Huli FHIR Core Implementation Guide (R5)
0.1.0 - Release Latin America and the Caribbean

Huli FHIR Core Implementation Guide (R5) - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: HuliAppointment - Detailed Descriptions

Active as of 2026-09-11

Definitions for the huli-appointment resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Appointment
Definition

A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s).

ShortA booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantsapp-2: Either start and end are specified, or neither (start.exists() = end.exists())
app-3: Only proposed or cancelled appointments can be missing start/end dates ((start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist')))
app-4: Cancellation reason is only used for appointments that have been cancelled, or noshow (cancellationReason.exists() implies (status='noshow' or status='cancelled'))
app-5: The start must be less than or equal to the end (start.exists() implies start <= end)
app-6: An appointment may have an originatingAppointment or recurrenceTemplate, but not both (originatingAppointment.exists().not() or recurrenceTemplate.exists().not())
app-7: Cancellation date is only used for appointments that have been cancelled, or noshow (cancellationDate.exists() implies (status='noshow' or status='cancelled'))
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
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 (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. Appointment.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Appointment.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

Control0..*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. Appointment.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. 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.

ShortExtensionAdditional content defined by implementations
Comments

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.

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Appointment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. Appointment.extension:confirmationStatus
    Slice NameconfirmationStatus
    Definition

    Patient confirmation status for an appointment, representing whether the patient has confirmed, declined, or not yet responded to the appointment. This is distinct from Appointment.participant.status which tracks the provider's acceptance.

    Runtime values (emitted by appointment_codec.go confirmationStatusCode):

    • unconfirmed (Sin confirmar) — patient has not responded
    • confirmed (Confirmada) — patient confirmed attendance
    • cancelled (Cancelada) — cancelled before confirmation

    Mapping: appointment.id_confirmation_status → one of the runtime codes above. Server-derived; read-only on write.

    ShortHuli Confirmation Status
    Control0..1
    TypeExtension(Huli Confirmation Status) (Extension Type: code)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Appointment.extension:insuranceSnapshot
    Slice NameinsuranceSnapshot
    Definition

    Point-in-time insurance snapshot captured at the moment an appointment was booked. Independent of the patient's current insurance list — the snapshot is immutable history attached to the appointment.

    Sub-extensions:

    • provider (string, required) — insurer name at booking time
    • policyNumber (string, optional) — policy number at booking time
    • certificateNumber (string, optional) — certificate / member ID at booking time

    Mapping: appointment.appointment_data.insurance JSONB sub-object.

    ShortHuli Insurance Snapshot
    Control0..1
    TypeExtension(Huli Insurance Snapshot) (Complex Extension)
    Is Modifierfalse
    Must Supportfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. Appointment.extension:createdBy
    Slice NamecreatedBy
    Definition

    Audit attribution: the internal Huli user who created the appointment. Distinct from Appointment.participant, which records clinical participants rather than the actor who booked the slot.

    The actor can be ANY staff identity — practitioner, receptionist, accountant, a service account, or the Huli "Sistema" sentinel — and is not exposed as a resource on this API. The value is therefore a logical reference: valueReference.identifier carries the Huli user id under system = https://huli.io/fhir/identifier/user-id, with no literal reference and no type (D-013). Earlier releases emitted a typed Reference(Practitioner) literal; that mislabeled non-practitioner actors and minted unresolvable references, and was retired.

    Mapping: the id of the user who created the appointment, projected as valueReference.identifier (logical reference).

    ShortHuli Created By
    Control0..1
    TypeExtension(Huli Created By) (Extension Type: Reference)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. Appointment.extension:modifiedBy
    Slice NamemodifiedBy
    Definition

    Audit attribution: the internal Huli user who last modified the appointment. Companion to huli-created-by for audit attribution. The actor can be ANY staff identity — practitioner, receptionist, accountant, a service account, or the Huli "Sistema" sentinel — and is not exposed as a resource on this API. The value is therefore a logical reference: valueReference.identifier carries the Huli user id under system = https://huli.io/fhir/identifier/user-id, with no literal reference and no type (D-013). Earlier releases emitted a typed Reference(Practitioner) literal; that mislabeled non-practitioner actors and minted unresolvable references, and was retired.

    Mapping: the id of the user who last modified the appointment, projected as valueReference.identifier (logical reference).

    ShortHuli Modified By
    Control0..1
    TypeExtension(Huli Modified By) (Extension Type: Reference)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. Appointment.extension:cancellationInfo
    Slice NamecancellationInfo
    Definition

    Audit detail about an appointment cancellation. The structured FHIR Appointment.cancelationReason carries the SNOMED-coded reason; this extension carries the operational metadata (actor, timestamp, free-text notes) that Huli additionally records.

