"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Intention"
          } ]
        } ]
      },
      "sliceName": "durchfuehrungsabsicht",
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Procedure.extension:durchfuehrungsabsicht",
      "condition": [ "ele-1" ],
      "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": "DomainResource.extension"
      }
    }, {
      "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": "Procedure.extension",
      "min": 1,
      "definition": "Intention der OP gemäß 13.1 oBDS 2021",
      "short": "Intention der OP",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Intention der OP gemäß 13.1 oBDS 2021"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-operation-intention" ]
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Intention der OP"
          } ]
        } ]
      },
      "sliceName": "Intention",
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Procedure.extension:Intention",
      "condition": [ "ele-1" ],
      "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": "DomainResource.extension"
      }
    }, {
      "path": "Procedure.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.",
      "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": "Procedure.extension:Intention.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "0",
      "id": "Procedure.extension:Intention.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "path": "Procedure.extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "short": "identifies the meaning of the extension",
      "fixedUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-operation-intention",
      "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": "Procedure.extension:Intention.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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.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).",
      "short": "Value of extension",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-operation-intention"
      },
      "max": "1",
      "id": "Procedure.extension:Intention.value[x]",
      "condition": [ "ele-1" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      }
    }, {
      "path": "Procedure.extension.value[x].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.",
      "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": "Procedure.extension:Intention.value[x].id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.extension.value[x].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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.extension:Intention.value[x].extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.extension.value[x].coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 0,
      "definition": "A reference to a code defined by a terminology system.",
      "short": "Code defined by a terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "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": "Procedure.extension:Intention.value[x].coding",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "path": "Procedure.extension.value[x].coding.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.",
      "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": "Procedure.extension:Intention.value[x].coding.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.extension.value[x].coding.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.extension:Intention.value[x].coding.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.extension.value[x].coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Identity of the terminology system",
      "fixedUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-intention",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Procedure.extension:Intention.value[x].coding.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.extension.value[x].coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Procedure.extension:Intention.value[x].coding.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.extension.value[x].coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 1,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      }, {
        "map": "13.1",
        "comment": "Intention der Operation",
        "identity": "oBDS"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "max": "1",
      "id": "Procedure.extension:Intention.value[x].coding.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.extension.value[x].coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.extension:Intention.value[x].coding.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.extension.value[x].coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Procedure.extension:Intention.value[x].coding.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.extension.value[x].text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.extension:Intention.value[x].text",
      "condition": [ "ele-1" ],
      "comment": "Very often the text is the same as a displayName of one of the codings.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "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": "Procedure.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.modifierExtension",
      "condition": [ "ele-1" ],
      "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": "DomainResource.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"
    }, {
      "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())"
      } ],
      "path": "Procedure.identifier",
      "requirements": "Allows identification of the procedure as it is known by various participating systems and in a way that remains consistent across servers.",
      "min": 0,
      "definition": "Business identifiers assigned to this procedure by the performer or other systems which remain constant as the resource is updated and is propagated from server to server.",
      "short": "External Identifiers for this procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CX / EI (occasionally, more often EI maps to a resource id or a URL)",
        "identity": "v2"
      }, {
        "map": "II - The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs.  Also maps to Role[classCode=IDENT]",
        "identity": "rim"
      }, {
        "map": "Identifier",
        "identity": "servd"
      }, {
        "map": "Event.identifier",
        "identity": "workflow"
      }, {
        "map": "FiveWs.identifier",
        "identity": "w5"
      }, {
        "map": "Some combination of ORC-2 / ORC-3 / OBR-2 / OBR-3 / IPC-1 / IPC-2 / IPC-3 / IPC-4",
        "identity": "v2"
      }, {
        "map": ".id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "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": "Procedure.identifier",
      "condition": [ "ele-1" ],
      "comment": "This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)).  It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types.  For example, multiple Patient and Person resource instances might share the same social insurance number.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.identifier"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.instantiatesCanonical",
      "min": 0,
      "definition": "The URL pointing to a FHIR-defined protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.",
      "short": "Instantiates FHIR protocol or definition",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Event.instantiatesCanonical",
        "identity": "workflow"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "canonical",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/PlanDefinition", "http://hl7.org/fhir/StructureDefinition/ActivityDefinition", "http://hl7.org/fhir/StructureDefinition/Measure", "http://hl7.org/fhir/StructureDefinition/OperationDefinition", "http://hl7.org/fhir/StructureDefinition/Questionnaire" ]
      } ],
      "max": "*",
      "id": "Procedure.instantiatesCanonical",
      "condition": [ "ele-1" ],
      "comment": "see [Canonical References](references.html#canonical)",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.instantiatesCanonical"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.instantiatesUri",
      "min": 0,
      "definition": "The URL pointing to an externally maintained protocol, guideline, order set or other definition that is adhered to in whole or in part by this Procedure.",
      "short": "Instantiates external protocol or definition",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Event.instantiatesUri",
        "identity": "workflow"
      }, {
        "map": ".outboundRelationship[typeCode=DEFN].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "*",
      "id": "Procedure.instantiatesUri",
      "condition": [ "ele-1" ],
      "comment": "This might be an HTML page, PDF, etc. or could just be a non-resolvable URI identifier.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.instantiatesUri"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.basedOn",
      "min": 0,
      "definition": "A reference to a resource that contains details of the request for this procedure.",
      "short": "A request for this procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "Event.basedOn",
        "identity": "workflow"
      }, {
        "map": ".outboundRelationship[typeCode=FLFS].target[classCode=(various e.g. PROC, OBS, PCPR, ACT,  moodCode=RQO].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/CarePlan" ]
      } ],
      "mustSupport": true,
      "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"
      } ],
      "alias": [ "fulfills" ],
      "max": "*",
      "id": "Procedure.basedOn",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.basedOn"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.partOf",
      "min": 0,
      "definition": "A larger event of which this particular procedure is a component or step.",
      "short": "Part of referenced event",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "Event.partOf",
        "identity": "workflow"
      }, {
        "map": ".inboundRelationship[typeCode=COMP].source[classCode=SBADM or PROC or OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Observation" ]
      } ],
      "mustSupport": true,
      "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"
      } ],
      "alias": [ "container" ],
      "max": "*",
      "id": "Procedure.partOf",
      "condition": [ "ele-1" ],
      "comment": "The MedicationAdministration resource has a partOf reference to Procedure, but this is not a circular reference.   For example, the anesthesia MedicationAdministration is part of the surgical Procedure (MedicationAdministration.partOf = Procedure).  For example, the procedure to insert the IV port for an IV medication administration is part of the medication administration (Procedure.partOf = MedicationAdministration).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.partOf"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.status",
      "min": 1,
      "definition": "Vorbereitung | in Arbeit | nicht durchgeführt | pausiert | abgebrochen | abgeschlossen | Eingabe fehlerhaft | unbekannt",
      "isModifier": true,
      "short": "Status",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Vorbereitung | in Arbeit | nicht durchgeführt | pausiert | abgebrochen | abgeschlossen | Eingabe fehlerhaft | unbekannt"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Event.status",
        "identity": "workflow"
      }, {
        "map": "FiveWs.status",
        "identity": "w5"
      }, {
        "map": "statusCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Status"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Status"
          } ]
        } ]
      },
      "binding": {
        "strength": "required",
        "valueSet": "http://hl7.org/fhir/ValueSet/event-status|4.0.1",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureStatus"
        } ],
        "description": "A code specifying the state of the procedure."
