This profile grades a single category of the WHO International Classification of Functioning, Disability and Health (ICF) for one patient. Both the JARDIN MDS draft and the ERDRI-CDS require functioning and disability to be recorded this way, and no MII module covered it before.

Observation.code carries the ICF category, Observation.component carries the WHO qualifiers.

Why qualifiers are components, not a value

The number of qualifiers differs by ICF chapter, so a single value[x] cannot carry them. value[x] is therefore closed off (0..0), and an invariant per chapter enforces which components may appear:

Without these constraints the profile would accept an anatomical location on a body function, which the ICF does not define.

The distinction in chapter d is the heart of the classification and is frequently the whole point in rare disease: capacity is what someone can do under test conditions, performance is what they actually do in their own environment. Both share one BfArM code system, so they are told apart by the component code, not by the value system.

Note on ordering: the ICF's own convention for chapter d puts performance first and capacity second. The slice order in this profile is alphabetical and carries no meaning — read the component code, not the position.

Terminology

Resolved against the BfArM FHIR package bfarm.terminologien.icf:

• The classification is published under the HL7 canonical http://hl7.org/fhir/sid/icf. BfArM does not mint its own URI for it.
• German is not a second code system. icf-translation is a content=supplement against the same canonical — one code system, both languages. Nothing here has to choose a language, and the value set needs no German twin.
• The qualifiers are separate code systems, seven of them, published by BfArM under https://terminologien.bfarm.de/fhir/CodeSystem/icf-q-*.
• The separator carries meaning, and BfArM put it into the codes: extent of impairment runs .0….4, .8, .9, while facilitators run +0…+4. A barrier and a facilitator are therefore distinguished by the code itself, not by a sign a parser has to reconstruct.

Three open points

The binding may not resolve in a build. The MII terminology server does not currently carry http://hl7.org/fhir/sid/icf and reports it as an unknown code system, so mii-vs-seltene-icf has no expansion in this publication even though code.coding is bound required against it. The gap is one of server provisioning and closes once the BfArM package is loaded there. ICF codes themselves remain valid.

The edition is not pinned. BfArM ships release 2005 with 1495 concepts; tx.fhir.org serves 2017a under the same canonical URI, and an expansion there returned 1616. Same URI, roughly 120 concepts apart. A required binding must not straddle both silently.

Ownership is open — deliberately, not by oversight. This data point is not specific to rare diseases: functioning and disability are graded for stroke, oncology and geriatric patients alike, and the ICF is a WHO classification for the whole of health, not for one indication. It is modelled here because the need arose here and was concrete — the JARDIN MDS draft is the data requirement of a European reference network with a deadline, and no connected MII module covered it. A module for symptoms and the clinical phenotype is the natural home should one take it on; the same weighing came out differently for sex at birth (HDB-782), which was referred to the base module because both a standard and a place for it already existed. Comments on this point are welcome in the ballot.

Search parameters are declared module-wide in the CapabilityStatement — machine-readable and complete there, rather than repeated by hand per profile.

Example instances are linked in the "Examples" section of the profile page.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7, mii-icf-1, mii-icf-2, mii-icf-3, mii-icf-4, mii-icf-5
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	Category: survey/assessment Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	ICF category being graded Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding	SΣ	0..*	Coding	Code defined by a terminology system Binding: MII VS SE ICF Categories (required)
system	Σ	0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/icf
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
effective[x]	SΣ	1..1		When the assessment was made — ICF gradings are point-in-time and change over the course of a disease
effectiveDateTime			dateTime
effectivePeriod			Period
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
note	S	0..*	Annotation	Comments about the observation
Slices for component	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
component:extentOfImpairment	SΣ	0..1	BackboneElement	Body functions (b): extent of impairment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung (required)
component:extentOfImpairmentBodyStructure	SΣ	0..1	BackboneElement	Body structures (s), first qualifier: extent of impairment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment-structure
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s (required)
component:natureOfChange	SΣ	0..1	BackboneElement	Body structures (s), second qualifier: nature of the change
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: nature-of-change
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur (required)
component:anatomicalLocation	SΣ	0..1	BackboneElement	Body structures (s), third qualifier: anatomical location
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: anatomical-location
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation (required)
component:capacity	SΣ	0..1	BackboneElement	Activities and participation (d): CAPACITY — what the person can do in a standardised environment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: capacity
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
component:performance	SΣ	0..1	BackboneElement	Activities and participation (d): PERFORMANCE — what the person actually does in their current environment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: performance
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
component:barrier	SΣ	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a barrier
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: barrier
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren (required)
component:facilitator	SΣ	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a facilitator
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: facilitator
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren (required)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:survey	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.code.coding	Base	required	MII VS SE ICF Categories	📦2027.0.0-ballot	This IG
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung	Not State	Unknown
Observation.component:extentOfImpairmentBodyStructure.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairmentBodyStructure.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s	Not State	Unknown
Observation.component:natureOfChange.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:natureOfChange.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur	Not State	Unknown
Observation.component:anatomicalLocation.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:anatomicalLocation.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation	Not State	Unknown
Observation.component:capacity.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:capacity.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:performance.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:performance.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:barrier.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:barrier.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren	Not State	Unknown
Observation.component:facilitator.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:facilitator.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren	Not State	Unknown

