FHIR Vocabulary binding for Authors

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Unsorted rules

  • if the type of the element is "code"
    • the value set should be defined as part of FHIR.
    • the binding strength should be required
    • codes should be mapped to v2 and/or v3 if equivalent concepts exist in v3
  • If the type of the element is "coding" or "CodeableConcept"
    • the value set should not include codes defined as part of FHIR; the codes should be drawn from v2 tables or v3 code systems, or external vocabularies (anything listed here: http://hl7-fhir.github.io/terminologies-systems.html)
    • v3 value sets can be used if appropriate
    • the binding strength should be at the most required
      • LOINC value sets can at the most be preferred
      • SNOMED CT value sets can at the most be example
    • mapping can be performed but is not required


  • the rules differ depending on the underlying data type. The build tool won't let bindings cross data types
  • the binding strength limitations for Coding/CodeableConcept do not apply to implementation guides (e.g. realm specific etc)
  • for exemptions to these rules, consult MnM or Vocab for approval
  • there are many legacy valuesets for Coding/CodeableConcept that are defined in FHIR itself, in violation of the above rule. Replacing these with external content is an ongoing task