icd11-cluster-expression
type: StructureDefinition
node role: treeRoot
id:
  v: icd11-cluster-expression
text:
  status:
    v: extensions
  div:
    v: English Generated Narrative: StructureDefinition icd11-cluster-expression Name Flags Card. Type Description & Constraints <a href="StructureDefinition-icd11-cluster-expression-definitions.html#Extension" title="Carries a postcoordinated ICD-11 cluster expression as a single string#xA;on a Coding element where the stem code alone is insufficient to fully#xA;represent the clinical concept.#xA;#xA;A cluster expression combines a stem code with one or more satellite#xA;codes using the & operator (combination) or / operator (specificity).#xA;Example: NC72.Z&XK8G&XJ7ZH&XJ7YM#xA; - NC72.Z — stem: Fracture of femur, unspecified#xA; - XK8G — satellite: laterality#xA; - XJ7ZH — satellite: fracture subtype#xA; - XJ7YM — satellite: fracture open or closed#xA;#xA;Usage rules:#xA; - SHALL only be present when the expression contains at least one#xA; satellite code joined by & or / operators.#xA; - Single stem codes SHALL be represented in Coding.code only and#xA; validated via OCL $validate-code. The cluster validator at#xA; https://icd11.dghs.gov.bd/cluster/validate explicitly rejects#xA; stem-only expressions.#xA; - The stem code in Coding.code SHALL match the leading stem code#xA; in this expression string.#xA; - Satellite codes in the cluster expression are exempt from the#xA; Diagnosis/Finding class restriction that applies to stem codes#xA; in Condition.code.#xA; - Cluster expressions SHALL be validated against the Bangladesh#xA; ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate#xA; prior to submission to the HIE.#xA;#xA;Cluster validator endpoint:#xA; POST https://icd11.dghs.gov.bd/cluster/validate#xA; Body: { "expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM" }#xA;#xA;This extension is not MustSupport and is not mandatory. It is present#xA;only when postcoordination is clinically required. Cluster expressions#xA;are typically sourced from the WHO Electronic Coding Tool (ECT) at the#xA;point of care.">Extension 0..* Extension ICD-11 Cluster Expression #xD; extens…
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
    l: structuredefinition-fmm
  value: Integer
    v: 1
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: https://fhir.dghs.gov.bd/core/ImplementationGuide/bd.fhir.core
        l: bd.fhir.core
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
    l: structuredefinition-standards-status
  value: Code
    v: informative
    extension:
      url:
        v: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
        l: structuredefinition-conformance-derivedFrom
      value: Canonical
        v: https://fhir.dghs.gov.bd/core/ImplementationGuide/bd.fhir.core
        l: bd.fhir.core
url:
  v: https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression
  l: icd11-cluster-expression
version:
  v: 0.4.3
name:
  v: ICD11ClusterExpression
title:
  v: ICD-11 Cluster Expression
status:
  v: active
experimental:
  v: false
date:
  v: 2026-04-10T17:10:06+00:00
publisher:
  v: Directorate General of Health Services (DGHS), Bangladesh
contact:
  telecom:
    system:
      v: url
    value:
      v: http://dghs.gov.bd
description:
  v: Carries a postcoordinated ICD-11 cluster expression as a single string on a Coding element where the stem code alone is insufficient to fully represent the clinical concept. A cluster expression combines a stem code with one or more satellite codes using the & operator (combination) or / operator (specificity). Example: NC72.Z&XK8G&XJ7ZH&XJ7YM - NC72.Z — stem: Fracture of femur, unspecified - XK8G — satellite: laterality - XJ7ZH — satellite: fracture subtype - XJ7YM — satellite: fracture open or closed Usage rules: - SHALL only be present when the expression contains at least one satellite code joined by & or / operators. - Single stem codes SHALL be represented in Coding.code only and validated via OCL $validate-code. The cluster validator at https://icd11.dghs.gov.bd/cluster/validate explicitly rejects stem-only expressions. - The stem code in Coding.code SHALL match the leading stem code in this expression string. - Satellite codes in the cluster expression are exempt from the Diagnosis/Finding class restriction that applies to stem codes in Condition.code. - Cluster expressions SHALL be validated against the Bangladesh ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate prior to submission to the HIE. Cluster validator endpoint: POST https://icd11.dghs.gov.bd/cluster/validate Body: { "expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM" } This extension is not MustSupport and is not mandatory. It is present only when postcoordination is clinically required. Cluster expressions are typically sourced from the WHO Electronic Coding Tool (ECT) at the point of care.