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	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	Observation	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	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	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()
mii-icf-1	error	Observation	Body functions (chapter b) take only the extent-of-impairment qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('b') implies component.where(code.coding.code != 'extent-of-impairment').empty()
mii-icf-2	error	Observation	Body structures (chapter s) take only extent, nature of change and anatomical location.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('s') implies component.where(code.coding.code != 'extent-of-impairment-structure' and code.coding.code != 'nature-of-change' and code.coding.code != 'anatomical-location').empty()
mii-icf-3	error	Observation	Activities and participation (chapter d) take only capacity and performance.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('d') implies component.where(code.coding.code != 'capacity' and code.coding.code != 'performance').empty()
mii-icf-4	error	Observation	Environmental factors (chapter e) take only the barrier or facilitator qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('e') implies component.where(code.coding.code != 'barrier' and code.coding.code != 'facilitator').empty()
mii-icf-5	error	Observation	An environmental factor is graded as a barrier or as a facilitator, not as both at once.	component.where(code.coding.code = 'barrier').empty() or component.where(code.coding.code = 'facilitator').empty()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: mii-icf-1, mii-icf-2, mii-icf-3, mii-icf-4, mii-icf-5
id	S	0..1	id	Logical id of this artifact
meta	S	0..1	Meta	Metadata about the resource
profile	S	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
status	S	1..1	code	registered | preliminary | final | amended +
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this
category:survey	S	1..1	CodeableConcept	Category: survey/assessment Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
code	S	1..1	CodeableConcept	ICF category being graded
coding	S	0..*	Coding	Code defined by a terminology system Binding: MII VS SE ICF Categories (required)
system		0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/icf
subject	S	1..1	Reference(Patient)	Who and/or what the observation is about
effective[x]	S	1..1		When the assessment was made — ICF gradings are point-in-time and change over the course of a disease
effectiveDateTime			dateTime
effectivePeriod			Period
performer	S	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
value[x]		0..0		Actual result
note	S	0..*	Annotation	Comments about the observation
Slices for component	S	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
value[x]		0..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
component:extentOfImpairment	S	0..1	BackboneElement	Body functions (b): extent of impairment
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung (required)
component:extentOfImpairmentBodyStructure	S	0..1	BackboneElement	Body structures (s), first qualifier: extent of impairment
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment-structure
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s (required)
component:natureOfChange	S	0..1	BackboneElement	Body structures (s), second qualifier: nature of the change
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: nature-of-change
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur (required)
component:anatomicalLocation	S	0..1	BackboneElement	Body structures (s), third qualifier: anatomical location
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: anatomical-location
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation (required)
component:capacity	S	0..1	BackboneElement	Activities and participation (d): CAPACITY — what the person can do in a standardised environment
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: capacity
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
component:performance	S	0..1	BackboneElement	Activities and participation (d): PERFORMANCE — what the person actually does in their current environment
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: performance
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
component:barrier	S	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a barrier
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: barrier
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren (required)
component:facilitator	S	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a facilitator
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
code		1..1	code	Symbol in syntax defined by the system Fixed Value: facilitator
value[x]		0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.code.coding	Base	required	MII VS SE ICF Categories	📦2027.0.0-ballot	This IG
Observation.component:extentOfImpairment.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung	Not State	Unknown
Observation.component:extentOfImpairmentBodyStructure.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s	Not State	Unknown
Observation.component:natureOfChange.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur	Not State	Unknown
Observation.component:anatomicalLocation.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation	Not State	Unknown
Observation.component:capacity.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:performance.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:barrier.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren	Not State	Unknown
Observation.component:facilitator.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren	Not State	Unknown

