ePA Laboratory Report Implementation Guide
Version 1.0.0-ballot.1 - ballot

Ressourcenprofil: Diagnostic Report dgLP - XML-Profil

Active Stand: 2026-09-30

XML-Darstellung des diagnostic-report-dglp ressourcenprofil.

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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="diagnostic-report-dglp"/>
  <language value="de"/>
  <url
       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/diagnostic-report-dglp"/>
  <version value="1.0.0"/>
  <name value="DiagnosticReportdgLP"/>
  <title value="Diagnostic Report dgLP"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2026-09-30"/>
  <publisher value="gematik GmbH"/>
  <contact>
    <name value="gematik GmbH"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.gematik.de"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="patientteam [ at ] gematik.de"/>
    </telecom>
  </contact>
  <description
               value="Profil für den Laborgesamtbefund (DiagnosticReport). Darin verschachtelt unter &quot;Ergebnisse&quot; (DiagnosticReport.result) ist die Referenz auf &quot;Untersuchungsgruppe&quot; (Observation_Laboratory_Study_Group), darin die Referenz auf &quot;Laboruntersuchung&quot; (Observation_Laboratory_Study), darin die Referenz auf &quot;Probe&quot; (Specimen)."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="DE"/>
    </coding>
  </jurisdiction>
  <copyright
             value="gematik GmbH / Dieses Artefakt ist lizenziert unter [Apache License](./license.html), Version 2.0."/>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="workflow"/>
    <uri value="http://hl7.org/fhir/workflow"/>
    <name value="Workflow Pattern"/>
  </mapping>
  <mapping>
    <identity value="v2"/>
    <uri value="http://hl7.org/v2"/>
    <name value="HL7 v2 Mapping"/>
  </mapping>
  <mapping>
    <identity value="rim"/>
    <uri value="http://hl7.org/v3"/>
    <name value="RIM Mapping"/>
  </mapping>
  <mapping>
    <identity value="w5"/>
    <uri value="http://hl7.org/fhir/fivews"/>
    <name value="FiveWs Pattern Mapping"/>
  </mapping>
  <kind value="resource"/>
  <abstract value="false"/>
  <type value="DiagnosticReport"/>
  <baseDefinition
                  value="http://hl7.eu/fhir/laboratory/StructureDefinition/DiagnosticReport-eu-lab"/>
  <derivation value="constraint"/>
  <snapshot>
    <extension
               url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
      <valueString value="2.0.0"/>
    </extension>
    <element id="DiagnosticReport">
      <path value="DiagnosticReport"/>
      <short value="Laboratory Report DiagnosticReport"/>
      <definition
                  value="Profil für den Laborgesamtbefund (DiagnosticReport). Darin verschachtelt unter &quot;Ergebnisse&quot; (DiagnosticReport.result) ist die Referenz auf &quot;Untersuchungsgruppe&quot; (Observation_Laboratory_Study_Group), darin die Referenz auf &quot;Laboruntersuchung&quot; (Observation_Laboratory_Study), darin die Referenz auf &quot;Probe&quot; (Specimen)."/>
      <comment
               value="This is intended to capture a single report and is not suitable for use in displaying summary information that covers multiple reports.  For example, this resource has not been designed for laboratory cumulative reporting formats nor detailed structured reports for sequencing."/>
      <alias value="Report"/>
      <alias value="Test"/>
      <alias value="Result"/>
      <alias value="Results"/>
      <alias value="Labs"/>
      <alias value="Laboratory"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <constraint>
        <key value="dom-2"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL NOT contain nested Resources"/>
        <expression value="contained.contained.empty()"/>
        <xpath value="not(parent::f:contained and f:contained)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-3"/>
        <severity value="error"/>
        <human
               value="If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource"/>
        <expression
                    value="contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"/>
        <xpath
               value="not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-4"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated"/>
        <expression
                    value="contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"/>
        <xpath
               value="not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="dom-5"/>
        <severity value="error"/>
        <human
               value="If a resource is contained in another resource, it SHALL NOT have a security label"/>
        <expression value="contained.meta.security.empty()"/>
        <xpath value="not(exists(f:contained/*/f:meta/f:security))"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice">
          <valueBoolean value="true"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation">
          <valueMarkdown
                         value="When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."/>
        </extension>
        <key value="dom-6"/>
        <severity value="warning"/>
        <human
               value="A resource should have narrative for robust management"/>
        <expression value="text.`div`.exists()"/>
        <xpath value="exists(f:text/h:div)"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/DomainResource"/>
      </constraint>
      <constraint>
        <key value="diag-status-1"/>
        <severity value="error"/>
        <human
               value="A secondary status can only be provided if the diagnostic report status is either &quot;partial&quot; or &quot;preliminary&quot;."/>
        <expression
                    value="status in ('registered'|'final'|'amended'|'corrected'|'appended'|'cancelled'|'entered-in-error'|'unknown') implies extension('https://gematik.de/fhir/ti/StructureDefinition/secondary-status-extension').empty()"/>
        <source
                value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/diagnostic-report-dglp"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Entity. Role, or Act"/>
      </mapping>
      <mapping>
        <identity value="workflow"/>
        <map value="Event"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="ORU -&gt; OBR"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Observation[classCode=OBS, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.id">
      <path value="DiagnosticReport.id"/>
      <short value="Logical id of this artifact"/>
      <definition
                  value="The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes."/>
      <comment
               value="The only time that a resource does not have an id is when it is being submitted to the server using a create operation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="DiagnosticReport.meta">
      <path value="DiagnosticReport.meta"/>
      <short value="Metadata about the resource"/>
      <definition
                  value="The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.meta"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Meta"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
    </element>
    <element id="DiagnosticReport.implicitRules">
      <path value="DiagnosticReport.implicitRules"/>
      <short value="A set of rules under which this content was created"/>
      <definition
                  value="A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc."/>
      <comment
               value="Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.implicitRules"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation"/>
      <isSummary value="true"/>
    </element>
    <element id="DiagnosticReport.language">
      <path value="DiagnosticReport.language"/>
      <short value="Language of the diagnostic report content"/>
      <definition
                  value="The base language in which the resource is written."/>
      <comment
               value="Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute)."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Resource.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages|4.0.1"/>
      </binding>
    </element>
    <element id="DiagnosticReport.text">
      <path value="DiagnosticReport.text"/>
      <short value="Text summary of the resource, for human interpretation"/>
      <definition
                  value="A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it &quot;clinically safe&quot; for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety."/>
      <comment
               value="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 &quot;text blob&quot; or where text is additionally entered raw or narrated and encoded information is added later."/>
      <alias value="narrative"/>
      <alias value="html"/>
      <alias value="xhtml"/>
      <alias value="display"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Narrative"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text?"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.contained">
      <path value="DiagnosticReport.contained"/>
      <short value="Contained, inline Resources"/>
      <definition
                  value="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."/>
      <comment
               value="This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels."/>
      <alias value="inline resources"/>
      <alias value="anonymous resources"/>
      <alias value="contained resources"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.contained"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Resource"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension">
      <path value="DiagnosticReport.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:DiagnosticReportCompositionR5">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="DiagnosticReportCompositionR5"/>
      <short
             value="R5: Reference to a Composition resource for the DiagnosticReport structure (new)"/>
      <definition
                  value="R5: `DiagnosticReport.composition` (new:Reference(Composition))"/>
      <comment
               value="Element `DiagnosticReport.composition` has a context of DiagnosticReport based on following the parent source element upwards and mapping to `DiagnosticReport`.
Element `DiagnosticReport.composition` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
The Composition provides structure to the content of the DiagnosticReport (and only contains contents referenced in the DiagnosticReport) - e.g., to order the sections of an anatomic pathology structured report."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Element|4.0.1"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Extension|4.0.1"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.id">
      <path value="DiagnosticReport.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.extension">
      <path value="DiagnosticReport.extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Element|4.0.1"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Extension|4.0.1"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.url">
      <path value="DiagnosticReport.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.composition"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <short
             value="Reference to a Composition resource for the DiagnosticReport structure"/>
      <definition
                  value="Reference to a Composition resource instance that provides structure for organizing the contents of the DiagnosticReport."/>
      <comment
               value="The Composition provides structure to the content of the DiagnosticReport (and only contains contents referenced in the DiagnosticReport) - e.g., to order the sections of an anatomic pathology structured report."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/composition-dglp"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Element|4.0.1"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].id">
      <path value="DiagnosticReport.extension.value[x].id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].extension">
      <path value="DiagnosticReport.extension.value[x].extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].reference">
      <path value="DiagnosticReport.extension.value[x].reference"/>
      <short value="Literal reference, Relative, internal or absolute URL"/>
      <definition
                  value="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."/>
      <comment
               value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ref-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].type">
      <path value="DiagnosticReport.extension.value[x].type"/>
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;)"/>
      <definition
                  value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)."/>
      <comment
               value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Aa resource (or, for logical models, the URI of the logical model)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].identifier">
      <path value="DiagnosticReport.extension.value[x].identifier"/>
      <short value="Logical reference, when literal reference is not known"/>
      <definition
                  value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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."/>
      <comment
               value="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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.extension.value[x].display"/>
      <short value="Text alternative for the resource"/>
      <definition
                  value="Plain text narrative that identifies the resource in addition to the resource reference."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:note">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="note"/>
      <short value="R5: Comments about the diagnostic report (new)"/>
      <definition
                  value="Freitextliche Angabe von zusätzliche Informationen zum Laborgesamtbefund."/>
      <comment
               value="Element `DiagnosticReport.note` has a context of DiagnosticReport based on following the parent source element upwards and mapping to `DiagnosticReport`.
Element `DiagnosticReport.note` has no mapping targets in FHIR R4. Typically, this is because the element has been added (is a new element).
May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Element|4.0.1"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Extension|4.0.1"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:note.id">
      <path value="DiagnosticReport.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:note.extension">
      <path value="DiagnosticReport.extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Element|4.0.1"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Extension|4.0.1"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:note.url">
      <path value="DiagnosticReport.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="http://hl7.org/fhir/5.0/StructureDefinition/extension-DiagnosticReport.note"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:note.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <short value="Comments about the diagnostic report"/>
      <definition value="Comments about the diagnostic report."/>
      <comment
               value="May include general statements about the diagnostic report, or statements about significant, unexpected or unreliable results values contained within the diagnostic report, or information about its source when relevant to its interpretation."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Annotation"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source
                value="http://hl7.org/fhir/StructureDefinition/Element|4.0.1"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:note.value[x].id">
      <path value="DiagnosticReport.extension.value[x].id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:note.value[x].extension">
      <path value="DiagnosticReport.extension.value[x].extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:note.value[x].extension:annotation-type">
      <path value="DiagnosticReport.extension.value[x].extension"/>
      <sliceName value="annotation-type"/>
      <short value="The type of annotation"/>
      <definition
                  value="The type of annotation.  This extension can be used to map the v2 NTE-4 comment type field."/>
      <comment value="This is used to identify the type of annotation."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/annotationType"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element
             id="DiagnosticReport.extension:note.value[x].extension:annotation-type.id">
      <path value="DiagnosticReport.extension.value[x].extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <condition value="ele-1"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:note.value[x].extension:annotation-type.extension">
      <path value="DiagnosticReport.extension.value[x].extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element
             id="DiagnosticReport.extension:note.value[x].extension:annotation-type.url">
      <path value="DiagnosticReport.extension.value[x].extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="http://hl7.org/fhir/StructureDefinition/annotationType"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:note.value[x].extension:annotation-type.value[x]">
      <path value="DiagnosticReport.extension.value[x].extension.value[x]"/>
      <short value="Type of note"/>
      <definition
                  value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <condition value="ext-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <strength value="example"/>
        <valueSet value="http://terminology.hl7.org/ValueSet/v2-0364|3.0.0"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:note.value[x].author[x]">
      <path value="DiagnosticReport.extension.value[x].author[x]"/>
      <short value="Individual responsible for the annotation"/>
      <definition
                  value="The individual responsible for making the annotation."/>
      <comment
               value="Organization is used when there's no need for specific attribution as to who made the comment."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Annotation.author[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Patient|4.0.1"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/RelatedPerson|4.0.1"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"/>
      </type>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Act.participant[typeCode=AUT].role"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:note.value[x].time">
      <path value="DiagnosticReport.extension.value[x].time"/>
      <short value="When the annotation was made"/>
      <definition
                  value="Indicates when this particular annotation was made."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Annotation.time"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Act.effectiveTime"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:note.value[x].text">
      <path value="DiagnosticReport.extension.value[x].text"/>
      <short value="The annotation  - text content (as markdown)"/>
      <definition value="The text of the annotation in markdown format."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Annotation.text"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="markdown"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Act.text"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:orderEntryTime">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="orderEntryTime"/>
      <short value="Auftrageingangszeitpunkt im Labor"/>
      <definition
                  value="Die Bedeutung und Verwendung des Auftragseingangszeitpunktes im Laborprozess kann unterschiedlich sein, beispielsweise:

* In einem OrderEntry-Setting kann der Auftragseingangszeitstempel zum Zeitpunkt der ersten Probeneinbuchung für diesen Auftrag im Labor gesetzt werden. In einem solchen Fall aktiviert/generiert die erste Probe den Auftrag im LIS.
* In einem papiergebundenen Setting ist in der Regel der Scanzeitpunkt des Papierauftrages der Auftragseingangszeitstempel. Ggf. kann dieser vor oder nach der/den zugehörigen Probeneinbuchungen liegen."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/order-entry-time-extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:orderEntryTime.id">
      <path value="DiagnosticReport.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:orderEntryTime.extension">
      <path value="DiagnosticReport.extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:orderEntryTime.url">
      <path value="DiagnosticReport.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="https://gematik.de/fhir/ti/StructureDefinition/order-entry-time-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:orderEntryTime.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:pseudonymizedReport">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="pseudonymizedReport"/>
      <short value="Kennzeichnung, ob ein Laborbefund pseudonymisiert ist"/>
      <definition
                  value="Mit diesem Kennzeichen kann ein Laborbefund als \&quot;pseudonymisiert\&quot; deklariert werden.

Fachlicher Hintergrund: es gibt Anwendungsfälle, z.B. aus der Betriebsmedizin, die erfordern, dass ein Laborbefund pseudonymisiert, also ohne personenidentifizierende Inhalte übertragen wird. Nach welchen Regeln und mit welchem Identifikator ein pseudonymisierter Laborbefund übermittelt wird, ist Gegenstand einer Einzelabstimmung zwischen der anfordernden Einrichtung und dem Labor. Oft ist bereits der Auftrag pseudonymisiert. Hinweis: Zu einem späteren Zeitpunkt könnten Patient:innen berechtigterweise fordern, dass der Laborbefund seinen anderen Befunden hinzugefügt wird, z.B. in der ePA. Durch das Hochladen in die ePA wird der Befund eindeutig einer Person zugeordnet und dadurch die Pseudonymisierung (auch bei unverändert verdeckten Personendaten) \&quot;demaskiert\&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/pseudonymized-report-extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:pseudonymizedReport.id">
      <path value="DiagnosticReport.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:pseudonymizedReport.extension">
      <path value="DiagnosticReport.extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:pseudonymizedReport.url">
      <path value="DiagnosticReport.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="https://gematik.de/fhir/ti/StructureDefinition/pseudonymized-report-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:pseudonymizedReport.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:criticalResult">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="criticalResult"/>
      <short value="Manuell gesetztes Kennzeichen Kritischer Befund"/>
      <definition
                  value="Dieses Kennzeichen ist optional und deklariert einen aus labormedizinischer Sicht medizinisch kritischen Befund. Es wird aus einer aktiven Entscheidung des/der Labormediziners/in manuell gesetzt."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/critical-result-extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:criticalResult.id">
      <path value="DiagnosticReport.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:criticalResult.extension">
      <path value="DiagnosticReport.extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:criticalResult.url">
      <path value="DiagnosticReport.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="https://gematik.de/fhir/ti/StructureDefinition/critical-result-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:criticalResult.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="secondaryStatus"/>
      <short value="Änderungsstatus Laborbefund (Sekundärstatus)"/>
      <definition
                  value="Optionale sekundäre Angabe des Änderungsstatus, die zusätzlich zum Hauptstatus \&quot;Status Gesamtbefund\&quot; mitgegeben werden kann. Es können mehrere Werte als Änderungsgrund angegeben werden. Die möglichen Werte sind:

* Geändert
* Korrigiert
* Angefügt

Der typische und in jedem Labor alltägliche Anwendungsfall ist die Nachforderung bei einer Stufendiagnostik. Änderungen am Gesamtbefund können sich auch auf einen noch nicht abgeschlossenen Befund beziehen, z.B. auf einen Teilbefund oder einen vorläufigen Befund."/>
      <min value="0"/>
      <max value="3"/>
      <base>
        <path value="DomainResource.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/secondary-status-extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.id">
      <path value="DiagnosticReport.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.extension">
      <path value="DiagnosticReport.extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.url">
      <path value="DiagnosticReport.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="https://gematik.de/fhir/ti/StructureDefinition/secondary-status-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="https://gematik.de/fhir/terminology/ValueSet/secondary-status"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.value[x].id">
      <path value="DiagnosticReport.extension.value[x].id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:secondaryStatus.value[x].extension">
      <path value="DiagnosticReport.extension.value[x].extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.value[x].system">
      <path value="DiagnosticReport.extension.value[x].system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comment
               value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:secondaryStatus.value[x].version">
      <path value="DiagnosticReport.extension.value[x].version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.version"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.value[x].code">
      <path value="DiagnosticReport.extension.value[x].code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="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)."/>
      <requirements
                    value="Need to refer to a particular code in the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:secondaryStatus.value[x].display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.extension.value[x].display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <comment value="Note that FHIR strings SHALL NOT exceed 1MB in size"/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.extension:secondaryStatus.value[x].userSelected">
      <path value="DiagnosticReport.extension.value[x].userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
      <comment
               value="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."/>
      <requirements
                    value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Coding.userSelected"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.modifierExtension">
      <path value="DiagnosticReport.modifierExtension"/>
      <short value="Extensions that cannot be ignored"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DomainResource.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier">
      <path value="DiagnosticReport.identifier"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="type"/>
        </discriminator>
        <rules value="closed"/>
      </slicing>
      <short value="Business identifier for report"/>
      <definition
                  value="Identifiers assigned to this report by the performer or other systems."/>
      <comment
               value="Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists"/>
      <requirements
                    value="Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context."/>
      <alias value="ReportID"/>
      <alias value="Filler ID"/>
      <alias value="Placer ID"/>
      <min value="1"/>
      <max value="2"/>
      <base>
        <path value="DiagnosticReport.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-51/ for globally unique filler ID  - OBR-3 , For non-globally unique filler-id the flller/placer number must be combined with the universal service Id -  OBR-2(if present)+OBR-3+OBR-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab">
      <path value="DiagnosticReport.identifier"/>
      <sliceName value="orderNumberLab"/>
      <short value="Auftragnummer des Labors"/>
      <definition
                  value="Auftragsnummer, die das auftragsnehmende Labor vergibt und führt"/>
      <comment
               value="Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists"/>
      <requirements
                    value="Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context."/>
      <alias value="ReportID"/>
      <alias value="Filler ID"/>
      <alias value="Placer ID"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-51/ for globally unique filler ID  - OBR-3 , For non-globally unique filler-id the flller/placer number must be combined with the universal service Id -  OBR-2(if present)+OBR-3+OBR-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.id">
      <path value="DiagnosticReport.identifier.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.extension">
      <path value="DiagnosticReport.identifier.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.use">
      <path value="DiagnosticReport.identifier.use"/>
      <short value="usual | official | temp | secondary | old (If known)"/>
      <definition value="The purpose of this identifier."/>
      <comment
               value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary."/>
      <requirements
                    value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Identifier.use"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one."/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Identifies the purpose for this identifier, if known ."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.code or implied by context"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type">
      <path value="DiagnosticReport.identifier.type"/>
      <short value="Description of identifier"/>
      <definition
                  value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose."/>
      <comment
               value="This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type."/>
      <requirements
                    value="Allows users to make use of identifiers when the identifier system is not known."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <patternCodeableConcept>
        <coding>
          <system
                  value="https://gematik.de/fhir/terminology/CodeSystem/laboratory-identificator"/>
          <code value="AL"/>
          <display value="Auftragsnummer des Labors"/>
        </coding>
      </patternCodeableConcept>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type|4.0.1"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="CX.5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.code or implied by context"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type.id">
      <path value="DiagnosticReport.identifier.type.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type.extension">
      <path value="DiagnosticReport.identifier.type.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type.coding">
      <path value="DiagnosticReport.identifier.type.coding"/>
      <short value="Code defined by a terminology system"/>
      <definition
                  value="A reference to a code defined by a terminology system."/>
      <comment
               value="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."/>
      <requirements
                    value="Allows for alternative encodings within a code system, and translations to other code systems."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type.coding.id">
      <path value="DiagnosticReport.identifier.type.coding.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.extension">
      <path value="DiagnosticReport.identifier.type.coding.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.system">
      <path value="DiagnosticReport.identifier.type.coding.system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comment
               value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.version">
      <path value="DiagnosticReport.identifier.type.coding.version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.version"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.code">
      <path value="DiagnosticReport.identifier.type.coding.code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="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)."/>
      <requirements
                    value="Need to refer to a particular code in the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.identifier.type.coding.display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.userSelected">
      <path value="DiagnosticReport.identifier.type.coding.userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
      <comment
               value="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."/>
      <requirements
                    value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Coding.userSelected"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.identifier.type.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="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."/>
      <comment
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CodeableConcept.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.system">
      <path value="DiagnosticReport.identifier.system"/>
      <short value="The namespace for the identifier value"/>
      <definition
                  value="Establishes the namespace for the value - that is, a URL that describes a set values that are unique."/>
      <comment value="Identifier.system is always case sensitive."/>
      <requirements
                    value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Identifier.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <example>
        <label value="General"/>
        <valueUri value="http://www.acme.com/identifiers/patient"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.4 / EI-2-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="II.root or Role.id.root"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./IdentifierType"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.value">
      <path value="DiagnosticReport.identifier.value"/>
      <short value="The value that is unique"/>
      <definition
                  value="The portion of the identifier typically relevant to the user and which is unique within the context of the system."/>
      <comment
               value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.value"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <example>
        <label value="General"/>
        <valueString value="123456"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.1 / EI.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./Value"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.period">
      <path value="DiagnosticReport.identifier.period"/>
      <short value="Time period when id is/was valid for use"/>
      <definition
                  value="Time period during which identifier is/was valid for use."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Identifier.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.7 + CX.8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.effectiveTime or implied by context"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StartDate and ./EndDate"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.assigner">
      <path value="DiagnosticReport.identifier.assigner"/>
      <short value="Organization that issued id (may be just text)"/>
      <definition value="Organization that issued/manages the identifier."/>
      <comment
               value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Identifier.assigner"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.4 / (CX.4,CX.9,CX.10)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./IdentifierIssuingAuthority"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport">
      <path value="DiagnosticReport.identifier"/>
      <sliceName value="overallLabReport"/>
      <short
             value="Versionsunabhängiger konstanter Identifikator Laborgesamtbefund (UUID)"/>
      <definition
                  value="Die eindeutige Identifikation des Laborbefundes zu einem Laborauftrag geschieht mittels UUID (Universal Unique Identifier). Sie wird durch das auftragnehmende, Befund erzeugende Labor generiert.

