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Narrative

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Generated Narrative: StructureDefinition ext-R4-ServiceRequest.reasonReference

Name	Flags	Card.	Type	Description & Constraints
Extension		0..*	Extension(5.0.0)	R4: Explanation/Justification for service or service additional types
url		1..1	uri	"http://hl7.org/fhir/4.0/StructureDefinition/extension-ServiceRequest.reasonReference"
value[x]		0..1	Reference(Cross-version Profile for R4.Observation for use in FHIR R5(0.1.0) | Observation | Cross-version Profile for R4.DiagnosticReport for use in FHIR R5(0.1.0) | DiagnosticReport | Cross-version Profile for R4.DocumentReference for use in FHIR R5(0.1.0) | DocumentReference)	Explanation/Justification for service or service
Documentation for this format

Source1

{
  "resourceType": "StructureDefinition",
  "id": "ext-R4-ServiceRequest.reasonReference",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fhir"
    },
    {
      "extension": [
        {
          "url": "packageId",
          "valueId": "hl7.fhir.uv.xver-r4.r5"
        },
        {
          "url": "version",
          "valueString": "0.1.0"
        },
        {
          "url": "uri",
          "valueUri": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r4.r5"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/package-source"
    },
    {
      "extension": [
        {
          "url": "startFhirVersion",
          "valueCode": "5.0"
        },
        {
          "url": "endFhirVersion",
          "valueCode": "5.0"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/version-specific-use"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-type-characteristics",
      "valueCode": "can-bind"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0,
      "_valueInteger": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r4.r5"
          }
        ]
      }
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/uv/xver/ImplementationGuide/hl7.fhir.uv.xver-r4.r5"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/4.0/StructureDefinition/extension-ServiceRequest.reasonReference",
  "version": "0.1.0",
  "name": "ExtensionServiceRequest_ReasonReference",
  "title": "R4: Explanation/Justification for service or service additional types",
  "status": "active",
  "experimental": false,
  "date": "2026-03-17T21:02:03.8104715+00:00",
  "publisher": "FHIR Infrastructure",
  "contact": [
    {
      "name": "FHIR Infrastructure",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fiwg"
        }
      ]
    }
  ],
  "description": "R4: `ServiceRequest.reasonReference` additional types (Reference(http://hl7.org/fhir/StructureDefinition/Observation), Reference(http://hl7.org/fhir/StructureDefinition/DiagnosticReport), Reference(http://hl7.org/fhir/StructureDefinition/DocumentReference))",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "purpose": "This extension is part of the cross-version definitions generated to enable use of the\r\nelement `ServiceRequest.reasonReference` as defined in FHIR R4\r\nin FHIR R5.\r\n\r\nThe source element is defined as:\r\n`ServiceRequest.reasonReference` 0..* `Reference(http://hl7.org/fhir/StructureDefinition/Condition,http://hl7.org/fhir/StructureDefinition/Observation,http://hl7.org/fhir/StructureDefinition/DiagnosticReport,http://hl7.org/fhir/StructureDefinition/DocumentReference)`\r\n\r\nAcross FHIR versions, the element set has been mapped as:\r\n*  R4: `ServiceRequest.reasonReference` 0..* `Reference(http://hl7.org/fhir/StructureDefinition/Condition,http://hl7.org/fhir/StructureDefinition/Observation,http://hl7.org/fhir/StructureDefinition/DiagnosticReport,http://hl7.org/fhir/StructureDefinition/DocumentReference)`\n*  R4B: `ServiceRequest.reasonReference` 0..* `Reference(http://hl7.org/fhir/StructureDefinition/Condition,http://hl7.org/fhir/StructureDefinition/Observation,http://hl7.org/fhir/StructureDefinition/DiagnosticReport,http://hl7.org/fhir/StructureDefinition/DocumentReference)`\n*  R5: `ServiceRequest.reason` 0..* `CodeableReference(http://hl7.org/fhir/StructureDefinition/Condition,http://hl7.org/fhir/StructureDefinition/Observation,http://hl7.org/fhir/StructureDefinition/DiagnosticReport,http://hl7.org/fhir/StructureDefinition/DocumentReference,http://hl7.org/fhir/StructureDefinition/DetectedIssue)`\r\n\r\nFollowing are the generation technical comments:\r\nElement `ServiceRequest.reasonReference` is mapped to FHIR R5 element `ServiceRequest.reason` as `RelatedTo`.\nThe mappings for `ServiceRequest.reasonReference` do not cover the following types: Reference.",
  "fhirVersion": "5.0.0",
  "mapping": [
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    }
  ],
  "kind": "complex-type",
  "abstract": false,
  "context": [
    {
      "type": "element",
      "expression": "ServiceRequest.reason"
    }
  ],
  "type": "Extension",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension|5.0.0",
  "derivation": "constraint",
  "snapshot": {
    "extension": [
      {
        "url": "http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version",
        "valueString": "5.0.0"
      }
    ],
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "R4: Explanation/Justification for service or service additional types",
        "definition": "R4: `ServiceRequest.reasonReference` additional types (Reference(http://hl7.org/fhir/StructureDefinition/Observation), Reference(http://hl7.org/fhir/StructureDefinition/DiagnosticReport), Reference(http://hl7.org/fhir/StructureDefinition/DocumentReference))",
        "comment": "Element `ServiceRequest.reasonReference` is mapped to FHIR R5 element `ServiceRequest.reason` as `RelatedTo`.\nThe mappings for `ServiceRequest.reasonReference` do not cover the following types: Reference.\nThis element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all.    To be as specific as possible,  a reference to  *Observation* or *Condition* should be used if available.  Otherwise when referencing  *DiagnosticReport*  it should contain a finding  in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`.   When using a reference to *DocumentReference*, the target document should contain clear findings language providing the relevant reason for this service request.  Use  the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the [CT Scan example](https://hl7.org/fhir/servicerequest-example-di.html).",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Extension",
          "min": 0,
          "max": "*"
        },
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element|5.0.0"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension|5.0.0"
          }
        ],
