Resolve validation errors to ValueSet with UCUM (#1948)

* Add tests for validation errors * Work on validation errors * Bump core version * Fix validation errors * Test fixes * Add changelog * Test fix * Test fix * Test fix
2020-07-05 19:59:21 -04:00 · 2020-07-05 19:59:21 -04:00 · 6fb6675b1e
parent 9e19b87e67
commit 6fb6675b1e
27 changed files with 3878 additions and 205 deletions
--- a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/5_1_0/1948-correct-validation-with-ucum-vss.yaml
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/5_1_0/1948-correct-validation-with-ucum-vss.yaml
@ -0,0 +1,5 @@
+---
+type: fix
+issue: 1948
+title: "When validating resources containing codes in a ValueSet that included UCUM codes, the validator would
+  incorrectly report that the code was valid even if it was not in the ValueSet. This has been corrected."
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/BaseTermReadSvcImpl.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/BaseTermReadSvcImpl.java
@ -89,7 +89,6 @@ import com.github.benmanes.caffeine.cache.Cache;
 import com.github.benmanes.caffeine.cache.Caffeine;
 import com.google.common.annotations.VisibleForTesting;
 import com.google.common.base.Stopwatch;
-import net.bytebuddy.implementation.bytecode.Throw;
 import org.apache.commons.lang3.StringUtils;
 import org.apache.commons.lang3.Validate;
 import org.apache.commons.lang3.time.DateUtils;
@ -625,7 +624,138 @@ public abstract class BaseTermReadSvcImpl implements ITermReadSvc {
 			TermCodeSystem cs = myCodeSystemDao.findByCodeSystemUri(system);
 			if (cs != null) {