Die UUID wird als Befundinhalt beim Übermitteln des Laborbefundes mitgegeben, auch dann, wenn der Laborbefund jenseits der ePA übermittelt wird (z. B: per E-Mail oder KIM). Diese UUID bleibt über den gesamten Workflow der Abarbeitung des Auftrages die selbe; und zwar durch die Versionierung eines Laborbefundes hindurch (z.B. vorläufiger Befund, finaler Befund, Befund mit Änderungen ...) und durch alle Systeme hindurch."/>
      <comment
               value="Composition.identifier SHALL be equal to one of the DiagnosticReport.identifier, if at least one exists"/>
      <requirements
                    value="Need to know what identifier to use when making queries about this report from the source laboratory, and for linking to the report outside FHIR context."/>
      <alias value="ReportID"/>
      <alias value="Filler ID"/>
      <alias value="Placer ID"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.identifier"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.identifier"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.identifier"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-51/ for globally unique filler ID  - OBR-3 , For non-globally unique filler-id the flller/placer number must be combined with the universal service Id -  OBR-2(if present)+OBR-3+OBR-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="id"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.id">
      <path value="DiagnosticReport.identifier.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.extension">
      <path value="DiagnosticReport.identifier.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.use">
      <path value="DiagnosticReport.identifier.use"/>
      <short value="usual | official | temp | secondary | old (If known)"/>
      <definition value="The purpose of this identifier."/>
      <comment
               value="Applications can assume that an identifier is permanent unless it explicitly says that it is temporary."/>
      <requirements
                    value="Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Identifier.use"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one."/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierUse"/>
        </extension>
        <strength value="required"/>
        <description
                     value="Identifies the purpose for this identifier, if known ."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-use|4.0.1"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="N/A"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.code or implied by context"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.type">
      <path value="DiagnosticReport.identifier.type"/>
      <short value="Description of identifier"/>
      <definition
                  value="A coded type for the identifier that can be used to determine which identifier to use for a specific purpose."/>
      <comment
               value="This element deals only with general categories of identifiers.  It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage.   Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type."/>
      <requirements
                    value="Allows users to make use of identifiers when the identifier system is not known."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <version value="5.0.0"/>
          <code value="RI"/>
          <display value="Resource Identifier"/>
        </coding>
      </patternCodeableConcept>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="IdentifierType"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="A coded type for an identifier that can be used to determine which identifier to use for a specific purpose."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/identifier-type|4.0.1"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="CX.5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.code or implied by context"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.type.id">
      <path value="DiagnosticReport.identifier.type.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.extension">
      <path value="DiagnosticReport.identifier.type.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.type.coding">
      <path value="DiagnosticReport.identifier.type.coding"/>
      <short value="Code defined by a terminology system"/>
      <definition
                  value="A reference to a code defined by a terminology system."/>
      <comment
               value="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."/>
      <requirements
                    value="Allows for alternative encodings within a code system, and translations to other code systems."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.id">
      <path value="DiagnosticReport.identifier.type.coding.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.extension">
      <path value="DiagnosticReport.identifier.type.coding.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.system">
      <path value="DiagnosticReport.identifier.type.coding.system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comment
               value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.version">
      <path value="DiagnosticReport.identifier.type.coding.version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Coding.version"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.code">
      <path value="DiagnosticReport.identifier.type.coding.code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="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)."/>
      <requirements
                    value="Need to refer to a particular code in the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.identifier.type.coding.display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.userSelected">
      <path value="DiagnosticReport.identifier.type.coding.userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
      <comment
               value="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."/>
      <requirements
                    value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Coding.userSelected"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.type.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.identifier.type.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="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."/>
      <comment
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="CodeableConcept.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.system">
      <path value="DiagnosticReport.identifier.system"/>
      <short value="The namespace for the identifier value"/>
      <definition value="System, welches den Aufbau der UUID reguliert"/>
      <comment value="Identifier.system is always case sensitive."/>
      <requirements
                    value="There are many sets  of identifiers.  To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <patternUri value="urn:ietf:rfc:3986"/>
      <example>
        <label value="General"/>
        <valueUri value="http://www.acme.com/identifiers/patient"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.4 / EI-2-4"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="II.root or Role.id.root"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./IdentifierType"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.value">
      <path value="DiagnosticReport.identifier.value"/>
      <short value="The value that is unique"/>
      <definition
                  value="Hier wird die UUID eingetragen. Der String beginnt immer mit &quot;urn:uuid:&quot;, der zusammengesetzte String sähe dann beispielsweise so aus: &quot;urn:uuid:f81d4fae-7dec-11d0-a765-00a0c91e6bf6&quot;."/>
      <comment
               value="If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986.  The value's primary purpose is computational mapping.  As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.)  A value formatted for human display can be conveyed using the [Rendered Value extension](http://hl7.org/fhir/R4/extension-rendered-value.html). Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Identifier.value"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <example>
        <label value="General"/>
        <valueString value="123456"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.1 / EI.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./Value"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.period">
      <path value="DiagnosticReport.identifier.period"/>
      <short value="Time period when id is/was valid for use"/>
      <definition
                  value="Time period during which identifier is/was valid for use."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Identifier.period"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.7 + CX.8"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="Role.effectiveTime or implied by context"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./StartDate and ./EndDate"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.assigner">
      <path value="DiagnosticReport.identifier.assigner"/>
      <short value="Organization that issued id (may be just text)"/>
      <definition value="Organization that issued/manages the identifier."/>
      <comment
               value="The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Identifier.assigner"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Organization|4.0.1"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="CX.4 / (CX.4,CX.9,CX.10)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="II.assigningAuthorityName but note that this is an improper use by the definition of the field.  Also Role.scoper"/>
      </mapping>
      <mapping>
        <identity value="servd"/>
        <map value="./IdentifierIssuingAuthority"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.basedOn">
      <path value="DiagnosticReport.basedOn"/>
      <short value="Referenz Laborauftrag-Information"/>
      <definition
                  value="Hier wird eine Laborauftrags-Information referenziert."/>
      <comment
               value="Note: Usually there is one test request for each result, however in some circumstances multiple test requests may be represented using a single test result resource. Note that there are also cases where one request leads to multiple reports."/>
      <requirements
                    value="This allows tracing of authorization for the report and tracking whether proposals/recommendations were acted upon."/>
      <alias value="Request"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.basedOn"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/service-request-dglp"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.basedOn"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="ORC? OBR-2/3?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=FLFS].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.basedOn.id">
      <path value="DiagnosticReport.basedOn.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.basedOn.extension">
      <path value="DiagnosticReport.basedOn.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.basedOn.reference">
      <path value="DiagnosticReport.basedOn.reference"/>
      <short value="Literal reference, Relative, internal or absolute URL"/>
      <definition
                  value="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."/>
      <comment
               value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ref-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.basedOn.type">
      <path value="DiagnosticReport.basedOn.type"/>
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;)"/>
      <definition
                  value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)."/>
      <comment
               value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Aa resource (or, for logical models, the URI of the logical model)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.basedOn.identifier">
      <path value="DiagnosticReport.basedOn.identifier"/>
      <short value="Logical reference, when literal reference is not known"/>
      <definition
                  value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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."/>
      <comment
               value="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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.basedOn.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.basedOn.display"/>
      <short value="Text alternative for the resource"/>
      <definition
                  value="Plain text narrative that identifies the resource in addition to the resource reference."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.status">
      <path value="DiagnosticReport.status"/>
      <short value="Bearbeitungsstatus Laborbefund (Hauptstatus)"/>
      <definition
                  value="Bearbeitungsstatus des Laborgesamtbefundes. Die Status-Werte orientieren sich am HL7 FHIR® Standard, jedoch werden der Wert &quot;unknown&quot; und die Werte für Änderungen in diesem ValueSet nicht verwendet.

  * Registered - Registriert
  * Partial - Nicht vollständig
  * Preliminary - Vorläufig
  * Final - Abgeschlossen
  * Entered in Error - Irrtümliche Eingabe
  * Cancelled - Storniert
  * Amended - Geändert
  * Corrected - Korrigiert
  * Appended - Angefügt

  Änderungen am finalen Befund werden über die hier aufgeführten (Haupt)Status &quot;Geändert&quot;, &quot;Korrgiert&quot;, &quot;Angefügt&quot; abgebildet.

  Änderungen an vorläufigen oder nicht vollständigen Befunden werden über den Sekundärstatus mit den entsprechenden Werten abgebildet.