      },
      "max": "1",
      "id": "Procedure.status",
      "condition": [ "ele-1" ],
      "comment": "The \"unknown\" code is not to be used to convey other statuses.  The \"unknown\" code should be used when one of the statuses applies, but the authoring system doesn't know the current state of the procedure.\n\nThis element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Procedure.status"
      },
      "isModifierReason": "This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.statusReason",
      "min": 0,
      "definition": "Captures the reason for the current state of the procedure.",
      "short": "Reason for current status",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "Event.statusReason",
        "identity": "workflow"
      }, {
        "map": ".reason.Observation.value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/procedure-not-performed-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureNegationReason"
        } ],
        "description": "A code that identifies the reason a procedure was not performed."
      },
      "alias": [ "Suspended Reason", "Cancelled Reason" ],
      "max": "1",
      "id": "Procedure.statusReason",
      "condition": [ "ele-1" ],
      "comment": "This is generally only used for \"exception\" statuses such as \"not-done\", \"suspended\" or \"aborted\". The reason for performing the event at all is captured in reasonCode, not here.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.statusReason"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.category",
      "min": 0,
      "definition": "Diagnostische Maßnahmen | Bildgebende Diagnostik | Operationen | Medikamente | Nichtoperative therapeutische Maßnahmen | Ergänzende Maßnahmen",
      "short": "Kategorie",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Diagnostische Maßnahmen | Bildgebende Diagnostik | Operationen | Medikamente | Nichtoperative therapeutische Maßnahmen | Ergänzende Maßnahmen"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Diagnostic procedures | Imaging procedures | Operations | Medications | Non-operative therapeutic procedures | Other procedures"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "FiveWs.class",
        "identity": "w5"
      }, {
        "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Kategorie"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Category"
          } ]
        } ]
      },
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/procedure-category",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureCategory"
        } ],
        "description": "A code that classifies a procedure for searching, sorting and display purposes."
      },
      "max": "1",
      "id": "Procedure.category",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.category"
      },
      "isSummary": true
    }, {
      "path": "Procedure.category.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.",
      "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": "Procedure.category.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.category.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.category.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.category.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 0,
      "definition": "A reference to a code defined by a terminology system.",
      "short": "Code defined by a terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "type": [ {
        "code": "Coding"
      } ],
      "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": "Procedure.category.coding",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.category.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 0,
      "definition": "Ein Verweis auf einen von SNOMED CT definierten Code",
      "short": "SNOMED CT Code",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Ein Verweis auf einen von SNOMED CT definierten Code"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "A reference to a code defined by SNOMED CT"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "SNOMED CT Code"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "SNOMED CT code"
          } ]
        } ]
      },
      "sliceName": "sct",
      "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"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/ValueSet/procedures-category-sct"
      },
      "max": "1",
      "id": "Procedure.category.coding:sct",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
      "patternCoding": {
        "system": "http://snomed.info/sct"
      },
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "path": "Procedure.category.coding.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.",
      "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": "Procedure.category.coding:sct.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.category.coding.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.category.coding:sct.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.category.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Identity of the terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.category.coding:sct.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.category.coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Procedure.category.coding:sct.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.category.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 1,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.category.coding:sct.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.category.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.category.coding:sct.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.category.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Procedure.category.coding:sct.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.category.text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.category.text",
      "condition": [ "ele-1" ],
      "comment": "Very often the text is the same as a displayName of one of the codings.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "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": "sct-ops-1",
        "human": "Eine Prozedur MUSS mit OPS oder SNOMED-CT kodiert werden.",
        "source": "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Procedure",
        "severity": "error",
        "expression": "coding.where(system = 'http://snomed.info/sct').exists() or coding.where(system = 'http://fhir.de/CodeSystem/bfarm/ops').exists()"
      } ],
      "path": "Procedure.code",
      "requirements": "0..1 to account for primarily narrative only resources.",
      "min": 1,
      "definition": "Code aus OPS - Operationen- und Prozedurenschlüssel, SNOMED CT oder andere.",
      "short": "Code",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Code aus OPS - Operationen- und Prozedurenschlüssel, SNOMED CT oder andere."
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Code from OPS - Operationen- und Prozedurenschlüssel, SNOMED CT or other."
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "Event.code",
        "identity": "workflow"
      }, {
        "map": "FiveWs.what[x]",
        "identity": "w5"
      }, {
        "map": "OBR-44/OBR-45",
        "identity": "v2"
      }, {
        "map": ".code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Code"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Code"
          } ]
        } ]
      },
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/procedure-code",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureCode"
        } ],
        "description": "A code to identify a specific procedure ."
