Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Zib AllergyIntolerance - Detailed Descriptions

Active as of 2025-09-22

Definitions for the zib-AllergyIntolerance resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. AllergyIntolerance
ShortAllergyIntolerance
Alternate NamesAllergieIntolerantie
2. AllergyIntolerance.identifier
ShortIdentifier
NoteThis is a business identifier, not a resource identifier (see discussion)
Alternate NamesIdentificatie
4. AllergyIntolerance.clinicalStatus
ShortAllergyStatus
Alternate NamesAllergieStatus
6. AllergyIntolerance.clinicalStatus.extension
Control0..?
SlicingThis element introduces a set of slices on AllergyIntolerance.clinicalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst
    Slice NameAllergieStatusCodelijst
    Definition

    Statement on the status of the patient’s hypersensitivity.

    ShortAllergyStatus
    Control0..1
    TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
    Alternate NamesAllergieStatus
    10. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.valueCodeableConcept:valueCodeableConcept
    Slice NamevalueCodeableConcept
    BindingUnless not suitable, these codes SHALL be taken from AllergieStatusCodelijst
    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.3--20171231000000)

    AllergieStatusCodelijst

    12. AllergyIntolerance.verificationStatus
    ShortAllergyStatus
    Comments

    When HCIM AllergyStatus = Nullified, .verificationStatus should be set to entered-in-error. In all other cases it is up to the sending system to populate this element with the correct value.

    Alternate NamesAllergieStatus
    14. AllergyIntolerance.category
    16. AllergyIntolerance.category.extension
    Control0..?
    SlicingThis element introduces a set of slices on AllergyIntolerance.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 18. AllergyIntolerance.category.extension:AllergieCategorieCodelijst
      Slice NameAllergieCategorieCodelijst
      Definition

      Identifies the allergy category such as medication, food or environment.

      ShortAllergyCategory
      Control0..1
      TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
      Alternate NamesAllergieCategorie
      20. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.valueCodeableConcept:valueCodeableConcept
      Slice NamevalueCodeableConcept
      BindingUnless not suitable, these codes SHALL be taken from AllergieCategorieCodelijst
      (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.2--20171231000000)

      AllergieCategorieCodelijst

      22. AllergyIntolerance.criticality
      24. AllergyIntolerance.criticality.extension
      Control0..?
      SlicingThis element introduces a set of slices on AllergyIntolerance.criticality.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 26. AllergyIntolerance.criticality.extension:CriticalExtentCodelist
        Slice NameCriticalExtentCodelist
        Definition

        Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself.

        ShortCriticality
        Control0..1
        TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
        Alternate NamesMateVanKritiekZijn
        28. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.valueCodeableConcept:valueCodeableConcept
        Slice NamevalueCodeableConcept
        BindingUnless not suitable, these codes SHALL be taken from MateVanKritiekZijnCodelijst
        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.4--20171231000000)

        CriticalExtentCodelist

        30. AllergyIntolerance.code
        ShortCausativeAgent
        Control1..?
        Alternate NamesVeroorzakendeStof
        32. AllergyIntolerance.code.coding
        SlicingThis element introduces a set of slices on AllergyIntolerance.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ system
        • 34. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist
          Slice NamecausativeAgentAllergicAgentCodelist
          BindingThe codes SHALL be taken from VeroorzakendeStofAllergeneStoffenCodelijst
          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.17--20171231000000)

          SNOMED CT - Alle waarden

          36. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.system
          Control1..?
          Fixed Valuehttp://snomed.info/sct
          38. AllergyIntolerance.code.coding:causativeAgentHPKCodelist
          Slice NamecausativeAgentHPKCodelist
          BindingThe codes SHALL be taken from VeroorzakendeStofHPKCodelijst
          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.19--20171231000000)

          G-Standaard Handels Product Kode (HPK) - Alle waarden

          40. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.system
          Control1..?
          Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.7
          42. AllergyIntolerance.code.coding:causativeAgentSNKCodelist
          Slice NamecausativeAgentSNKCodelist
          BindingThe codes SHALL be taken from VeroorzakendeStofSNKCodelijst
          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.14--20171231000000)

          G-standaard Stofnaamcode (SNK) - Alle waarden

          44. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.system
          Control1..?
          Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.750
          46. AllergyIntolerance.code.coding:causativeAgentSSKCodelist
          Slice NamecausativeAgentSSKCodelist
          BindingThe codes SHALL be taken from VeroorzakendeStofSSKCodelijst
          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.13--20171231000000)

          G-standaard Stofnaamcode i.c.m. toedieningsweg (SSK) - Alle waarden

          48. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.system
          Control1..?
          Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.725
          50. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist
          Slice NamecausativeAgentThesaurus122Codelist
          BindingThe codes SHALL be taken from VeroorzakendeStofThesaurus122Codelijst
          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.15--20171231000000)

          G-standaard Ongewenste medicatiegroepen - Alle waarden

          52. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.system
          Control1..?
          Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.902.122
          54. AllergyIntolerance.patient
          ShortPatient
          TypeReference(nl-core-patient)
          Alternate NamesPatiënt
          56. AllergyIntolerance.onset[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          SlicingThis element introduces a set of slices on AllergyIntolerance.onset[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 58. AllergyIntolerance.onset[x]:onsetDateTime
            Slice NameonsetDateTime
            Definition

            The date and time at which the allergy or undesired reaction was determined.
            This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).

            ShortStartDateTime
            TypedateTime
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Alternate NamesBeginDatumTijd
            60. AllergyIntolerance.recorder
            ShortRecorder
            TypeReference(nl-core-practitioner, nl-core-patient)
            Alternate NamesAuteur
            62. AllergyIntolerance.recorder.extension
            Control0..?
            SlicingThis element introduces a set of slices on AllergyIntolerance.recorder.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 64. AllergyIntolerance.recorder.extension:practitionerRole
              Slice NamepractitionerRole
              Control0..1
              TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
              66. AllergyIntolerance.asserter
              ShortInformant
              TypeReference(nl-core-patient, nl-core-relatedperson, nl-core-practitioner)
              68. AllergyIntolerance.asserter.extension
              Control0..?
              SlicingThis element introduces a set of slices on AllergyIntolerance.asserter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 70. AllergyIntolerance.asserter.extension:practitionerRole
                Slice NamepractitionerRole
                Control0..1
                TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                72. AllergyIntolerance.lastOccurrence
                Definition

                Entry of the last time a hypersensitive reaction took place.

                ShortLastReactionDateTime
                Alternate NamesLaatsteReactieDatumTijd
                74. AllergyIntolerance.note
                76. AllergyIntolerance.note.author[x]
                ShortAuthor
                TypeChoice of: string, Reference(nl-core-practitioner, nl-core-patient, nl-core-relatedperson)
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Alternate NamesAuteur
                SlicingThis element introduces a set of slices on AllergyIntolerance.note.author[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                • type @ $this
                • 78. AllergyIntolerance.note.author[x]:authorReference
                  Slice NameauthorReference
                  TypeReference(Practitioner, Patient, RelatedPerson)
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  80. AllergyIntolerance.note.author[x]:authorReference.extension
                  Control0..?
                  SlicingThis element introduces a set of slices on AllergyIntolerance.note.author[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 82. AllergyIntolerance.note.author[x]:authorReference.extension:practitionerRole
                    Slice NamepractitionerRole
                    Comments

                    Relevant only in combination with Reference(Practitioner)

                    Control0..1
                    TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                    84. AllergyIntolerance.note.author[x]:authorString
                    Slice NameauthorString
                    Typestring
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    86. AllergyIntolerance.note.text
                    Definition

                    Textual explanation of the hypersensitivity which cannot be entered in any of the other fields.

                    ShortComment
                    Alternate NamesToelichting
                    88. AllergyIntolerance.reaction
                    ShortReaction
                    Alternate NamesReactie
                    90. AllergyIntolerance.reaction.substance
                    Definition

                    More specific indication of the substance that caused the reaction. This can be a specific substance from a group of substances to which the patient is allergic or hypersensitive.

                    ShortSpecificSubstance
                    Alternate NamesSpecifiekeStof
                    92. AllergyIntolerance.reaction.substance.coding
                    SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ system
                    • 94. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist
                      Slice NamespecificSubstanceAllergicAgentCodelist
                      Comments

                      SNOMED refset ^42931000146101 has been deprecated in favor of refset ^98061000146100. For compatibility reasons, this original refset has been re-activated, but its contents have been replaced with that of the new refset.

                      BindingThe codes SHALL be taken from SpecifiekeStofAllergeneStoffenCodelijst
                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.16--20171231000000)

                      SNOMED CT - SNOMED CT: ^42931000146101| Dutch non-drug allergen simple reference set (foundation metadata concept)

                      96. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.system
                      Control1..?
                      Fixed Valuehttp://snomed.info/sct
                      98. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist
                      Slice NamespecificSubstanceHPKCodelist
                      BindingThe codes SHALL be taken from SpecifiekeStofHPKCodelijst
                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.18--20171231000000)

                      G-Standaard Handels Product Kode (HPK) - Alle waarden

                      100. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.system
                      Control1..?
                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.7
                      102. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist
                      Slice NamespecificSubstanceSNKCodelist
                      BindingThe codes SHALL be taken from SpecifiekeStofSNKCodelijst
                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.10--20171231000000)

                      G-standaard Stofnaamcode (SNK) - Alle waarden

                      104. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.system
                      Control1..?
                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.750
                      106. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist
                      Slice NamespecificSubstanceSSKCodelist
                      BindingThe codes SHALL be taken from SpecifiekeStofSSKCodelijst
                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.9--20171231000000)

                      SpecifiekeStofSSKCodelijst

                      108. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.system
                      Control1..?
                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.725
                      110. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist
                      Slice NamespecificSubstanceThesaurus122Codelist
                      BindingThe codes SHALL be taken from SpecifiekeStofThesaurus122Codelijst
                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.11--20171231000000)

                      G-standaard Ongewenste medicatiegroepen - Alle waarden

                      112. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.system
                      Control1..?
                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.902.122
                      114. AllergyIntolerance.reaction.manifestation
                      Definition

                      The content specifications of the reaction that takes place when the patient is exposed to the causative substance.

                      ShortSymptom
                      BindingThe codes SHALL be taken from SymptoomCodelijst
                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.5--20171231000000)
                      Alternate NamesSymptoom
                      116. AllergyIntolerance.reaction.description
                      ShortReactionDescription
                      Alternate NamesReactieBeschrijving
                      118. AllergyIntolerance.reaction.onset
                      Definition

                      Date and time at which the reaction took place. This may also be just the date or a partial date, in the event that the exact date is unknown.

                      ShortReactionTime
                      Alternate NamesReactieTijdstip
                      120. AllergyIntolerance.reaction.severity
                      Definition

                      The severity of the reaction as a result of exposure to the causative substance.

                      ShortSeverity
                      Alternate NamesErnst
                      122. AllergyIntolerance.reaction.severity.extension
                      Control0..?
                      SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.severity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • value @ url
                      • 124. AllergyIntolerance.reaction.severity.extension:SeverityCodelist
                        Slice NameSeverityCodelist
                        Control0..?
                        TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                        126. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.valueCodeableConcept:valueCodeableConcept
                        Slice NamevalueCodeableConcept
                        BindingUnless not suitable, these codes SHALL be taken from ErnstCodelijst
                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.6--20171231000000)

                        ErnstCodelijst

                        128. AllergyIntolerance.reaction.exposureRoute
                        Definition

                        Way in which the patient came into contact with the causative agent or the way in which the agent was administered.