  Achtung! Auch Patientenstammdaten, die der Personenidentität dienen, können korrigiert werden. Im Falle einer Patientenverwechslung muss der Hauptstatus=&quot;Irrtümliche Eingabe&quot; gesetzt werden, dies darf nicht als Änderung versendet werden!)"/>
      <comment
               value="DiagnosticReport.status and Composition.status shall be aligned"/>
      <requirements
                    value="Diagnostic services routinely issue provisional/incomplete reports, and sometimes withdraw previously released reports."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.status"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="true"/>
      <isModifierReason
                        value="This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="https://gematik.de/fhir/terminology/ValueSet/diagnostic-report-status"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.status"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.status"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-25 (not 1:1 mapping)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="statusCode  Note: final and amended are distinguished by whether observation is the subject of a ControlAct event of type &quot;revise&quot;"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category">
      <path value="DiagnosticReport.category"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="$this"/>
        </discriminator>
        <rules value="open"/>
      </slicing>
      <short value="Report Category"/>
      <definition
                  value="A code that classifies this laboratory report. Two basic categories has been selected in this guide: laboratory specialty and Study type. Laboratory specialty is characteristic of the laboratory that produced the test result while Study type is an arbitrary classificion of the test type."/>
      <comment
               value="DiagnosticReport.category and Composition.category shall be aligned"/>
      <alias value="Department"/>
      <alias value="Sub-department"/>
      <alias value="Service"/>
      <alias value="Discipline"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.category"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="DiagnosticServiceSection"/>
        </extension>
        <strength value="example"/>
        <description value="Codes for diagnostic service sections."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/diagnostic-service-sections|4.0.1"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-24"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code &lt; LabService].code"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category:studyType">
      <path value="DiagnosticReport.category"/>
      <sliceName value="studyType"/>
      <short
             value="The way of grouping of the test results into clinically meaningful domains (e.g. hematology study, microbiology study, etc.)"/>
      <definition
                  value="Laboratory services, i.e., results of tests performed, could be characterized using typology of services, commonly called study types. Study type could be seen as an attribute or grouping mechanism that assigns a common clinical sense to certain types of laboratory test results., e.g., Hemoglobin, Platelet count, etc. belongs to 'Hematology study'."/>
      <comment
               value="In comparison to the laboratory specialty which is an attribute of laboratory, study type is a categorization of laboratory service. It needs to be mentioned that classification of test to study types in not standardized."/>
      <alias value="Department"/>
      <alias value="Sub-department"/>
      <alias value="Service"/>
      <alias value="Discipline"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.category"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.eu/fhir/laboratory/ValueSet/lab-studyType-eu-lab"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-24"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code &lt; LabService].code"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.category:specialty">
      <path value="DiagnosticReport.category"/>
      <sliceName value="specialty"/>
      <short
             value="The clinical domain of the laboratory performing the observation (e.g. microbiology, toxicology, chemistry)"/>
      <definition
                  value="Laboratory specialty is an attribute of any laboratory setting representing professional qualification of the laboratory to execute certain kind of laboratory tests."/>
      <comment
               value="Specialty could be used as parameter for searching/querying of laboratory test results."/>
      <alias value="Department"/>
      <alias value="Sub-department"/>
      <alias value="Service"/>
      <alias value="Discipline"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.category"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="http://hl7.eu/fhir/laboratory/ValueSet/lab-specialty-eu-lab"/>
      </binding>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.class"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-24"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=LIST, moodCode=EVN, code &lt; LabService].code"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code">
      <path value="DiagnosticReport.code"/>
      <short value="Deklariert &quot;Laborbefund&quot;"/>
      <definition
                  value="Codierte Angabe zur Art des Befundes, hier Laborbefund"/>
      <comment
               value="At least one DiagnosticReport.code.coding and Composition.type.coding SHALL be equal"/>
      <alias value="Type"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.code"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <strength value="preferred"/>
        <valueSet
                  value="http://hl7.eu/fhir/laboratory/ValueSet/lab-reportType-eu-lab"/>
      </binding>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.code"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.what[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-4 (HL7 v2 doesn't provide an easy way to indicate both the ordered test and the performed panel)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="code"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.id">
      <path value="DiagnosticReport.code.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.extension">
      <path value="DiagnosticReport.code.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.coding">
      <path value="DiagnosticReport.code.coding"/>
      <short value="Code defined by a terminology system"/>
      <definition
                  value="A reference to a code defined by a terminology system."/>
      <comment
               value="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."/>
      <requirements
                    value="Allows for alternative encodings within a code system, and translations to other code systems."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.coding"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Coding"/>
      </type>
      <patternCoding>
        <system value="http://loinc.org"/>
        <version value="2.82"/>
        <code value="11502-2"/>
        <display value="Laboratory report"/>
      </patternCoding>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1-8, C*E.10-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="union(., ./translation)"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.coding.id">
      <path value="DiagnosticReport.code.coding.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.coding.extension">
      <path value="DiagnosticReport.code.coding.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.coding.system">
      <path value="DiagnosticReport.code.coding.system"/>
      <short value="Identity of the terminology system"/>
      <definition
                  value="The identification of the code system that defines the meaning of the symbol in the code."/>
      <comment
               value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...).  OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously."/>
      <requirements
                    value="Need to be unambiguous about the source of the definition of the symbol."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.system"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.3"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystem"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.coding.version">
      <path value="DiagnosticReport.code.coding.version"/>
      <short value="Version of the system - if relevant"/>
      <definition
                  value="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."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.version"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./codeSystemVersion"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.coding.code">
      <path value="DiagnosticReport.code.coding.code"/>
      <short value="Symbol in syntax defined by the system"/>
      <definition
                  value="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)."/>
      <requirements
                    value="Need to refer to a particular code in the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.code"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.1"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./code"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.coding.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.code.coding.display"/>
      <short value="Representation defined by the system"/>
      <definition
                  value="A representation of the meaning of the code in the system, following the rules of the system."/>
      <requirements
                    value="Need to be able to carry a human-readable meaning of the code for readers that do not know  the system."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Coding.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.2 - but note this is not well followed"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CV.displayName"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.coding.userSelected">
      <path value="DiagnosticReport.code.coding.userSelected"/>
      <short value="If this coding was chosen directly by the user"/>
      <definition
                  value="Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays)."/>
      <comment
               value="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."/>
      <requirements
                    value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Coding.userSelected"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="boolean"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="Sometimes implied by being first"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="CD.codingRationale"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map;   fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [     fhir:source &quot;true&quot;;     fhir:target dt:CDCoding.codingRationale\#O   ]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.code.text">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.code.text"/>
      <short value="Plain text representation of the concept"/>
      <definition
                  value="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."/>
      <comment
               value="Very often the text is the same as a displayName of one of the codings."/>
      <requirements
                    value="The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="CodeableConcept.text"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="C*E.9. But note many systems use C*E.2 for this"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="./originalText[mediaType/code=&quot;text/plain&quot;]/data"/>
      </mapping>
      <mapping>
        <identity value="orim"/>
        <map
             value="fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.subject">
      <path value="DiagnosticReport.subject"/>
      <short value="Who and/or what this report is about"/>
      <definition
                  value="Who or what this report is about. The report can be about a human patient, a living subject, a device (e.g. a machine), a location or even a group of subjects (such as a document about a herd of livestock, or a set of patients that share a common exposure)."/>
      <comment
               value="DiagnosticReport and Composition SHALL have the same subject"/>
      <requirements value="SHALL know the subject context."/>
      <alias value="Patient"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.subject"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/ti/StructureDefinition/ti-patient"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.subject"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PID-3 (no HL7 v2 mapping for Group or Device)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SBJ]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.subject"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.subject.id">
      <path value="DiagnosticReport.subject.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.subject.extension">
      <path value="DiagnosticReport.subject.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.subject.reference">
      <path value="DiagnosticReport.subject.reference"/>
      <short value="Literal reference, Relative, internal or absolute URL"/>
      <definition
                  value="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."/>
      <comment
               value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Reference.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ref-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.subject.type">
      <path value="DiagnosticReport.subject.type"/>
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;)"/>
      <definition
                  value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)."/>
      <comment
               value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Reference.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Aa resource (or, for logical models, the URI of the logical model)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.subject.identifier">
      <path value="DiagnosticReport.subject.identifier"/>
      <short value="Logical reference, when literal reference is not known"/>
      <definition
                  value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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."/>
      <comment
               value="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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://fhir.de/StructureDefinition/identifier-kvid-10"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.subject.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.subject.display"/>
      <short value="Text alternative for the resource"/>
      <definition
                  value="Plain text narrative that identifies the resource in addition to the resource reference."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Reference.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.encounter">
      <path value="DiagnosticReport.encounter"/>
      <short value="Fallbezug"/>
      <definition
                  value="Referenzierung auf die Fall-Identifikation / Fallnummer bezüglich Begegnung/Aufenthalt."/>
      <comment
               value="This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

  DiagnosticReport and Composition SHALL have the same encounter."/>
      <requirements value="Links the request to the Encounter context."/>
      <alias value="Context"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.encounter"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Encounter|4.0.1"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.encounter"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.context"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PV1-19"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.effective[x]">
      <path value="DiagnosticReport.effective[x]"/>
      <slicing>
        <discriminator>
          <type value="type"/>
          <path value="$this"/>
        </discriminator>
        <ordered value="false"/>
        <rules value="closed"/>
      </slicing>
      <short value="Clinically relevant time/time-period for report."/>
      <definition
                  value="The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself."/>
      <comment
               value="If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic."/>
      <requirements
                    value="Need to know where in the patient history to file/present this report."/>
      <alias value="Observation time"/>
      <alias value="Effective Time"/>
      <alias value="Occurrence"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.effective[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.done[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.effective[x]:effectivePeriod">
      <path value="DiagnosticReport.effective[x]"/>
      <sliceName value="effectivePeriod"/>
      <short value="Effective period of the report"/>
      <definition
                  value="The time or time-period the observed values are related to. When the subject of the report is a patient, this is usually either the time of the procedure or of specimen collection(s), but very often the source of the date/time is not known, only the date/time itself."/>
      <comment
               value="If the diagnostic procedure was performed on the patient, this is the time it was performed. If there are specimens, the diagnostically relevant time can be derived from the specimen collection times, but the specimen information is not always available, and the exact relationship between the specimens and the diagnostically relevant time is not always automatic."/>
      <requirements
                    value="Need to know where in the patient history to file/present this report."/>
      <alias value="Observation time"/>
      <alias value="Effective Time"/>
      <alias value="Occurrence"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.effective[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Period"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.occurrence[x]"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.done[x]"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-7"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="effectiveTime"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.issued">
      <path value="DiagnosticReport.issued"/>
      <short value="Dokumentationszeitpunkt Laborgesamtbefund"/>
      <definition
                  value="Dokumentationszeitpunkt des Befundes durch das auftragnehmende Labor."/>
      <comment
               value="May be different from the update time of the resource itself, because that is the status of the record (potentially a secondary copy), not the actual release time of the report."/>
      <requirements
                    value="Clinicians need to be able to check the date that the report was released."/>
      <alias value="Date published"/>
      <alias value="Date Issued"/>
      <alias value="Date Verified"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.issued"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.recorded"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="OBR-22"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=VRF or AUT].time"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer">
      <path value="DiagnosticReport.performer"/>
      <slicing>
        <discriminator>
          <type value="profile"/>
          <path value="$this"/>
        </discriminator>
        <description value="Organization that delivered the report"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Auftragnehmendes Labor"/>
      <definition
                  value="Person oder Organisation, die für Erstellung des Laborgesamtbefundes verantwortlich ist.