      },
      "alias": [ "type" ],
      "max": "1",
      "id": "Procedure.code",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.code"
      },
      "isSummary": true
    }, {
      "path": "Procedure.code.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.",
      "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": "Procedure.code.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.code.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.code.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 1,
      "definition": "A reference to a code defined by a terminology system.",
      "short": "Code defined by a terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "type": [ {
        "code": "Coding"
      } ],
      "mustSupport": true,
      "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": "Procedure.code.coding",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 1,
      "definition": "Komplikation der OP gemäß 13.5 oBDS 2021",
      "short": "Komplikation der OP laut oBDS",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "A reference to a code defined by the German Procedure Classification OPS"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "A reference to a code defined by the German Procedure Classification OPS"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding",
        "profile": [ "http://fhir.de/StructureDefinition/CodingOPS" ]
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "OPS code"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "OPS code"
          } ]
        } ]
      },
      "sliceName": "ops",
      "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"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://fhir.de/ValueSet/bfarm/ops"
      },
      "max": "1",
      "id": "Procedure.code.coding:ops",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.",
      "patternCoding": {
        "system": "http://fhir.de/CodeSystem/bfarm/ops"
      },
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "path": "Procedure.code.coding.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.",
      "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": "Procedure.code.coding:ops.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.code.coding.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.code.coding:ops.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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": "Procedure.code.coding.extension",
      "min": 0,
      "definition": "Optional Extension Element - found in all resources.",
      "short": "Optional Extensions Element",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension",
        "profile": [ "http://fhir.de/StructureDefinition/seitenlokalisation" ]
      } ],
      "mustSupport": true,
      "sliceName": "Seitenlokalisation",
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "1",
      "id": "Procedure.code.coding:ops.extension:Seitenlokalisation",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Canonische CodeSystem URL für OPS",
      "fixedUri": "http://fhir.de/CodeSystem/bfarm/ops",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.code.coding:ops.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.version",
      "min": 1,
      "definition": "Bie Verwendung von OPS ist die Angabe der Version zwingend erforderlich.\r\nHierdurch wird der Tatsache Rechnung getragen, dass jede der jährlich neu erscheinenden Fassung von OPS ein neues Codesystem darstellt.",
      "short": "Die Jahresversion des OPS Kataloges. Angegeben wird immer die vierstellige Jahreszahl (z.B. \"2017\")",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      }, {
        "map": "13.4",
        "comment": "OPS Version",
        "identity": "oBDS"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.code.coding:ops.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "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": "ops-regex",
        "human": "In code sind nur gültige OPS-Codes ohne Zusätze erlaubt",
        "source": "http://fhir.de/StructureDefinition/CodingOPS",
        "severity": "warning",
        "expression": "matches('^[1|3|5|6|8|9]-[a-zA-Z0-9]{3}([.][a-zA-Z0-9]{1,2})?$')"
      } ],
      "path": "Procedure.code.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 1,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "short": "Der OPS-Code",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      }, {
        "map": "13.3",
        "comment": "OPS",
        "identity": "oBDS"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.code.coding:ops.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "example": [ {
        "label": "Einfacher OPS-Code",
        "valueCode": "5-470"
      } ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.code.coding:ops.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Procedure.code.coding:ops.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 0,
      "definition": "Ein Verweis auf einen von SNOMED CT definierten Code",
      "short": "SNOMED CT Code",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Ein Verweis auf einen von SNOMED CT definierten Code"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "A reference to a code defined by SNOMED CT"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "SNOMED CT Code"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "SNOMED CT code"
          } ]
        } ]
      },
      "sliceName": "sct",
      "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"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/ValueSet/procedures-sct"
      },
      "max": "1",
      "id": "Procedure.code.coding:sct",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
      "patternCoding": {
        "system": "http://snomed.info/sct"
      },
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "path": "Procedure.code.coding.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.",
      "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": "Procedure.code.coding:sct.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.code.coding.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.code.coding:sct.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Identity of the terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.code.coding:sct.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Procedure.code.coding:sct.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 1,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.code.coding:sct.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.code.coding:sct.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Procedure.code.coding:sct.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.code.text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.code.text",
      "condition": [ "ele-1" ],
      "comment": "Very often the text is the same as a displayName of one of the codings.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.subject",
      "min": 1,
      "definition": "The person, animal or group on which the procedure was performed.",
      "short": "Who the procedure was performed on",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "Event.subject",
        "identity": "workflow"
      }, {
        "map": "FiveWs.subject[x]",
        "identity": "w5"
      }, {
        "map": "PID-3",
        "identity": "v2"
      }, {
        "map": ".participation[typeCode=SBJ].role",
        "identity": "rim"
      }, {
        "map": "FiveWs.subject",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient" ]
      } ],
      "mustSupport": true,
      "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"
      } ],
      "alias": [ "patient" ],
      "max": "1",
      "id": "Procedure.subject",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Procedure.subject"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.encounter",
      "min": 0,
      "definition": "The Encounter during which this Procedure was created or performed or to which the creation of this record is tightly associated.",
      "short": "Encounter created as part of",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "Event.context",
        "identity": "workflow"
      }, {
        "map": "FiveWs.context",
        "identity": "w5"
      }, {
        "map": "PV1-19",
        "identity": "v2"
      }, {
        "map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter" ]
      } ],
      "mustSupport": true,
      "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": "1",
      "id": "Procedure.encounter",
      "condition": [ "ele-1" ],
      "comment": "This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.encounter"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.performed[x]",
      "min": 1,
      "definition": "Durchführungsdatum oder -zeitraum der Prozedur.",
      "short": "Durchführungsdatum",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Durchführungsdatum oder -zeitraum der Prozedur."
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "The date or period of time the procedure was performed."
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "FiveWs.done[x]",
        "identity": "w5"
      }, {
        "map": "OBR-7",
        "identity": "v2"
      }, {
        "map": ".effectiveTime",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        } ]
      },
      "type": [ {
        "code": "dateTime"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Durchführungsdatum"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Performed date"
          } ]
        } ]
      },
      "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": "1",
      "id": "Procedure.performed[x]",
      "condition": [ "ele-1" ],
      "comment": "Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old.  dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.performed[x]"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.performed[x]",
      "min": 0,
      "definition": "Durchführungsdatum der Prozedur.",
      "short": "When the procedure was performed",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Durchführungsdatum der Prozedur."
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "The date the procedure was performed."