-				TermCodeSystemVersion csv = cs.getCurrentVersion();
+				return expandValueSetHandleIncludeOrExcludeUsingDatabase(theValueSetCodeAccumulator, theAddedCodes, theIncludeOrExclude, theAdd, theCodeCounter, theQueryIndex, theWantConceptOrNull, system, cs);
+
+			} else {
+
+				if (theIncludeOrExclude.getConcept().size() > 0 && theWantConceptOrNull != null) {
+					if (defaultString(theIncludeOrExclude.getSystem()).equals(theWantConceptOrNull.getSystem())) {
+						if (theIncludeOrExclude.getConcept().stream().noneMatch(t -> t.getCode().equals(theWantConceptOrNull.getCode()))) {
+							return false;
+						}
+					}
+				}
+
+				// No CodeSystem matching the URL found in the database.
+				CodeSystem codeSystemFromContext = fetchCanonicalCodeSystemFromCompleteContext(system);
+				if (codeSystemFromContext == null) {
+
+					// This is a last ditch effort.. We don't have a CodeSystem resource for the desired CS, and we don't have
+					// anything at all in the database that matches it. So let's try asking the validation support context
+					// just in case there is a registered service that knows how to handle this. This can happen, for example,
+					// if someone creates a valueset that includes UCUM codes, since we don't have a CodeSystem resource for those
+					// but CommonCodeSystemsTerminologyService can validate individual codes.
+					List<VersionIndependentConcept> includedConcepts = null;
+					if (theWantConceptOrNull != null) {
+						includedConcepts = new ArrayList<>();
+						includedConcepts.add(theWantConceptOrNull);
+					} else if (!theIncludeOrExclude.getConcept().isEmpty()) {
+						includedConcepts = theIncludeOrExclude
+							.getConcept()
+							.stream()
+							.map(t->new VersionIndependentConcept(theIncludeOrExclude.getSystem(), t.getCode()))
+							.collect(Collectors.toList());
+					}
+
+					if (includedConcepts != null) {
+						int foundCount = 0;
+						for (VersionIndependentConcept next : includedConcepts) {
+							LookupCodeResult lookup = myValidationSupport.lookupCode(new ValidationSupportContext(myValidationSupport), next.getSystem(), next.getCode());
+							if (lookup != null && lookup.isFound()) {
+								addOrRemoveCode(theValueSetCodeAccumulator, theAddedCodes, theAdd, next.getSystem(), next.getCode(), lookup.getCodeDisplay());
+								foundCount++;
+							}
+						}
+
+						if (foundCount == includedConcepts.size()) {
+							return false;
+							// ELSE, we'll continue below and throw an exception
+						}
+					}
+
+					String msg = myContext.getLocalizer().getMessage(BaseTermReadSvcImpl.class, "expansionRefersToUnknownCs", system);
+					if (provideExpansionOptions(theExpansionOptions).isFailOnMissingCodeSystem()) {
+						throw new PreconditionFailedException(msg);
+					} else {
+						ourLog.warn(msg);
+						theValueSetCodeAccumulator.addMessage(msg);
+						return false;
+					}
+
+				}
+
+				if (!theIncludeOrExclude.getConcept().isEmpty()) {
+					for (ValueSet.ConceptReferenceComponent next : theIncludeOrExclude.getConcept()) {
+						String nextCode = next.getCode();
+						if (theWantConceptOrNull == null || theWantConceptOrNull.getCode().equals(nextCode)) {
+							if (isNoneBlank(system, nextCode) && !theAddedCodes.contains(system + "|" + nextCode)) {
+
+								CodeSystem.ConceptDefinitionComponent code = findCode(codeSystemFromContext.getConcept(), nextCode);
+								if (code != null) {
+									String display = code.getDisplay();
+									addOrRemoveCode(theValueSetCodeAccumulator, theAddedCodes, theAdd, system, nextCode, display);
+								}
+
+							}
+						}
+					}
+				} else {
+					List<CodeSystem.ConceptDefinitionComponent> concept = codeSystemFromContext.getConcept();
+					addConceptsToList(theValueSetCodeAccumulator, theAddedCodes, system, concept, theAdd, theWantConceptOrNull);
+				}
+
+				return false;
+			}
+
+		} else if (hasValueSet) {
+
+			for (CanonicalType nextValueSet : theIncludeOrExclude.getValueSet()) {
+				ourLog.debug("Starting {} expansion around ValueSet: {}", (theAdd ? "inclusion" : "exclusion"), nextValueSet.getValueAsString());
+
+				List<VersionIndependentConcept> expanded = expandValueSet(theExpansionOptions, nextValueSet.getValueAsString());
+				Map<String, TermCodeSystem> uriToCodeSystem = new HashMap<>();
+
+				for (VersionIndependentConcept nextConcept : expanded) {
+					if (theAdd) {
+
+						if (!uriToCodeSystem.containsKey(nextConcept.getSystem())) {
+							TermCodeSystem codeSystem = myCodeSystemDao.findByCodeSystemUri(nextConcept.getSystem());
+							uriToCodeSystem.put(nextConcept.getSystem(), codeSystem);
+						}
+
+						TermCodeSystem codeSystem = uriToCodeSystem.get(nextConcept.getSystem());
+						if (codeSystem != null) {
+							myConceptDao
+								.findByCodeSystemAndCode(codeSystem.getCurrentVersion(), nextConcept.getCode())
+								.ifPresent(concept ->
+									addCodeIfNotAlreadyAdded(theValueSetCodeAccumulator, theAddedCodes, concept, theAdd, theCodeCounter)
+								);
+						} else {
+							// This will happen if we're expanding against a built-in (part of FHIR) ValueSet that
+							// isn't actually in the database anywhere
+							Collection<TermConceptDesignation> emptyCollection = Collections.emptyList();
+							addCodeIfNotAlreadyAdded(theValueSetCodeAccumulator, theAddedCodes, emptyCollection, theAdd, theCodeCounter, nextConcept.getSystem(), nextConcept.getCode(), nextConcept.getDisplay());
+						}
+					}
+					if (isNoneBlank(nextConcept.getSystem(), nextConcept.getCode()) && !theAdd && theAddedCodes.remove(nextConcept.getSystem() + "|" + nextConcept.getCode())) {
+						theValueSetCodeAccumulator.excludeConcept(nextConcept.getSystem(), nextConcept.getCode());
+					}
+				}
+
+			}
+
+			return false;
+
+		} else {
+			throw new InvalidRequestException("ValueSet contains " + (theAdd ? "include" : "exclude") + " criteria with no system defined");
+		}
+
+
+	}
+
+	@Nonnull
+	private Boolean expandValueSetHandleIncludeOrExcludeUsingDatabase(IValueSetConceptAccumulator theValueSetCodeAccumulator, Set<String> theAddedCodes, ValueSet.ConceptSetComponent theIncludeOrExclude, boolean theAdd, AtomicInteger theCodeCounter, int theQueryIndex, VersionIndependentConcept theWantConceptOrNull, String theSystem, TermCodeSystem theCs) {
+		TermCodeSystemVersion csv = theCs.getCurrentVersion();
 		FullTextEntityManager em = org.hibernate.search.jpa.Search.getFullTextEntityManager(myEntityManager);