    Sub-extensions:

    • cancelledBy (Reference, required when extension is present — a logical reference: valueReference.identifier carries the internal Huli user id of the cancelling actor under system = https://huli.io/fhir/identifier/user-id, with no literal reference and no type. The actor can be any staff identity — practitioner, receptionist, accountant, a service account, or the Huli "Sistema" sentinel — and is not exposed as a resource on this API; see D-013. Earlier releases emitted a typed Reference(Practitioner) literal, which mislabeled non-practitioner actors.)
    • cancelledOn (dateTime, optional)
    • cancellationNotes (string, optional)

    Mapping: appointment.cancelled_by / .cancelled_on / .cancellation_notes columns.

    ShortHuli Cancellation Info
    Control0..1
    TypeExtension(Huli Cancellation Info) (Complex Extension)
    Is Modifierfalse
    Must Supportfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. Appointment.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. Appointment.status
    Definition

    The overall status of the Appointment. Each of the participants has their own participation status which indicates their involvement in the process, however this status indicates the shared status.

    Shortproposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
    Comments

    If the Appointment's status is "cancelled" then all participants are expected to have their calendars released for the appointment period, and as such any Slots that were marked as BUSY can be re-set to FREE.

    This element is labeled as a modifier because the status contains the code entered-in-error that mark the Appointment as not currently valid.

    Control1..1
    This element is affected by the following invariants: app-4, app-3, app-7
    BindingThe codes SHALL be taken from AppointmentStatushttp://hl7.org/fhir/ValueSet/appointmentstatus|5.0.0
    (required to http://hl7.org/fhir/ValueSet/appointmentstatus|5.0.0)

    The free/busy status of an appointment.

    Typecode
    Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. Appointment.cancellationReason
    Definition

    The coded reason for the appointment being cancelled. This is often used in reporting/billing/futher processing to determine if further actions are required, or specific fees apply.

    ShortThe coded reason for the appointment being cancelled
    Control0..1
    This element is affected by the following invariants: app-4
    BindingThe codes SHOULD be taken from For example codes, see Huli Cancellation Reason Value Sethttp://hl7.org/fhir/ValueSet/appointment-cancellation-reason|5.0.0
    (preferred to https://fhir.huli.ai/r5/ValueSet/huli-cancellation-reason-vs)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Appointment.serviceType
    Definition

    The specific service that is to be performed during this appointment.

    ShortThe specific service that is to be performed during this appointment
    Comments

    For a provider to provider appointment the code "FOLLOWUP" may be appropriate, as this is expected to be discussing some patient that was seen in the past.

    Control10..1*
    BindingFor example codes, see ServiceTypehttp://hl7.org/fhir/ValueSet/service-type|5.0.0
    (example to http://hl7.org/fhir/ValueSet/service-type|5.0.0)
    TypeCodeableReference(HealthcareService)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    26. Appointment.appointmentType
    Definition

    The style of appointment or patient that has been booked in the slot (not service type).

    ShortThe style of appointment or patient that has been booked in the slot (not service type)
    Control0..1
    BindingThe codes SHOULD be taken from Huli Appointment Type Value Sethttp://terminology.hl7.org/ValueSet/v2-0276
    (preferred to https://fhir.huli.ai/r5/ValueSet/huli-appointment-type-vs)
    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. Appointment.start
    Definition

    Date/Time that the appointment is to take place.

    ShortWhen appointment is to take place
    Comments

    If actual start/end times are not known then the requested period start/end can be used.

    Control0..1
    This element is affected by the following invariants: app-5, app-3, app-2
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. Appointment.end
    Definition

    Date/Time that the appointment is to conclude.

    ShortWhen appointment is to conclude
    Comments

    If actual start/end times are not known then the requested period start/end can be used.

    Control0..1
    This element is affected by the following invariants: app-5, app-3, app-2
    Typeinstant
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    32. Appointment.subject
    Definition

    The patient or group associated with the appointment, if they are to be present (usually) then they should also be included in the participant backbone element.

    ShortThe patient or group associated with the appointment
    Control0..1
    TypeReference(Huli Patient, Patient, Group)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    34. Appointment.participant
    Definition

    List of participants involved in the appointment.

    ShortParticipants involved in appointment
    Control1..*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsapp-1: Either the type or actor on the participant SHALL be specified (type.exists() or actor.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    36. Appointment.participant.modifierExtension
    Definition

    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    38. Appointment.participant.status
    Definition

    Participation status of the actor.