Das auftragnehmende Labor kann die Laborleistung selbst erbringen, teilweise selbst erbringen und teilweise an ein Speziallabor weiterleiten oder insgesamt an ein Speziallabor weiterleiten. Der Gesamtbefund wird vollumfänglich zum gesamten Laborauftrag vom Auftragnehmer erstellt."/>
      <comment
               value="If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author."/>
      <requirements
                    value="Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis."/>
      <alias value="Laboratory"/>
      <alias value="Service"/>
      <alias value="Practitioner"/>
      <alias value="Department"/>
      <alias value="Company"/>
      <alias value="Authorized by"/>
      <alias value="Director"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/ti/StructureDefinition/ti-organization"/>
        <targetProfile
                       value="https://gematik.de/fhir/ti/StructureDefinition/ti-practitioner"/>
        <targetProfile
                       value="https://gematik.de/fhir/ti/StructureDefinition/ti-practitioner-role"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer.actor"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRT-8 (where this PRT-4-Participation = &quot;PO&quot;)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer.id">
      <path value="DiagnosticReport.performer.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer.extension">
      <path value="DiagnosticReport.performer.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer.reference">
      <path value="DiagnosticReport.performer.reference"/>
      <short value="Literal reference, Relative, internal or absolute URL"/>
      <definition
                  value="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."/>
      <comment
               value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ref-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer.type">
      <path value="DiagnosticReport.performer.type"/>
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;)"/>
      <definition
                  value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)."/>
      <comment
               value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Aa resource (or, for logical models, the URI of the logical model)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer.identifier">
      <path value="DiagnosticReport.performer.identifier"/>
      <short value="Logical reference, when literal reference is not known"/>
      <definition
                  value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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."/>
      <comment
               value="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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.performer.display"/>
      <short value="Text alternative for the resource"/>
      <definition
                  value="Plain text narrative that identifies the resource in addition to the resource reference."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.performer:organization">
      <path value="DiagnosticReport.performer"/>
      <sliceName value="organization"/>
      <short value="The organization producer of this report"/>
      <definition
                  value="The organization responsible for producing this report. In case practitioners produce them in their private practices, they will be accounted as an organization for this purpose."/>
      <comment
               value="This is not necessarily the source of the atomic data items or the entity that interpreted the results. It is the entity that takes responsibility for the clinical report."/>
      <requirements
                    value="Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis."/>
      <alias value="Laboratory"/>
      <alias value="Service"/>
      <alias value="Practitioner"/>
      <alias value="Department"/>
      <alias value="Company"/>
      <alias value="Authorized by"/>
      <alias value="Director"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.performer"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.eu/fhir/base/StructureDefinition/organization-eu-core"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer.actor"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map value="PRT-8 (where this PRT-4-Participation = &quot;PO&quot;)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.resultsInterpreter">
      <path value="DiagnosticReport.resultsInterpreter"/>
      <slicing>
        <discriminator>
          <type value="profile"/>
          <path value="resolve()"/>
        </discriminator>
        <description value="Primary interpreter of results"/>
        <ordered value="false"/>
        <rules value="open"/>
      </slicing>
      <short value="Primary result interpreter"/>
      <definition
                  value="The practitioner or organization that is responsible for the report's conclusions and interpretations."/>
      <comment
               value="If a DiagnosticReport.resultsInterpreter exists this is expected to be a Composition.author; otherwise a DiagnosticReport.performer should be an author."/>
      <requirements
                    value="Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis."/>
      <alias value="Analyzed by"/>
      <alias value="Reported by"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.resultsInterpreter"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu-core"/>
        <targetProfile
                       value="http://hl7.eu/fhir/base/StructureDefinition/practitioner-eu-core"/>
        <targetProfile
                       value="http://hl7.eu/fhir/base/StructureDefinition/organization-eu-core"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/CareTeam"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer.actor"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-32, PRT-8 (where this PRT-4-Participation = &quot;PI&quot;)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.resultsInterpreter:author">
      <path value="DiagnosticReport.resultsInterpreter"/>
      <sliceName value="author"/>
      <short value="Primary result interpreter"/>
      <definition
                  value="The practitioner or organization that is responsible for the report's conclusions and interpretations."/>
      <comment
               value="Might not be the same entity that takes responsibility for the clinical report."/>
      <requirements
                    value="Need to know whom to contact if there are queries about the results. Also may need to track the source of reports for secondary data analysis."/>
      <alias value="Analyzed by"/>
      <alias value="Reported by"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.resultsInterpreter"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu-core"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="workflow"/>
        <map value="Event.performer.actor"/>
      </mapping>
      <mapping>
        <identity value="w5"/>
        <map value="FiveWs.actor"/>
      </mapping>
      <mapping>
        <identity value="v2"/>
        <map
             value="OBR-32, PRT-8 (where this PRT-4-Participation = &quot;PI&quot;)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value=".participation[typeCode=PRF]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.specimen">
      <path value="DiagnosticReport.specimen"/>
      <short value="Specimens this report is based on."/>
      <definition
                  value="Details about the specimens on which this diagnostic report is based."/>
      <comment
               value="Zum Erhalt der europäischen Interoperabilität, orientiert an der Veröffentlichung https://hl7.eu/fhir/laboratory/history.html kann auf Gesamtbefundebene auf das gesamte Probenmaterial referenziert werden. Diese optionale Angabe ist redundant zu den Probenreferenzen der Einzeluntersuchungen."/>
      <requirements
                    value="Need to be able to report information about the collected specimens on which the report is based."/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.specimen"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/specimen-dglp"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="SPM"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="participation[typeCode=SBJ]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.specimen.id">
      <path value="DiagnosticReport.specimen.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.specimen.extension">
      <path value="DiagnosticReport.specimen.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.specimen.reference">
      <path value="DiagnosticReport.specimen.reference"/>
      <short value="Literal reference, Relative, internal or absolute URL"/>
      <definition
                  value="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."/>
      <comment
               value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ref-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.specimen.type">
      <path value="DiagnosticReport.specimen.type"/>
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;)"/>
      <definition
                  value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)."/>
      <comment
               value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Aa resource (or, for logical models, the URI of the logical model)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.specimen.identifier">
      <path value="DiagnosticReport.specimen.identifier"/>
      <short value="Logical reference, when literal reference is not known"/>
      <definition
                  value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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."/>
      <comment
               value="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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.specimen.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.specimen.display"/>
      <short value="Text alternative for the resource"/>
      <definition
                  value="Plain text narrative that identifies the resource in addition to the resource reference."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result">
      <path value="DiagnosticReport.result"/>
      <short value="results"/>
      <definition
                  value="Die Laborergebnisse werden grundsätzlich gruppiert. Es gibt mindestens eine Untersuchungsgruppe."/>
      <comment value="Observations can contain observations."/>
      <requirements
                    value="Need to support individual results, or  groups of results, where the result grouping is arbitrary, but meaningful."/>
      <alias value="Data"/>
      <alias value="Atomic Value"/>
      <alias value="Result"/>
      <alias value="Atomic result"/>
      <alias value="Data"/>
      <alias value="Test"/>
      <alias value="Analyte"/>
      <alias value="Battery"/>
      <alias value="Organizer"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.result"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/observation-laboratory-study-group-dglp"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/observation-image-attachment-dglp"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBXs"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result.id">
      <path value="DiagnosticReport.result.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result.extension">
      <path value="DiagnosticReport.result.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="closed"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.result.extension:sortingNumberGroup">
      <path value="DiagnosticReport.result.extension"/>
      <sliceName value="sortingNumberGroup"/>
      <short value="Sortiernummer Untersuchungsgruppe"/>
      <definition
                  value="Zu jeder Untersuchungsgruppe gibt es immer eine Sortiernummer. Die mit dem Datenstrom mitgegebenen Sortiernummern sind als Standardsortierung gedacht. Die Standardsortierung legt das Befund-erstellende Labor fest. Verwender können in Primärsystemen zusätzlich interaktiv auch anders sortieren, wenn das Primärsystem solche Funktionen anbietet."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/sorting-number-extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.result.extension:sortingNumberGroup.id">
      <path value="DiagnosticReport.result.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.result.extension:sortingNumberGroup.extension">
      <path value="DiagnosticReport.result.extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.result.extension:sortingNumberGroup.url">
      <path value="DiagnosticReport.result.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="https://gematik.de/fhir/ti/StructureDefinition/sorting-number-extension"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.result.extension:sortingNumberGroup.value[x]">
      <path value="DiagnosticReport.result.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="positiveInt"/>
      </type>
      <condition value="ele-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result.reference">
      <path value="DiagnosticReport.result.reference"/>
      <short value="Literal reference, Relative, internal or absolute URL"/>
      <definition
                  value="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."/>
      <comment
               value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ref-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result.type">
      <path value="DiagnosticReport.result.type"/>
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;)"/>
      <definition
                  value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)."/>
      <comment
               value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Aa resource (or, for logical models, the URI of the logical model)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result.identifier">
      <path value="DiagnosticReport.result.identifier"/>
      <short value="Logical reference, when literal reference is not known"/>
      <definition
                  value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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."/>
      <comment
               value="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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.result.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.result.display"/>
      <short value="Text alternative for the resource"/>
      <definition
                  value="Plain text narrative that identifies the resource in addition to the resource reference."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.imagingStudy">
      <path value="DiagnosticReport.imagingStudy"/>
      <short value="Study subject to this report"/>
      <definition
                  value="One or more links to full details of any imaging performed during the diagnostic investigation. Typically, this is imaging performed by DICOM enabled modalities, but this is not required. A fully enabled PACS viewer can use this information to provide views of the source images."/>
      <comment
               value="ImagingStudy and the image element are somewhat overlapping - typically, the list of image references in the image element will also be found in one of the imaging study resources. However, each caters to different types of displays for different types of purposes. Neither, either, or both may be provided."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.imagingStudy"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/ImagingStudy|4.0.1"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value="outboundRelationship[typeCode=COMP].target[classsCode=DGIMG, moodCode=EVN]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media">
      <path value="DiagnosticReport.media"/>
      <short
             value="Ergänzende Dokumente (zusätzlich zum strukturierten Teil des Laborbefundes)"/>
      <definition
                  value="Zum Anhängen zusätzlicher Resultate, die nicht Teil des strukturierten Laborbefundes sind. Hier können Befunde aus labormedizinischen Spezialbereichen in einem digitalen Dokumentformat angehängt werden, beispielsweise Ergebnisse aus mikrobiologischen Kulturen oder humangenetischen Untersuchungen. Ziel ist es, grundsätzlich alle Laborbefunde in digitalem Format übermitteln zu können und in der elektronischen Patientenakte ablegen zu können."/>
      <requirements
                    value="Some diagnostic reports may include additional data such as images, diagrams or documents that are relevant to the report. This additional information can provide further context and support for the findings presented in the report."/>
      <alias value="DICOM"/>
      <alias value="Slides"/>
      <alias value="Scans"/>
      <alias value="DICOM; Slides; Scans; Pictures; Documents; Diagrams"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.media"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX?"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="outboundRelationship[typeCode=COMP].target"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.id">
      <path value="DiagnosticReport.media.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.extension">
      <path value="DiagnosticReport.media.extension"/>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.modifierExtension">
      <path value="DiagnosticReport.media.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.comment">
      <path value="DiagnosticReport.media.comment"/>
      <short value="Freitext-Angaben zum ergänzenden Dokument"/>
      <definition
                  value="Feld für Freitext-Angaben zum ergänzenden Dokument, die in der vorgegebenen Datenstruktur nicht erfasst werden können."/>
      <comment
               value="The comment should be displayed with the image. It would be common for the report to include additional discussion of the image contents in other sections such as the conclusion."/>
      <requirements
                    value="The provider of the report should make a comment about each image or data included in the report. This comment can provide valuable context and help the reader understand the significance of the image or data in relation to the overall findings of the report."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.media.comment"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".inboundRelationship[typeCode=COMP].source[classCode=OBS, moodCode=EVN, code=&quot;annotation&quot;].value"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link">
      <path value="DiagnosticReport.media.link"/>
      <short value="Reference to the image or data"/>
      <definition
                  value="A reference to the image or data associated with this report."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.media.link"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="http://hl7.org/fhir/StructureDefinition/Media|4.0.1"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".value.reference"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.id">
      <path value="DiagnosticReport.media.link.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.extension">
      <path value="DiagnosticReport.media.link.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.media.link.extension:link">
      <path value="DiagnosticReport.media.link.extension"/>
      <sliceName value="link"/>
      <short value="Referenzierung auf ergänzende Dokumente"/>
      <definition value="Referenzierung auf ergänzende Dokumente"/>
      <comment
               value="Given that a reference SHALL have a display or reference, using this extension implies that there's a display present."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/alternate-reference"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.media.link.extension:link.id">
      <path value="DiagnosticReport.media.link.extension.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="id"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <condition value="ele-1"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.extension:link.extension">
      <path value="DiagnosticReport.media.link.extension.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Extension"/>
      <definition value="An Extension"/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
    </element>
    <element id="DiagnosticReport.media.link.extension:link.url">
      <path value="DiagnosticReport.media.link.extension.url"/>
      <representation value="xmlAttr"/>
      <short value="identifies the meaning of the extension"/>
      <definition