 		/*
@ -633,7 +763,7 @@ public abstract class BaseTermReadSvcImpl implements ITermReadSvc {
 		 * since we're going to do it without the database.
 		 */
 		if (myFulltextSearchSvc == null) {
-					expandWithoutHibernateSearch(theValueSetCodeAccumulator, csv, theAddedCodes, theIncludeOrExclude, system, theAdd, theCodeCounter);
+			expandWithoutHibernateSearch(theValueSetCodeAccumulator, csv, theAddedCodes, theIncludeOrExclude, theSystem, theAdd, theCodeCounter);
 			return false;
 		}

@ -652,7 +782,7 @@ public abstract class BaseTermReadSvcImpl implements ITermReadSvc {
 		/*
 		 * Filters
 		 */
-				handleFilters(bool, system, qb, theIncludeOrExclude);
+		handleFilters(bool, theSystem, qb, theIncludeOrExclude);

 		Query luceneQuery = bool.createQuery();

@ -741,88 +871,6 @@ public abstract class BaseTermReadSvcImpl implements ITermReadSvc {
 		} else {
 			return true;
 		}
-
-			} else {
-				// No CodeSystem matching the URL found in the database.
-
-				CodeSystem codeSystemFromContext = fetchCanonicalCodeSystemFromCompleteContext(system);
-				if (codeSystemFromContext == null) {
-					String msg = myContext.getLocalizer().getMessage(BaseTermReadSvcImpl.class, "expansionRefersToUnknownCs", system);
-					if (provideExpansionOptions(theExpansionOptions).isFailOnMissingCodeSystem()) {
-						throw new PreconditionFailedException(msg);
-					} else {
-						ourLog.warn(msg);
-						theValueSetCodeAccumulator.addMessage(msg);
-						return false;
-					}
-				}
-
-				if (!theIncludeOrExclude.getConcept().isEmpty()) {
-					for (ValueSet.ConceptReferenceComponent next : theIncludeOrExclude.getConcept()) {
-						String nextCode = next.getCode();
-						if (theWantConceptOrNull == null || theWantConceptOrNull.getCode().equals(nextCode)) {
-							if (isNoneBlank(system, nextCode) && !theAddedCodes.contains(system + "|" + nextCode)) {
-
-								CodeSystem.ConceptDefinitionComponent code = findCode(codeSystemFromContext.getConcept(), nextCode);
-								if (code != null) {
-									String display = code.getDisplay();
-									addOrRemoveCode(theValueSetCodeAccumulator, theAddedCodes, theAdd, system, nextCode, display);
-								}
-
-							}
-						}
-					}
-				} else {
-					List<CodeSystem.ConceptDefinitionComponent> concept = codeSystemFromContext.getConcept();
-					addConceptsToList(theValueSetCodeAccumulator, theAddedCodes, system, concept, theAdd, theWantConceptOrNull);
-				}
-
-				return false;
-			}
-		} else if (hasValueSet) {
-
-			for (CanonicalType nextValueSet : theIncludeOrExclude.getValueSet()) {
-				ourLog.debug("Starting {} expansion around ValueSet: {}", (theAdd ? "inclusion" : "exclusion"), nextValueSet.getValueAsString());
-
-				List<VersionIndependentConcept> expanded = expandValueSet(theExpansionOptions, nextValueSet.getValueAsString());
-				Map<String, TermCodeSystem> uriToCodeSystem = new HashMap<>();
-
-				for (VersionIndependentConcept nextConcept : expanded) {
-					if (theAdd) {
-
-						if (!uriToCodeSystem.containsKey(nextConcept.getSystem())) {
-							TermCodeSystem codeSystem = myCodeSystemDao.findByCodeSystemUri(nextConcept.getSystem());
-							uriToCodeSystem.put(nextConcept.getSystem(), codeSystem);
-						}
-
-						TermCodeSystem codeSystem = uriToCodeSystem.get(nextConcept.getSystem());
-						if (codeSystem != null) {
-							myConceptDao
-								.findByCodeSystemAndCode(codeSystem.getCurrentVersion(), nextConcept.getCode())
-								.ifPresent(concept ->
-									addCodeIfNotAlreadyAdded(theValueSetCodeAccumulator, theAddedCodes, concept, theAdd, theCodeCounter)
-								);
-						} else {
-							// This will happen if we're expanding against a built-in (part of FHIR) ValueSet that
-							// isn't actually in the database anywhere
-							Collection<TermConceptDesignation> emptyCollection = Collections.emptyList();
-							addCodeIfNotAlreadyAdded(theValueSetCodeAccumulator, theAddedCodes, emptyCollection, theAdd, theCodeCounter, nextConcept.getSystem(), nextConcept.getCode(), nextConcept.getDisplay());
-						}
-					}
-					if (isNoneBlank(nextConcept.getSystem(), nextConcept.getCode()) && !theAdd && theAddedCodes.remove(nextConcept.getSystem() + "|" + nextConcept.getCode())) {
-						theValueSetCodeAccumulator.excludeConcept(nextConcept.getSystem(), nextConcept.getCode());
-					}
-				}
-
-			}
-
-			return false;
-
-		} else {
-			throw new InvalidRequestException("ValueSet contains " + (theAdd ? "include" : "exclude") + " criteria with no system defined");
-		}
-
-
 	}