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "FiveWs.done[x]",
        "identity": "w5"
      }, {
        "map": "OBR-7",
        "identity": "v2"
      }, {
        "map": ".effectiveTime",
        "identity": "rim"
      }, {
        "map": "13.2",
        "comment": "OP Datum",
        "identity": "oBDS"
      } ],
      "type": [ {
        "code": "dateTime"
      } ],
      "sliceName": "performedDateTime",
      "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": "1",
      "id": "Procedure.performed[x]:performedDateTime",
      "condition": [ "ele-1" ],
      "comment": "Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old.  dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.performed[x]"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.performed[x]",
      "min": 0,
      "definition": "Zeitraum, in dem die Prozedur durchgeführt wurde.",
      "short": "Durchführungszeitraum",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Zeitraum, in dem die Prozedur durchgeführt wurde."
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "The period of time the procedure was performed."
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "FiveWs.done[x]",
        "identity": "w5"
      }, {
        "map": "OBR-7",
        "identity": "v2"
      }, {
        "map": ".effectiveTime",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Period"
      } ],
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Durchführungszeitraum"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Performed period"
          } ]
        } ]
      },
      "sliceName": "performedPeriod",
      "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": "1",
      "id": "Procedure.performed[x]:performedPeriod",
      "condition": [ "ele-1" ],
      "comment": "Age is generally used when the patient reports an age at which the procedure was performed. Range is generally used when the patient reports an age range when the procedure was performed, such as sometime between 20-25 years old.  dateTime supports a range of precision due to some procedures being reported as past procedures that might not have millisecond precision while other procedures performed and documented during the encounter might have more precise UTC timestamps with timezone.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.performed[x]"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.recorder",
      "min": 0,
      "definition": "Individual who recorded the record and takes responsibility for its content.",
      "short": "Who recorded the procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "FiveWs.author",
        "identity": "w5"
      }, {
        "map": ".participation[typeCode=AUT].role",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ]
      } ],
      "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": "1",
      "id": "Procedure.recorder",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.recorder"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.asserter",
      "min": 0,
      "definition": "Individual who is making the procedure statement.",
      "short": "Person who asserts this procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "FiveWs.source",
        "identity": "w5"
      }, {
        "map": ".participation[typeCode=INF].role",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ]
      } ],
      "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": "1",
      "id": "Procedure.asserter",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.asserter"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.performer",
      "min": 0,
      "definition": "Limited to \"real\" people rather than equipment.",
      "short": "The people who performed the procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Event.performer",
        "identity": "workflow"
      }, {
        "map": ".participation[typeCode=PRF]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "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": "Procedure.performer",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.performer"
      },
      "isSummary": true
    }, {
      "path": "Procedure.performer.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.",
      "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": "Procedure.performer.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.performer.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.performer.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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": "Procedure.performer.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Procedure.performer.modifierExtension",
      "condition": [ "ele-1" ],
      "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": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.performer.function",
      "requirements": "Allows disambiguation of the types of involvement of different performers.",
      "min": 0,
      "definition": "Distinguishes the type of involvement of the performer in the procedure. For example, surgeon, anaesthetist, endoscopist.",
      "short": "Type of performance",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "Event.performer.function",
        "identity": "workflow"
      }, {
        "map": "Some combination of STF-18 / PRA-3 / PRT-4 / ROL-3 / ORC-12 / OBR-16 / PV1-7 / PV1-8 / PV1-9 / PV1-17 / OBX-25",
        "identity": "v2"
      }, {
        "map": ".functionCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/performer-role",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedurePerformerRole"
        } ],
        "description": "A code that identifies the role of a performer of the procedure."
      },
      "max": "1",
      "id": "Procedure.performer.function",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.performer.function"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.performer.actor",
      "requirements": "A reference to Device supports use cases, such as pacemakers.",
      "min": 1,
      "definition": "The practitioner who was involved in the procedure.",
      "short": "The reference to the practitioner",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "Event.performer.actor",
        "identity": "workflow"
      }, {
        "map": "FiveWs.actor",
        "identity": "w5"
      }, {
        "map": "ORC-19/PRT-5",
        "identity": "v2"
      }, {
        "map": ".role",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Device" ]
      } ],
      "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": "1",
      "id": "Procedure.performer.actor",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Procedure.performer.actor"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.performer.onBehalfOf",
      "requirements": "Practitioners and Devices can be associated with multiple organizations.  This element indicates which organization they were acting on behalf of when performing the action.",
      "min": 0,
      "definition": "The organization the device or practitioner was acting on behalf of.",
      "short": "Organization the device or practitioner was acting for",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".scoper",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Organization" ]
      } ],
      "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": "1",
      "id": "Procedure.performer.onBehalfOf",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.performer.onBehalfOf"
      }
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.location",
      "requirements": "Ties a procedure to where the records are likely kept.",
      "min": 0,
      "definition": "The location where the procedure actually happened.  E.g. a newborn at home, a tracheostomy at a restaurant.",
      "short": "Where the procedure happened",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "FiveWs.where[x]",
        "identity": "w5"
      }, {
        "map": ".participation[typeCode=LOC].role[classCode=SDLOC]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Location" ]
      } ],
      "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": "1",
      "id": "Procedure.location",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.location"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.reasonCode",
      "min": 0,
      "definition": "The coded reason why the procedure was performed. This may be a coded entity of some type, or may simply be present as text.",
      "short": "Coded reason procedure performed",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "Event.reasonCode",
        "identity": "workflow"
      }, {
        "map": "FiveWs.why[x]",
        "identity": "w5"
      }, {
        "map": ".reasonCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/procedure-reason",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureReason"
        } ],
        "description": "A code that identifies the reason a procedure is  required."