                  value="Source of the definition for the extension code - a logical name or a URL."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.url"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="uri"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <fixedUri
                value="http://hl7.org/fhir/StructureDefinition/alternate-reference"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.extension:link.value[x]">
      <path value="DiagnosticReport.media.link.extension.value[x]"/>
      <short value="Value of extension"/>
      <definition
                  value="Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R5/extensibility.html) for a list)."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Extension.value[x]"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/document-reference-dglp"/>
      </type>
      <condition value="ext-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.extension:link.value[x].id">
      <path value="DiagnosticReport.media.link.extension.value[x].id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.media.link.extension:link.value[x].extension">
      <path value="DiagnosticReport.media.link.extension.value[x].extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.media.link.extension:link.value[x].reference">
      <path value="DiagnosticReport.media.link.extension.value[x].reference"/>
      <short value="Literal reference, Relative, internal or absolute URL"/>
      <definition
                  value="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."/>
      <comment
               value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ref-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.extension:link.value[x].type">
      <path value="DiagnosticReport.media.link.extension.value[x].type"/>
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;)"/>
      <definition
                  value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)."/>
      <comment
               value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Aa resource (or, for logical models, the URI of the logical model)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.media.link.extension:link.value[x].identifier">
      <path
            value="DiagnosticReport.media.link.extension.value[x].identifier"/>
      <short value="Logical reference, when literal reference is not known"/>
      <definition
                  value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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."/>
      <comment
               value="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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element
             id="DiagnosticReport.media.link.extension:link.value[x].display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.media.link.extension.value[x].display"/>
      <short value="Text alternative for the resource"/>
      <definition
                  value="Plain text narrative that identifies the resource in addition to the resource reference."/>
      <comment
               value="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."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.reference">
      <path value="DiagnosticReport.media.link.reference"/>
      <short value="Literal reference, Relative, internal or absolute URL"/>
      <definition
                  value="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."/>
      <comment
               value="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 &quot;/[type]/[id]&quot; then it should be assumed that the reference is to a FHIR RESTful server."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.reference"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <condition value="ref-1"/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.type">
      <path value="DiagnosticReport.media.link.type"/>
      <short value="Type the reference refers to (e.g. &quot;Patient&quot;)"/>
      <definition
                  value="The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. &quot;Patient&quot; is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources)."/>
      <comment
               value="This element is used to indicate the type of  the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.type"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="uri"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="FHIRResourceTypeExt"/>
        </extension>
        <strength value="extensible"/>
        <description
                     value="Aa resource (or, for logical models, the URI of the logical model)."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/resource-types|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.identifier">
      <path value="DiagnosticReport.media.link.identifier"/>
      <short value="Logical reference, when literal reference is not known"/>
      <definition
                  value="An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents 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."/>
      <comment
               value="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.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference.  For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport).  One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Reference.identifier"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Identifier"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value=".identifier"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.media.link.display">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.media.link.display"/>
      <short value="Text stating use of cross-version extension 'link'"/>
      <definition
                  value="Hinweis, der besagt, dass anstelle einer Referenz auf Media auf eine DocumentReference über die Cross-version Extension „link“ referenziert wird."/>
      <comment
               value="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."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Reference.display"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <patternString
                     value="Media wird durch eine DocumentReference dargestellt, auf die in einer Extension verwiesen wird."/>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.conclusion">
      <path value="DiagnosticReport.conclusion"/>
      <short value="Beurteilung des Laborgesamtbefundes"/>
      <definition
                  value="Befund-Bewertung, die sich auf den gesamten Laborbefund bezieht und ggf. Antworten auf klinische Fragestellungen formuliert. "/>
      <requirements
                    value="Need to be able to provide a conclusion that is not lost among the basic result data."/>
      <alias value="Report"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="DiagnosticReport.conclusion"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=&quot;SPRT&quot;].source[classCode=OBS, moodCode=EVN, code=LOINC:48767-8].value (type=ST)"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.conclusionCode">
      <path value="DiagnosticReport.conclusionCode"/>
      <short value="Codes for the clinical conclusion of test results"/>
      <definition
                  value="One or more codes that represent the summary conclusion (interpretation/impression) of the diagnostic report."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="DiagnosticReport.conclusionCode"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="AdjunctDiagnosis"/>
        </extension>
        <strength value="example"/>
        <description
                     value="Diagnosis codes provided as adjuncts to the report."/>
        <valueSet
                  value="http://hl7.org/fhir/ValueSet/clinical-findings|4.0.1"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map
             value="inboundRelationship[typeCode=SPRT].source[classCode=OBS, moodCode=EVN, code=LOINC:54531-9].value (type=CD)"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm">
      <path value="DiagnosticReport.presentedForm"/>
      <short value="Kompletter Gesamtbefund als exportierbares Format"/>
      <definition
                  value="Zusätzlich zur FHIR®-Instanz soll der GESAMTE Laborbefund (das bezieht sowohl die strukturierten Daten als auch ergänzende Dokument-Anteile mit ein) in einem weiteren Format z.B. als PDF mitgegeben werden."/>
      <comment
               value="&quot;application/pdf&quot; is recommended as the most reliable and interoperable in this context."/>
      <requirements
                    value="Gives laboratory the ability to provide its own fully formatted report for clinical fidelity."/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="DiagnosticReport.presentedForm"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Attachment"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="OBX"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="text (type=ED)"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.id">
      <path value="DiagnosticReport.presentedForm.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.extension">
      <path value="DiagnosticReport.presentedForm.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.contentType">
      <path value="DiagnosticReport.presentedForm.contentType"/>
      <short value="Mime type of the content, with charset etc."/>
      <definition value="Hier wird das Dateiformat abgebildet."/>
      <requirements
                    value="Processors of the data need to be able to know how to interpret the data."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Attachment.contentType"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <patternCode value="application/pdf"/>
      <example>
        <label value="General"/>
        <valueCode value="text/plain; charset=UTF-8, image/png"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="MimeType"/>
        </extension>
        <strength value="required"/>
        <description
                     value="The mime type of an attachment. Any valid mime type is allowed."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/mimetypes|4.0.1"/>
      </binding>
      <mapping>
        <identity value="v2"/>
        <map
             value="ED.2+ED.3/RP.2+RP.3. Note conversion may be needed if old style values are being used"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./mediaType, ./charset"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.language">
      <path value="DiagnosticReport.presentedForm.language"/>
      <short value="Human language of the content (BCP-47)"/>
      <definition
                  value="The human language of the content. The value can be any valid value according to BCP 47."/>
      <requirements
                    value="Users need to be able to choose between the languages in a set of attachments."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Attachment.language"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="code"/>
      </type>
      <example>
        <label value="General"/>
        <valueCode value="en-AU"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <binding>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet">
          <valueCanonical value="http://hl7.org/fhir/ValueSet/all-languages"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName">
          <valueString value="Language"/>
        </extension>
        <strength value="preferred"/>
        <description value="A human language."/>
        <valueSet value="http://hl7.org/fhir/ValueSet/languages|4.0.1"/>
      </binding>
      <mapping>
        <identity value="rim"/>
        <map value="./language"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.data">
      <path value="DiagnosticReport.presentedForm.data"/>
      <short value="Data inline, base64ed"/>
      <definition value="Hier wird die Dokument-Datei angehängt."/>
      <comment
               value="The base64-encoded data SHALL be expressed in the same character set as the base resource XML or JSON."/>
      <requirements value="The data needs to able to be transmitted inline."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Attachment.data"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="base64Binary"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="v2"/>
        <map value="ED.5"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./data"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.url">
      <path value="DiagnosticReport.presentedForm.url"/>
      <short value="Uri where the data can be found"/>
      <definition value="A location where the data can be accessed."/>
      <comment
               value="If both data and url are provided, the url SHALL point to the same content as the data contains. Urls may be relative references or may reference transient locations such as a wrapping envelope using cid: though this has ramifications for using signatures. Relative URLs are interpreted relative to the service url, like a resource reference, rather than relative to the resource itself. If a URL is provided, it SHALL resolve to actual data."/>
      <requirements value="The data needs to be transmitted by reference."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Attachment.url"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="url"/>
      </type>
      <example>
        <label value="General"/>
        <valueUrl value="http://www.acme.com/logo-small.png"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="v2"/>
        <map value="RP.1+RP.2 - if they refer to a URL (see v2.6)"/>
      </mapping>
      <mapping>
        <identity value="rim"/>
        <map value="./reference/literal"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.size">
      <path value="DiagnosticReport.presentedForm.size"/>
      <short value="Number of bytes of content (if url provided)"/>
      <definition
                  value="The number of bytes of data that make up this attachment (before base64 encoding, if that is done)."/>
      <comment
               value="The number of bytes is redundant if the data is provided as a base64binary, but is useful if the data is provided as a url reference."/>
      <requirements
                    value="Representing the size allows applications to determine whether they should fetch the content automatically in advance, or refuse to fetch it at all."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Attachment.size"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="unsignedInt"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (needs data type R3 proposal)"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.hash">
      <path value="DiagnosticReport.presentedForm.hash"/>
      <short value="Hash of the data (sha-1, base64ed)"/>
      <definition
                  value="The calculated hash of the data using SHA-1. Represented using base64."/>
      <comment
               value="The hash is calculated on the data prior to base64 encoding, if the data is based64 encoded. The hash is not intended to support digital signatures. Where protection against malicious threats a digital signature should be considered, see [Provenance.signature](http://hl7.org/fhir/R4/provenance-definitions.html#Provenance.signature) for mechanism to protect a resource with a digital signature."/>
      <requirements
                    value="Included so that applications can verify that the contents of a location have not changed due to technical failures (e.g., storage rot, transport glitch, incorrect version)."/>
      <min value="0"/>
      <max value="0"/>
      <base>
        <path value="Attachment.hash"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="base64Binary"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map
             value=".integrityCheck[parent::ED/integrityCheckAlgorithm=&quot;SHA-1&quot;]"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.title">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable">
        <valueBoolean value="true"/>
      </extension>
      <path value="DiagnosticReport.presentedForm.title"/>
      <short value="Label to display in place of the data"/>
      <definition
                  value="Hier wird ein Titel bzw. eine Bezeichnung für die angehängte Datei angegeben."/>
      <requirements
                    value="Applications need a label to display to a human user in place of the actual data if the data cannot be rendered or perceived by the viewer."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Attachment.title"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <example>
        <label value="General"/>
        <valueString value="Official Corporate Logo"/>
      </example>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="./title/data"/>
      </mapping>
    </element>
    <element id="DiagnosticReport.presentedForm.creation">
      <path value="DiagnosticReport.presentedForm.creation"/>
      <short value="Date attachment was first created"/>
      <definition
                  value="Hier wird der Zeitpunkt der Erstellung des referenzierten Dokumentes bzw. des Anhangs angegeben."/>
      <requirements
                    value="This is often tracked as an integrity issue for use of the attachment."/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="Attachment.creation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <mustSupport value="true"/>
      <isModifier value="false"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A (needs data type R3 proposal)"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="DiagnosticReport">
      <path value="DiagnosticReport"/>
      <definition
                  value="Profil für den Laborgesamtbefund (DiagnosticReport). Darin verschachtelt unter &quot;Ergebnisse&quot; (DiagnosticReport.result) ist die Referenz auf &quot;Untersuchungsgruppe&quot; (Observation_Laboratory_Study_Group), darin die Referenz auf &quot;Laboruntersuchung&quot; (Observation_Laboratory_Study), darin die Referenz auf &quot;Probe&quot; (Specimen)."/>
      <constraint>
        <key value="diag-status-1"/>
        <severity value="error"/>
        <human
               value="A secondary status can only be provided if the diagnostic report status is either &quot;partial&quot; or &quot;preliminary&quot;."/>
        <expression
                    value="status in ('registered'|'final'|'amended'|'corrected'|'appended'|'cancelled'|'entered-in-error'|'unknown') implies extension('https://gematik.de/fhir/ti/StructureDefinition/secondary-status-extension').empty()"/>
        <source
                value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/diagnostic-report-dglp"/>
      </constraint>
    </element>
    <element id="DiagnosticReport.extension">
      <path value="DiagnosticReport.extension"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:DiagnosticReportCompositionR5">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="DiagnosticReportCompositionR5"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/composition-dglp"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].reference">
      <path value="DiagnosticReport.extension.value[x].reference"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].type">
      <path value="DiagnosticReport.extension.value[x].type"/>
      <max value="0"/>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].identifier">
      <path value="DiagnosticReport.extension.value[x].identifier"/>
      <max value="0"/>
    </element>
    <element
             id="DiagnosticReport.extension:DiagnosticReportCompositionR5.value[x].display">
      <path value="DiagnosticReport.extension.value[x].display"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.extension:note">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="note"/>
      <definition
                  value="Freitextliche Angabe von zusätzliche Informationen zum Laborgesamtbefund."/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:note.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:note.value[x].author[x]">
      <path value="DiagnosticReport.extension.value[x].author[x]"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.extension:note.value[x].time">
      <path value="DiagnosticReport.extension.value[x].time"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.extension:note.value[x].text">
      <path value="DiagnosticReport.extension.value[x].text"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:orderEntryTime">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="orderEntryTime"/>
      <short value="Auftrageingangszeitpunkt im Labor"/>
      <definition
                  value="Die Bedeutung und Verwendung des Auftragseingangszeitpunktes im Laborprozess kann unterschiedlich sein, beispielsweise:

* In einem OrderEntry-Setting kann der Auftragseingangszeitstempel zum Zeitpunkt der ersten Probeneinbuchung für diesen Auftrag im Labor gesetzt werden. In einem solchen Fall aktiviert/generiert die erste Probe den Auftrag im LIS.
* In einem papiergebundenen Setting ist in der Regel der Scanzeitpunkt des Papierauftrages der Auftragseingangszeitstempel. Ggf. kann dieser vor oder nach der/den zugehörigen Probeneinbuchungen liegen."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/order-entry-time-extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:orderEntryTime.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:pseudonymizedReport">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="pseudonymizedReport"/>
      <short value="Kennzeichnung, ob ein Laborbefund pseudonymisiert ist"/>
      <definition
                  value="Mit diesem Kennzeichen kann ein Laborbefund als \&quot;pseudonymisiert\&quot; deklariert werden.

Fachlicher Hintergrund: es gibt Anwendungsfälle, z.B. aus der Betriebsmedizin, die erfordern, dass ein Laborbefund pseudonymisiert, also ohne personenidentifizierende Inhalte übertragen wird. Nach welchen Regeln und mit welchem Identifikator ein pseudonymisierter Laborbefund übermittelt wird, ist Gegenstand einer Einzelabstimmung zwischen der anfordernden Einrichtung und dem Labor. Oft ist bereits der Auftrag pseudonymisiert. Hinweis: Zu einem späteren Zeitpunkt könnten Patient:innen berechtigterweise fordern, dass der Laborbefund seinen anderen Befunden hinzugefügt wird, z.B. in der ePA. Durch das Hochladen in die ePA wird der Befund eindeutig einer Person zugeordnet und dadurch die Pseudonymisierung (auch bei unverändert verdeckten Personendaten) \&quot;demaskiert\&quot;."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/pseudonymized-report-extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:pseudonymizedReport.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:criticalResult">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="criticalResult"/>
      <short value="Manuell gesetztes Kennzeichen Kritischer Befund"/>
      <definition
                  value="Dieses Kennzeichen ist optional und deklariert einen aus labormedizinischer Sicht medizinisch kritischen Befund. Es wird aus einer aktiven Entscheidung des/der Labormediziners/in manuell gesetzt."/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/critical-result-extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:criticalResult.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus">
      <path value="DiagnosticReport.extension"/>
      <sliceName value="secondaryStatus"/>
      <short value="Änderungsstatus Laborbefund (Sekundärstatus)"/>
      <definition
                  value="Optionale sekundäre Angabe des Änderungsstatus, die zusätzlich zum Hauptstatus \&quot;Status Gesamtbefund\&quot; mitgegeben werden kann. Es können mehrere Werte als Änderungsgrund angegeben werden. Die möglichen Werte sind:

* Geändert
* Korrigiert
* Angefügt

Der typische und in jedem Labor alltägliche Anwendungsfall ist die Nachforderung bei einer Stufendiagnostik. Änderungen am Gesamtbefund können sich auch auf einen noch nicht abgeschlossenen Befund beziehen, z.B. auf einen Teilbefund oder einen vorläufigen Befund."/>
      <min value="0"/>
      <max value="3"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/secondary-status-extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.value[x]">
      <path value="DiagnosticReport.extension.value[x]"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.value[x].system">
      <path value="DiagnosticReport.extension.value[x].system"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.extension:secondaryStatus.value[x].version">
      <path value="DiagnosticReport.extension.value[x].version"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.extension:secondaryStatus.value[x].code">
      <path value="DiagnosticReport.extension.value[x].code"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.extension:secondaryStatus.value[x].display">
      <path value="DiagnosticReport.extension.value[x].display"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.extension:secondaryStatus.value[x].userSelected">
      <path value="DiagnosticReport.extension.value[x].userSelected"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier">
      <path value="DiagnosticReport.identifier"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="type"/>
        </discriminator>
        <rules value="closed"/>
      </slicing>
      <min value="1"/>
      <max value="2"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab">
      <path value="DiagnosticReport.identifier"/>
      <sliceName value="orderNumberLab"/>
      <short value="Auftragnummer des Labors"/>
      <definition
                  value="Auftragsnummer, die das auftragsnehmende Labor vergibt und führt"/>
      <min value="0"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.use">
      <path value="DiagnosticReport.identifier.use"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type">
      <path value="DiagnosticReport.identifier.type"/>
      <min value="1"/>
      <patternCodeableConcept>
        <coding>
          <system
                  value="https://gematik.de/fhir/terminology/CodeSystem/laboratory-identificator"/>
          <code value="AL"/>
          <display value="Auftragsnummer des Labors"/>
        </coding>
      </patternCodeableConcept>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type.coding">
      <path value="DiagnosticReport.identifier.type.coding"/>
      <min value="1"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.system">
      <path value="DiagnosticReport.identifier.type.coding.system"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.version">
      <path value="DiagnosticReport.identifier.type.coding.version"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.code">
      <path value="DiagnosticReport.identifier.type.coding.code"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.display">
      <path value="DiagnosticReport.identifier.type.coding.display"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:orderNumberLab.type.coding.userSelected">
      <path value="DiagnosticReport.identifier.type.coding.userSelected"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.type.text">
      <path value="DiagnosticReport.identifier.type.text"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.system">
      <path value="DiagnosticReport.identifier.system"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.value">
      <path value="DiagnosticReport.identifier.value"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.period">
      <path value="DiagnosticReport.identifier.period"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:orderNumberLab.assigner">
      <path value="DiagnosticReport.identifier.assigner"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport">
      <path value="DiagnosticReport.identifier"/>
      <sliceName value="overallLabReport"/>
      <short
             value="Versionsunabhängiger konstanter Identifikator Laborgesamtbefund (UUID)"/>
      <definition
                  value="Die eindeutige Identifikation des Laborbefundes zu einem Laborauftrag geschieht mittels UUID (Universal Unique Identifier). Sie wird durch das auftragnehmende, Befund erzeugende Labor generiert.

Die UUID wird als Befundinhalt beim Übermitteln des Laborbefundes mitgegeben, auch dann, wenn der Laborbefund jenseits der ePA übermittelt wird (z. B: per E-Mail oder KIM). Diese UUID bleibt über den gesamten Workflow der Abarbeitung des Auftrages die selbe; und zwar durch die Versionierung eines Laborbefundes hindurch (z.B. vorläufiger Befund, finaler Befund, Befund mit Änderungen ...) und durch alle Systeme hindurch."/>
      <min value="1"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.use">
      <path value="DiagnosticReport.identifier.use"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.type">
      <path value="DiagnosticReport.identifier.type"/>
      <min value="1"/>
      <patternCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <version value="5.0.0"/>
          <code value="RI"/>
          <display value="Resource Identifier"/>
        </coding>
      </patternCodeableConcept>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.type.coding">
      <path value="DiagnosticReport.identifier.type.coding"/>
      <min value="1"/>
      <max value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.system">
      <path value="DiagnosticReport.identifier.type.coding.system"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.version">
      <path value="DiagnosticReport.identifier.type.coding.version"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.code">
      <path value="DiagnosticReport.identifier.type.coding.code"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.display">
      <path value="DiagnosticReport.identifier.type.coding.display"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.identifier:overallLabReport.type.coding.userSelected">
      <path value="DiagnosticReport.identifier.type.coding.userSelected"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.type.text">
      <path value="DiagnosticReport.identifier.type.text"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.system">
      <path value="DiagnosticReport.identifier.system"/>
      <definition value="System, welches den Aufbau der UUID reguliert"/>
      <min value="1"/>
      <patternUri value="urn:ietf:rfc:3986"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.value">
      <path value="DiagnosticReport.identifier.value"/>
      <definition
                  value="Hier wird die UUID eingetragen. Der String beginnt immer mit &quot;urn:uuid:&quot;, der zusammengesetzte String sähe dann beispielsweise so aus: &quot;urn:uuid:f81d4fae-7dec-11d0-a765-00a0c91e6bf6&quot;."/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.period">
      <path value="DiagnosticReport.identifier.period"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.identifier:overallLabReport.assigner">
      <path value="DiagnosticReport.identifier.assigner"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.basedOn">
      <path value="DiagnosticReport.basedOn"/>
      <short value="Referenz Laborauftrag-Information"/>
      <definition
                  value="Hier wird eine Laborauftrags-Information referenziert."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/service-request-dglp"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.basedOn.reference">
      <path value="DiagnosticReport.basedOn.reference"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.basedOn.type">
      <path value="DiagnosticReport.basedOn.type"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.basedOn.identifier">
      <path value="DiagnosticReport.basedOn.identifier"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.basedOn.display">
      <path value="DiagnosticReport.basedOn.display"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.status">
      <path value="DiagnosticReport.status"/>
      <short value="Bearbeitungsstatus Laborbefund (Hauptstatus)"/>
      <definition
                  value="Bearbeitungsstatus des Laborgesamtbefundes. Die Status-Werte orientieren sich am HL7 FHIR® Standard, jedoch werden der Wert &quot;unknown&quot; und die Werte für Änderungen in diesem ValueSet nicht verwendet.

  * Registered - Registriert
  * Partial - Nicht vollständig
  * Preliminary - Vorläufig
  * Final - Abgeschlossen
  * Entered in Error - Irrtümliche Eingabe
  * Cancelled - Storniert
  * Amended - Geändert
  * Corrected - Korrigiert
  * Appended - Angefügt

  Änderungen am finalen Befund werden über die hier aufgeführten (Haupt)Status &quot;Geändert&quot;, &quot;Korrgiert&quot;, &quot;Angefügt&quot; abgebildet.

  Änderungen an vorläufigen oder nicht vollständigen Befunden werden über den Sekundärstatus mit den entsprechenden Werten abgebildet.


