Name	Flags	Card.	Type	Description & Constraints
OperationOutcome		0..*	OperationOutcome	Information about the success/failure of an action dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
meta	SΣ	0..1	EsmdMeta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
Slices for profile	Σ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to Slice: Unordered, Open by value:$this ele-1: All FHIR elements must have a @value or children
profile:esmdoperationoutcome	Σ	1..1	canonical(StructureDefinition)	Profiles this resource claims to conform to ele-1: All FHIR elements must have a @value or children Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-OperationOutcome
security	SΣC	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. ele-1: All FHIR elements must have a @value or children inv-esmd-meta-security-01: esMD supports only V security code
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:transactionId	S	1..1	string	ESMD Transaction ID URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
issue	SΣ	1..*	BackboneElement	A single issue associated with the action ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
severity	SΣ	1..1	code	fatal | error | warning | information Binding: IssueSeverity (required): How the issue affects the success of the action. ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	code	Error or warning code Binding: IssueType (required): A code that describes the type of issue. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
OperationOutcome.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
OperationOutcome.issue.severity	required	IssueSeverity http://hl7.org/fhir/ValueSet/issue-severity|4.0.1 from the FHIR Standard
OperationOutcome.issue.code	required	IssueType http://hl7.org/fhir/ValueSet/issue-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	OperationOutcome	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	OperationOutcome	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 : 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()
dom-4	error	OperationOutcome	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	OperationOutcome	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	OperationOutcome	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-esmd-meta-security-01	error	OperationOutcome.meta.security	esMD supports only V security code : code.exists() implies (code = 'V' or code = 'HTEST')

Name	Flags	Card.	Type	Description & Constraints
OperationOutcome		0..*	OperationOutcome	Information about the success/failure of an action
meta	S	0..1	EsmdMeta	Metadata about the resource
Slices for profile				Content/Rules for all slices
profile:esmdoperationoutcome		1..1	canonical(StructureDefinition)	Profiles this resource claims to conform to Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-OperationOutcome
security	S	0..*	Coding	Security Labels applied to this resource
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:transactionId	S	1..1	string	ESMD Transaction ID URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
issue	S	1..*	BackboneElement	A single issue associated with the action
severity	S	1..1	code	fatal | error | warning | information
code	S	1..1	code	Error or warning code
details
coding		0..1	Coding	Code defined by a terminology system
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
OperationOutcome		0..*	OperationOutcome	Information about the success/failure of an action
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	EsmdMeta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
Slices for profile	Σ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to Slice: Unordered, Open by value:$this
profile:esmdoperationoutcome	Σ	1..1	canonical(StructureDefinition)	Profiles this resource claims to conform to Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-OperationOutcome
security	SΣC	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. inv-esmd-meta-security-01: esMD supports only V security code
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:transactionId	S	1..1	string	ESMD Transaction ID URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
issue	SΣ	1..*	BackboneElement	A single issue associated with the action
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
severity	SΣ	1..1	code	fatal | error | warning | information Binding: IssueSeverity (required): How the issue affects the success of the action.
code	SΣ	1..1	code	Error or warning code Binding: IssueType (required): A code that describes the type of issue.
details	Σ	0..1	CodeableConcept	Additional details about the error Binding: OperationOutcomeCodes (example): A code that provides details as the exact issue.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..1	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
diagnostics	Σ	0..1	string	Additional diagnostic information about the issue
location	Σ	0..*	string	Deprecated: Path of element(s) related to issue
expression	Σ	0..*	string	FHIRPath of element(s) related to issue
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
OperationOutcome.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
OperationOutcome.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
OperationOutcome.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
OperationOutcome.issue.severity	required	IssueSeverity http://hl7.org/fhir/ValueSet/issue-severity|4.0.1 from the FHIR Standard
OperationOutcome.issue.code	required	IssueType http://hl7.org/fhir/ValueSet/issue-type|4.0.1 from the FHIR Standard
OperationOutcome.issue.details	example	OperationOutcomeCodes http://hl7.org/fhir/ValueSet/operation-outcome from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	OperationOutcome	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	OperationOutcome	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 : 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()
dom-4	error	OperationOutcome	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	OperationOutcome	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	OperationOutcome	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-esmd-meta-security-01	error	OperationOutcome.meta.security	esMD supports only V security code : code.exists() implies (code = 'V' or code = 'HTEST')

Summary

Mandatory: 2 elements(1 nested mandatory element)
Must-Support: 6 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• esMD Meta (https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Meta)

Extensions

This structure refers to these extensions:

• https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId

Name	Flags	Card.	Type	Description & Constraints
OperationOutcome		0..*	OperationOutcome	Information about the success/failure of an action dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management
meta	SΣ	0..1	EsmdMeta	Metadata about the resource ele-1: All FHIR elements must have a @value or children
Slices for profile	Σ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to Slice: Unordered, Open by value:$this ele-1: All FHIR elements must have a @value or children
profile:esmdoperationoutcome	Σ	1..1	canonical(StructureDefinition)	Profiles this resource claims to conform to ele-1: All FHIR elements must have a @value or children Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-OperationOutcome
security	SΣC	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. ele-1: All FHIR elements must have a @value or children inv-esmd-meta-security-01: esMD supports only V security code
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:transactionId	S	1..1	string	ESMD Transaction ID URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
issue	SΣ	1..*	BackboneElement	A single issue associated with the action ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
severity	SΣ	1..1	code	fatal | error | warning | information Binding: IssueSeverity (required): How the issue affects the success of the action. ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	code	Error or warning code Binding: IssueType (required): A code that describes the type of issue. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
OperationOutcome.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
OperationOutcome.issue.severity	required	IssueSeverity http://hl7.org/fhir/ValueSet/issue-severity|4.0.1 from the FHIR Standard
OperationOutcome.issue.code	required	IssueType http://hl7.org/fhir/ValueSet/issue-type|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	OperationOutcome	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	OperationOutcome	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 : 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()
dom-4	error	OperationOutcome	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	OperationOutcome	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	OperationOutcome	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-esmd-meta-security-01	error	OperationOutcome.meta.security	esMD supports only V security code : code.exists() implies (code = 'V' or code = 'HTEST')

Name	Flags	Card.	Type	Description & Constraints
OperationOutcome		0..*	OperationOutcome	Information about the success/failure of an action
meta	S	0..1	EsmdMeta	Metadata about the resource
Slices for profile				Content/Rules for all slices
profile:esmdoperationoutcome		1..1	canonical(StructureDefinition)	Profiles this resource claims to conform to Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-OperationOutcome
security	S	0..*	Coding	Security Labels applied to this resource
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:transactionId	S	1..1	string	ESMD Transaction ID URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
issue	S	1..*	BackboneElement	A single issue associated with the action
severity	S	1..1	code	fatal | error | warning | information
code	S	1..1	code	Error or warning code
details
coding		0..1	Coding	Code defined by a terminology system
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
OperationOutcome		0..*	OperationOutcome	Information about the success/failure of an action
id	Σ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	EsmdMeta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
Slices for profile	Σ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to Slice: Unordered, Open by value:$this
profile:esmdoperationoutcome	Σ	1..1	canonical(StructureDefinition)	Profiles this resource claims to conform to Fixed Value: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-OperationOutcome
security	SΣC	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. inv-esmd-meta-security-01: esMD supports only V security code
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:transactionId	S	1..1	string	ESMD Transaction ID URL: https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
issue	SΣ	1..*	BackboneElement	A single issue associated with the action
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
severity	SΣ	1..1	code	fatal | error | warning | information Binding: IssueSeverity (required): How the issue affects the success of the action.
code	SΣ	1..1	code	Error or warning code Binding: IssueType (required): A code that describes the type of issue.
details	Σ	0..1	CodeableConcept	Additional details about the error Binding: OperationOutcomeCodes (example): A code that provides details as the exact issue.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..1	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
diagnostics	Σ	0..1	string	Additional diagnostic information about the issue
location	Σ	0..*	string	Deprecated: Path of element(s) related to issue
expression	Σ	0..*	string	FHIRPath of element(s) related to issue
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
OperationOutcome.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels from the FHIR Standard
OperationOutcome.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags from the FHIR Standard
OperationOutcome.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
OperationOutcome.issue.severity	required	IssueSeverity http://hl7.org/fhir/ValueSet/issue-severity|4.0.1 from the FHIR Standard
OperationOutcome.issue.code	required	IssueType http://hl7.org/fhir/ValueSet/issue-type|4.0.1 from the FHIR Standard
OperationOutcome.issue.details	example	OperationOutcomeCodes http://hl7.org/fhir/ValueSet/operation-outcome from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	OperationOutcome	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	OperationOutcome	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 : 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()
dom-4	error	OperationOutcome	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	OperationOutcome	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	OperationOutcome	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
inv-esmd-meta-security-01	error	OperationOutcome.meta.security	esMD supports only V security code : code.exists() implies (code = 'V' or code = 'HTEST')

Summary

Mandatory: 2 elements(1 nested mandatory element)
Must-Support: 6 elements
Fixed: 1 element

Structures

This structure refers to these other structures:

• esMD Meta (https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Meta)

Extensions

This structure refers to these extensions:

• https://terminology.esmduat.cms.gov:8099/fhir/StructureDefinition/Esmd-Ext-TransactionId