    Shortaccepted | declined | tentative | needs-action
    Control1..1
    BindingThe codes SHALL be taken from ParticipationStatushttp://hl7.org/fhir/ValueSet/participationstatus|5.0.0
    (required to http://hl7.org/fhir/ValueSet/participationstatus|5.0.0)

    The Participation status of an appointment.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

    Guidance on how to interpret the contents of this table can be foundhere

    0. Appointment
    2. Appointment.extension
    SlicingThis element introduces a set of slices on Appointment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 4. Appointment.extension:confirmationStatus
      Slice NameconfirmationStatus
      Control0..1
      TypeExtension(Huli Confirmation Status) (Extension Type: code)
      Must Supporttrue
      6. Appointment.extension:insuranceSnapshot
      Slice NameinsuranceSnapshot
      Control0..1
      TypeExtension(Huli Insurance Snapshot) (Complex Extension)
      8. Appointment.extension:createdBy
      Slice NamecreatedBy
      Control0..1
      TypeExtension(Huli Created By) (Extension Type: Reference)
      10. Appointment.extension:modifiedBy
      Slice NamemodifiedBy
      Control0..1
      TypeExtension(Huli Modified By) (Extension Type: Reference)
      12. Appointment.extension:cancellationInfo
      Slice NamecancellationInfo
      Control0..1
      TypeExtension(Huli Cancellation Info) (Complex Extension)
      14. Appointment.status
      Must Supporttrue
      16. Appointment.cancellationReason
      BindingThe codes SHOULD be taken from Huli Cancellation Reason Value Set
      (preferred to https://fhir.huli.ai/r5/ValueSet/huli-cancellation-reason-vs)
      18. Appointment.serviceType
      Control1..1
      Must Supporttrue
      20. Appointment.appointmentType
      BindingThe codes SHOULD be taken from Huli Appointment Type Value Set
      (preferred to https://fhir.huli.ai/r5/ValueSet/huli-appointment-type-vs)
      22. Appointment.start
      Must Supporttrue
      24. Appointment.end
      Must Supporttrue
      26. Appointment.subject
      TypeReference(Huli Patient)
      Must Supporttrue
      28. Appointment.participant
      Must Supporttrue
      30. Appointment.recurrenceTemplate
      32. Appointment.recurrenceTemplate.occurrenceDate
      Control0..1

      Guidance on how to interpret the contents of this table can be foundhere

      0. Appointment
      Definition

      A booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s).

      ShortA booking of a healthcare event among patient(s), practitioner(s), related person(s) and/or device(s) for a specific date/time. This may result in one or more Encounter(s)
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsapp-2: Either start and end are specified, or neither (start.exists() = end.exists())
      app-3: Only proposed or cancelled appointments can be missing start/end dates ((start.exists() and end.exists()) or (status in ('proposed' | 'cancelled' | 'waitlist')))
      app-4: Cancellation reason is only used for appointments that have been cancelled, or noshow (cancellationReason.exists() implies (status='noshow' or status='cancelled'))
      app-5: The start must be less than or equal to the end (start.exists() implies start <= end)
      app-6: An appointment may have an originatingAppointment or recurrenceTemplate, but not both (originatingAppointment.exists().not() or recurrenceTemplate.exists().not())
      app-7: Cancellation date is only used for appointments that have been cancelled, or noshow (cancellationDate.exists() implies (status='noshow' or status='cancelled'))
      dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      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 (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. Appointment.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

      Control0..1
      Typeid
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      4. Appointment.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control0..1
      TypeMeta
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. Appointment.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. Appointment.language
      Definition

      The base language in which the resource is written.

      ShortLanguage of the resource content
      Comments

      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

      Control0..1
      BindingThe codes SHALL be taken from AllLanguages
      (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

      IETF language tag for a human language

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. Appointment.text
      Definition

      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

      ShortText summary of the resource, for human interpretation
      Comments

      Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

      Control0..1
      This element is affected by the following invariants: dom-6
      TypeNarrative
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesnarrative, html, xhtml, display
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. Appointment.contained
      Definition

      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

      ShortContained, inline Resources
      Comments

      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

      Control0..*
      This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
      TypeResource
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Alternate Namesinline resources, anonymous resources, contained resources
      14. Appointment.extension
      Definition

      An Extension

      ShortExtension
      Control0..*
      TypeExtension
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Appointment.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 16. Appointment.extension:confirmationStatus
        Slice NameconfirmationStatus
        Definition

        Patient confirmation status for an appointment, representing whether the patient has confirmed, declined, or not yet responded to the appointment. This is distinct from Appointment.participant.status which tracks the provider's acceptance.

        Runtime values (emitted by appointment_codec.go confirmationStatusCode):

        • unconfirmed (Sin confirmar) — patient has not responded
        • confirmed (Confirmada) — patient confirmed attendance
        • cancelled (Cancelada) — cancelled before confirmation

        Mapping: appointment.id_confirmation_status → one of the runtime codes above. Server-derived; read-only on write.

        ShortHuli Confirmation Status
        Control0..1
        TypeExtension(Huli Confirmation Status) (Extension Type: code)
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        18. Appointment.extension:insuranceSnapshot
        Slice NameinsuranceSnapshot
        Definition

        Point-in-time insurance snapshot captured at the moment an appointment was booked. Independent of the patient's current insurance list — the snapshot is immutable history attached to the appointment.

        Sub-extensions:

        • provider (string, required) — insurer name at booking time
        • policyNumber (string, optional) — policy number at booking time
        • certificateNumber (string, optional) — certificate / member ID at booking time

        Mapping: appointment.appointment_data.insurance JSONB sub-object.