Constraints

Id	Grade	Path(s)	Description	Expression
mii-icf-1	error	Observation	Body functions (chapter b) take only the extent-of-impairment qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('b') implies component.where(code.coding.code != 'extent-of-impairment').empty()
mii-icf-2	error	Observation	Body structures (chapter s) take only extent, nature of change and anatomical location.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('s') implies component.where(code.coding.code != 'extent-of-impairment-structure' and code.coding.code != 'nature-of-change' and code.coding.code != 'anatomical-location').empty()
mii-icf-3	error	Observation	Activities and participation (chapter d) take only capacity and performance.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('d') implies component.where(code.coding.code != 'capacity' and code.coding.code != 'performance').empty()
mii-icf-4	error	Observation	Environmental factors (chapter e) take only the barrier or facilitator qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('e') implies component.where(code.coding.code != 'barrier' and code.coding.code != 'facilitator').empty()
mii-icf-5	error	Observation	An environmental factor is graded as a barrier or as a facilitator, not as both at once.	component.where(code.coding.code = 'barrier').empty() or component.where(code.coding.code = 'facilitator').empty()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7, mii-icf-1, mii-icf-2, mii-icf-3, mii-icf-4, mii-icf-5
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	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
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:survey	S	1..1	CodeableConcept	Category: survey/assessment Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: survey
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	ICF category being graded Binding: LOINCCodes (example): Codes identifying names of simple observations.
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	SΣ	0..*	Coding	Code defined by a terminology system Binding: MII VS SE ICF Categories (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Required Pattern: http://hl7.org/fhir/sid/icf
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	1..1		When the assessment was made — ICF gradings are point-in-time and change over the course of a disease
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note	S	0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation Constraints: obs-3
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
low	C	0..1	SimpleQuantity(4.0.1)	Low Range, if relevant
high	C	0..1	SimpleQuantity(4.0.1)	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Slices for component	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:extentOfImpairment	SΣ	0..1	BackboneElement	Body functions (b): extent of impairment
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung (required)
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:extentOfImpairmentBodyStructure	SΣ	0..1	BackboneElement	Body structures (s), first qualifier: extent of impairment
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: extent-of-impairment-structure
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s (required)
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:natureOfChange	SΣ	0..1	BackboneElement	Body structures (s), second qualifier: nature of the change
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: nature-of-change
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur (required)
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:anatomicalLocation	SΣ	0..1	BackboneElement	Body structures (s), third qualifier: anatomical location
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: anatomical-location
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation (required)
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:capacity	SΣ	0..1	BackboneElement	Activities and participation (d): CAPACITY — what the person can do in a standardised environment
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: capacity
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:performance	SΣ	0..1	BackboneElement	Activities and participation (d): PERFORMANCE — what the person actually does in their current environment
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: performance
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung (required)
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:barrier	SΣ	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a barrier
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: barrier
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren (required)
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:facilitator	SΣ	0..1	BackboneElement	Environmental factors (e): extent to which the factor acts as a facilitator
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
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://www.medizininformatik-initiative.de/fhir/ext/modul-seltene/CodeSystem/mii-cs-seltene-icf-beurteilungsmerkmal
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: facilitator
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren (required)
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.meta.security	Base	extensible	SecurityLabels	📍4.0.1	FHIR Std.
Observation.meta.tag	Base	example	Common Tags	📍4.0.1	FHIR Std.
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:survey	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.code.coding	Base	required	MII VS SE ICF Categories	📦2027.0.0-ballot	This IG
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📍4.0.1	FHIR Std.
Observation.method	Base	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung	Not State	Unknown
Observation.component:extentOfImpairment.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairment.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairmentBodyStructure.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairmentBodyStructure.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-ausmass-der-schaedigung-s	Not State	Unknown
Observation.component:extentOfImpairmentBodyStructure.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:extentOfImpairmentBodyStructure.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:natureOfChange.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:natureOfChange.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-art-oder-veraenderung-in-der-entsprechenden-koerperstruktur	Not State	Unknown
Observation.component:natureOfChange.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:natureOfChange.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:anatomicalLocation.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:anatomicalLocation.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-anatomische-lokalisation	Not State	Unknown
Observation.component:anatomicalLocation.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:anatomicalLocation.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:capacity.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:capacity.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:capacity.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:capacity.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:performance.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:performance.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-leistungsfaehigkeit-und-leistung	Not State	Unknown
Observation.component:performance.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:performance.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:barrier.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:barrier.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-barrieren	Not State	Unknown
Observation.component:barrier.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:barrier.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:facilitator.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:facilitator.​value[x]	Base	required	https://terminologien.bfarm.de/fhir/ValueSet/icf-q-foerderfaktoren	Not State	Unknown
Observation.component:facilitator.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:facilitator.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	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	Observation	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	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	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()
mii-icf-1	error	Observation	Body functions (chapter b) take only the extent-of-impairment qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('b') implies component.where(code.coding.code != 'extent-of-impairment').empty()
mii-icf-2	error	Observation	Body structures (chapter s) take only extent, nature of change and anatomical location.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('s') implies component.where(code.coding.code != 'extent-of-impairment-structure' and code.coding.code != 'nature-of-change' and code.coding.code != 'anatomical-location').empty()
mii-icf-3	error	Observation	Activities and participation (chapter d) take only capacity and performance.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('d') implies component.where(code.coding.code != 'capacity' and code.coding.code != 'performance').empty()
mii-icf-4	error	Observation	Environmental factors (chapter e) take only the barrier or facilitator qualifier.	code.coding.where(system='http://hl7.org/fhir/sid/icf').code.first().startsWith('e') implies component.where(code.coding.code != 'barrier' and code.coding.code != 'facilitator').empty()
mii-icf-5	error	Observation	An environmental factor is graded as a barrier or as a facilitator, not as both at once.	component.where(code.coding.code = 'barrier').empty() or component.where(code.coding.code = 'facilitator').empty()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text	low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present	dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()