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
      l: 3166
    code:
      v: 050
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
    l: v3
  name:
    v: RIM Mapping
kind:
  v: complex-type
abstract:
  v: false
context:
  type:
    v: element
  expression:
    v: Coding
type:
  v: Extension
  l: Extension
base definition:
  v: http://hl7.org/fhir/StructureDefinition/Extension
  l: Extension
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: Extension
    path:
      v: Extension
    short:
      v: ICD-11 Cluster Expression
    definition:
      v: Carries a postcoordinated ICD-11 cluster expression as a single string on a Coding element where the stem code alone is insufficient to fully represent the clinical concept. A cluster expression combines a stem code with one or more satellite codes using the & operator (combination) or / operator (specificity). Example: NC72.Z&XK8G&XJ7ZH&XJ7YM - NC72.Z — stem: Fracture of femur, unspecified - XK8G — satellite: laterality - XJ7ZH — satellite: fracture subtype - XJ7YM — satellite: fracture open or closed Usage rules: - SHALL only be present when the expression contains at least one satellite code joined by & or / operators. - Single stem codes SHALL be represented in Coding.code only and validated via OCL $validate-code. The cluster validator at https://icd11.dghs.gov.bd/cluster/validate explicitly rejects stem-only expressions. - The stem code in Coding.code SHALL match the leading stem code in this expression string. - Satellite codes in the cluster expression are exempt from the Diagnosis/Finding class restriction that applies to stem codes in Condition.code. - Cluster expressions SHALL be validated against the Bangladesh ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate prior to submission to the HIE. Cluster validator endpoint: POST https://icd11.dghs.gov.bd/cluster/validate Body: { "expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM" } This extension is not MustSupport and is not mandatory. It is present only when postcoordination is clinically required. Cluster expressions are typically sourced from the WHO Electronic Coding Tool (ECT) at the point of care.
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: Extension
      min:
        v: 0
      max:
        v: *
    condition:
      v: ele-1
    constraint:
      key:
        v: ele-1
      severity:
        v: error
      human:
        v: All FHIR elements must have a @value or children
      expression:
        v: hasValue() or (children().count() > id.count())
      xpath:
        v: @value|f:*|h:div
      source:
        v: http://hl7.org/fhir/StructureDefinition/Element
        l: Element
    constraint:
      key:
        v: ext-1
      severity:
        v: error
      human:
        v: Must have either extensions or value[x], not both
      expression:
        v: extension.exists() != value.exists()
      xpath:
        v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
      source:
        v: http://hl7.org/fhir/StructureDefinition/Extension
        l: Extension
    is modifier:
      v: false
  element:
    id:
      v: Extension.id
    path:
      v: Extension.id
    representation:
      v: xmlAttr
    short:
      v: Unique id for inter-element referencing
    definition:
      v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
    min:
      v: 0
    max:
      v: 1
    base:
      path:
        v: Element.id
      min:
        v: 0
      max:
        v: 1
    type:
      extension:
        value: Url
      code:
        v: http://hl7.org/fhirpath/System.String
        l: System.String
    is modifier:
      v: false
    is summary:
      v: false
    mapping:
      identity:
        v: rim
      map:
        v: n/a
  element:
    id:
      v: Extension.extension
    path:
      v: Extension.extension
    slicing:
      description:
        v: Extensions are always sliced by (at least) url
      rules:
        v: open
    short:
      v: Extension