        ShortHuli Insurance Snapshot
        Control0..1
        TypeExtension(Huli Insurance Snapshot) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. Appointment.extension:createdBy
        Slice NamecreatedBy
        Definition

        Audit attribution: the internal Huli user who created the appointment. Distinct from Appointment.participant, which records clinical participants rather than the actor who booked the slot.

        The actor can be ANY staff identity — practitioner, receptionist, accountant, a service account, or the Huli "Sistema" sentinel — and is not exposed as a resource on this API. The value is therefore a logical reference: valueReference.identifier carries the Huli user id under system = https://huli.io/fhir/identifier/user-id, with no literal reference and no type (D-013). Earlier releases emitted a typed Reference(Practitioner) literal; that mislabeled non-practitioner actors and minted unresolvable references, and was retired.

        Mapping: the id of the user who created the appointment, projected as valueReference.identifier (logical reference).

        ShortHuli Created By
        Control0..1
        TypeExtension(Huli Created By) (Extension Type: Reference)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        22. Appointment.extension:modifiedBy
        Slice NamemodifiedBy
        Definition

        Audit attribution: the internal Huli user who last modified the appointment. Companion to huli-created-by for audit attribution. The actor can be ANY staff identity — practitioner, receptionist, accountant, a service account, or the Huli "Sistema" sentinel — and is not exposed as a resource on this API. The value is therefore a logical reference: valueReference.identifier carries the Huli user id under system = https://huli.io/fhir/identifier/user-id, with no literal reference and no type (D-013). Earlier releases emitted a typed Reference(Practitioner) literal; that mislabeled non-practitioner actors and minted unresolvable references, and was retired.

        Mapping: the id of the user who last modified the appointment, projected as valueReference.identifier (logical reference).

        ShortHuli Modified By
        Control0..1
        TypeExtension(Huli Modified By) (Extension Type: Reference)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        24. Appointment.extension:cancellationInfo
        Slice NamecancellationInfo
        Definition

        Audit detail about an appointment cancellation. The structured FHIR Appointment.cancelationReason carries the SNOMED-coded reason; this extension carries the operational metadata (actor, timestamp, free-text notes) that Huli additionally records.

        Sub-extensions:

        • cancelledBy (Reference, required when extension is present — a logical reference: valueReference.identifier carries the internal Huli user id of the cancelling actor under system = https://huli.io/fhir/identifier/user-id, with no literal reference and no type. The actor can be any staff identity — practitioner, receptionist, accountant, a service account, or the Huli "Sistema" sentinel — and is not exposed as a resource on this API; see D-013. Earlier releases emitted a typed Reference(Practitioner) literal, which mislabeled non-practitioner actors.)
        • cancelledOn (dateTime, optional)
        • cancellationNotes (string, optional)

        Mapping: appointment.cancelled_by / .cancelled_on / .cancellation_notes columns.

        ShortHuli Cancellation Info
        Control0..1
        TypeExtension(Huli Cancellation Info) (Complex Extension)
        Is Modifierfalse
        Must Supportfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        26. Appointment.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Must Supportfalse
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        28. Appointment.identifier
        Definition

        This records identifiers associated with this appointment concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

        ShortExternal Ids for this item
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control0..*
        TypeIdentifier
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        30. Appointment.status
        Definition

        The overall status of the Appointment. Each of the participants has their own participation status which indicates their involvement in the process, however this status indicates the shared status.

        Shortproposed | pending | booked | arrived | fulfilled | cancelled | noshow | entered-in-error | checked-in | waitlist
        Comments

        If the Appointment's status is "cancelled" then all participants are expected to have their calendars released for the appointment period, and as such any Slots that were marked as BUSY can be re-set to FREE.

        This element is labeled as a modifier because the status contains the code entered-in-error that mark the Appointment as not currently valid.

        Control1..1
        This element is affected by the following invariants: app-4, app-3, app-7
        BindingThe codes SHALL be taken from AppointmentStatus
        (required to http://hl7.org/fhir/ValueSet/appointmentstatus|5.0.0)

        The free/busy status of an appointment.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        32. Appointment.cancellationReason
        Definition

        The coded reason for the appointment being cancelled. This is often used in reporting/billing/futher processing to determine if further actions are required, or specific fees apply.

        ShortThe coded reason for the appointment being cancelled
        Control0..1
        This element is affected by the following invariants: app-4
        BindingThe codes SHOULD be taken from Huli Cancellation Reason Value Set
        (preferred to https://fhir.huli.ai/r5/ValueSet/huli-cancellation-reason-vs)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        34. Appointment.class
        Definition

        Concepts representing classification of patient encounter such as ambulatory (outpatient), inpatient, emergency, home health or others due to local variations.