  Achtung! Auch Patientenstammdaten, die der Personenidentität dienen, können korrigiert werden. Im Falle einer Patientenverwechslung muss der Hauptstatus=&quot;Irrtümliche Eingabe&quot; gesetzt werden, dies darf nicht als Änderung versendet werden!)"/>
      <mustSupport value="true"/>
      <binding>
        <strength value="required"/>
        <valueSet
                  value="https://gematik.de/fhir/terminology/ValueSet/diagnostic-report-status"/>
      </binding>
    </element>
    <element id="DiagnosticReport.category">
      <path value="DiagnosticReport.category"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.category:studyType">
      <path value="DiagnosticReport.category"/>
      <sliceName value="studyType"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.category:specialty">
      <path value="DiagnosticReport.category"/>
      <sliceName value="specialty"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.code">
      <path value="DiagnosticReport.code"/>
      <short value="Deklariert &quot;Laborbefund&quot;"/>
      <definition
                  value="Codierte Angabe zur Art des Befundes, hier Laborbefund"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.code.coding">
      <path value="DiagnosticReport.code.coding"/>
      <min value="1"/>
      <max value="1"/>
      <patternCoding>
        <system value="http://loinc.org"/>
        <version value="2.82"/>
        <code value="11502-2"/>
        <display value="Laboratory report"/>
      </patternCoding>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.code.coding.system">
      <path value="DiagnosticReport.code.coding.system"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.code.coding.version">
      <path value="DiagnosticReport.code.coding.version"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.code.coding.code">
      <path value="DiagnosticReport.code.coding.code"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.code.coding.display">
      <path value="DiagnosticReport.code.coding.display"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.code.coding.userSelected">
      <path value="DiagnosticReport.code.coding.userSelected"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.code.text">
      <path value="DiagnosticReport.code.text"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.subject">
      <path value="DiagnosticReport.subject"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/ti/StructureDefinition/ti-patient"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.subject.identifier">
      <path value="DiagnosticReport.subject.identifier"/>
      <min value="1"/>
      <type>
        <code value="Identifier"/>
        <profile
                 value="http://fhir.de/StructureDefinition/identifier-kvid-10"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.encounter">
      <path value="DiagnosticReport.encounter"/>
      <short value="Fallbezug"/>
      <definition
                  value="Referenzierung auf die Fall-Identifikation / Fallnummer bezüglich Begegnung/Aufenthalt."/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.effective[x]">
      <path value="DiagnosticReport.effective[x]"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.effective[x]:effectivePeriod">
      <path value="DiagnosticReport.effective[x]"/>
      <sliceName value="effectivePeriod"/>
      <max value="0"/>
      <type>
        <code value="Period"/>
      </type>
    </element>
    <element id="DiagnosticReport.issued">
      <path value="DiagnosticReport.issued"/>
      <short value="Dokumentationszeitpunkt Laborgesamtbefund"/>
      <definition
                  value="Dokumentationszeitpunkt des Befundes durch das auftragnehmende Labor."/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.performer">
      <path value="DiagnosticReport.performer"/>
      <short value="Auftragnehmendes Labor"/>
      <definition
                  value="Person oder Organisation, die für Erstellung des Laborgesamtbefundes verantwortlich ist.


Das auftragnehmende Labor kann die Laborleistung selbst erbringen, teilweise selbst erbringen und teilweise an ein Speziallabor weiterleiten oder insgesamt an ein Speziallabor weiterleiten. Der Gesamtbefund wird vollumfänglich zum gesamten Laborauftrag vom Auftragnehmer erstellt."/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/ti/StructureDefinition/ti-organization"/>
        <targetProfile
                       value="https://gematik.de/fhir/ti/StructureDefinition/ti-practitioner"/>
        <targetProfile
                       value="https://gematik.de/fhir/ti/StructureDefinition/ti-practitioner-role"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.performer.reference">
      <path value="DiagnosticReport.performer.reference"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.performer.type">
      <path value="DiagnosticReport.performer.type"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.performer.identifier">
      <path value="DiagnosticReport.performer.identifier"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.performer.display">
      <path value="DiagnosticReport.performer.display"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.performer:organization">
      <path value="DiagnosticReport.performer"/>
      <sliceName value="organization"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.resultsInterpreter">
      <path value="DiagnosticReport.resultsInterpreter"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.resultsInterpreter:author">
      <path value="DiagnosticReport.resultsInterpreter"/>
      <sliceName value="author"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.specimen">
      <path value="DiagnosticReport.specimen"/>
      <comment
               value="Zum Erhalt der europäischen Interoperabilität, orientiert an der Veröffentlichung https://hl7.eu/fhir/laboratory/history.html kann auf Gesamtbefundebene auf das gesamte Probenmaterial referenziert werden. Diese optionale Angabe ist redundant zu den Probenreferenzen der Einzeluntersuchungen."/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/specimen-dglp"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.specimen.reference">
      <path value="DiagnosticReport.specimen.reference"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.specimen.type">
      <path value="DiagnosticReport.specimen.type"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.specimen.identifier">
      <path value="DiagnosticReport.specimen.identifier"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.specimen.display">
      <path value="DiagnosticReport.specimen.display"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.result">
      <path value="DiagnosticReport.result"/>
      <definition
                  value="Die Laborergebnisse werden grundsätzlich gruppiert. Es gibt mindestens eine Untersuchungsgruppe."/>
      <min value="1"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/observation-laboratory-study-group-dglp"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/observation-image-attachment-dglp"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.result.extension">
      <path value="DiagnosticReport.result.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="closed"/>
      </slicing>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.result.extension:sortingNumberGroup">
      <path value="DiagnosticReport.result.extension"/>
      <sliceName value="sortingNumberGroup"/>
      <short value="Sortiernummer Untersuchungsgruppe"/>
      <definition
                  value="Zu jeder Untersuchungsgruppe gibt es immer eine Sortiernummer. Die mit dem Datenstrom mitgegebenen Sortiernummern sind als Standardsortierung gedacht. Die Standardsortierung legt das Befund-erstellende Labor fest. Verwender können in Primärsystemen zusätzlich interaktiv auch anders sortieren, wenn das Primärsystem solche Funktionen anbietet."/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="https://gematik.de/fhir/ti/StructureDefinition/sorting-number-extension"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.result.extension:sortingNumberGroup.value[x]">
      <path value="DiagnosticReport.result.extension.value[x]"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.result.reference">
      <path value="DiagnosticReport.result.reference"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.result.type">
      <path value="DiagnosticReport.result.type"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.result.identifier">
      <path value="DiagnosticReport.result.identifier"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.result.display">
      <path value="DiagnosticReport.result.display"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.media">
      <path value="DiagnosticReport.media"/>
      <short
             value="Ergänzende Dokumente (zusätzlich zum strukturierten Teil des Laborbefundes)"/>
      <definition
                  value="Zum Anhängen zusätzlicher Resultate, die nicht Teil des strukturierten Laborbefundes sind. Hier können Befunde aus labormedizinischen Spezialbereichen in einem digitalen Dokumentformat angehängt werden, beispielsweise Ergebnisse aus mikrobiologischen Kulturen oder humangenetischen Untersuchungen. Ziel ist es, grundsätzlich alle Laborbefunde in digitalem Format übermitteln zu können und in der elektronischen Patientenakte ablegen zu können."/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.media.comment">
      <path value="DiagnosticReport.media.comment"/>
      <short value="Freitext-Angaben zum ergänzenden Dokument"/>
      <definition
                  value="Feld für Freitext-Angaben zum ergänzenden Dokument, die in der vorgegebenen Datenstruktur nicht erfasst werden können."/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.media.link">
      <path value="DiagnosticReport.media.link"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.media.link.extension">
      <path value="DiagnosticReport.media.link.extension"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.media.link.extension:link">
      <path value="DiagnosticReport.media.link.extension"/>
      <sliceName value="link"/>
      <short value="Referenzierung auf ergänzende Dokumente"/>
      <definition value="Referenzierung auf ergänzende Dokumente"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.media.link.extension:link.value[x]">
      <path value="DiagnosticReport.media.link.extension.value[x]"/>
      <type>
        <code value="Reference"/>
        <targetProfile
                       value="https://gematik.de/fhir/epa-laboratory/StructureDefinition/document-reference-dglp"/>
      </type>
      <mustSupport value="true"/>
    </element>
    <element
             id="DiagnosticReport.media.link.extension:link.value[x].reference">
      <path value="DiagnosticReport.media.link.extension.value[x].reference"/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.media.link.extension:link.value[x].type">
      <path value="DiagnosticReport.media.link.extension.value[x].type"/>
      <max value="0"/>
    </element>
    <element
             id="DiagnosticReport.media.link.extension:link.value[x].identifier">
      <path
            value="DiagnosticReport.media.link.extension.value[x].identifier"/>
      <max value="0"/>
    </element>
    <element
             id="DiagnosticReport.media.link.extension:link.value[x].display">
      <path value="DiagnosticReport.media.link.extension.value[x].display"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.media.link.display">
      <path value="DiagnosticReport.media.link.display"/>
      <definition
                  value="Hinweis, der besagt, dass anstelle einer Referenz auf Media auf eine DocumentReference über die Cross-version Extension „link“ referenziert wird."/>
      <patternString
                     value="Media wird durch eine DocumentReference dargestellt, auf die in einer Extension verwiesen wird."/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.conclusion">
      <path value="DiagnosticReport.conclusion"/>
      <short value="Beurteilung des Laborgesamtbefundes"/>
      <definition
                  value="Befund-Bewertung, die sich auf den gesamten Laborbefund bezieht und ggf. Antworten auf klinische Fragestellungen formuliert. "/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.conclusionCode">
      <path value="DiagnosticReport.conclusionCode"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.presentedForm">
      <path value="DiagnosticReport.presentedForm"/>
      <short value="Kompletter Gesamtbefund als exportierbares Format"/>
      <definition
                  value="Zusätzlich zur FHIR®-Instanz soll der GESAMTE Laborbefund (das bezieht sowohl die strukturierten Daten als auch ergänzende Dokument-Anteile mit ein) in einem weiteren Format z.B. als PDF mitgegeben werden."/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.presentedForm.contentType">
      <path value="DiagnosticReport.presentedForm.contentType"/>
      <definition value="Hier wird das Dateiformat abgebildet."/>
      <min value="1"/>
      <patternCode value="application/pdf"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.presentedForm.language">
      <path value="DiagnosticReport.presentedForm.language"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.presentedForm.data">
      <path value="DiagnosticReport.presentedForm.data"/>
      <definition value="Hier wird die Dokument-Datei angehängt."/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.presentedForm.url">
      <path value="DiagnosticReport.presentedForm.url"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.presentedForm.size">
      <path value="DiagnosticReport.presentedForm.size"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.presentedForm.hash">
      <path value="DiagnosticReport.presentedForm.hash"/>
      <max value="0"/>
    </element>
    <element id="DiagnosticReport.presentedForm.title">
      <path value="DiagnosticReport.presentedForm.title"/>
      <definition
                  value="Hier wird ein Titel bzw. eine Bezeichnung für die angehängte Datei angegeben."/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
    <element id="DiagnosticReport.presentedForm.creation">
      <path value="DiagnosticReport.presentedForm.creation"/>
      <definition
                  value="Hier wird der Zeitpunkt der Erstellung des referenzierten Dokumentes bzw. des Anhangs angegeben."/>
      <min value="1"/>
      <mustSupport value="true"/>
    </element>
  </differential>
</StructureDefinition>