{
  "description": "Carries a postcoordinated ICD-11 cluster expression as a single string\\non a Coding element where the stem code alone is insufficient to fully\\nrepresent the clinical concept.\\n\\nA cluster expression combines a stem code with one or more satellite\\ncodes using the & operator (combination) or / operator (specificity).\\nExample: NC72.Z&XK8G&XJ7ZH&XJ7YM\\n  - NC72.Z  — stem: Fracture of femur, unspecified\\n  - XK8G    — satellite: laterality\\n  - XJ7ZH   — satellite: fracture subtype\\n  - XJ7YM   — satellite: fracture open or closed\\n\\nUsage rules:\\n  - SHALL only be present when the expression contains at least one\\n    satellite code joined by & or / operators.\\n  - Single stem codes SHALL be represented in Coding.code only and\\n    validated via OCL $validate-code. The cluster validator at\\n    https://icd11.dghs.gov.bd/cluster/validate explicitly rejects\\n    stem-only expressions.\\n  - The stem code in Coding.code SHALL match the leading stem code\\n    in this expression string.\\n  - Satellite codes in the cluster expression are exempt from the\\n    Diagnosis/Finding class restriction that applies to stem codes\\n    in Condition.code.\\n  - Cluster expressions SHALL be validated against the Bangladesh\\n    ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate\\n    prior to submission to the HIE.\\n\\nCluster validator endpoint:\\n  POST https://icd11.dghs.gov.bd/cluster/validate\\n  Body: { \\\"expression\\\": \\\"NC72.Z&XK8G&XJ7ZH&XJ7YM\\\" }\\n\\nThis extension is not MustSupport and is not mandatory. It is present\\nonly when postcoordination is clinically required. Cluster expressions\\nare typically sourced from the WHO Electronic Coding Tool (ECT) at the\\npoint of care.",
  "_filename": "StructureDefinition-icd11-cluster-expression.json",
  "package_name": "bd.fhir.core",
  "date": "2026-04-10T17:10:06+00:00",
  "derivation": "constraint",
  "publisher": "Directorate General of Health Services (DGHS), Bangladesh",
  "fhirVersion": "4.0.1",
  "jurisdiction": [ {
    "coding": [ {
      "code": "050",
      "system": "urn:iso:std:iso:3166"
    } ]
  } ],
  "name": "ICD11ClusterExpression",
  "mapping": [ {
    "uri": "http://hl7.org/v3",
    "name": "RIM Mapping",
    "identity": "rim"
  } ],
  "abstract": false,
  "type": "Extension",
  "experimental": "false",
  "resourceType": "StructureDefinition",
  "title": "ICD-11 Cluster Expression",
  "package_version": "0.4.3",
  "extension": [ {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger": 1,
    "_valueInteger": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical": "https://fhir.dghs.gov.bd/core/ImplementationGuide/bd.fhir.core"
      } ]
    }
  }, {
    "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode": "informative",
    "_valueCode": {
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical": "https://fhir.dghs.gov.bd/core/ImplementationGuide/bd.fhir.core"
      } ]
    }
  } ],
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Extension",
      "min": 0,
      "definition": "Carries a postcoordinated ICD-11 cluster expression as a single string\non a Coding element where the stem code alone is insufficient to fully\nrepresent the clinical concept.\n\nA cluster expression combines a stem code with one or more satellite\ncodes using the & operator (combination) or / operator (specificity).\nExample: NC72.Z&XK8G&XJ7ZH&XJ7YM\n  - NC72.Z  — stem: Fracture of femur, unspecified\n  - XK8G    — satellite: laterality\n  - XJ7ZH   — satellite: fracture subtype\n  - XJ7YM   — satellite: fracture open or closed\n\nUsage rules:\n  - SHALL only be present when the expression contains at least one\n    satellite code joined by & or / operators.\n  - Single stem codes SHALL be represented in Coding.code only and\n    validated via OCL $validate-code. The cluster validator at\n    https://icd11.dghs.gov.bd/cluster/validate explicitly rejects\n    stem-only expressions.\n  - The stem code in Coding.code SHALL match the leading stem code\n    in this expression string.\n  - Satellite codes in the cluster expression are exempt from the\n    Diagnosis/Finding class restriction that applies to stem codes\n    in Condition.code.\n  - Cluster expressions SHALL be validated against the Bangladesh\n    ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate\n    prior to submission to the HIE.\n\nCluster validator endpoint:\n  POST https://icd11.dghs.gov.bd/cluster/validate\n  Body: { \"expression\": \"NC72.Z&XK8G&XJ7ZH&XJ7YM\" }\n\nThis extension is not MustSupport and is not mandatory. It is present\nonly when postcoordination is clinically required. Cluster expressions\nare typically sourced from the WHO Electronic Coding Tool (ECT) at the\npoint of care.",
      "isModifier": false,
      "short": "ICD-11 Cluster Expression",
      "max": "*",
      "id": "Extension",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "Extension"
      }
    }, {