        "isModifier": false
      },
      {
        "id": "Extension.id",
        "path": "Extension.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "Unique id for inter-element referencing",
        "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "id"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "condition": [
          "ele-1"
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Extension.extension",
        "path": "Extension.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, 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": "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": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "*",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element|5.0.0"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension|5.0.0"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          }
        ]
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "representation": [
          "xmlAttr"
        ],
        "short": "identifies the meaning of the extension",
        "definition": "Source of the definition for the extension code - a logical name or a URL.",
        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Extension.url",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "uri"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "fixedUri": "http://hl7.org/fhir/4.0/StructureDefinition/extension-ServiceRequest.reasonReference",
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "short": "Explanation/Justification for service or service",
        "definition": "Indicates another resource that provides a justification for why this service is being requested.   May relate to the resources referred to in `supportingInfo`.",
        "comment": "This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all.    To be as specific as possible,  a reference to  *Observation* or *Condition* should be used if available.  Otherwise when referencing  *DiagnosticReport*  it should contain a finding  in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`.   When using a reference to *DocumentReference*, the target document should contain clear findings language providing the relevant reason for this service request.  Use  the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the [CT Scan example](https://hl7.org/fhir/servicerequest-example-di.html).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Extension.value[x]",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/4.0/StructureDefinition/profile-Observation|0.1.0",
              "http://hl7.org/fhir/StructureDefinition/Observation|5.0.0",
              "http://hl7.org/fhir/4.0/StructureDefinition/profile-DiagnosticReport|0.1.0",
              "http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0",
              "http://hl7.org/fhir/4.0/StructureDefinition/profile-DocumentReference|0.1.0",
              "http://hl7.org/fhir/StructureDefinition/DocumentReference|5.0.0"
            ]
          }
        ],
        "condition": [
          "ext-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "source": "http://hl7.org/fhir/StructureDefinition/Element|5.0.0"
          }
        ],
        "isModifier": false,
        "isSummary": false,
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      }
    ]
  },
  "differential": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "R4: Explanation/Justification for service or service additional types",
        "definition": "R4: `ServiceRequest.reasonReference` additional types (Reference(http://hl7.org/fhir/StructureDefinition/Observation), Reference(http://hl7.org/fhir/StructureDefinition/DiagnosticReport), Reference(http://hl7.org/fhir/StructureDefinition/DocumentReference))",
        "comment": "Element `ServiceRequest.reasonReference` is mapped to FHIR R5 element `ServiceRequest.reason` as `RelatedTo`.\nThe mappings for `ServiceRequest.reasonReference` do not cover the following types: Reference.\nThis element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all.    To be as specific as possible,  a reference to  *Observation* or *Condition* should be used if available.  Otherwise when referencing  *DiagnosticReport*  it should contain a finding  in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`.   When using a reference to *DocumentReference*, the target document should contain clear findings language providing the relevant reason for this service request.  Use  the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the [CT Scan example](https://hl7.org/fhir/servicerequest-example-di.html).",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Extension",
          "min": 0,
          "max": "*"
        },
        "isModifier": false
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Extension.url",
          "min": 1,
          "max": "1"
        },
        "fixedUri": "http://hl7.org/fhir/4.0/StructureDefinition/extension-ServiceRequest.reasonReference"
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "short": "Explanation/Justification for service or service",
        "definition": "Indicates another resource that provides a justification for why this service is being requested.   May relate to the resources referred to in `supportingInfo`.",
        "comment": "This element represents why the referral is being made and may be used to decide how the service will be performed, or even if it will be performed at all.    To be as specific as possible,  a reference to  *Observation* or *Condition* should be used if available.  Otherwise when referencing  *DiagnosticReport*  it should contain a finding  in `DiagnosticReport.conclusion` and/or `DiagnosticReport.conclusionCode`.   When using a reference to *DocumentReference*, the target document should contain clear findings language providing the relevant reason for this service request.  Use  the CodeableConcept text element in `ServiceRequest.reasonCode` if the data is free (uncoded) text as shown in the [CT Scan example](https://hl7.org/fhir/servicerequest-example-di.html).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Extension.value[x]",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/4.0/StructureDefinition/profile-Observation|0.1.0",
              "http://hl7.org/fhir/StructureDefinition/Observation|5.0.0",
              "http://hl7.org/fhir/4.0/StructureDefinition/profile-DiagnosticReport|0.1.0",
              "http://hl7.org/fhir/StructureDefinition/DiagnosticReport|5.0.0",
              "http://hl7.org/fhir/4.0/StructureDefinition/profile-DocumentReference|0.1.0",
              "http://hl7.org/fhir/StructureDefinition/DocumentReference|5.0.0"
            ]
          }
        ]
      }
    ]
  }
}