                        ShortMannerOfExposure
                        BindingUnless not suitable, these codes SHALL be taken from WijzeVanBlootstellingCodelijst
                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.12--20171231000000)
                        Alternate NamesWijzeVanBlootstelling

                        Guidance on how to interpret the contents of this table can be foundhere

                        0. AllergyIntolerance
                        Definition

                        Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

                        ShortAllergyIntoleranceAllergy or Intolerance (generally: Risk of adverse reaction to a substance)
                        Comments

                        Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

                        Control0..*
                        Alternate NamesAllergy, Intolerance, Adverse Reaction, AllergieIntolerantie
                        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                        dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
                        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
                        ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. (verificationStatus='entered-in-error' or clinicalStatus.exists())
                        ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus!='entered-in-error' or clinicalStatus.empty())
                        dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                        dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
                        dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                        dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
                        ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. (verificationStatus='entered-in-error' or clinicalStatus.exists())
                        ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus!='entered-in-error' or clinicalStatus.empty())
                        2. AllergyIntolerance.implicitRules
                        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.

                        ShortA set of rules under which this content was created
                        Comments

                        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.

                        This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

                        Control0..1
                        Typeuri
                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        4. AllergyIntolerance.modifierExtension
                        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. Usually modifier elements provide negation or qualification. In order 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.

                        ShortExtensions that cannot be ignored
                        Comments

                        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.

                        Control0..*
                        TypeExtension
                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                        Alternate Namesextensions, user content
                        6. AllergyIntolerance.identifier
                        Definition

                        This records identifiers associated with this allergy/intolerance concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

                        ShortIdentifierExternal ids for this item
                        NoteThis is a business identifier, not a resource identifier (see discussion)
                        Control0..*
                        TypeIdentifier
                        Summarytrue
                        Alternate NamesIdentificatie
                        8. AllergyIntolerance.clinicalStatus
                        Definition

                        The clinical status of the allergy or intolerance.

                        ShortAllergyStatusactive | inactive | resolved
                        Comments

                        This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.

                        Control0..1
                        This element is affected by the following invariants: ait-1, ait-2
                        BindingThe codes SHALL be taken from AllergyIntoleranceClinicalStatushttp://hl7.org/fhir/ValueSet/allergy-clinical-status|3.0.2
                        (required to http://hl7.org/fhir/ValueSet/allergy-clinical-status|3.0.2)
                        Typecode
                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Alternate NamesAllergieStatus
                        10. AllergyIntolerance.clinicalStatus.extension
                        Definition

                        An Extension


                        May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                        ShortExtensionAdditional Content defined by implementations
                        Comments

                        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.

                        Control0..*
                        TypeExtension
                        Alternate Namesextensions, user content
                        SlicingThis element introduces a set of slices on AllergyIntolerance.clinicalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • value @ url
                        • 12. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst
                          Slice NameAllergieStatusCodelijst
                          Definition

                          Statement on the status of the patient’s hypersensitivity.

                          ShortAllergyStatus
                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                          Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., AllergieStatus
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          14. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.url
                          Definition

                          Source of the definition for the extension code - a logical name or a URL.

                          Shortidentifies the meaning of the extension
                          Comments

                          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.

                          Control1..1
                          Typeuri
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          XML FormatIn the XML format, this property is represented as an attribute.
                          Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                          16. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.value[x]
                          Definition

                          Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                          ShortValue of extension
                          Control10..1
                          TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          SlicingThis element introduces a set of slices on AllergyIntolerance.clinicalStatus.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 18. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.value[x]:valueCodeableConcept
                            Slice NamevalueCodeableConcept
                            Definition

                            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                            ShortValue of extension
                            Control10..1
                            BindingUnless not suitable, these codes SHALL be taken from For codes, see AllergieStatusCodelijst
                            (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.3--20171231000000)

                            AllergieStatusCodelijst

                            TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            20. AllergyIntolerance.verificationStatus
                            Definition

                            Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).

                            ShortAllergyStatusunconfirmed | confirmed | refuted | entered-in-error
                            Comments

                            When HCIM AllergyStatus = Nullified, .verificationStatus should be set to entered-in-error. In all other cases it is up to the sending system to populate this element with the correct value.


                            This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.

                            Control1..1
                            This element is affected by the following invariants: ait-1, ait-2
                            BindingThe codes SHALL be taken from AllergyIntoleranceVerificationStatushttp://hl7.org/fhir/ValueSet/allergy-verification-status|3.0.2
                            (required to http://hl7.org/fhir/ValueSet/allergy-verification-status|3.0.2)

                            Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

                            Typecode
                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesAllergieStatus
                            22. AllergyIntolerance.category
                            Definition

                            Category of the identified substance.

                            Shortfood | medication | environment | biologic
                            Comments

                            This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.

                            Control0..*
                            BindingThe codes SHALL be taken from AllergyIntoleranceCategoryhttp://hl7.org/fhir/ValueSet/allergy-intolerance-category|3.0.2
                            (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-category|3.0.2)
                            Typecode
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Alternate NamesCategory, Type, Reaction Type, Class
                            24. AllergyIntolerance.category.extension
                            Definition

                            An Extension


                            May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                            ShortExtensionAdditional Content defined by implementations
                            Comments

                            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.

                            Control0..*
                            TypeExtension
                            Alternate Namesextensions, user content
                            SlicingThis element introduces a set of slices on AllergyIntolerance.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 26. AllergyIntolerance.category.extension:AllergieCategorieCodelijst
                              Slice NameAllergieCategorieCodelijst
                              Definition

                              Identifies the allergy category such as medication, food or environment.

                              ShortAllergyCategory
                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                              Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., AllergieCategorie
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              28. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.url
                              Definition

                              Source of the definition for the extension code - a logical name or a URL.

                              Shortidentifies the meaning of the extension
                              Comments

                              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.

                              Control1..1
                              Typeuri
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                              30. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.value[x]
                              Definition

                              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                              ShortValue of extension
                              Control10..1
                              TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              SlicingThis element introduces a set of slices on AllergyIntolerance.category.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 32. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.value[x]:valueCodeableConcept
                                Slice NamevalueCodeableConcept
                                Definition

                                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                ShortValue of extension
                                Control10..1
                                BindingUnless not suitable, these codes SHALL be taken from For codes, see AllergieCategorieCodelijst
                                (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.2--20171231000000)

                                AllergieCategorieCodelijst

                                TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                34. AllergyIntolerance.criticality
                                Definition

                                Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.

                                Shortlow | high | unable-to-assess
                                Comments

                                The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).

                                Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.

                                Control0..1
                                BindingThe codes SHALL be taken from AllergyIntoleranceCriticalityhttp://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|3.0.2
                                (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|3.0.2)
                                Typecode
                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                Summarytrue
                                Alternate NamesSeverity, Seriousness, Contra-indication, Risk
                                36. AllergyIntolerance.criticality.extension
                                Definition

                                An Extension


                                May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                ShortExtensionAdditional Content defined by implementations
                                Comments

                                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.

                                Control0..*
                                TypeExtension
                                Alternate Namesextensions, user content
                                SlicingThis element introduces a set of slices on AllergyIntolerance.criticality.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 38. AllergyIntolerance.criticality.extension:CriticalExtentCodelist
                                  Slice NameCriticalExtentCodelist
                                  Definition

                                  Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself.

                                  ShortCriticality
                                  Control0..1
                                  This element is affected by the following invariants: ele-1
                                  TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                                  Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., MateVanKritiekZijn
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  40. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.url
                                  Definition

                                  Source of the definition for the extension code - a logical name or a URL.

                                  Shortidentifies the meaning of the extension
                                  Comments

                                  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.

                                  Control1..1
                                  Typeuri
                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                                  42. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.value[x]
                                  Definition

                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                  ShortValue of extension
                                  Control10..1
                                  TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  SlicingThis element introduces a set of slices on AllergyIntolerance.criticality.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 44. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.value[x]:valueCodeableConcept
                                    Slice NamevalueCodeableConcept
                                    Definition

                                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                    ShortValue of extension
                                    Control10..1
                                    BindingUnless not suitable, these codes SHALL be taken from For codes, see MateVanKritiekZijnCodelijst
                                    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.4--20171231000000)

                                    CriticalExtentCodelist

                                    TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    46. AllergyIntolerance.code
                                    Definition

                                    Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies").

                                    ShortCausativeAgentCode that identifies the allergy or intolerance
                                    Comments

                                    It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.

                                    When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.

                                    The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.

                                    Control10..1
                                    BindingFor example codes, see AllergyIntolerance Substance/Product, Condition and Negation Codeshttp://hl7.org/fhir/ValueSet/allergyintolerance-code|3.0.2
                                    (example to http://hl7.org/fhir/ValueSet/allergyintolerance-code|3.0.2)

                                    Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.

                                    TypeCodeableConcept
                                    Summarytrue
                                    Alternate NamesCode, VeroorzakendeStof
                                    48. AllergyIntolerance.code.coding
                                    Definition

                                    A reference to a code defined by a terminology system.

                                    ShortCode defined by a terminology system
                                    Comments

                                    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.

                                    Control0..*
                                    TypeCoding
                                    Summarytrue
                                    Requirements

                                    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                    SlicingThis element introduces a set of slices on AllergyIntolerance.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ system
                                    • 50. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist
                                      Slice NamecausativeAgentAllergicAgentCodelist
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      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.

                                      Control0..*
                                      BindingThe codes SHALL be taken from For codes, see VeroorzakendeStofAllergeneStoffenCodelijst
                                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.17--20171231000000)

                                      SNOMED CT - Alle waarden

                                      TypeCoding
                                      Summarytrue
                                      Requirements

                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                      52. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.system
                                      Definition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      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 de-reference to some definition that establish the system clearly and unambiguously.

                                      Control10..1
                                      Typeuri
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      Fixed Valuehttp://snomed.info/sct
                                      54. AllergyIntolerance.code.coding:causativeAgentHPKCodelist
                                      Slice NamecausativeAgentHPKCodelist
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      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.

                                      Control0..*
                                      BindingThe codes SHALL be taken from For codes, see VeroorzakendeStofHPKCodelijst
                                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.19--20171231000000)

                                      G-Standaard Handels Product Kode (HPK) - Alle waarden

                                      TypeCoding
                                      Summarytrue
                                      Requirements

                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                      56. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.system
                                      Definition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      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 de-reference to some definition that establish the system clearly and unambiguously.

                                      Control10..1
                                      Typeuri
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.7
                                      58. AllergyIntolerance.code.coding:causativeAgentSNKCodelist
                                      Slice NamecausativeAgentSNKCodelist
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      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.

                                      Control0..*
                                      BindingThe codes SHALL be taken from For codes, see VeroorzakendeStofSNKCodelijst
                                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.14--20171231000000)

                                      G-standaard Stofnaamcode (SNK) - Alle waarden

                                      TypeCoding
                                      Summarytrue
                                      Requirements

                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                      60. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.system
                                      Definition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      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 de-reference to some definition that establish the system clearly and unambiguously.

                                      Control10..1
                                      Typeuri
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.750
                                      62. AllergyIntolerance.code.coding:causativeAgentSSKCodelist
                                      Slice NamecausativeAgentSSKCodelist
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      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.

                                      Control0..*
                                      BindingThe codes SHALL be taken from For codes, see VeroorzakendeStofSSKCodelijst
                                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.13--20171231000000)

                                      G-standaard Stofnaamcode i.c.m. toedieningsweg (SSK) - Alle waarden

                                      TypeCoding
                                      Summarytrue
                                      Requirements

                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                      64. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.system
                                      Definition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      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 de-reference to some definition that establish the system clearly and unambiguously.

                                      Control10..1
                                      Typeuri
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.725
                                      66. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist
                                      Slice NamecausativeAgentThesaurus122Codelist
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      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.

                                      Control0..*
                                      BindingThe codes SHALL be taken from For codes, see VeroorzakendeStofThesaurus122Codelijst
                                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.15--20171231000000)

                                      G-standaard Ongewenste medicatiegroepen - Alle waarden

                                      TypeCoding
                                      Summarytrue
                                      Requirements

                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                      68. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.system
                                      Definition

                                      The identification of the code system that defines the meaning of the symbol in the code.