      },
      "max": "*",
      "id": "Procedure.reasonCode",
      "condition": [ "ele-1" ],
      "comment": "Use Procedure.reasonCode when a code sufficiently describes the reason.  Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative.  For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used.  Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference.  Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.reasonCode"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.reasonReference",
      "min": 0,
      "definition": "The justification of why the procedure was performed.",
      "short": "The justification that the procedure was performed",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": "Event.reasonReference",
        "identity": "workflow"
      }, {
        "map": "FiveWs.why[x]",
        "identity": "w5"
      }, {
        "map": ".reasonCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-diagnose-primaertumor", "http://hl7.org/fhir/StructureDefinition/Condition" ]
      } ],
      "mustSupport": true,
      "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": "Procedure.reasonReference",
      "condition": [ "ele-1" ],
      "comment": "It is possible for a procedure to be a reason (such as C-Section) for another procedure (such as an epidural). Other examples include endoscopy for dilatation and biopsy (a combination of diagnostic and therapeutic use). \nUse Procedure.reasonCode when a code sufficiently describes the reason.  Use Procedure.reasonReference when referencing a resource, which allows more information to be conveyed, such as onset date. Procedure.reasonCode and Procedure.reasonReference are not meant to be duplicative.  For a single reason, either Procedure.reasonCode or Procedure.reasonReference can be used.  Procedure.reasonCode may be a summary code, or Procedure.reasonReference may be used to reference a very precise definition of the reason using Condition | Observation | Procedure | DiagnosticReport | DocumentReference.  Both Procedure.reasonCode and Procedure.reasonReference can be used if they are describing different reasons for the procedure.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.reasonReference"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.bodySite",
      "min": 0,
      "definition": "Körperstelle der Prozedur mittels SNOMED CT inklusive Lateralität.",
      "short": "Körperstelle",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Körperstelle der Prozedur mittels SNOMED CT inklusive Lateralität."
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "The body site of the procedure using SNOMED CT including laterality."
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "OBX-20",
        "identity": "v2"
      }, {
        "map": ".targetSiteCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Körperstelle"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Body site"
          } ]
        } ]
      },
      "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"
      } ],
      "binding": {
        "strength": "extensible",
        "valueSet": "http://hl7.org/fhir/ValueSet/body-site",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "BodySite"
        } ],
        "description": "Codes describing anatomical locations. May include laterality."
      },
      "max": "*",
      "id": "Procedure.bodySite",
      "condition": [ "ele-1" ],
      "comment": "If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension [procedure-targetbodystructure](extension-procedure-targetbodystructure.html).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.bodySite"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.outcome",
      "min": 0,
      "definition": "The outcome of the procedure - did it resolve the reasons for the procedure being performed?",
      "short": "The result of procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": ".outboundRelationship[typeCode=OUT].target.text",
        "identity": "rim"
      }, {
        "map": "10.1",
        "comment": "Beurteilung des lokalen Residualstatus nach Abschluss der Operation",
        "identity": "oBDS"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "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"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-beurteilung-lokaler-residualstatus",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureOutcome"
        } ],
        "description": "An outcome of a procedure - whether it was resolved or otherwise."
      },
      "max": "1",
      "id": "Procedure.outcome",
      "condition": [ "ele-1" ],
      "comment": "If outcome contains narrative text only, it can be captured using the CodeableConcept.text.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.outcome"
      },
      "isSummary": true
    }, {
      "path": "Procedure.outcome.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.",
      "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": "Procedure.outcome.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.outcome.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.outcome.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.outcome.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 0,
      "definition": "Lokaler Residualstatus der OP gemäß 10.1 oBDS 2021. Globaler Residualstatus wird prozedurenunabhängig als eigenständige Observation kodiert.",
      "short": "Lokaler Residualstatus",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Lokaler Residualstatus der OP gemäß 10.1 oBDS 2021. Globaler Residualstatus wird prozedurenunabhängig als eigenständige Observation kodiert."
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Lokaler Residualstatus"
          } ]
        } ]
      },
      "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": "Procedure.outcome.coding",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "path": "Procedure.outcome.coding.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.",
      "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": "Procedure.outcome.coding.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.outcome.coding.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.outcome.coding.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.outcome.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 0,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Identity of the terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.outcome.coding.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "patternUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-residualstatus",
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.outcome.coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Procedure.outcome.coding.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.outcome.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 0,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.outcome.coding.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.outcome.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.outcome.coding.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.outcome.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Procedure.outcome.coding.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.outcome.text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.outcome.text",
      "condition": [ "ele-1" ],
      "comment": "Very often the text is the same as a displayName of one of the codings.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.report",
      "min": 0,
      "definition": "This could be a histology result, pathology report, surgical report, etc.",
      "short": "Any report resulting from the procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DiagnosticReport", "http://hl7.org/fhir/StructureDefinition/DocumentReference", "http://hl7.org/fhir/StructureDefinition/Composition" ]
      } ],
      "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": "Procedure.report",
      "condition": [ "ele-1" ],
      "comment": "There could potentially be multiple reports - e.g. if this was a procedure which took multiple biopsies resulting in a number of anatomical pathology reports.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.report"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.complication",
      "min": 0,
      "definition": "Any complications that occurred during the procedure, or in the immediate post-performance period. These are generally tracked separately from the notes, which will typically describe the procedure itself rather than any 'post procedure' issues.",
      "short": "Complication following the procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value",
        "identity": "rim"
      }, {
        "map": "13.5",
        "comment": "OP Komplikationen",
        "identity": "oBDS"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/condition-code",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureComplication"
        } ],
        "description": "Codes describing complications that resulted from a procedure."
      },
      "max": "*",
      "id": "Procedure.complication",
      "condition": [ "ele-1" ],
      "comment": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.complication"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.complication",
      "min": 0,
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Komplikation der OP gemäß 13.5 oBDS 2021"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Komplikation der OP laut oBDS"
          } ]
        } ]
      },
      "sliceName": "compl_obds",
      "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"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-operation-komplikation",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureComplication"
        } ],
        "description": "Codes describing complications that resulted from a procedure."