Url
v: string
l: string

v: value

v: url

v: An Extension

v: 0

v: 0

path:
  v: Element.extension
min:
  v: 0
max:
  v: *

code:
  v: Extension
  l: Extension

key:
  v: ele-1
severity:
  v: error
human:
  v: All FHIR elements must have a @value or children
expression:
  v: hasValue() or (children().count() > id.count())
xpath:
  v: @value|f:*|h:div
source:
  v: http://hl7.org/fhir/StructureDefinition/Element
  l: Element

key:
  v: ext-1
severity:
  v: error
human:
  v: Must have either extensions or value[x], not both
expression:
  v: extension.exists() != value.exists()
xpath:
  v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
source:
  v: http://hl7.org/fhir/StructureDefinition/Extension
  l: Extension

v: false

v: false

id:
  v: Extension.url
path:
  v: Extension.url
representation:
  v: xmlAttr
short:
  v: identifies the meaning of the extension
definition:
  v: Source of the definition for the extension code - a logical name or a URL.
comment:
  v: The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.url
  min:
    v: 1
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: uri
      l: uri
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
fixed: Uri
  v: https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression
  l: icd11-cluster-expression
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: Extension.value[x]
path:
  v: Extension.value[x]
short:
  v: ICD-11 postcoordinated cluster expression string
definition:
  v: The full postcoordinated cluster expression, including the stem code and all satellite codes joined by & or / operators. Example: NC72.Z&XK8G&XJ7ZH&XJ7YM. The stem code in this string SHALL match Coding.code on the parent Coding element.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: Extension.value[x]
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

element:
  id:
    v: Extension
  path:
    v: Extension
  short:
    v: ICD-11 Cluster Expression
  definition:
    v: Carries a postcoordinated ICD-11 cluster expression as a single string on a Coding element where the stem code alone is insufficient to fully represent the clinical concept. A cluster expression combines a stem code with one or more satellite codes using the & operator (combination) or / operator (specificity). Example: NC72.Z&XK8G&XJ7ZH&XJ7YM - NC72.Z — stem: Fracture of femur, unspecified - XK8G — satellite: laterality - XJ7ZH — satellite: fracture subtype - XJ7YM — satellite: fracture open or closed Usage rules: - SHALL only be present when the expression contains at least one satellite code joined by & or / operators. - Single stem codes SHALL be represented in Coding.code only and validated via OCL $validate-code. The cluster validator at https://icd11.dghs.gov.bd/cluster/validate explicitly rejects stem-only expressions. - The stem code in Coding.code SHALL match the leading stem code in this expression string. - Satellite codes in the cluster expression are exempt from the Diagnosis/Finding class restriction that applies to stem codes in Condition.code. - Cluster expressions SHALL be validated against the Bangladesh ICD-11 Cluster Validator at https://icd11.dghs.gov.bd/cluster/validate prior to submission to the HIE. Cluster validator endpoint: POST https://icd11.dghs.gov.bd/cluster/validate Body: { "expression": "NC72.Z&XK8G&XJ7ZH&XJ7YM" } This extension is not MustSupport and is not mandatory. It is present only when postcoordination is clinically required. Cluster expressions are typically sourced from the WHO Electronic Coding Tool (ECT) at the point of care.
element:
  id:
    v: Extension.extension
  path:
    v: Extension.extension
  max:
    v: 0
element:
  id:
    v: Extension.url
  path:
    v: Extension.url
  fixed: Uri
    v: https://fhir.dghs.gov.bd/core/StructureDefinition/icd11-cluster-expression
    l: icd11-cluster-expression
element:
  id:
    v: Extension.value[x]
  path:
    v: Extension.value[x]
  short:
    v: ICD-11 postcoordinated cluster expression string
  definition:
    v: The full postcoordinated cluster expression, including the stem code and all satellite codes joined by & or / operators. Example: NC72.Z&XK8G&XJ7ZH&XJ7YM. The stem code in this string SHALL match Coding.code on the parent Coding element.
  min:
    v: 1
  type:
    code:
      v: string
      l: string