                                      ShortIdentity of the terminology system
                                      Comments

                                      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 de-reference to some definition that establish the system clearly and unambiguously.

                                      Control10..1
                                      Typeuri
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      Summarytrue
                                      Requirements

                                      Need to be unambiguous about the source of the definition of the symbol.

                                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.902.122
                                      70. AllergyIntolerance.patient
                                      Definition

                                      The patient who has the allergy or intolerance.

                                      ShortPatientWho the sensitivity is for
                                      Control1..1
                                      TypeReference(nl-core-patient, Patient)
                                      Summarytrue
                                      Alternate NamesPatient, Patiënt
                                      72. AllergyIntolerance.onset[x]
                                      Definition

                                      Estimated or actual date, date-time, or age when allergy or intolerance was identified.

                                      ShortWhen allergy or intolerance was identified
                                      Control0..1
                                      TypeChoice of: dateTime, Age, Period, Range, string
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                      SlicingThis element introduces a set of slices on AllergyIntolerance.onset[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • type @ $this
                                      • 74. AllergyIntolerance.onset[x]:onsetDateTime
                                        Slice NameonsetDateTime
                                        Definition

                                        The date and time at which the allergy or undesired reaction was determined.
                                        This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).


                                        Estimated or actual date, date-time, or age when allergy or intolerance was identified.

                                        ShortStartDateTimeWhen allergy or intolerance was identified
                                        Control0..1
                                        TypedateTime, string, Period, Range, Age
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Alternate NamesBeginDatumTijd
                                        76. AllergyIntolerance.recorder
                                        Definition

                                        Individual who recorded the record and takes responsibility for its content.

                                        ShortRecorderWho recorded the sensitivity
                                        Control0..1
                                        TypeReference(nl-core-practitioner, nl-core-patient, Practitioner, Patient)
                                        Alternate NamesAuthor, Auteur
                                        78. AllergyIntolerance.recorder.extension
                                        Definition

                                        An Extension


                                        May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                        ShortExtensionAdditional Content defined by implementations
                                        Comments

                                        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.

                                        Control0..*
                                        TypeExtension
                                        Alternate Namesextensions, user content
                                        SlicingThis element introduces a set of slices on AllergyIntolerance.recorder.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 80. AllergyIntolerance.recorder.extension:practitionerRole
                                          Slice NamepractitionerRole
                                          Definition

                                          Optional Extension Element - found in all resources.

                                          ShortOptional Extensions Element
                                          Control0..1
                                          TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                          82. AllergyIntolerance.asserter
                                          Definition

                                          The source of the information about the allergy that is recorded.

                                          ShortInformantSource of the information about the allergy
                                          Comments

                                          The recorder takes repsonsibility for the content, but can reference the source from where they got it.

                                          Control0..1
                                          TypeReference(nl-core-patient, nl-core-relatedperson, nl-core-practitioner, Patient, RelatedPerson, Practitioner)
                                          Summarytrue
                                          Alternate NamesSource, Informant
                                          84. AllergyIntolerance.asserter.extension
                                          Definition

                                          An Extension


                                          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                          ShortExtensionAdditional Content defined by implementations
                                          Comments

                                          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.

                                          Control0..*
                                          TypeExtension
                                          Alternate Namesextensions, user content
                                          SlicingThis element introduces a set of slices on AllergyIntolerance.asserter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 86. AllergyIntolerance.asserter.extension:practitionerRole
                                            Slice NamepractitionerRole
                                            Definition

                                            Optional Extension Element - found in all resources.

                                            ShortOptional Extensions Element
                                            Control0..1
                                            TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                            88. AllergyIntolerance.lastOccurrence
                                            Definition

                                            Entry of the last time a hypersensitive reaction took place.


                                            Represents the date and/or time of the last known occurrence of a reaction event.

                                            ShortLastReactionDateTimeDate(/time) of last known occurrence of a reaction
                                            Comments

                                            This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.

                                            Control0..1
                                            TypedateTime
                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                            Alternate NamesLaatsteReactieDatumTijd
                                            90. AllergyIntolerance.reaction
                                            Definition

                                            Details about each adverse reaction event linked to exposure to the identified substance.

                                            ShortReactionAdverse Reaction Events linked to exposure to substance
                                            Control0..*
                                            TypeBackboneElement
                                            Alternate NamesReactie
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                            ele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                            92. AllergyIntolerance.reaction.modifierExtension
                                            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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                                            ShortExtensions that cannot be ignored
                                            Comments

                                            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.

                                            Control0..*
                                            TypeExtension
                                            Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                            Summarytrue
                                            Alternate Namesextensions, user content, modifiers
                                            94. AllergyIntolerance.reaction.substance
                                            Definition

                                            More specific indication of the substance that caused the reaction. This can be a specific substance from a group of substances to which the patient is allergic or hypersensitive.


                                            Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.

                                            ShortSpecificSubstanceSpecific substance or pharmaceutical product considered to be responsible for event
                                            Comments

                                            Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.

                                            Control0..1
                                            BindingFor example codes, see Substance Codehttp://hl7.org/fhir/ValueSet/substance-code|3.0.2
                                            (example to http://hl7.org/fhir/ValueSet/substance-code|3.0.2)

                                            Codes defining the type of the substance (including pharmaceutical products).

                                            TypeCodeableConcept
                                            Alternate NamesSpecifiekeStof
                                            96. AllergyIntolerance.reaction.substance.coding
                                            Definition

                                            A reference to a code defined by a terminology system.

                                            ShortCode defined by a terminology system
                                            Comments

                                            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.

                                            Control0..*
                                            TypeCoding
                                            Summarytrue
                                            Requirements

                                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                            SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ system
                                            • 98. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist
                                              Slice NamespecificSubstanceAllergicAgentCodelist
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              SNOMED refset ^42931000146101 has been deprecated in favor of refset ^98061000146100. For compatibility reasons, this original refset has been re-activated, but its contents have been replaced with that of the new refset.


                                              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.

                                              Control0..*
                                              BindingThe codes SHALL be taken from For codes, see SpecifiekeStofAllergeneStoffenCodelijst
                                              (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.16--20171231000000)

                                              SNOMED CT - SNOMED CT: ^42931000146101| Dutch non-drug allergen simple reference set (foundation metadata concept)

                                              TypeCoding
                                              Summarytrue
                                              Requirements

                                              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                              100. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.system
                                              Definition

                                              The identification of the code system that defines the meaning of the symbol in the code.

                                              ShortIdentity of the terminology system
                                              Comments

                                              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 de-reference to some definition that establish the system clearly and unambiguously.

                                              Control10..1
                                              Typeuri
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to be unambiguous about the source of the definition of the symbol.

                                              Fixed Valuehttp://snomed.info/sct
                                              102. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist
                                              Slice NamespecificSubstanceHPKCodelist
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              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.

                                              Control0..*
                                              BindingThe codes SHALL be taken from For codes, see SpecifiekeStofHPKCodelijst
                                              (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.18--20171231000000)

                                              G-Standaard Handels Product Kode (HPK) - Alle waarden

                                              TypeCoding
                                              Summarytrue
                                              Requirements

                                              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                              104. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.system
                                              Definition

                                              The identification of the code system that defines the meaning of the symbol in the code.

                                              ShortIdentity of the terminology system
                                              Comments

                                              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 de-reference to some definition that establish the system clearly and unambiguously.

                                              Control10..1
                                              Typeuri
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to be unambiguous about the source of the definition of the symbol.

                                              Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.7
                                              106. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist
                                              Slice NamespecificSubstanceSNKCodelist
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              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.

                                              Control0..*
                                              BindingThe codes SHALL be taken from For codes, see SpecifiekeStofSNKCodelijst
                                              (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.10--20171231000000)

                                              G-standaard Stofnaamcode (SNK) - Alle waarden

                                              TypeCoding
                                              Summarytrue
                                              Requirements

                                              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                              108. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.system
                                              Definition

                                              The identification of the code system that defines the meaning of the symbol in the code.

                                              ShortIdentity of the terminology system
                                              Comments

                                              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 de-reference to some definition that establish the system clearly and unambiguously.

                                              Control10..1
                                              Typeuri
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to be unambiguous about the source of the definition of the symbol.

                                              Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.750
                                              110. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist
                                              Slice NamespecificSubstanceSSKCodelist
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              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.

                                              Control0..*
                                              BindingThe codes SHALL be taken from For codes, see SpecifiekeStofSSKCodelijst
                                              (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.9--20171231000000)

                                              SpecifiekeStofSSKCodelijst

                                              TypeCoding
                                              Summarytrue
                                              Requirements

                                              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                              112. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.system
                                              Definition

                                              The identification of the code system that defines the meaning of the symbol in the code.

                                              ShortIdentity of the terminology system
                                              Comments

                                              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 de-reference to some definition that establish the system clearly and unambiguously.

                                              Control10..1
                                              Typeuri
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to be unambiguous about the source of the definition of the symbol.

                                              Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.725
                                              114. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist
                                              Slice NamespecificSubstanceThesaurus122Codelist
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              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.

                                              Control0..*
                                              BindingThe codes SHALL be taken from For codes, see SpecifiekeStofThesaurus122Codelijst
                                              (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.11--20171231000000)

                                              G-standaard Ongewenste medicatiegroepen - Alle waarden

                                              TypeCoding
                                              Summarytrue
                                              Requirements

                                              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                              116. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.system
                                              Definition

                                              The identification of the code system that defines the meaning of the symbol in the code.

                                              ShortIdentity of the terminology system
                                              Comments

                                              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 de-reference to some definition that establish the system clearly and unambiguously.

                                              Control10..1
                                              Typeuri
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              Need to be unambiguous about the source of the definition of the symbol.

                                              Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.902.122
                                              118. AllergyIntolerance.reaction.manifestation
                                              Definition

                                              The content specifications of the reaction that takes place when the patient is exposed to the causative substance.


                                              Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.

                                              ShortSymptomClinical symptoms/signs associated with the Event
                                              Comments

                                              Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.

                                              Control1..*
                                              BindingThe codes SHALL be taken from For example codes, see SymptoomCodelijsthttp://hl7.org/fhir/ValueSet/clinical-findings|3.0.2
                                              (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.5--20171231000000)
                                              TypeCodeableConcept
                                              Alternate NamesSymptoms, Signs, Symptoom
                                              120. AllergyIntolerance.reaction.description
                                              Definition

                                              Text description about the reaction as a whole, including details of the manifestation if required.

                                              ShortReactionDescriptionDescription of the event as a whole
                                              Comments

                                              Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.

                                              Control0..1
                                              Typestring
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Alternate NamesNarrative, Text, ReactieBeschrijving
                                              122. AllergyIntolerance.reaction.onset
                                              Definition

                                              Date and time at which the reaction took place. This may also be just the date or a partial date, in the event that the exact date is unknown.


                                              Record of the date and/or time of the onset of the Reaction.

                                              ShortReactionTimeDate(/time) when manifestations showed
                                              Control0..1
                                              TypedateTime
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Alternate NamesReactieTijdstip
                                              124. AllergyIntolerance.reaction.severity
                                              Definition

                                              The severity of the reaction as a result of exposure to the causative substance.


                                              Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.

                                              ShortSeveritymild | moderate | severe (of event as a whole)
                                              Comments

                                              It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

                                              Control0..1
                                              BindingThe codes SHALL be taken from AllergyIntoleranceSeverityhttp://hl7.org/fhir/ValueSet/reaction-event-severity|3.0.2
                                              (required to http://hl7.org/fhir/ValueSet/reaction-event-severity|3.0.2)
                                              Typecode
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Alternate NamesErnst
                                              126. AllergyIntolerance.reaction.severity.extension
                                              Definition

                                              An Extension


                                              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                              ShortExtensionAdditional Content defined by implementations
                                              Comments

                                              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.