      "path": "Extension.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "Unique id for inter-element referencing",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "string"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Extension.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
        "source": "http://hl7.org/fhir/StructureDefinition/Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Extension.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "rules": "open",
        "description": "Extensions are always sliced by (at least) url",
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "0",
      "id": "Extension.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Extension.url",
      "min": 1,
      "definition": "Source of the definition for the extension code - a logical name or a URL.",
      "isModifier": false,
      "short": "identifies the meaning of the extension",
      "fixedUri": "https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "http://hl7.org/fhirpath/System.String",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
          "valueUrl": "uri"
        } ]
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Extension.url",
      "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Extension.url"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "http://hl7.org/fhir/StructureDefinition/Element",
        "severity": "error",
        "expression": "hasValue() or (children().count() > id.count())"
      } ],
      "path": "Extension.value[x]",
      "min": 1,
      "definition": "The full postcoordinated cluster expression, including the stem code and\nall satellite codes joined by & or / operators. Example:\nNC72.Z&XK8G&XJ7ZH&XJ7YM. The stem code in this string SHALL match\nCoding.code on the parent Coding element.",
      "isModifier": false,
      "short": "ICD-11 postcoordinated cluster expression string",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Extension.value[x]",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Extension.value[x]"
      },
      "isSummary": false
    } ],
    "extension": [ {
      "url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
      "valueString": "4.0.1"
    } ]
  },
  "status": "active",
  "id": "fb335246-3958-4755-bdbd-611e63becc66",
  "kind": "complex-type",
  "url": "https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression",
  "context": [ {
    "type": "element",
    "expression": "Coding"
  } ],
  "version": "0.4.3",
  "differential": {
    "element": [ {
      "id": "Extension",
      "path": "Extension",
      "short": "ICD-11 Cluster Expression",
      "definition": "Carries a postcoordinated ICD-11 cluster expression as a single string\non a Coding element where the stem code alone is insufficient to fully\nrepresent the clinical concept.\n\nA cluster expression combines a stem code with one or more satellite\ncodes using the & operator (combination) or / operator (specificity).\nExample: NC72.Z&XK8G&XJ7ZH&XJ7YM\n  - NC72.Z  — stem: Fracture of femur, unspecified\n  - XK8G    — satellite: laterality\n  - XJ7ZH   — satellite: fracture subtype\n  - XJ7YM   — satellite: fracture open or closed\n\nUsage rules:\n  - SHALL only be present when the expression contains at least one\n    satellite code joined by & or / operators.\n  - Single stem codes SHALL be represented in Coding.code only and\n    validated via OCL $validate-code. The cluster validator at\n    https://icd11.dghs.gov.bd/cluster/validate explicitly rejects\n    stem-only expressions.\n  - The stem code in Coding.code SHALL match the leading stem code\n    in this expression string.\n  - Satellite codes in the cluster expression are exempt from the\n    Diagnosis/Finding class restriction that applies to stem codes\n    in Condition.code.\n  - Cluster expressions SHALL be validated against the Bangladesh\n    ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate\n    prior to submission to the HIE.\n\nCluster validator endpoint:\n  POST https://icd11.dghs.gov.bd/cluster/validate\n  Body: { \"expression\": \"NC72.Z&XK8G&XJ7ZH&XJ7YM\" }\n\nThis extension is not MustSupport and is not mandatory. It is present\nonly when postcoordination is clinically required. Cluster expressions\nare typically sourced from the WHO Electronic Coding Tool (ECT) at the\npoint of care."
    }, {
      "id": "Extension.extension",
      "max": "0",
      "path": "Extension.extension"
    }, {
      "id": "Extension.url",
      "path": "Extension.url",
      "fixedUri": "https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression"
    }, {
      "id": "Extension.value[x]",
      "min": 1,
      "path": "Extension.value[x]",
      "type": [ {
        "code": "string"
      } ],
      "short": "ICD-11 postcoordinated cluster expression string",
      "definition": "The full postcoordinated cluster expression, including the stem code and\nall satellite codes joined by & or / operators. Example:\nNC72.Z&XK8G&XJ7ZH&XJ7YM. The stem code in this string SHALL match\nCoding.code on the parent Coding element."
    } ]
  },
  "contact": [ {
    "telecom": [ {
      "value": "http://dghs.gov.bd",
      "system": "url"
    } ]
  } ],
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension"
}