      },
      "max": "*",
      "id": "Procedure.complication:compl_obds",
      "condition": [ "ele-1" ],
      "comment": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.complication"
      }
    }, {
      "path": "Procedure.complication.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.",
      "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": "Procedure.complication:compl_obds.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.complication.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.complication:compl_obds.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 0,
      "definition": "A reference to a code defined by a terminology system.",
      "short": "Code defined by a terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "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": "Procedure.complication:compl_obds.coding",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "path": "Procedure.complication.coding.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.",
      "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": "Procedure.complication:compl_obds.coding.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.complication.coding.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.complication:compl_obds.coding.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 0,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Identity of the terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_obds.coding.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "patternUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-operation-komplikation",
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_obds.coding.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 1,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Procedure.complication:compl_obds.coding.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_obds.coding.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_obds.coding.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_obds.text",
      "condition": [ "ele-1" ],
      "comment": "Very often the text is the same as a displayName of one of the codings.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication",
      "min": 0,
      "definition": "Komplikation der OP - soweit nicht in 13.1 oBDS 2021 enthalten - als ICD-10-GM",
      "short": "Komplikation der OP Sonstige ICD-10",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Komplikation der OP - soweit nicht in 13.1 oBDS 2021 enthalten - als ICD-10-GM"
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Komplikation der OP Sonstige ICD-10"
          } ]
        } ]
      },
      "sliceName": "compl_icd10",
      "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"
      } ],
      "binding": {
        "strength": "required",
        "valueSet": "http://fhir.de/ValueSet/bfarm/icd-10-gm",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureComplication"
        } ],
        "description": "Codes describing complications that resulted from a procedure."
      },
      "max": "*",
      "id": "Procedure.complication:compl_icd10",
      "condition": [ "ele-1" ],
      "comment": "If complications are only expressed by the narrative text, they can be captured using the CodeableConcept.text.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.complication"
      }
    }, {
      "path": "Procedure.complication.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.",
      "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": "Procedure.complication:compl_icd10.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.complication.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.complication:compl_icd10.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding",
      "requirements": "Allows for alternative encodings within a code system, and translations to other code systems.",
      "min": 0,
      "definition": "A reference to a code defined by a terminology system.",
      "short": "Code defined by a terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE subset one of the sets of component 1-3 or 4-6",
        "identity": "v2"
      }, {
        "map": "CV",
        "identity": "rim"
      }, {
        "map": "fhir:Coding rdfs:subClassOf dt:CDCoding",
        "identity": "orim"
      }, {
        "map": "C*E.1-8, C*E.10-22",
        "identity": "v2"
      }, {
        "map": "union(., ./translation)",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "Coding"
      } ],
      "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": "Procedure.complication:compl_icd10.coding",
      "condition": [ "ele-1" ],
      "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.  Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "CodeableConcept.coding"
      },
      "isSummary": true
    }, {
      "path": "Procedure.complication.coding.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.",
      "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": "Procedure.complication:compl_icd10.coding.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.complication.coding.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.complication:compl_icd10.coding.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.system",
      "requirements": "Need to be unambiguous about the source of the definition of the symbol.",
      "min": 1,
      "definition": "The identification of the code system that defines the meaning of the symbol in the code.",
      "short": "Identity of the terminology system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.3",
        "identity": "v2"
      }, {
        "map": "./codeSystem",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_icd10.coding.system",
      "condition": [ "ele-1" ],
      "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.system"
      },
      "patternUri": "http://fhir.de/CodeSystem/bfarm/icd-10-gm",
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.version",
      "min": 0,
      "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.",
      "short": "Version of the system - if relevant",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.7",
        "identity": "v2"
      }, {
        "map": "./codeSystemVersion",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_icd10.coding.version",
      "condition": [ "ele-1" ],
      "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.version"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.code",
      "requirements": "Need to refer to a particular code in the system.",
      "min": 1,
      "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).",
      "short": "Symbol in syntax defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.1",
        "identity": "v2"
      }, {
        "map": "./code",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_icd10.coding.code",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.code"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.display",
      "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know  the system.",
      "min": 0,
      "definition": "A representation of the meaning of the code in the system, following the rules of the system.",
      "short": "Representation defined by the system",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.2 - but note this is not well followed",
        "identity": "v2"
      }, {
        "map": "CV.displayName",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_icd10.coding.display",
      "condition": [ "ele-1" ],
      "comment": "Note that FHIR strings SHALL NOT exceed 1MB in size",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.display"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.coding.userSelected",
      "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.",
      "min": 0,
      "definition": "Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).",
      "short": "If this coding was chosen directly by the user",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "Sometimes implied by being first",
        "identity": "v2"
      }, {
        "map": "CD.codingRationale",
        "identity": "rim"
      }, {
        "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [     fhir:source \"true\";     fhir:target dt:CDCoding.codingRationale\\#O   ]",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "boolean"
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_icd10.coding.userSelected",
      "condition": [ "ele-1" ],
      "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Coding.userSelected"
      },
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.complication.text",
      "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.",
      "min": 0,
      "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.",
      "short": "Plain text representation of the concept",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "C*E.9. But note many systems use C*E.2 for this",
        "identity": "v2"
      }, {
        "map": "./originalText[mediaType/code=\"text/plain\"]/data",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText",
        "identity": "orim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable",
        "valueBoolean": true
      } ],
      "max": "1",
      "id": "Procedure.complication:compl_icd10.text",
      "condition": [ "ele-1" ],
      "comment": "Very often the text is the same as a displayName of one of the codings.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "CodeableConcept.text"
      },
      "isSummary": true
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.complicationDetail",
      "requirements": "This is used to document a condition that is a result of the procedure, not the condition that was the reason for the procedure.",
      "min": 0,
      "definition": "Any complications that occurred during the procedure, or in the immediate post-performance period.",
      "short": "A condition that is a result of the procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".outboundRelationship[typeCode=OUTC].target[classCode=OBS, code=\"complication\", moodCode=EVN].value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Condition" ]
      } ],
      "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": "Procedure.complicationDetail",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.complicationDetail"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.followUp",
      "min": 0,
      "definition": "If the procedure required specific follow up - e.g. removal of sutures. The follow up may be represented as a simple note or could potentially be more complex, in which case the CarePlan resource can be used.",
      "short": "Instructions for follow up",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": ".outboundRelationship[typeCode=COMP].target[classCode=ACT, moodCode=INT].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/procedure-followup",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureFollowUp"
        } ],
        "description": "Specific follow up required for a procedure e.g. removal of sutures."
      },
      "max": "*",
      "id": "Procedure.followUp",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.followUp"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.note",
      "min": 0,
      "definition": "Zusätzliche Informationen zur Prozedur als Freitext.",
      "short": "Hinweis",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Zusätzliche Informationen zur Prozedur als Freitext."