                                              Control0..*
                                              TypeExtension
                                              Alternate Namesextensions, user content
                                              SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.severity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • value @ url
                                              • 128. AllergyIntolerance.reaction.severity.extension:SeverityCodelist
                                                Slice NameSeverityCodelist
                                                Definition

                                                Defines a more specific coded value for a code or string. Especially useful for FHIR's required ValueSets. These extensions are primarily used on codes bound to a required value set, where you would like to use a more specific code than the codes in the bounded value set.

                                                ShortProvides the specific HCIM code for a FHIR element that has a required binding to a FHIR ValueSet
                                                Control0..*
                                                This element is affected by the following invariants: ele-1
                                                TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                                                Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet.
                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                130. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.url
                                                Definition

                                                Source of the definition for the extension code - a logical name or a URL.

                                                Shortidentifies the meaning of the extension
                                                Comments

                                                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.

                                                Control1..1
                                                Typeuri
                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                                                132. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.value[x]
                                                Definition

                                                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                ShortValue of extension
                                                Control10..1
                                                TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.severity.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 134. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.value[x]:valueCodeableConcept
                                                  Slice NamevalueCodeableConcept
                                                  Definition

                                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                  ShortValue of extension
                                                  Control10..1
                                                  BindingUnless not suitable, these codes SHALL be taken from For codes, see ErnstCodelijst
                                                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.6--20171231000000)

                                                  ErnstCodelijst

                                                  TypeCodeableConcept, date, dateTime, Meta, code, string, Address, Attachment, integer, oid, Count, instant, ContactPoint, HumanName, Money, Identifier, Coding, markdown, SampledData, Ratio, id, positiveInt, Age, Distance, Reference, Period, Quantity, Duration, Range, uri, Annotation, boolean, base64Binary, Signature, unsignedInt, time, Timing, decimal
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  136. AllergyIntolerance.reaction.exposureRoute
                                                  Definition

                                                  Way in which the patient came into contact with the causative agent or the way in which the agent was administered.


                                                  Identification of the route by which the subject was exposed to the substance.

                                                  ShortMannerOfExposureHow the subject was exposed to the substance
                                                  Comments

                                                  Coding of the route of exposure with a terminology should be used wherever possible.

                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from For example codes, see WijzeVanBlootstellingCodelijsthttp://hl7.org/fhir/ValueSet/route-codes|3.0.2
                                                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.12--20171231000000)
                                                  TypeCodeableConcept
                                                  Alternate NamesWijzeVanBlootstelling

                                                  Guidance on how to interpret the contents of this table can be foundhere

                                                  0. AllergyIntolerance
                                                  Definition

                                                  Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

                                                  ShortAllergyIntolerance
                                                  Comments

                                                  Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

                                                  Control0..*
                                                  Alternate NamesAllergy, Intolerance, Adverse Reaction, AllergieIntolerantie
                                                  Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                  dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative (contained.text.empty())
                                                  dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                  dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource (contained.where(('#'+id in %resource.descendants().reference).not()).empty())
                                                  ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. (verificationStatus='entered-in-error' or clinicalStatus.exists())
                                                  ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus!='entered-in-error' or clinicalStatus.empty())
                                                  2. AllergyIntolerance.id
                                                  Definition

                                                  The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                  ShortLogical id of this artifact
                                                  Comments

                                                  The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                  Control0..1
                                                  Typeid
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  4. AllergyIntolerance.meta
                                                  Definition

                                                  The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

                                                  ShortMetadata about the resource
                                                  Control0..1
                                                  TypeMeta
                                                  Summarytrue
                                                  6. AllergyIntolerance.implicitRules
                                                  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.

                                                  ShortA set of rules under which this content was created
                                                  Comments

                                                  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.

                                                  This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

                                                  Control0..1
                                                  Typeuri
                                                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  8. AllergyIntolerance.language
                                                  Definition

                                                  The base language in which the resource is written.

                                                  ShortLanguage of the resource content
                                                  Comments

                                                  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).

                                                  Control0..1
                                                  BindingUnless not suitable, these codes SHALL be taken from Common Languages
                                                  (extensible to http://hl7.org/fhir/ValueSet/languages|3.0.2)

                                                  A human language.

                                                  Additional BindingsPurpose
                                                  All LanguagesMax Binding
                                                  Typecode
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  10. AllergyIntolerance.text
                                                  Definition

                                                  A human-readable narrative that contains a summary of the resource, and may 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.

                                                  ShortText summary of the resource, for human interpretation
                                                  Comments

                                                  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 in formation is added later.

                                                  Control0..1
                                                  This element is affected by the following invariants: dom-1
                                                  TypeNarrative
                                                  Alternate Namesnarrative, html, xhtml, display
                                                  12. AllergyIntolerance.contained
                                                  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.

                                                  ShortContained, inline Resources
                                                  Comments

                                                  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.

                                                  Control0..*
                                                  TypeResource
                                                  Alternate Namesinline resources, anonymous resources, contained resources
                                                  14. AllergyIntolerance.extension
                                                  Definition

                                                  May be used to represent additional information that is not part of the basic definition of the resource. In order 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.

                                                  ShortAdditional Content defined by implementations
                                                  Comments

                                                  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.

                                                  Control0..*
                                                  TypeExtension
                                                  Alternate Namesextensions, user content
                                                  16. AllergyIntolerance.modifierExtension
                                                  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. Usually modifier elements provide negation or qualification. In order 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.

                                                  ShortExtensions that cannot be ignored
                                                  Comments

                                                  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.

                                                  Control0..*
                                                  TypeExtension
                                                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                  Alternate Namesextensions, user content
                                                  18. AllergyIntolerance.identifier
                                                  Definition

                                                  This records identifiers associated with this allergy/intolerance concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

                                                  ShortIdentifier
                                                  NoteThis is a business identifier, not a resource identifier (see discussion)
                                                  Control0..*
                                                  TypeIdentifier
                                                  Summarytrue
                                                  Alternate NamesIdentificatie
                                                  20. AllergyIntolerance.clinicalStatus
                                                  Definition

                                                  The clinical status of the allergy or intolerance.

                                                  ShortAllergyStatus
                                                  Comments

                                                  This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.

                                                  Control0..1
                                                  This element is affected by the following invariants: ait-1, ait-2
                                                  BindingThe codes SHALL be taken from AllergyIntoleranceClinicalStatus
                                                  (required to http://hl7.org/fhir/ValueSet/allergy-clinical-status|3.0.2)
                                                  Typecode
                                                  Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  Summarytrue
                                                  Alternate NamesAllergieStatus
                                                  22. AllergyIntolerance.clinicalStatus.id
                                                  Definition

                                                  unique id for the element within a resource (for internal references)

                                                  Shortxml:id (or equivalent in JSON)
                                                  Control0..1
                                                  Typestring
                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                  24. AllergyIntolerance.clinicalStatus.extension
                                                  Definition

                                                  An Extension

                                                  ShortExtension
                                                  Control0..*
                                                  TypeExtension
                                                  SlicingThis element introduces a set of slices on AllergyIntolerance.clinicalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • value @ url
                                                  • 26. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst
                                                    Slice NameAllergieStatusCodelijst
                                                    Definition

                                                    Statement on the status of the patient’s hypersensitivity.

                                                    ShortAllergyStatus
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                                                    Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., AllergieStatus
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    28. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.id
                                                    Definition

                                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                    Shortxml:id (or equivalent in JSON)
                                                    Control0..1
                                                    Typestring
                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    30. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                    ShortAdditional Content defined by implementations
                                                    Comments

                                                    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.

                                                    Control0..*
                                                    TypeExtension
                                                    Alternate Namesextensions, user content
                                                    SlicingThis element introduces a set of slices on AllergyIntolerance.clinicalStatus.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 32. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.url
                                                      Definition

                                                      Source of the definition for the extension code - a logical name or a URL.

                                                      Shortidentifies the meaning of the extension
                                                      Comments

                                                      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.

                                                      Control1..1
                                                      Typeuri
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                      Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                                                      34. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.value[x]
                                                      Definition

                                                      Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                      ShortValue of extension
                                                      Control1..1
                                                      TypeCodeableConcept
                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                      SlicingThis element introduces a set of slices on AllergyIntolerance.clinicalStatus.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                      • type @ $this
                                                      • 36. AllergyIntolerance.clinicalStatus.extension:AllergieStatusCodelijst.value[x]:valueCodeableConcept
                                                        Slice NamevalueCodeableConcept
                                                        Definition

                                                        Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                        ShortValue of extension
                                                        Control1..1
                                                        BindingUnless not suitable, these codes SHALL be taken from AllergieStatusCodelijst
                                                        (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.3--20171231000000)

                                                        AllergieStatusCodelijst

                                                        TypeCodeableConcept
                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                        38. AllergyIntolerance.clinicalStatus.value
                                                        Definition

                                                        Primitive value for code

                                                        ShortPrimitive value for code
                                                        Control0..1
                                                        Typecode
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        40. AllergyIntolerance.verificationStatus
                                                        Definition

                                                        Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).

                                                        ShortAllergyStatus
                                                        Comments

                                                        When HCIM AllergyStatus = Nullified, .verificationStatus should be set to entered-in-error. In all other cases it is up to the sending system to populate this element with the correct value.

                                                        Control1..1
                                                        This element is affected by the following invariants: ait-1, ait-2
                                                        BindingThe codes SHALL be taken from AllergyIntoleranceVerificationStatus
                                                        (required to http://hl7.org/fhir/ValueSet/allergy-verification-status|3.0.2)

                                                        Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

                                                        Typecode
                                                        Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Alternate NamesAllergieStatus
                                                        42. AllergyIntolerance.type
                                                        Definition

                                                        Identification of the underlying physiological mechanism for the reaction risk.

                                                        Shortallergy | intolerance - Underlying mechanism (if known)
                                                        Comments

                                                        Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.

                                                        Control0..1
                                                        BindingThe codes SHALL be taken from AllergyIntoleranceType
                                                        (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-type|3.0.2)

                                                        Identification of the underlying physiological mechanism for a Reaction Risk.

                                                        Typecode
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Alternate NamesCategory, Class
                                                        44. AllergyIntolerance.category
                                                        Definition

                                                        Category of the identified substance.

                                                        Shortfood | medication | environment | biologic
                                                        Comments

                                                        This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.

                                                        Control0..*
                                                        BindingThe codes SHALL be taken from AllergyIntoleranceCategory
                                                        (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-category|3.0.2)
                                                        Typecode
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        Summarytrue
                                                        Alternate NamesCategory, Type, Reaction Type, Class
                                                        46. AllergyIntolerance.category.id
                                                        Definition

                                                        unique id for the element within a resource (for internal references)

                                                        Shortxml:id (or equivalent in JSON)
                                                        Control0..1
                                                        Typestring
                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                        48. AllergyIntolerance.category.extension
                                                        Definition

                                                        An Extension

                                                        ShortExtension
                                                        Control0..*
                                                        TypeExtension
                                                        SlicingThis element introduces a set of slices on AllergyIntolerance.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 50. AllergyIntolerance.category.extension:AllergieCategorieCodelijst
                                                          Slice NameAllergieCategorieCodelijst
                                                          Definition

                                                          Identifies the allergy category such as medication, food or environment.

                                                          ShortAllergyCategory
                                                          Control0..1
                                                          This element is affected by the following invariants: ele-1
                                                          TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                                                          Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., AllergieCategorie
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                          52. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.id
                                                          Definition

                                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                          Shortxml:id (or equivalent in JSON)
                                                          Control0..1
                                                          Typestring
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                          54. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.extension
                                                          Definition

                                                          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                          ShortAdditional Content defined by implementations
                                                          Comments

                                                          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.

                                                          Control0..*
                                                          TypeExtension
                                                          Alternate Namesextensions, user content
                                                          SlicingThis element introduces a set of slices on AllergyIntolerance.category.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ url
                                                          • 56. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.url
                                                            Definition

                                                            Source of the definition for the extension code - a logical name or a URL.