 	private @Nonnull
@ -1939,12 +1987,7 @@ public abstract class BaseTermReadSvcImpl implements ITermReadSvc {
 	@Override
 	@Transactional
 	public CodeValidationResult validateCodeInValueSet(ValidationSupportContext theValidationSupportContext, ConceptValidationOptions theOptions, String theCodeSystem, String theCode, String theDisplay, @Nonnull IBaseResource theValueSet) {
-
-		if (myInvokeOnNextCallForUnitTest != null) {
-			Runnable invokeOnNextCallForUnitTest = myInvokeOnNextCallForUnitTest;
-			myInvokeOnNextCallForUnitTest = null;
-			invokeOnNextCallForUnitTest.run();
-		}
+		invokeRunnableForUnitTest();

 		IPrimitiveType<?> urlPrimitive = myContext.newTerser().getSingleValueOrNull(theValueSet, "url", IPrimitiveType.class);
 		String url = urlPrimitive.getValueAsString();
@ -2115,6 +2158,17 @@ public abstract class BaseTermReadSvcImpl implements ITermReadSvc {
 		}
 	}

+	/**
+	 * This is only used for unit tests to test failure conditions
+	 */
+	static void invokeRunnableForUnitTest() {
+		if (myInvokeOnNextCallForUnitTest != null) {
+			Runnable invokeOnNextCallForUnitTest = myInvokeOnNextCallForUnitTest;
+			myInvokeOnNextCallForUnitTest = null;
+			invokeOnNextCallForUnitTest.run();
+		}
+	}
+
 	@VisibleForTesting
 	public static void setInvokeOnNextCallForUnitTest(Runnable theInvokeOnNextCallForUnitTest) {
 		myInvokeOnNextCallForUnitTest = theInvokeOnNextCallForUnitTest;
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/TermReadSvcR4.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/TermReadSvcR4.java
@ -101,6 +101,8 @@ public class TermReadSvcR4 extends BaseTermReadSvcImpl implements ITermReadSvcR4
 	@CoverageIgnore
 	@Override
 	public IValidationSupport.CodeValidationResult validateCode(ValidationSupportContext theValidationSupportContext, ConceptValidationOptions theOptions, String theCodeSystem, String theCode, String theDisplay, String theValueSetUrl) {
+		invokeRunnableForUnitTest();
+
 		Optional<VersionIndependentConcept> codeOpt = Optional.empty();
 		boolean haveValidated = false;