        ShortClassification when becoming an encounter
        Control0..*
        BindingThe codes SHOULD be taken from http://terminology.hl7.org/ValueSet/EncounterClass
        (preferred to http://terminology.hl7.org/ValueSet/EncounterClass)

        Classification of the encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Appointment.serviceCategory
        Definition

        A broad categorization of the service that is to be performed during this appointment.

        ShortA broad categorization of the service that is to be performed during this appointment
        Control0..*
        BindingFor example codes, see ServiceCategory
        (example to http://hl7.org/fhir/ValueSet/service-category|5.0.0)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. Appointment.serviceType
        Definition

        The specific service that is to be performed during this appointment.

        ShortThe specific service that is to be performed during this appointment
        Comments

        For a provider to provider appointment the code "FOLLOWUP" may be appropriate, as this is expected to be discussing some patient that was seen in the past.

        Control1..1
        BindingFor example codes, see ServiceType
        (example to http://hl7.org/fhir/ValueSet/service-type|5.0.0)
        TypeCodeableReference(HealthcareService)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. Appointment.specialty
        Definition

        The specialty of a practitioner that would be required to perform the service requested in this appointment.

        ShortThe specialty of a practitioner that would be required to perform the service requested in this appointment
        Control0..*
        BindingThe codes SHOULD be taken from PracticeSettingCodeValueSet
        (preferred to http://hl7.org/fhir/ValueSet/c80-practice-codes|5.0.0)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Appointment.appointmentType
        Definition

        The style of appointment or patient that has been booked in the slot (not service type).

        ShortThe style of appointment or patient that has been booked in the slot (not service type)
        Control0..1
        BindingThe codes SHOULD be taken from Huli Appointment Type Value Set
        (preferred to https://fhir.huli.ai/r5/ValueSet/huli-appointment-type-vs)
        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Appointment.reason
        Definition

        The reason that this appointment is being scheduled. This is more clinical than administrative. This can be coded, or as specified using information from another resource. When the patient arrives and the encounter begins it may be used as the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.

        ShortReason this appointment is scheduled
        Control0..*
        BindingThe codes SHOULD be taken from EncounterReasonCodes
        (preferred to http://hl7.org/fhir/ValueSet/encounter-reason|5.0.0)

        The Reason for the appointment to take place.

        TypeCodeableReference(Condition, Procedure, Observation, ImmunizationRecommendation)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Appointment.priority
        Definition

        The priority of the appointment. Can be used to make informed decisions if needing to re-prioritize appointments. (The iCal Standard specifies 0 as undefined, 1 as highest, 9 as lowest priority).

        ShortUsed to make informed decisions if needing to re-prioritize
        Comments

        Seeking implementer feedback on this property and how interoperable it is.

        Using an extension to record a CodeableConcept for named values may be tested at a future connectathon.

        Control0..1
        BindingFor example codes, see ActPriority
        (example to http://terminology.hl7.org/ValueSet/v3-ActPriority)

        Indicates the urgency of the appointment.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. Appointment.description
        Definition

        The brief description of the appointment as would be shown on a subject line in a meeting request, or appointment list. Detailed or expanded information should be put in the note field.

        ShortShown on a subject line in a meeting request, or appointment list
        Control0..1
        Typestring
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. Appointment.replaces
        Definition

        Appointment replaced by this Appointment in cases where there is a cancellation, the details of the cancellation can be found in the cancellationReason property (on the referenced resource).

        ShortAppointment replaced by this Appointment
        Control0..*
        TypeReference(Appointment)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. Appointment.virtualService
        Definition

        Connection details of a virtual service (e.g. conference call).

        ShortConnection details of a virtual service (e.g. conference call)
        Comments

        There are two types of virtual meetings that often exist:

        • a persistent, virtual meeting room that can only be used for a single purpose at a time,
        • and a dynamic virtual meeting room that is generated on demand for a specific purpose.

        Implementers may consider using Location.virtualService for persistent meeting rooms.

        If each participant would have a different meeting link, an extension using the VirtualServiceContactDetail can be applied to the Appointment.participant BackboneElement.

        Control0..*
        TypeVirtualServiceDetail
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. Appointment.supportingInformation
        Definition

        Additional information to support the appointment provided when making the appointment.

        ShortAdditional information to support the appointment
        Control0..*
        TypeReference(Resource)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        56. Appointment.previousAppointment
        Definition

        The previous appointment in a series of related appointments.

        ShortThe previous appointment in a series
        Comments

        This property is intended for use when representing a series of related appointments. For example, in a nuclear medicine procedure, where there is an appointment for the injection of the isotopes, and then a subsequent appointment for the scan, the scan appointment would refer to the injection appointment via Appointment.previousAppointment. For representing recurring appointments, see the guidance on recurring vs. series appointments.

        Control0..1
        TypeReference(Appointment)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. Appointment.originatingAppointment
        Definition

        The originating appointment in a recurring set of related appointments.

        ShortThe originating appointment in a recurring set of appointments
        Comments

        This property is intended for use when representing a recurring set of related appointments.