                                                            Shortidentifies the meaning of the extension
                                                            Comments

                                                            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.

                                                            Control1..1
                                                            Typeuri
                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                                                            58. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.value[x]
                                                            Definition

                                                            Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                            ShortValue of extension
                                                            Control1..1
                                                            TypeCodeableConcept
                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                            SlicingThis element introduces a set of slices on AllergyIntolerance.category.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                            • type @ $this
                                                            • 60. AllergyIntolerance.category.extension:AllergieCategorieCodelijst.value[x]:valueCodeableConcept
                                                              Slice NamevalueCodeableConcept
                                                              Definition

                                                              Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                              ShortValue of extension
                                                              Control1..1
                                                              BindingUnless not suitable, these codes SHALL be taken from AllergieCategorieCodelijst
                                                              (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.2--20171231000000)

                                                              AllergieCategorieCodelijst

                                                              TypeCodeableConcept
                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                              62. AllergyIntolerance.category.value
                                                              Definition

                                                              Primitive value for code

                                                              ShortPrimitive value for code
                                                              Control0..1
                                                              Typecode
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              64. AllergyIntolerance.criticality
                                                              Definition

                                                              Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.

                                                              Shortlow | high | unable-to-assess
                                                              Comments

                                                              The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).

                                                              Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.

                                                              Control0..1
                                                              BindingThe codes SHALL be taken from AllergyIntoleranceCriticality
                                                              (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|3.0.2)
                                                              Typecode
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Alternate NamesSeverity, Seriousness, Contra-indication, Risk
                                                              66. AllergyIntolerance.criticality.id
                                                              Definition

                                                              unique id for the element within a resource (for internal references)

                                                              Shortxml:id (or equivalent in JSON)
                                                              Control0..1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              68. AllergyIntolerance.criticality.extension
                                                              Definition

                                                              An Extension

                                                              ShortExtension
                                                              Control0..*
                                                              TypeExtension
                                                              SlicingThis element introduces a set of slices on AllergyIntolerance.criticality.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 70. AllergyIntolerance.criticality.extension:CriticalExtentCodelist
                                                                Slice NameCriticalExtentCodelist
                                                                Definition

                                                                Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself.

                                                                ShortCriticality
                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                                                                Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., MateVanKritiekZijn
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                72. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.id
                                                                Definition

                                                                unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                Shortxml:id (or equivalent in JSON)
                                                                Control0..1
                                                                Typestring
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                74. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.extension
                                                                Definition

                                                                May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                ShortAdditional Content defined by implementations
                                                                Comments

                                                                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.

                                                                Control0..*
                                                                TypeExtension
                                                                Alternate Namesextensions, user content
                                                                SlicingThis element introduces a set of slices on AllergyIntolerance.criticality.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • value @ url
                                                                • 76. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.url
                                                                  Definition

                                                                  Source of the definition for the extension code - a logical name or a URL.

                                                                  Shortidentifies the meaning of the extension
                                                                  Comments

                                                                  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.

                                                                  Control1..1
                                                                  Typeuri
                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                                                                  78. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.value[x]
                                                                  Definition

                                                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                  ShortValue of extension
                                                                  Control1..1
                                                                  TypeCodeableConcept
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  SlicingThis element introduces a set of slices on AllergyIntolerance.criticality.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                  • type @ $this
                                                                  • 80. AllergyIntolerance.criticality.extension:CriticalExtentCodelist.value[x]:valueCodeableConcept
                                                                    Slice NamevalueCodeableConcept
                                                                    Definition

                                                                    Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                    ShortValue of extension
                                                                    Control1..1
                                                                    BindingUnless not suitable, these codes SHALL be taken from MateVanKritiekZijnCodelijst
                                                                    (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.4--20171231000000)

                                                                    CriticalExtentCodelist

                                                                    TypeCodeableConcept
                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                    82. AllergyIntolerance.criticality.value
                                                                    Definition

                                                                    Primitive value for code

                                                                    ShortPrimitive value for code
                                                                    Control0..1
                                                                    Typecode
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    84. AllergyIntolerance.code
                                                                    Definition

                                                                    Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies").

                                                                    ShortCausativeAgent
                                                                    Comments

                                                                    It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.

                                                                    When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.

                                                                    The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.

                                                                    Control1..1
                                                                    BindingFor example codes, see AllergyIntolerance Substance/Product, Condition and Negation Codes
                                                                    (example to http://hl7.org/fhir/ValueSet/allergyintolerance-code|3.0.2)

                                                                    Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.

                                                                    TypeCodeableConcept
                                                                    Summarytrue
                                                                    Alternate NamesCode, VeroorzakendeStof
                                                                    86. AllergyIntolerance.code.id
                                                                    Definition

                                                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                    Shortxml:id (or equivalent in JSON)
                                                                    Control0..1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                    88. AllergyIntolerance.code.extension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                    ShortAdditional Content defined by implementations
                                                                    Comments

                                                                    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.

                                                                    Control0..*
                                                                    TypeExtension
                                                                    Alternate Namesextensions, user content
                                                                    SlicingThis element introduces a set of slices on AllergyIntolerance.code.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • value @ url
                                                                    • 90. AllergyIntolerance.code.coding
                                                                      Definition

                                                                      A reference to a code defined by a terminology system.

                                                                      ShortCode defined by a terminology system
                                                                      Comments

                                                                      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.

                                                                      Control0..*
                                                                      TypeCoding
                                                                      Summarytrue
                                                                      Requirements

                                                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                      SlicingThis element introduces a set of slices on AllergyIntolerance.code.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ system
                                                                      • 92. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist
                                                                        Slice NamecausativeAgentAllergicAgentCodelist
                                                                        Definition

                                                                        A reference to a code defined by a terminology system.

                                                                        ShortCode defined by a terminology system
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        BindingThe codes SHALL be taken from VeroorzakendeStofAllergeneStoffenCodelijst
                                                                        (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.17--20171231000000)

                                                                        SNOMED CT - Alle waarden

                                                                        TypeCoding
                                                                        Summarytrue
                                                                        Requirements

                                                                        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                        94. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.id
                                                                        Definition

                                                                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        Shortxml:id (or equivalent in JSON)
                                                                        Control0..1
                                                                        Typestring
                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        96. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                        ShortAdditional Content defined by implementations
                                                                        Comments

                                                                        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.

                                                                        Control0..*
                                                                        TypeExtension
                                                                        Alternate Namesextensions, user content
                                                                        SlicingThis element introduces a set of slices on AllergyIntolerance.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 98. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.system
                                                                          Definition

                                                                          The identification of the code system that defines the meaning of the symbol in the code.

                                                                          ShortIdentity of the terminology system
                                                                          Comments

                                                                          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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                          Control1..1
                                                                          Typeuri
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be unambiguous about the source of the definition of the symbol.

                                                                          Fixed Valuehttp://snomed.info/sct
                                                                          100. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.version
                                                                          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.

                                                                          ShortVersion of the system - if relevant
                                                                          Comments

                                                                          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.

                                                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          102. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.code
                                                                          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).

                                                                          ShortSymbol in syntax defined by the system
                                                                          Control0..1
                                                                          Typecode
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to refer to a particular code in the system.

                                                                          104. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.display
                                                                          Definition

                                                                          A representation of the meaning of the code in the system, following the rules of the system.

                                                                          ShortRepresentation defined by the system
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                          106. AllergyIntolerance.code.coding:causativeAgentAllergicAgentCodelist.userSelected
                                                                          Definition

                                                                          Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                          ShortIf this coding was chosen directly by the user
                                                                          Comments

                                                                          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.

                                                                          Control0..1
                                                                          Typeboolean
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          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.

                                                                          108. AllergyIntolerance.code.coding:causativeAgentHPKCodelist
                                                                          Slice NamecausativeAgentHPKCodelist
                                                                          Definition

                                                                          A reference to a code defined by a terminology system.

                                                                          ShortCode defined by a terminology system
                                                                          Comments

                                                                          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.

                                                                          Control0..*
                                                                          BindingThe codes SHALL be taken from VeroorzakendeStofHPKCodelijst
                                                                          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.19--20171231000000)

                                                                          G-Standaard Handels Product Kode (HPK) - Alle waarden

                                                                          TypeCoding
                                                                          Summarytrue
                                                                          Requirements

                                                                          Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                          110. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.id
                                                                          Definition

                                                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          Shortxml:id (or equivalent in JSON)
                                                                          Control0..1
                                                                          Typestring
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          112. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                          ShortAdditional Content defined by implementations
                                                                          Comments

                                                                          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.

                                                                          Control0..*
                                                                          TypeExtension
                                                                          Alternate Namesextensions, user content
                                                                          SlicingThis element introduces a set of slices on AllergyIntolerance.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 114. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.system
                                                                            Definition

                                                                            The identification of the code system that defines the meaning of the symbol in the code.

                                                                            ShortIdentity of the terminology system
                                                                            Comments

                                                                            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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                            Control1..1
                                                                            Typeuri
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to be unambiguous about the source of the definition of the symbol.

                                                                            Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.7
                                                                            116. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.version
                                                                            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.

                                                                            ShortVersion of the system - if relevant
                                                                            Comments

                                                                            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.

                                                                            NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                            Control0..1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            118. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.code
                                                                            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).

                                                                            ShortSymbol in syntax defined by the system
                                                                            Control0..1
                                                                            Typecode
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to refer to a particular code in the system.

                                                                            120. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.display
                                                                            Definition

                                                                            A representation of the meaning of the code in the system, following the rules of the system.

                                                                            ShortRepresentation defined by the system
                                                                            Control0..1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                            122. AllergyIntolerance.code.coding:causativeAgentHPKCodelist.userSelected
                                                                            Definition

                                                                            Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                            ShortIf this coding was chosen directly by the user
                                                                            Comments

                                                                            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.

                                                                            Control0..1
                                                                            Typeboolean
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            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.

                                                                            124. AllergyIntolerance.code.coding:causativeAgentSNKCodelist
                                                                            Slice NamecausativeAgentSNKCodelist
                                                                            Definition

                                                                            A reference to a code defined by a terminology system.

                                                                            ShortCode defined by a terminology system
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            BindingThe codes SHALL be taken from VeroorzakendeStofSNKCodelijst
                                                                            (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.14--20171231000000)

                                                                            G-standaard Stofnaamcode (SNK) - Alle waarden

                                                                            TypeCoding
                                                                            Summarytrue
                                                                            Requirements

                                                                            Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                            126. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.id
                                                                            Definition

                                                                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                            Shortxml:id (or equivalent in JSON)
                                                                            Control0..1
                                                                            Typestring
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            128. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.extension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                            ShortAdditional Content defined by implementations
                                                                            Comments

                                                                            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.

                                                                            Control0..*
                                                                            TypeExtension
                                                                            Alternate Namesextensions, user content
                                                                            SlicingThis element introduces a set of slices on AllergyIntolerance.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 130. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.system
                                                                              Definition

                                                                              The identification of the code system that defines the meaning of the symbol in the code.

                                                                              ShortIdentity of the terminology system
                                                                              Comments

                                                                              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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                              Control1..1
                                                                              Typeuri
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to be unambiguous about the source of the definition of the symbol.

                                                                              Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.750
                                                                              132. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.version
                                                                              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.

                                                                              ShortVersion of the system - if relevant
                                                                              Comments

                                                                              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.

                                                                              NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                              Control0..1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              134. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.code
                                                                              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).

                                                                              ShortSymbol in syntax defined by the system
                                                                              Control0..1
                                                                              Typecode
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to refer to a particular code in the system.

                                                                              136. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.display
                                                                              Definition

                                                                              A representation of the meaning of the code in the system, following the rules of the system.

                                                                              ShortRepresentation defined by the system
                                                                              Control0..1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              Requirements

                                                                              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                              138. AllergyIntolerance.code.coding:causativeAgentSNKCodelist.userSelected
                                                                              Definition

                                                                              Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                              ShortIf this coding was chosen directly by the user
                                                                              Comments

                                                                              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.