--- a/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4QueryCountTest.java
+++ b/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4QueryCountTest.java
@ -145,7 +145,8 @@ public class FhirResourceDaoR4QueryCountTest extends BaseJpaR4Test {
 		// Validate once
 		myCaptureQueriesListener.clear();
 		myObservationDao.validate(obs, null, null, null, null, null, null);
-		assertEquals(9, myCaptureQueriesListener.getSelectQueriesForCurrentThread().size());
+		myCaptureQueriesListener.logSelectQueriesForCurrentThread();
+		assertEquals(10, myCaptureQueriesListener.getSelectQueriesForCurrentThread().size());
 		assertEquals(0, myCaptureQueriesListener.getUpdateQueriesForCurrentThread().size());
 		assertEquals(0, myCaptureQueriesListener.getInsertQueriesForCurrentThread().size());
 		assertEquals(0, myCaptureQueriesListener.getDeleteQueriesForCurrentThread().size());
--- a/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4ValidateTest.java
+++ b/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4ValidateTest.java
@ -5,6 +5,8 @@ import ca.uhn.fhir.jpa.api.config.DaoConfig;
 import ca.uhn.fhir.jpa.api.dao.DaoRegistry;
 import ca.uhn.fhir.jpa.api.dao.IFhirResourceDao;
 import ca.uhn.fhir.jpa.entity.TermCodeSystemVersion;
+import ca.uhn.fhir.jpa.entity.TermValueSet;
+import ca.uhn.fhir.jpa.entity.TermValueSetPreExpansionStatusEnum;
 import ca.uhn.fhir.jpa.model.entity.ResourceTable;
 import ca.uhn.fhir.jpa.term.BaseTermReadSvcImpl;
 import ca.uhn.fhir.jpa.term.api.ITermCodeSystemStorageSvc;
@ -12,6 +14,8 @@ import ca.uhn.fhir.jpa.term.api.ITermReadSvc;
 import ca.uhn.fhir.jpa.term.custom.CustomTerminologySet;
 import ca.uhn.fhir.jpa.validation.JpaValidationSupportChain;
 import ca.uhn.fhir.jpa.validation.ValidationSettings;
+import ca.uhn.fhir.parser.LenientErrorHandler;
+import ca.uhn.fhir.parser.StrictErrorHandler;
 import ca.uhn.fhir.rest.api.EncodingEnum;
 import ca.uhn.fhir.rest.api.MethodOutcome;
 import ca.uhn.fhir.rest.api.ValidationModeEnum;
@ -91,6 +95,122 @@ public class FhirResourceDaoR4ValidateTest extends BaseJpaR4Test {
 	@Autowired
 	private ValidationSettings myValidationSettings;