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Additional information about the procedure as free text."
          } ]
        } ]
      },
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "Act",
        "identity": "rim"
      }, {
        "map": "Event.note",
        "identity": "workflow"
      }, {
        "map": "NTE",
        "identity": "v2"
      }, {
        "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"annotation\"].value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Annotation"
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Hinweis"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "Note"
          } ]
        } ]
      },
      "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": "Procedure.note",
      "condition": [ "ele-1" ],
      "comment": "For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time.  This element may need to be included in narrative because of the potential for modifying information.  *Annotations SHOULD NOT* be used to communicate \"modifying\" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.note"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.focalDevice",
      "min": 0,
      "definition": "A device that is implanted, removed or otherwise manipulated (calibration, battery replacement, fitting a prosthesis, attaching a wound-vac, etc.) as a focal portion of the Procedure.",
      "short": "Manipulated, implanted, or removed device",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=DEV].role[classCode=MANU]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "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": "Procedure.focalDevice",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.focalDevice"
      }
    }, {
      "path": "Procedure.focalDevice.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.",
      "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": "Procedure.focalDevice.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      }
    }, {
      "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": "Procedure.focalDevice.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.",
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "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"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Procedure.focalDevice.extension",
      "condition": [ "ele-1" ],
      "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"
      }
    }, {
      "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": "Procedure.focalDevice.modifierExtension",
      "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
      "isModifier": true,
      "short": "Extensions that cannot be ignored even if unrecognized",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "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"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Procedure.focalDevice.modifierExtension",
      "condition": [ "ele-1" ],
      "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": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
      "isSummary": true
    }, {
      "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())"
      } ],
      "path": "Procedure.focalDevice.action",
      "min": 0,
      "definition": "The kind of change that happened to the device during the procedure.",
      "short": "Kind of change to device",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": ".inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=\"procedure device action\"].value=:procedure device action codes",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "preferred",
        "valueSet": "http://hl7.org/fhir/ValueSet/device-action",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "DeviceActionKind"
        } ],
        "description": "A kind of change that happened to the device during the procedure."
      },
      "max": "1",
      "id": "Procedure.focalDevice.action",
      "condition": [ "ele-1" ],
      "comment": "Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Procedure.focalDevice.action"
      }
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.focalDevice.manipulated",
      "min": 1,
      "definition": "The device that was manipulated (changed) during the procedure.",
      "short": "Device that was changed",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=DEV].role[classCode=SDLOC]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Device" ]
      } ],
      "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": "1",
      "id": "Procedure.focalDevice.manipulated",
      "condition": [ "ele-1" ],
      "comment": "References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Procedure.focalDevice.manipulated"
      }
    }, {
      "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": "ref-1",
        "human": "SHALL have a contained resource if a local reference is provided",
        "xpath": "not(starts-with(f:reference/@value, '#')) or exists(ancestor::*[self::f:entry or self::f:parameter]/f:resource/f:*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')]|/*/f:contained/f:*[f:id/@value=substring-after(current()/f:reference/@value, '#')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Reference",
        "severity": "error",
        "expression": "reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))"
      } ],
      "path": "Procedure.usedReference",
      "requirements": "Used for tracking contamination, etc.",
      "min": 0,
      "definition": "Identifies medications, devices and any other substance used as part of the procedure.",
      "short": "Items used during procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "The target of a resource reference is a RIM entry point (Act, Role, or Entity)",
        "identity": "rim"
      }, {
        "map": ".participation[typeCode=DEV].role[classCode=MANU] or\n.participation[typeCode=CSM].role[classCode=ADMM] (for Medication or Substance)",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/Medication", "http://hl7.org/fhir/StructureDefinition/Substance" ]
      } ],
      "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": "Procedure.usedReference",
      "condition": [ "ele-1" ],
      "comment": "For devices actually implanted or removed, use Procedure.device.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.usedReference"
      }
    }, {
      "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())"
      } ],
      "path": "Procedure.usedCode",
      "min": 0,
      "definition": "Identifies coded items that were used as part of the procedure.",
      "short": "Coded items used during the procedure",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      }, {
        "map": "CE/CNE/CWE",
        "identity": "v2"
      }, {
        "map": "CD",
        "identity": "rim"
      }, {
        "map": "fhir:CodeableConcept rdfs:subClassOf dt:CD",
        "identity": "orim"
      }, {
        "map": "participation[typeCode=Dev].role[classCode=MANU]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "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"
      } ],
      "binding": {
        "strength": "example",
        "valueSet": "http://hl7.org/fhir/ValueSet/device-kind",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ProcedureUsed"
        } ],
        "description": "Codes describing items used during a procedure."