                                                                              Control0..1
                                                                              Typeboolean
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              Summarytrue
                                                                              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.

                                                                              140. AllergyIntolerance.code.coding:causativeAgentSSKCodelist
                                                                              Slice NamecausativeAgentSSKCodelist
                                                                              Definition

                                                                              A reference to a code defined by a terminology system.

                                                                              ShortCode defined by a terminology system
                                                                              Comments

                                                                              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.

                                                                              Control0..*
                                                                              BindingThe codes SHALL be taken from VeroorzakendeStofSSKCodelijst
                                                                              (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.13--20171231000000)

                                                                              G-standaard Stofnaamcode i.c.m. toedieningsweg (SSK) - Alle waarden

                                                                              TypeCoding
                                                                              Summarytrue
                                                                              Requirements

                                                                              Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                              142. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.id
                                                                              Definition

                                                                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              Shortxml:id (or equivalent in JSON)
                                                                              Control0..1
                                                                              Typestring
                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              144. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                              ShortAdditional Content defined by implementations
                                                                              Comments

                                                                              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.

                                                                              Control0..*
                                                                              TypeExtension
                                                                              Alternate Namesextensions, user content
                                                                              SlicingThis element introduces a set of slices on AllergyIntolerance.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 146. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.system
                                                                                Definition

                                                                                The identification of the code system that defines the meaning of the symbol in the code.

                                                                                ShortIdentity of the terminology system
                                                                                Comments

                                                                                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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                                Control1..1
                                                                                Typeuri
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Requirements

                                                                                Need to be unambiguous about the source of the definition of the symbol.

                                                                                Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.725
                                                                                148. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.version
                                                                                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.

                                                                                ShortVersion of the system - if relevant
                                                                                Comments

                                                                                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.

                                                                                NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                Control0..1
                                                                                Typestring
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                150. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.code
                                                                                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).

                                                                                ShortSymbol in syntax defined by the system
                                                                                Control0..1
                                                                                Typecode
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Requirements

                                                                                Need to refer to a particular code in the system.

                                                                                152. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.display
                                                                                Definition

                                                                                A representation of the meaning of the code in the system, following the rules of the system.

                                                                                ShortRepresentation defined by the system
                                                                                Control0..1
                                                                                Typestring
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                Requirements

                                                                                Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                154. AllergyIntolerance.code.coding:causativeAgentSSKCodelist.userSelected
                                                                                Definition

                                                                                Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                                ShortIf this coding was chosen directly by the user
                                                                                Comments

                                                                                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.

                                                                                Control0..1
                                                                                Typeboolean
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                Summarytrue
                                                                                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.

                                                                                156. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist
                                                                                Slice NamecausativeAgentThesaurus122Codelist
                                                                                Definition

                                                                                A reference to a code defined by a terminology system.

                                                                                ShortCode defined by a terminology system
                                                                                Comments

                                                                                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.

                                                                                Control0..*
                                                                                BindingThe codes SHALL be taken from VeroorzakendeStofThesaurus122Codelijst
                                                                                (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.15--20171231000000)

                                                                                G-standaard Ongewenste medicatiegroepen - Alle waarden

                                                                                TypeCoding
                                                                                Summarytrue
                                                                                Requirements

                                                                                Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                                158. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.id
                                                                                Definition

                                                                                unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                Shortxml:id (or equivalent in JSON)
                                                                                Control0..1
                                                                                Typestring
                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                160. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                ShortAdditional Content defined by implementations
                                                                                Comments

                                                                                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.

                                                                                Control0..*
                                                                                TypeExtension
                                                                                Alternate Namesextensions, user content
                                                                                SlicingThis element introduces a set of slices on AllergyIntolerance.code.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 162. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.system
                                                                                  Definition

                                                                                  The identification of the code system that defines the meaning of the symbol in the code.

                                                                                  ShortIdentity of the terminology system
                                                                                  Comments

                                                                                  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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                                  Control1..1
                                                                                  Typeuri
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Need to be unambiguous about the source of the definition of the symbol.

                                                                                  Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.902.122
                                                                                  164. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.version
                                                                                  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.

                                                                                  ShortVersion of the system - if relevant
                                                                                  Comments

                                                                                  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.

                                                                                  NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  166. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.code
                                                                                  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).

                                                                                  ShortSymbol in syntax defined by the system
                                                                                  Control0..1
                                                                                  Typecode
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Need to refer to a particular code in the system.

                                                                                  168. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.display
                                                                                  Definition

                                                                                  A representation of the meaning of the code in the system, following the rules of the system.

                                                                                  ShortRepresentation defined by the system
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                  170. AllergyIntolerance.code.coding:causativeAgentThesaurus122Codelist.userSelected
                                                                                  Definition

                                                                                  Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                                  ShortIf this coding was chosen directly by the user
                                                                                  Comments

                                                                                  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.

                                                                                  Control0..1
                                                                                  Typeboolean
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  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.

                                                                                  172. AllergyIntolerance.code.text
                                                                                  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.

                                                                                  ShortPlain text representation of the concept
                                                                                  Comments

                                                                                  Very often the text is the same as a displayName of one of the codings.

                                                                                  Control0..1
                                                                                  Typestring
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  Summarytrue
                                                                                  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.

                                                                                  174. AllergyIntolerance.patient
                                                                                  Definition

                                                                                  The patient who has the allergy or intolerance.

                                                                                  ShortPatient
                                                                                  Control1..1
                                                                                  TypeReference(nl-core-patient)
                                                                                  Summarytrue
                                                                                  Alternate NamesPatient, Patiënt
                                                                                  176. AllergyIntolerance.onset[x]
                                                                                  Definition

                                                                                  Estimated or actual date, date-time, or age when allergy or intolerance was identified.

                                                                                  ShortWhen allergy or intolerance was identified
                                                                                  Control0..1
                                                                                  TypeChoice of: dateTime, Age, Period, Range, string
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                  SlicingThis element introduces a set of slices on AllergyIntolerance.onset[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • type @ $this
                                                                                  • 178. AllergyIntolerance.onset[x]:onsetDateTime
                                                                                    Slice NameonsetDateTime
                                                                                    Definition

                                                                                    The date and time at which the allergy or undesired reaction was determined.
                                                                                    This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).

                                                                                    ShortStartDateTime
                                                                                    Control0..1
                                                                                    TypedateTime
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    Alternate NamesBeginDatumTijd
                                                                                    180. AllergyIntolerance.assertedDate
                                                                                    Definition

                                                                                    The date on which the existance of the AllergyIntolerance was first asserted or acknowledged.

                                                                                    ShortDate record was believed accurate
                                                                                    Control0..1
                                                                                    TypedateTime
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    182. AllergyIntolerance.recorder
                                                                                    Definition

                                                                                    Individual who recorded the record and takes responsibility for its content.

                                                                                    ShortRecorder
                                                                                    Control0..1
                                                                                    TypeReference(nl-core-practitioner, nl-core-patient)
                                                                                    Alternate NamesAuthor, Auteur
                                                                                    184. AllergyIntolerance.recorder.id
                                                                                    Definition

                                                                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    Shortxml:id (or equivalent in JSON)
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    186. AllergyIntolerance.recorder.extension
                                                                                    Definition

                                                                                    An Extension

                                                                                    ShortExtension
                                                                                    Control0..*
                                                                                    TypeExtension
                                                                                    SlicingThis element introduces a set of slices on AllergyIntolerance.recorder.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 188. AllergyIntolerance.recorder.extension:practitionerRole
                                                                                      Slice NamepractitionerRole
                                                                                      Definition

                                                                                      Optional Extension Element - found in all resources.

                                                                                      ShortOptional Extensions Element
                                                                                      Control0..1
                                                                                      TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                                                                      190. AllergyIntolerance.recorder.reference
                                                                                      Definition

                                                                                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                      ShortLiteral reference, Relative, internal or absolute URL
                                                                                      Comments

                                                                                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ref-1
                                                                                      Typestring
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      192. AllergyIntolerance.recorder.identifier
                                                                                      Definition

                                                                                      An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                      ShortLogical reference, when literal reference is not known
                                                                                      Comments

                                                                                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                      NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                      Control0..1
                                                                                      TypeIdentifier
                                                                                      Summarytrue
                                                                                      194. AllergyIntolerance.recorder.display
                                                                                      Definition

                                                                                      Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                      ShortText alternative for the resource
                                                                                      Comments

                                                                                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      Summarytrue
                                                                                      196. AllergyIntolerance.asserter
                                                                                      Definition

                                                                                      The source of the information about the allergy that is recorded.

                                                                                      ShortInformant
                                                                                      Comments

                                                                                      The recorder takes repsonsibility for the content, but can reference the source from where they got it.

                                                                                      Control0..1
                                                                                      TypeReference(nl-core-patient, nl-core-relatedperson, nl-core-practitioner)
                                                                                      Summarytrue
                                                                                      Alternate NamesSource, Informant
                                                                                      198. AllergyIntolerance.asserter.id
                                                                                      Definition

                                                                                      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      Shortxml:id (or equivalent in JSON)
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      200. AllergyIntolerance.asserter.extension
                                                                                      Definition

                                                                                      An Extension

                                                                                      ShortExtension
                                                                                      Control0..*
                                                                                      TypeExtension
                                                                                      SlicingThis element introduces a set of slices on AllergyIntolerance.asserter.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 202. AllergyIntolerance.asserter.extension:practitionerRole
                                                                                        Slice NamepractitionerRole
                                                                                        Definition

                                                                                        Optional Extension Element - found in all resources.

                                                                                        ShortOptional Extensions Element
                                                                                        Control0..1
                                                                                        TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                                                                        204. AllergyIntolerance.asserter.reference
                                                                                        Definition

                                                                                        A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                        ShortLiteral reference, Relative, internal or absolute URL
                                                                                        Comments

                                                                                        Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ref-1
                                                                                        Typestring
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        206. AllergyIntolerance.asserter.identifier
                                                                                        Definition

                                                                                        An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                        ShortLogical reference, when literal reference is not known
                                                                                        Comments

                                                                                        When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                        When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                        Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                        NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                        Control0..1
                                                                                        TypeIdentifier
                                                                                        Summarytrue
                                                                                        208. AllergyIntolerance.asserter.display
                                                                                        Definition

                                                                                        Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                        ShortText alternative for the resource
                                                                                        Comments

                                                                                        This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Summarytrue
                                                                                        210. AllergyIntolerance.lastOccurrence
                                                                                        Definition

                                                                                        Entry of the last time a hypersensitive reaction took place.

                                                                                        ShortLastReactionDateTime
                                                                                        Comments

                                                                                        This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.

                                                                                        Control0..1
                                                                                        TypedateTime
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        Alternate NamesLaatsteReactieDatumTijd
                                                                                        212. AllergyIntolerance.note
                                                                                        Definition

                                                                                        Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.

                                                                                        ShortAdditional text not captured in other fields
                                                                                        Comments

                                                                                        For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.

                                                                                        Control0..*
                                                                                        TypeAnnotation
                                                                                        214. AllergyIntolerance.note.id
                                                                                        Definition

                                                                                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                        Shortxml:id (or equivalent in JSON)
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        216. AllergyIntolerance.note.extension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                        ShortAdditional Content defined by implementations
                                                                                        Comments

                                                                                        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.

                                                                                        Control0..*
                                                                                        TypeExtension
                                                                                        Alternate Namesextensions, user content
                                                                                        SlicingThis element introduces a set of slices on AllergyIntolerance.note.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • value @ url
                                                                                        • 218. AllergyIntolerance.note.author[x]
                                                                                          Definition

                                                                                          The individual responsible for making the annotation.