+	/**
+	 * Use a valueset that explicitly brings in some UCUM codes
+	 */
+	@Test
+	public void testValidateCodeInValueSetWithBuiltInCodeSystem() throws IOException {
+		myValueSetDao.create(loadResourceFromClasspath(ValueSet.class, "/r4/bl/bb-vs.json"));
+		myStructureDefinitionDao.create(loadResourceFromClasspath(StructureDefinition.class, "/r4/bl/bb-sd.json"));
+
+		runInTransaction(() -> {
+			TermValueSet vs = myTermValueSetDao.findByUrl("https://bb/ValueSet/BBDemographicAgeUnit").orElseThrow(() -> new IllegalArgumentException());
+			assertEquals(TermValueSetPreExpansionStatusEnum.NOT_EXPANDED, vs.getExpansionStatus());
+		});
+
+		OperationOutcome outcome;
+
+		// Use a code that's in the ValueSet
+		{
+			outcome = (OperationOutcome) myObservationDao.validate(loadResourceFromClasspath(Observation.class, "/r4/bl/bb-obs-code-in-valueset.json"), null, null, null, null, null, mySrd).getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			assertThat(outcomeStr, not(containsString("\"error\"")));
+		}
+
+		// Use a code that's not in the ValueSet
+		try {
+			outcome = (OperationOutcome) myObservationDao.validate(loadResourceFromClasspath(Observation.class, "/r4/bl/bb-obs-code-not-in-valueset.json"), null, null, null, null, null, mySrd).getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			fail();
+		} catch (PreconditionFailedException e) {
+			outcome = (OperationOutcome) e.getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			assertThat(outcomeStr, containsString("Could not confirm that the codes provided are in the value set https://bb/ValueSet/BBDemographicAgeUnit, and a code from this value set is required"));
+		}
+
+		// Before, the VS wasn't pre-expanded. Try again with it pre-expanded
+		runInTransaction(() -> {
+			TermValueSet vs = myTermValueSetDao.findByUrl("https://bb/ValueSet/BBDemographicAgeUnit").orElseThrow(() -> new IllegalArgumentException());
+			assertEquals(TermValueSetPreExpansionStatusEnum.NOT_EXPANDED, vs.getExpansionStatus());
+		});
+
+		myTermReadSvc.preExpandDeferredValueSetsToTerminologyTables();
+
+		runInTransaction(() -> {
+			TermValueSet vs = myTermValueSetDao.findByUrl("https://bb/ValueSet/BBDemographicAgeUnit").orElseThrow(() -> new IllegalArgumentException());
+			assertEquals(TermValueSetPreExpansionStatusEnum.EXPANDED, vs.getExpansionStatus());
+		});
+
+		// Use a code that's in the ValueSet
+		{
+			outcome = (OperationOutcome) myObservationDao.validate(loadResourceFromClasspath(Observation.class, "/r4/bl/bb-obs-code-in-valueset.json"), null, null, null, null, null, mySrd).getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			assertThat(outcomeStr, not(containsString("\"error\"")));
+		}
+
+		// Use a code that's not in the ValueSet
+		try {
+			outcome = (OperationOutcome) myObservationDao.validate(loadResourceFromClasspath(Observation.class, "/r4/bl/bb-obs-code-not-in-valueset.json"), null, null, null, null, null, mySrd).getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			fail();
+		} catch (PreconditionFailedException e) {
+			outcome = (OperationOutcome) e.getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			assertThat(outcomeStr, containsString("Could not confirm that the codes provided are in the value set https://bb/ValueSet/BBDemographicAgeUnit, and a code from this value set is required"));
+		}
+
+	}
+
+
+	@Test
+	public void testValidateCodeUsingQuantityBinding() throws IOException {
+		myValueSetDao.create(loadResourceFromClasspath(ValueSet.class, "/r4/bl/bb-vs.json"));
+		myStructureDefinitionDao.create(loadResourceFromClasspath(StructureDefinition.class, "/r4/bl/bb-sd.json"));
+
+		runInTransaction(() -> {
+			TermValueSet vs = myTermValueSetDao.findByUrl("https://bb/ValueSet/BBDemographicAgeUnit").orElseThrow(() -> new IllegalArgumentException());
+			assertEquals(TermValueSetPreExpansionStatusEnum.NOT_EXPANDED, vs.getExpansionStatus());
+		});
+
+		OperationOutcome outcome;
+
+		// Use the wrong datatype
+		try {
+			myFhirCtx.setParserErrorHandler(new LenientErrorHandler());
+			Observation resource = loadResourceFromClasspath(Observation.class, "/r4/bl/bb-obs-value-is-not-quantity2.json");
+			outcome = (OperationOutcome) myObservationDao.validate(resource, null, null, null, null, null, mySrd).getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			fail();
+		} catch (PreconditionFailedException e) {
+			outcome = (OperationOutcome) e.getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			assertThat(outcomeStr, containsString("\"error\""));
+		}
+
+		// Use the wrong datatype
+		try {
+			myFhirCtx.setParserErrorHandler(new LenientErrorHandler());
+			Observation resource = loadResourceFromClasspath(Observation.class, "/r4/bl/bb-obs-value-is-not-quantity.json");
+			outcome = (OperationOutcome) myObservationDao.validate(resource, null, null, null, null, null, mySrd).getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			fail();
+		} catch (PreconditionFailedException e) {
+			outcome = (OperationOutcome) e.getOperationOutcome();
+			String outcomeStr = myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome);
+			ourLog.info("Validation outcome: {}", outcomeStr);
+			assertThat(outcomeStr, containsString("The Profile \\\"https://bb/StructureDefinition/BBDemographicAge\\\" definition allows for the type Quantity but found type string"));
+		}
+	}
+
 	/**
 	 * Create a loinc valueset that expands to more results than the expander is willing to do
 	 * in memory, and make sure we can still validate correctly, even if we're using
@ -413,10 +533,16 @@ public class FhirResourceDaoR4ValidateTest extends BaseJpaR4Test {
 		obs.getCode().getCodingFirstRep().setSystem("http://example.com/codesystem");
 		obs.getCode().getCodingFirstRep().setCode("foo-foo");
 		obs.getCode().getCodingFirstRep().setDisplay("Some Code");
+		try {
 			outcome = (OperationOutcome) myObservationDao.validate(obs, null, null, null, ValidationModeEnum.CREATE, "http://example.com/structuredefinition", mySrd).getOperationOutcome();
 			ourLog.info("Outcome: {}", myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(outcome));
-		assertEquals("Unknown code in fragment CodeSystem 'http://example.com/codesystem#foo-foo'", outcome.getIssueFirstRep().getDiagnostics());
-		assertEquals(OperationOutcome.IssueSeverity.WARNING, outcome.getIssueFirstRep().getSeverity());
+			fail();
+		} catch (PreconditionFailedException e) {
+			OperationOutcome oo = (OperationOutcome) e.getOperationOutcome();
+			ourLog.info(myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(oo));
+			assertEquals("None of the codes provided are in the value set http://example.com/valueset (http://example.com/valueset), and a code from this value set is required) (codes = http://example.com/codesystem#foo-foo)", oo.getIssueFirstRep().getDiagnostics());
+			assertEquals(OperationOutcome.IssueSeverity.ERROR, oo.getIssueFirstRep().getSeverity());
+		}