      },
      "max": "*",
      "id": "Procedure.usedCode",
      "condition": [ "ele-1" ],
      "comment": "For devices actually implanted or removed, use Procedure.device.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Procedure.usedCode"
      }
    } ]
  },
  "status": "active",
  "id": "d8433312-acb6-4202-8cd2-17b10c90c866",
  "kind": "resource",
  "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-operation",
  "version": "2025.0.0",
  "differential": {
    "element": [ {
      "id": "Procedure",
      "path": "Procedure",
      "mapping": [ {
        "map": "13",
        "comment": "Operation",
        "identity": "oBDS"
      } ]
    }, {
      "id": "Procedure.extension",
      "min": 1,
      "path": "Procedure.extension"
    }, {
      "path": "Procedure.extension",
      "min": 1,
      "definition": "Intention der OP gemäß 13.1 oBDS 2021",
      "short": "Intention der OP",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Intention der OP gemäß 13.1 oBDS 2021"
          } ]
        } ]
      },
      "type": [ {
        "code": "Extension",
        "profile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-ex-onko-operation-intention" ]
      } ],
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Intention der OP"
          } ]
        } ]
      },
      "sliceName": "Intention",
      "max": "1",
      "id": "Procedure.extension:Intention"
    }, {
      "id": "Procedure.extension:Intention.value[x].coding.code",
      "path": "Procedure.extension.value[x].coding.code",
      "mapping": [ {
        "map": "13.1",
        "comment": "Intention der Operation",
        "identity": "oBDS"
      } ]
    }, {
      "id": "Procedure.basedOn",
      "path": "Procedure.basedOn",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/CarePlan" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Procedure.partOf",
      "path": "Procedure.partOf",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Observation" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Procedure.code.coding:ops",
      "min": 1,
      "path": "Procedure.code.coding",
      "short": "Komplikation der OP laut oBDS",
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "OPS-Kode der Operation"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "OPS code"
          } ]
        } ]
      },
      "sliceName": "ops",
      "definition": "Komplikation der OP gemäß 13.5 oBDS 2021",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "OPS-Kode der Operation gemäß 13.3 oBDS 2021"
          } ]
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "en-US"
          }, {
            "url": "content",
            "valueString": "A reference to a code defined by the German Procedure Classification OPS"
          } ]
        } ]
      }
    }, {
      "id": "Procedure.code.coding:ops.version",
      "path": "Procedure.code.coding.version",
      "mapping": [ {
        "map": "13.4",
        "comment": "OPS Version",
        "identity": "oBDS"
      } ]
    }, {
      "id": "Procedure.code.coding:ops.code",
      "path": "Procedure.code.coding.code",
      "mapping": [ {
        "map": "13.3",
        "comment": "OPS",
        "identity": "oBDS"
      } ]
    }, {
      "id": "Procedure.subject",
      "path": "Procedure.subject",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient" ]
      } ]
    }, {
      "id": "Procedure.encounter",
      "path": "Procedure.encounter",
      "mustSupport": true
    }, {
      "id": "Procedure.performed[x]",
      "path": "Procedure.performed[x]",
      "type": [ {
        "code": "dateTime"
      } ]
    }, {
      "id": "Procedure.performed[x]:performedDateTime",
      "path": "Procedure.performed[x]",
      "type": [ {
        "code": "dateTime"
      } ],
      "mapping": [ {
        "map": "13.2",
        "comment": "OP Datum",
        "identity": "oBDS"
      } ],
      "sliceName": "performedDateTime"
    }, {
      "id": "Procedure.reasonReference",
      "path": "Procedure.reasonReference",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-diagnose-primaertumor", "http://hl7.org/fhir/StructureDefinition/Condition" ]
      } ],
      "mustSupport": true
    }, {
      "id": "Procedure.outcome",
      "path": "Procedure.outcome",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-beurteilung-lokaler-residualstatus"
      },
      "mapping": [ {
        "map": "10.1",
        "comment": "Beurteilung des lokalen Residualstatus nach Abschluss der Operation",
        "identity": "oBDS"
      } ],
      "mustSupport": true
    }, {
      "id": "Procedure.outcome.coding",
      "path": "Procedure.outcome.coding",
      "short": "Lokaler Residualstatus",
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Lokaler Residualstatus"
          } ]
        } ]
      },
      "definition": "Lokaler Residualstatus der OP gemäß 10.1 oBDS 2021. Globaler Residualstatus wird prozedurenunabhängig als eigenständige Observation kodiert.",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Lokaler Residualstatus der OP gemäß 10.1 oBDS 2021. Globaler Residualstatus wird prozedurenunabhängig als eigenständige Observation kodiert."
          } ]
        } ]
      }
    }, {
      "id": "Procedure.outcome.coding.system",
      "path": "Procedure.outcome.coding.system",
      "patternUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-residualstatus",
      "mustSupport": true
    }, {
      "id": "Procedure.outcome.coding.code",
      "path": "Procedure.outcome.coding.code",
      "mustSupport": true
    }, {
      "id": "Procedure.complication",
      "path": "Procedure.complication",
      "mapping": [ {
        "map": "13.5",
        "comment": "OP Komplikationen",
        "identity": "oBDS"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "pattern"
        } ]
      },
      "mustSupport": true
    }, {
      "path": "Procedure.complication",
      "min": 0,
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Komplikation der OP gemäß 13.5 oBDS 2021"
          } ]
        } ]
      },
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Komplikation der OP laut oBDS"
          } ]
        } ]
      },
      "sliceName": "compl_obds",
      "binding": {
        "strength": "required",
        "valueSet": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/ValueSet/mii-vs-onko-operation-komplikation"
      },
      "max": "*",
      "id": "Procedure.complication:compl_obds"
    }, {
      "id": "Procedure.complication:compl_obds.coding.system",
      "path": "Procedure.complication.coding.system",
      "patternUri": "https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-operation-komplikation"
    }, {
      "id": "Procedure.complication:compl_obds.coding.code",
      "min": 1,
      "path": "Procedure.complication.coding.code",
      "mustSupport": true
    }, {
      "path": "Procedure.complication",
      "min": 0,
      "definition": "Komplikation der OP - soweit nicht in 13.1 oBDS 2021 enthalten - als ICD-10-GM",
      "short": "Komplikation der OP Sonstige ICD-10",
      "_definition": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Komplikation der OP - soweit nicht in 13.1 oBDS 2021 enthalten - als ICD-10-GM"
          } ]
        } ]
      },
      "mustSupport": true,
      "_short": {
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/translation",
          "extension": [ {
            "url": "lang",
            "valueCode": "de-DE"
          }, {
            "url": "content",
            "valueString": "Komplikation der OP Sonstige ICD-10"
          } ]
        } ]
      },
      "sliceName": "compl_icd10",
      "binding": {
        "strength": "required",
        "valueSet": "http://fhir.de/ValueSet/bfarm/icd-10-gm"
      },
      "max": "*",
      "id": "Procedure.complication:compl_icd10"
    }, {
      "id": "Procedure.complication:compl_icd10.coding.system",
      "min": 1,
      "path": "Procedure.complication.coding.system",
      "patternUri": "http://fhir.de/CodeSystem/bfarm/icd-10-gm"
    }, {
      "id": "Procedure.complication:compl_icd10.coding.code",
      "min": 1,
      "path": "Procedure.complication.coding.code"
    } ]
  },
  "contact": [ {
    "telecom": [ {
      "value": "https://www.medizininformatik-initiative.de",
      "system": "url"
    } ]
  } ],
  "baseDefinition": "https://www.medizininformatik-initiative.de/fhir/core/modul-prozedur/StructureDefinition/Procedure"
}