                                                                                          ShortAuthor
                                                                                          Control0..1
                                                                                          TypeChoice of: string, Reference(nl-core-practitioner, nl-core-patient, nl-core-relatedperson)
                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                          Summarytrue
                                                                                          Alternate NamesAuteur
                                                                                          SlicingThis element introduces a set of slices on AllergyIntolerance.note.author[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                          • type @ $this
                                                                                          • 220. AllergyIntolerance.note.author[x]:authorReference
                                                                                            Slice NameauthorReference
                                                                                            Definition

                                                                                            The individual responsible for making the annotation.

                                                                                            ShortIndividual responsible for the annotation
                                                                                            Control0..1
                                                                                            TypeReference(Practitioner, Patient, RelatedPerson)
                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                            Summarytrue
                                                                                            222. AllergyIntolerance.note.author[x]:authorReference.id
                                                                                            Definition

                                                                                            unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                            Shortxml:id (or equivalent in JSON)
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            224. AllergyIntolerance.note.author[x]:authorReference.extension
                                                                                            Definition

                                                                                            An Extension

                                                                                            ShortExtension
                                                                                            Control0..*
                                                                                            TypeExtension
                                                                                            SlicingThis element introduces a set of slices on AllergyIntolerance.note.author[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 226. AllergyIntolerance.note.author[x]:authorReference.extension:practitionerRole
                                                                                              Slice NamepractitionerRole
                                                                                              Definition

                                                                                              Optional Extension Element - found in all resources.

                                                                                              ShortOptional Extensions Element
                                                                                              Comments

                                                                                              Relevant only in combination with Reference(Practitioner)

                                                                                              Control0..1
                                                                                              TypeExtension(PractitionerRole Reference) (Extension Type: Reference)
                                                                                              228. AllergyIntolerance.note.author[x]:authorReference.reference
                                                                                              Definition

                                                                                              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                                                                                              ShortLiteral reference, Relative, internal or absolute URL
                                                                                              Comments

                                                                                              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: ref-1
                                                                                              Typestring
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              230. AllergyIntolerance.note.author[x]:authorReference.identifier
                                                                                              Definition

                                                                                              An identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                                                                                              ShortLogical reference, when literal reference is not known
                                                                                              Comments

                                                                                              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                                                                                              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                                                                                              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                                                                                              NoteThis is a business identifier, not a resource identifier (see discussion)
                                                                                              Control0..1
                                                                                              TypeIdentifier
                                                                                              Summarytrue
                                                                                              232. AllergyIntolerance.note.author[x]:authorReference.display
                                                                                              Definition

                                                                                              Plain text narrative that identifies the resource in addition to the resource reference.

                                                                                              ShortText alternative for the resource
                                                                                              Comments

                                                                                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              234. AllergyIntolerance.note.author[x]:authorString
                                                                                              Slice NameauthorString
                                                                                              Definition

                                                                                              The individual responsible for making the annotation.

                                                                                              ShortIndividual responsible for the annotation
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              236. AllergyIntolerance.note.time
                                                                                              Definition

                                                                                              Indicates when this particular annotation was made.

                                                                                              ShortWhen the annotation was made
                                                                                              Control0..1
                                                                                              TypedateTime
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Summarytrue
                                                                                              238. AllergyIntolerance.note.text
                                                                                              Definition

                                                                                              Textual explanation of the hypersensitivity which cannot be entered in any of the other fields.

                                                                                              ShortComment
                                                                                              Control1..1
                                                                                              Typestring
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              Alternate NamesToelichting
                                                                                              240. AllergyIntolerance.reaction
                                                                                              Definition

                                                                                              Details about each adverse reaction event linked to exposure to the identified substance.

                                                                                              ShortReaction
                                                                                              Control0..*
                                                                                              TypeBackboneElement
                                                                                              Alternate NamesReactie
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                              242. AllergyIntolerance.reaction.id
                                                                                              Definition

                                                                                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                              Shortxml:id (or equivalent in JSON)
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              244. AllergyIntolerance.reaction.extension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                              ShortAdditional Content defined by implementations
                                                                                              Comments

                                                                                              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.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Alternate Namesextensions, user content
                                                                                              246. AllergyIntolerance.reaction.modifierExtension
                                                                                              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 that contains it. Usually modifier elements provide negation or qualification. In order 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.

                                                                                              ShortExtensions that cannot be ignored
                                                                                              Comments

                                                                                              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.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Is Modifiertrue because No Modifier Reason provideed in previous versions of FHIR
                                                                                              Summarytrue
                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                              248. AllergyIntolerance.reaction.substance
                                                                                              Definition

                                                                                              More specific indication of the substance that caused the reaction. This can be a specific substance from a group of substances to which the patient is allergic or hypersensitive.

                                                                                              ShortSpecificSubstance
                                                                                              Comments

                                                                                              Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.

                                                                                              Control0..1
                                                                                              BindingFor example codes, see Substance Code
                                                                                              (example to http://hl7.org/fhir/ValueSet/substance-code|3.0.2)

                                                                                              Codes defining the type of the substance (including pharmaceutical products).

                                                                                              TypeCodeableConcept
                                                                                              Alternate NamesSpecifiekeStof
                                                                                              250. AllergyIntolerance.reaction.substance.id
                                                                                              Definition

                                                                                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                              Shortxml:id (or equivalent in JSON)
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              252. AllergyIntolerance.reaction.substance.extension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                              ShortAdditional Content defined by implementations
                                                                                              Comments

                                                                                              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.

                                                                                              Control0..*
                                                                                              TypeExtension
                                                                                              Alternate Namesextensions, user content
                                                                                              SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 254. AllergyIntolerance.reaction.substance.coding
                                                                                                Definition

                                                                                                A reference to a code defined by a terminology system.

                                                                                                ShortCode defined by a terminology system
                                                                                                Comments

                                                                                                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.

                                                                                                Control0..*
                                                                                                TypeCoding
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                                                SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.coding. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • value @ system
                                                                                                • 256. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist
                                                                                                  Slice NamespecificSubstanceAllergicAgentCodelist
                                                                                                  Definition

                                                                                                  A reference to a code defined by a terminology system.

                                                                                                  ShortCode defined by a terminology system
                                                                                                  Comments

                                                                                                  SNOMED refset ^42931000146101 has been deprecated in favor of refset ^98061000146100. For compatibility reasons, this original refset has been re-activated, but its contents have been replaced with that of the new refset.

                                                                                                  Control0..*
                                                                                                  BindingThe codes SHALL be taken from SpecifiekeStofAllergeneStoffenCodelijst
                                                                                                  (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.16--20171231000000)

                                                                                                  SNOMED CT - SNOMED CT: ^42931000146101| Dutch non-drug allergen simple reference set (foundation metadata concept)

                                                                                                  TypeCoding
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                                                  258. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.id
                                                                                                  Definition

                                                                                                  unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                  Shortxml:id (or equivalent in JSON)
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  260. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.extension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                                  ShortAdditional Content defined by implementations
                                                                                                  Comments

                                                                                                  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.

                                                                                                  Control0..*
                                                                                                  TypeExtension
                                                                                                  Alternate Namesextensions, user content
                                                                                                  SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 262. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.system
                                                                                                    Definition

                                                                                                    The identification of the code system that defines the meaning of the symbol in the code.

                                                                                                    ShortIdentity of the terminology system
                                                                                                    Comments

                                                                                                    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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                                                    Control1..1
                                                                                                    Typeuri
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Need to be unambiguous about the source of the definition of the symbol.

                                                                                                    Fixed Valuehttp://snomed.info/sct
                                                                                                    264. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.version
                                                                                                    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.

                                                                                                    ShortVersion of the system - if relevant
                                                                                                    Comments

                                                                                                    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.

                                                                                                    NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summarytrue
                                                                                                    266. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.code
                                                                                                    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).

                                                                                                    ShortSymbol in syntax defined by the system
                                                                                                    Control0..1
                                                                                                    Typecode
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Need to refer to a particular code in the system.

                                                                                                    268. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.display
                                                                                                    Definition

                                                                                                    A representation of the meaning of the code in the system, following the rules of the system.

                                                                                                    ShortRepresentation defined by the system
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                                    270. AllergyIntolerance.reaction.substance.coding:specificSubstanceAllergicAgentCodelist.userSelected
                                                                                                    Definition

                                                                                                    Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                                                    ShortIf this coding was chosen directly by the user
                                                                                                    Comments

                                                                                                    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.

                                                                                                    Control0..1
                                                                                                    Typeboolean
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    Summarytrue
                                                                                                    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.

                                                                                                    272. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist
                                                                                                    Slice NamespecificSubstanceHPKCodelist
                                                                                                    Definition

                                                                                                    A reference to a code defined by a terminology system.

                                                                                                    ShortCode defined by a terminology system
                                                                                                    Comments

                                                                                                    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.

                                                                                                    Control0..*
                                                                                                    BindingThe codes SHALL be taken from SpecifiekeStofHPKCodelijst
                                                                                                    (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.18--20171231000000)

                                                                                                    G-Standaard Handels Product Kode (HPK) - Alle waarden

                                                                                                    TypeCoding
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                                                    274. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.id
                                                                                                    Definition

                                                                                                    unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                    Shortxml:id (or equivalent in JSON)
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    276. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.extension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                                    ShortAdditional Content defined by implementations
                                                                                                    Comments

                                                                                                    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.

                                                                                                    Control0..*
                                                                                                    TypeExtension
                                                                                                    Alternate Namesextensions, user content
                                                                                                    SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • value @ url
                                                                                                    • 278. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.system
                                                                                                      Definition

                                                                                                      The identification of the code system that defines the meaning of the symbol in the code.

                                                                                                      ShortIdentity of the terminology system
                                                                                                      Comments

                                                                                                      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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                                                      Control1..1
                                                                                                      Typeuri
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Need to be unambiguous about the source of the definition of the symbol.

                                                                                                      Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.7
                                                                                                      280. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.version
                                                                                                      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.

                                                                                                      ShortVersion of the system - if relevant
                                                                                                      Comments

                                                                                                      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.

                                                                                                      NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      282. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.code
                                                                                                      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).

                                                                                                      ShortSymbol in syntax defined by the system
                                                                                                      Control0..1
                                                                                                      Typecode
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Need to refer to a particular code in the system.

                                                                                                      284. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.display
                                                                                                      Definition

                                                                                                      A representation of the meaning of the code in the system, following the rules of the system.

                                                                                                      ShortRepresentation defined by the system
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                                      286. AllergyIntolerance.reaction.substance.coding:specificSubstanceHPKCodelist.userSelected
                                                                                                      Definition

                                                                                                      Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                                                      ShortIf this coding was chosen directly by the user
                                                                                                      Comments

                                                                                                      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.

                                                                                                      Control0..1
                                                                                                      Typeboolean
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      Summarytrue
                                                                                                      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.

                                                                                                      288. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist
                                                                                                      Slice NamespecificSubstanceSNKCodelist
                                                                                                      Definition

                                                                                                      A reference to a code defined by a terminology system.

                                                                                                      ShortCode defined by a terminology system
                                                                                                      Comments

                                                                                                      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.

                                                                                                      Control0..*
                                                                                                      BindingThe codes SHALL be taken from SpecifiekeStofSNKCodelijst
                                                                                                      (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.10--20171231000000)

                                                                                                      G-standaard Stofnaamcode (SNK) - Alle waarden

                                                                                                      TypeCoding
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                                                      290. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.id
                                                                                                      Definition

                                                                                                      unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                      Shortxml:id (or equivalent in JSON)
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      292. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.extension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                                      ShortAdditional Content defined by implementations
                                                                                                      Comments

                                                                                                      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.

                                                                                                      Control0..*
                                                                                                      TypeExtension
                                                                                                      Alternate Namesextensions, user content
                                                                                                      SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 294. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.system
                                                                                                        Definition

                                                                                                        The identification of the code system that defines the meaning of the symbol in the code.

                                                                                                        ShortIdentity of the terminology system
                                                                                                        Comments

                                                                                                        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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                                                        Control1..1
                                                                                                        Typeuri
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need to be unambiguous about the source of the definition of the symbol.