        For example, a patient undergoing physical therapy may have a recurring appointment every Tuesday and Thursday. Each occurrence of the set will refer to the originating appointment, which contains the recurring template information. For representing appointment series, see the guidance on recurring vs. series appointments.

        Control0..1
        This element is affected by the following invariants: app-6
        TypeReference(Appointment)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        60. Appointment.start
        Definition

        Date/Time that the appointment is to take place.

        ShortWhen appointment is to take place
        Comments

        If actual start/end times are not known then the requested period start/end can be used.

        Control0..1
        This element is affected by the following invariants: app-5, app-3, app-2
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Appointment.end
        Definition

        Date/Time that the appointment is to conclude.

        ShortWhen appointment is to conclude
        Comments

        If actual start/end times are not known then the requested period start/end can be used.

        Control0..1
        This element is affected by the following invariants: app-5, app-3, app-2
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        64. Appointment.minutesDuration
        Definition

        Number of minutes that the appointment is to take. This can be less than the duration between the start and end times. For example, where the actual time of appointment is only an estimate or if a 30 minute appointment is being requested, but any time would work. Also, if there is, for example, a planned 15 minute break in the middle of a long appointment, the duration may be 15 minutes less than the difference between the start and end.

        ShortCan be less than start/end (e.g. estimate)
        Control0..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        66. Appointment.requestedPeriod
        Definition

        A set of date ranges (potentially including times) that the appointment is preferred to be scheduled within.

        The duration (usually in minutes) could also be provided to indicate the length of the appointment to fill and populate the start/end times for the actual allocated time. However, in other situations the duration may be calculated by the scheduling system.

        ShortPotential date/time interval(s) requested to allocate the appointment within
        Comments

        This does not introduce a capacity for recurring appointments.

        Control0..*
        TypePeriod
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        68. Appointment.slot
        Definition

        The slots from the participants' schedules that will be filled by the appointment.

        ShortThe slots that this appointment is filling
        Control0..*
        TypeReference(Slot)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        70. Appointment.account
        Definition

        The set of accounts that is expected to be used for billing the activities that result from this Appointment.

        ShortThe set of accounts that may be used for billing for this Appointment
        Comments

        The specified account(s) could be those identified during pre-registration workflows in preparation for an upcoming Encounter.

        Control0..*
        TypeReference(Account)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        72. Appointment.created
        Definition

        The date that this appointment was initially created. This could be different to the meta.lastModified value on the initial entry, as this could have been before the resource was created on the FHIR server, and should remain unchanged over the lifespan of the appointment.

        ShortThe date that this appointment was initially created
        Comments

        This property is required for many use cases where the age of an appointment is considered in processing workflows for scheduling and billing of appointments.

        Control0..1
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        74. Appointment.cancellationDate
        Definition

        The date/time describing when the appointment was cancelled.

        ShortWhen the appointment was cancelled
        Comments

        If the appointment was cancelled multiple times, this would reflect the most recent cancellation.

        Control0..1
        This element is affected by the following invariants: app-7
        TypedateTime
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        76. Appointment.note
        Definition

        Additional notes/comments about the appointment.

        ShortAdditional comments
        Comments

        Additional text to aid in facilitating the appointment. For instance, a note might be, "patient should proceed immediately to infusion room upon arrival"

        Where this is a planned appointment and the start/end dates are not set then this field can be used to provide additional guidance on the details of the appointment request, including any restrictions on when to book it.

        Typically only the concept.text will be used, however occasionally a reference to some generic documentation (or specific) and also supports coded instructions if/when they are required.

        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        78. Appointment.patientInstruction
        Definition

        While Appointment.note contains information for internal use, Appointment.patientInstructions is used to capture patient facing information about the Appointment (e.g. please bring your referral or fast from 8pm night before).

        ShortDetailed information and instructions for the patient
        Control0..*
        TypeCodeableReference(DocumentReference, Binary, Communication)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        80. Appointment.basedOn
        Definition

        The request this appointment is allocated to assess (e.g. incoming referral or procedure request).

        ShortThe request this appointment is allocated to assess
        Control0..*
        TypeReference(CarePlan, DeviceRequest, MedicationRequest, ServiceRequest)
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Alternate NamesincomingReferral
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        82. Appointment.subject
        Definition

        The patient or group associated with the appointment, if they are to be present (usually) then they should also be included in the participant backbone element.

        ShortThe patient or group associated with the appointment
        Control0..1
        TypeReference(Huli Patient)
        Is Modifierfalse
        Must Supporttrue
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        84. Appointment.participant
        Definition

        List of participants involved in the appointment.

        ShortParticipants involved in appointment
        Control1..*
        TypeBackboneElement
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsapp-1: Either the type or actor on the participant SHALL be specified (type.exists() or actor.exists())
        ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        86. Appointment.participant.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        88. Appointment.participant.extension
        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        90. Appointment.participant.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        92. Appointment.participant.type
        Definition

        Role of participant in the appointment.