                                                                                                        Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.750
                                                                                                        296. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.version
                                                                                                        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.

                                                                                                        ShortVersion of the system - if relevant
                                                                                                        Comments

                                                                                                        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.

                                                                                                        NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summarytrue
                                                                                                        298. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.code
                                                                                                        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).

                                                                                                        ShortSymbol in syntax defined by the system
                                                                                                        Control0..1
                                                                                                        Typecode
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need to refer to a particular code in the system.

                                                                                                        300. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.display
                                                                                                        Definition

                                                                                                        A representation of the meaning of the code in the system, following the rules of the system.

                                                                                                        ShortRepresentation defined by the system
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                                        302. AllergyIntolerance.reaction.substance.coding:specificSubstanceSNKCodelist.userSelected
                                                                                                        Definition

                                                                                                        Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                                                        ShortIf this coding was chosen directly by the user
                                                                                                        Comments

                                                                                                        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.

                                                                                                        Control0..1
                                                                                                        Typeboolean
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        Summarytrue
                                                                                                        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.

                                                                                                        304. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist
                                                                                                        Slice NamespecificSubstanceSSKCodelist
                                                                                                        Definition

                                                                                                        A reference to a code defined by a terminology system.

                                                                                                        ShortCode defined by a terminology system
                                                                                                        Comments

                                                                                                        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.

                                                                                                        Control0..*
                                                                                                        BindingThe codes SHALL be taken from SpecifiekeStofSSKCodelijst
                                                                                                        (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.9--20171231000000)

                                                                                                        SpecifiekeStofSSKCodelijst

                                                                                                        TypeCoding
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                                                        306. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.id
                                                                                                        Definition

                                                                                                        unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                        Shortxml:id (or equivalent in JSON)
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        308. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.extension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                                        ShortAdditional Content defined by implementations
                                                                                                        Comments

                                                                                                        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.

                                                                                                        Control0..*
                                                                                                        TypeExtension
                                                                                                        Alternate Namesextensions, user content
                                                                                                        SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ url
                                                                                                        • 310. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.system
                                                                                                          Definition

                                                                                                          The identification of the code system that defines the meaning of the symbol in the code.

                                                                                                          ShortIdentity of the terminology system
                                                                                                          Comments

                                                                                                          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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                                                          Control1..1
                                                                                                          Typeuri
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Need to be unambiguous about the source of the definition of the symbol.

                                                                                                          Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.725
                                                                                                          312. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.version
                                                                                                          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.

                                                                                                          ShortVersion of the system - if relevant
                                                                                                          Comments

                                                                                                          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.

                                                                                                          NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          314. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.code
                                                                                                          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).

                                                                                                          ShortSymbol in syntax defined by the system
                                                                                                          Control0..1
                                                                                                          Typecode
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Need to refer to a particular code in the system.

                                                                                                          316. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.display
                                                                                                          Definition

                                                                                                          A representation of the meaning of the code in the system, following the rules of the system.

                                                                                                          ShortRepresentation defined by the system
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                                          318. AllergyIntolerance.reaction.substance.coding:specificSubstanceSSKCodelist.userSelected
                                                                                                          Definition

                                                                                                          Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                                                          ShortIf this coding was chosen directly by the user
                                                                                                          Comments

                                                                                                          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.

                                                                                                          Control0..1
                                                                                                          Typeboolean
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          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.

                                                                                                          320. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist
                                                                                                          Slice NamespecificSubstanceThesaurus122Codelist
                                                                                                          Definition

                                                                                                          A reference to a code defined by a terminology system.

                                                                                                          ShortCode defined by a terminology system
                                                                                                          Comments

                                                                                                          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.

                                                                                                          Control0..*
                                                                                                          BindingThe codes SHALL be taken from SpecifiekeStofThesaurus122Codelijst
                                                                                                          (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.11--20171231000000)

                                                                                                          G-standaard Ongewenste medicatiegroepen - Alle waarden

                                                                                                          TypeCoding
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

                                                                                                          322. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.id
                                                                                                          Definition

                                                                                                          unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                          Shortxml:id (or equivalent in JSON)
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          324. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.extension
                                                                                                          Definition

                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                                          ShortAdditional Content defined by implementations
                                                                                                          Comments

                                                                                                          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.

                                                                                                          Control0..*
                                                                                                          TypeExtension
                                                                                                          Alternate Namesextensions, user content
                                                                                                          SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.substance.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 326. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.system
                                                                                                            Definition

                                                                                                            The identification of the code system that defines the meaning of the symbol in the code.

                                                                                                            ShortIdentity of the terminology system
                                                                                                            Comments

                                                                                                            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 de-reference to some definition that establish the system clearly and unambiguously.

                                                                                                            Control1..1
                                                                                                            Typeuri
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need to be unambiguous about the source of the definition of the symbol.

                                                                                                            Fixed Valueurn:oid:2.16.840.1.113883.2.4.4.1.902.122
                                                                                                            328. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.version
                                                                                                            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.

                                                                                                            ShortVersion of the system - if relevant
                                                                                                            Comments

                                                                                                            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.

                                                                                                            NoteThis is a business version Id, not a resource version Id (see discussion)
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            330. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.code
                                                                                                            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).

                                                                                                            ShortSymbol in syntax defined by the system
                                                                                                            Control0..1
                                                                                                            Typecode
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need to refer to a particular code in the system.

                                                                                                            332. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.display
                                                                                                            Definition

                                                                                                            A representation of the meaning of the code in the system, following the rules of the system.

                                                                                                            ShortRepresentation defined by the system
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                                                                                            334. AllergyIntolerance.reaction.substance.coding:specificSubstanceThesaurus122Codelist.userSelected
                                                                                                            Definition

                                                                                                            Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

                                                                                                            ShortIf this coding was chosen directly by the user
                                                                                                            Comments

                                                                                                            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.

                                                                                                            Control0..1
                                                                                                            Typeboolean
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            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.

                                                                                                            336. AllergyIntolerance.reaction.substance.text
                                                                                                            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.

                                                                                                            ShortPlain text representation of the concept
                                                                                                            Comments

                                                                                                            Very often the text is the same as a displayName of one of the codings.

                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            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.

                                                                                                            338. AllergyIntolerance.reaction.manifestation
                                                                                                            Definition

                                                                                                            The content specifications of the reaction that takes place when the patient is exposed to the causative substance.

                                                                                                            ShortSymptom
                                                                                                            Comments

                                                                                                            Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.

                                                                                                            Control1..*
                                                                                                            BindingThe codes SHALL be taken from SymptoomCodelijst
                                                                                                            (required to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.5--20171231000000)
                                                                                                            TypeCodeableConcept
                                                                                                            Alternate NamesSymptoms, Signs, Symptoom
                                                                                                            340. AllergyIntolerance.reaction.description
                                                                                                            Definition

                                                                                                            Text description about the reaction as a whole, including details of the manifestation if required.

                                                                                                            ShortReactionDescription
                                                                                                            Comments

                                                                                                            Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.

                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Alternate NamesNarrative, Text, ReactieBeschrijving
                                                                                                            342. AllergyIntolerance.reaction.onset
                                                                                                            Definition

                                                                                                            Date and time at which the reaction took place. This may also be just the date or a partial date, in the event that the exact date is unknown.

                                                                                                            ShortReactionTime
                                                                                                            Control0..1
                                                                                                            TypedateTime
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Alternate NamesReactieTijdstip
                                                                                                            344. AllergyIntolerance.reaction.severity
                                                                                                            Definition

                                                                                                            The severity of the reaction as a result of exposure to the causative substance.

                                                                                                            ShortSeverity
                                                                                                            Comments

                                                                                                            It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

                                                                                                            Control0..1
                                                                                                            BindingThe codes SHALL be taken from AllergyIntoleranceSeverity
                                                                                                            (required to http://hl7.org/fhir/ValueSet/reaction-event-severity|3.0.2)
                                                                                                            Typecode
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Alternate NamesErnst
                                                                                                            346. AllergyIntolerance.reaction.severity.id
                                                                                                            Definition

                                                                                                            unique id for the element within a resource (for internal references)

                                                                                                            Shortxml:id (or equivalent in JSON)
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            348. AllergyIntolerance.reaction.severity.extension
                                                                                                            Definition

                                                                                                            An Extension

                                                                                                            ShortExtension
                                                                                                            Control0..*
                                                                                                            TypeExtension
                                                                                                            SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.severity.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 350. AllergyIntolerance.reaction.severity.extension:SeverityCodelist
                                                                                                              Slice NameSeverityCodelist
                                                                                                              Definition

                                                                                                              Defines a more specific coded value for a code or string. Especially useful for FHIR's required ValueSets. These extensions are primarily used on codes bound to a required value set, where you would like to use a more specific code than the codes in the bounded value set.

                                                                                                              ShortProvides the specific HCIM code for a FHIR element that has a required binding to a FHIR ValueSet
                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeExtension(HCIM extension code-specification) (Extension Type: CodeableConcept)
                                                                                                              Alternate NamesBevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet.
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() | (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              352. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.id
                                                                                                              Definition

                                                                                                              unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                              Shortxml:id (or equivalent in JSON)
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              354. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.extension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. In order 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.

                                                                                                              ShortAdditional Content defined by implementations
                                                                                                              Comments

                                                                                                              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.

                                                                                                              Control0..*
                                                                                                              TypeExtension
                                                                                                              Alternate Namesextensions, user content
                                                                                                              SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.severity.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 356. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.url
                                                                                                                Definition

                                                                                                                Source of the definition for the extension code - a logical name or a URL.

                                                                                                                Shortidentifies the meaning of the extension
                                                                                                                Comments

                                                                                                                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.

                                                                                                                Control1..1
                                                                                                                Typeuri
                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                Fixed Valuehttp://nictiz.nl/fhir/StructureDefinition/code-specification
                                                                                                                358. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.value[x]
                                                                                                                Definition

                                                                                                                Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                                                ShortValue of extension
                                                                                                                Control1..1
                                                                                                                TypeCodeableConcept
                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                SlicingThis element introduces a set of slices on AllergyIntolerance.reaction.severity.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                                                                                                • type @ $this
                                                                                                                • 360. AllergyIntolerance.reaction.severity.extension:SeverityCodelist.value[x]:valueCodeableConcept
                                                                                                                  Slice NamevalueCodeableConcept
                                                                                                                  Definition

                                                                                                                  Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

                                                                                                                  ShortValue of extension
                                                                                                                  Control1..1
                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from ErnstCodelijst
                                                                                                                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.6--20171231000000)

                                                                                                                  ErnstCodelijst

                                                                                                                  TypeCodeableConcept
                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                  362. AllergyIntolerance.reaction.severity.value
                                                                                                                  Definition

                                                                                                                  Primitive value for code

                                                                                                                  ShortPrimitive value for code
                                                                                                                  Control0..1
                                                                                                                  Typecode
                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                  364. AllergyIntolerance.reaction.exposureRoute
                                                                                                                  Definition

                                                                                                                  Way in which the patient came into contact with the causative agent or the way in which the agent was administered.

                                                                                                                  ShortMannerOfExposure
                                                                                                                  Comments

                                                                                                                  Coding of the route of exposure with a terminology should be used wherever possible.

                                                                                                                  Control0..1
                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from WijzeVanBlootstellingCodelijst
                                                                                                                  (extensible to http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.12--20171231000000)
                                                                                                                  TypeCodeableConcept
                                                                                                                  Alternate NamesWijzeVanBlootstelling
                                                                                                                  366. AllergyIntolerance.reaction.note
                                                                                                                  Definition

                                                                                                                  Additional text about the adverse reaction event not captured in other fields.

                                                                                                                  ShortText about event not captured in other fields
                                                                                                                  Comments

                                                                                                                  Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.

                                                                                                                  Control0..*
                                                                                                                  TypeAnnotation