        ShortRole of participant in the appointment
        Comments

        The role of the participant can be used to declare what the actor will be doing in the scope of this appointment.

        If the actor is not specified, then it is expected that the actor will be filled in at a later stage of planning.

        This value SHALL be the same when creating an AppointmentResponse so that they can be matched, and subsequently update the Appointment.

        Control0..*
        This element is affected by the following invariants: app-1
        BindingUnless not suitable, these codes SHALL be taken from ParticipantType
        (extensible to http://hl7.org/fhir/ValueSet/encounter-participant-type|5.0.0)

        Role of participant in encounter.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        94. Appointment.participant.period
        Definition

        Participation period of the actor.

        ShortParticipation period of the actor
        Control0..1
        TypePeriod
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        96. Appointment.participant.actor
        Definition

        The individual, device, location, or service participating in the appointment.

        ShortThe individual, device, location, or service participating in the appointment
        Comments

        Where a CareTeam is provided, this does not imply that the entire team is included, just a single member from the group with the appropriate role. Where multiple members are required, please include the CareTeam the required number of times.

        Control0..1
        This element is affected by the following invariants: app-1
        TypeReference(Patient, Group, Practitioner, PractitionerRole, CareTeam, RelatedPerson, Device, HealthcareService, Location)
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        98. Appointment.participant.required
        Definition

        Whether this participant is required to be present at the meeting. If false, the participant is optional.

        ShortThe participant is required to attend (optional when false)
        Comments

        For the use-case where two doctors need to meet to discuss the results for a specific patient, and the patient is not required to be present include the patient in the subject field, but do not include them as a participant - this was formerly done prior to R5 with required='information-only'.

        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        100. Appointment.participant.status
        Definition

        Participation status of the actor.

        Shortaccepted | declined | tentative | needs-action
        Control1..1
        BindingThe codes SHALL be taken from ParticipationStatus
        (required to http://hl7.org/fhir/ValueSet/participationstatus|5.0.0)

        The Participation status of an appointment.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        102. Appointment.recurrenceId
        Definition

        The sequence number that identifies a specific appointment in a recurring pattern.

        ShortThe sequence number in the recurrence
        Control0..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        104. Appointment.occurrenceChanged
        Definition

        This appointment varies from the recurring pattern.

        ShortIndicates that this appointment varies from a recurrence pattern
        Comments

        For example, if a patient has physical therapy appointments every Tuesday and Thursday, but due to a national holiday, a single occurrence was rescheduled to a different day, while the rest of the recurring series remained on Tuesday / Thursday.

        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        106. Appointment.recurrenceTemplate
        Definition

        The details of the recurrence pattern or template that is used to generate recurring appointments.

        ShortDetails of the recurrence pattern/template used to generate occurrences
        Control0..*
        This element is affected by the following invariants: app-6
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        108. Appointment.recurrenceTemplate.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        110. Appointment.recurrenceTemplate.extension
        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        112. Appointment.recurrenceTemplate.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        114. Appointment.recurrenceTemplate.timezone
        Definition

        The timezone of the recurring appointment occurrences.

        ShortThe timezone of the occurrences
        Control0..1
        BindingThe codes SHALL be taken from IANATimezones
        (required to http://hl7.org/fhir/ValueSet/timezones|5.0.0)

        IANA Timezones (BCP 175)

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        116. Appointment.recurrenceTemplate.recurrenceType
        Definition

        How often the appointment series should recur.

        ShortThe frequency of the recurrence
        Control1..1
        BindingThe codes SHOULD be taken from AppointmentRecurrenceType
        (preferred to http://hl7.org/fhir/ValueSet/appointment-recurrrence-type|5.0.0)

        IANA Timezones (BCP 175)

        TypeCodeableConcept
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        118. Appointment.recurrenceTemplate.lastOccurrenceDate
        Definition

        Recurring appointments will not occur after this date.

        ShortThe date when the recurrence should end
        Control0..1
        Typedate
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        120. Appointment.recurrenceTemplate.occurrenceCount
        Definition

        How many appointments are planned in the recurrence.

        ShortThe number of planned occurrences
        Control0..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        122. Appointment.recurrenceTemplate.occurrenceDate
        Definition

        The list of specific dates that will have appointments generated.

        ShortSpecific dates for a recurring set of appointments (no template)
        Control0..1
        Typedate
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        124. Appointment.recurrenceTemplate.weeklyTemplate
        Definition

        Information about weekly recurring appointments.

        ShortInformation about weekly recurring appointments
        Control0..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        126. Appointment.recurrenceTemplate.weeklyTemplate.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        128. Appointment.recurrenceTemplate.weeklyTemplate.extension
        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        130. Appointment.recurrenceTemplate.weeklyTemplate.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        132. Appointment.recurrenceTemplate.weeklyTemplate.monday
        Definition

        Indicates that recurring appointments should occur on Mondays.

        ShortRecurs on Mondays
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        134. Appointment.recurrenceTemplate.weeklyTemplate.tuesday
        Definition

        Indicates that recurring appointments should occur on Tuesdays.

        ShortRecurs on Tuesday
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        136. Appointment.recurrenceTemplate.weeklyTemplate.wednesday
        Definition

        Indicates that recurring appointments should occur on Wednesdays.

        ShortRecurs on Wednesday
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        138. Appointment.recurrenceTemplate.weeklyTemplate.thursday
        Definition

        Indicates that recurring appointments should occur on Thursdays.

        ShortRecurs on Thursday
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        140. Appointment.recurrenceTemplate.weeklyTemplate.friday
        Definition

        Indicates that recurring appointments should occur on Fridays.

        ShortRecurs on Friday
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        142. Appointment.recurrenceTemplate.weeklyTemplate.saturday
        Definition

        Indicates that recurring appointments should occur on Saturdays.

        ShortRecurs on Saturday
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        144. Appointment.recurrenceTemplate.weeklyTemplate.sunday
        Definition

        Indicates that recurring appointments should occur on Sundays.

        ShortRecurs on Sunday
        Control0..1
        Typeboolean
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        146. Appointment.recurrenceTemplate.weeklyTemplate.weekInterval
        Definition

        The interval defines if the recurrence is every nth week. The default is every week, so it is expected that this value will be 2 or more.

        e.g. For recurring every second week this interval would be 2, or every third week the interval would be 3.

        ShortRecurs every nth week
        Control0..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        148. Appointment.recurrenceTemplate.monthlyTemplate
        Definition

        Information about monthly recurring appointments.

        ShortInformation about monthly recurring appointments
        Control0..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        150. Appointment.recurrenceTemplate.monthlyTemplate.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        152. Appointment.recurrenceTemplate.monthlyTemplate.extension
        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        154. Appointment.recurrenceTemplate.monthlyTemplate.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        156. Appointment.recurrenceTemplate.monthlyTemplate.dayOfMonth
        Definition

        Indicates that appointments in the series of recurring appointments should occur on a specific day of the month.

        ShortRecurs on a specific day of the month
        Control0..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        158. Appointment.recurrenceTemplate.monthlyTemplate.nthWeekOfMonth
        Definition

        Indicates which week within a month the appointments in the series of recurring appointments should occur on.

        ShortIndicates which week of the month the appointment should occur
        Control0..1
        BindingThe codes SHALL be taken from WeekOfMonth
        (required to http://hl7.org/fhir/ValueSet/week-of-month|5.0.0)

        The set of weeks in a month.

        TypeCoding
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        160. Appointment.recurrenceTemplate.monthlyTemplate.dayOfWeek
        Definition

        Indicates which day of the week the recurring appointments should occur each nth week.

        ShortIndicates which day of the week the appointment should occur
        Comments

        This property is intended to be used with Appointment.recurrenceTemplate.monthly.nthWeek.

        Control0..1
        BindingThe codes SHALL be taken from DaysOfWeek
        (required to http://hl7.org/fhir/ValueSet/days-of-week|5.0.0)

        The days of the week.

        TypeCoding
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        162. Appointment.recurrenceTemplate.monthlyTemplate.monthInterval
        Definition

        Indicates that recurring appointments should occur every nth month.

        ShortRecurs every nth month
        Control1..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        164. Appointment.recurrenceTemplate.yearlyTemplate
        Definition

        Information about yearly recurring appointments.

        ShortInformation about yearly recurring appointments
        Control0..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        166. Appointment.recurrenceTemplate.yearlyTemplate.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        This element is affected by the following invariants: ele-1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        168. Appointment.recurrenceTemplate.yearlyTemplate.extension
        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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        170. Appointment.recurrenceTemplate.yearlyTemplate.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and 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. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        172. Appointment.recurrenceTemplate.yearlyTemplate.yearInterval
        Definition

        Appointment recurs every nth year.

        ShortRecurs every nth year
        Control1..1
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        174. Appointment.recurrenceTemplate.excludingDate
        Definition

        Any dates, such as holidays, that should be excluded from the recurrence.

        ShortAny dates that should be excluded from the series
        Comments

        excludingDate is an alternative to excludingRecurrenceId. You may say either that 12/25/XXXX should be excluded using excludingDate, or you may indicate the recurrenceId of the appointment that would fall on the excluded date in the excludingRecurrenceId property.

        Control0..*
        Typedate
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        176. Appointment.recurrenceTemplate.excludingRecurrenceId
        Definition

        Any dates, such as holidays, that should be excluded from the recurrence.

        ShortAny recurrence IDs that should be excluded from the recurrence
        Comments

        excludingRecurrenceId is an alternative to excludingDate. You may say either that 12/25/XXXX should be excluded using excludingDate, or you may indicate the recurrenceId of the appointment that would fall on the excluded date in the excludingRecurrenceId property.

        Control0..*
        TypepositiveInt
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Must Supportfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))