 		// Correct codesystem, Code in codesystem
 		obs.getCode().getCodingFirstRep().setSystem("http://example.com/codesystem");
@ -610,6 +736,12 @@ public class FhirResourceDaoR4ValidateTest extends BaseJpaR4Test {
 	 */
 	@Test
 	public void testValidate_TermSvcHasNpe() {
+
+		CodeSystem cs = new CodeSystem();
+		cs.setUrl("http://FOO");
+		cs.setContent(CodeSystem.CodeSystemContentMode.NOTPRESENT);
+		myCodeSystemDao.create(cs);
+
 		BaseTermReadSvcImpl.setInvokeOnNextCallForUnitTest(() -> {
 			throw new NullPointerException("MY ERROR");
 		});
@ -623,18 +755,15 @@ public class FhirResourceDaoR4ValidateTest extends BaseJpaR4Test {
 		obs.setStatus(ObservationStatus.FINAL);
 		obs.setValue(new StringType("This is the value"));

-		OperationOutcome oo;

 		// Valid code
 		obs.getText().setStatus(Narrative.NarrativeStatus.GENERATED);
-		obs.getCode().getCodingFirstRep().setSystem("http://loinc.org").setCode("CODE99999").setDisplay("Display 3");
-		try {
-			validateAndReturnOutcome(obs);
-			fail();
-		} catch (NullPointerException e) {
-			assertEquals("MY ERROR", e.getMessage());
-		}
+		obs.getCode().getCodingFirstRep().setSystem("http://FOO").setCode("CODE99999").setDisplay("Display 3");

+		OperationOutcome oo = validateAndReturnOutcome(obs);
+		ourLog.info(myFhirCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(oo));
+		assertEquals("Error MY ERROR validating Coding: java.lang.NullPointerException: MY ERROR", oo.getIssueFirstRep().getDiagnostics());
+		assertEquals(OperationOutcome.IssueSeverity.ERROR, oo.getIssueFirstRep().getSeverity());
 	}

 	@Test
@ -943,6 +1072,7 @@ public class FhirResourceDaoR4ValidateTest extends BaseJpaR4Test {
 		BaseTermReadSvcImpl.setInvokeOnNextCallForUnitTest(null);

 		myValidationSettings.setLocalReferenceValidationDefaultPolicy(IResourceValidator.ReferenceValidationPolicy.IGNORE);
+		myFhirCtx.setParserErrorHandler(new StrictErrorHandler());
 	}

 	@Test
--- a/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/packages/NpmTestR4.java
+++ b/hapi-fhir-jpaserver-base/src/test/java/ca/uhn/fhir/jpa/packages/NpmTestR4.java
@ -198,6 +198,25 @@ public class NpmTestR4 extends BaseJpaR4Test {
 	}


+	@Test
+	public void testInstallR4PackageWithNoDescription() throws Exception {
+		myDaoConfig.setAllowExternalReferences(true);
+
+		byte[] bytes = loadClasspathBytes("/packages/UK.Core.r4-1.1.0.tgz");
+		myFakeNpmServlet.myResponses.put("/UK.Core.r4/1.1.0", bytes);
+
+		PackageInstallationSpec spec = new PackageInstallationSpec().setName("UK.Core.r4").setVersion("1.1.0").setInstallMode(PackageInstallationSpec.InstallModeEnum.STORE_AND_INSTALL);
+		igInstaller.install(spec);
+
+		// Be sure no further communication with the server
+		JettyUtil.closeServer(myServer);
+
+		// Make sure we can fetch the package by ID and Version
+		NpmPackage pkg = myPackageCacheManager.loadPackage("UK.Core.r4", "1.1.0");
+		assertEquals(null, pkg.description());
+		assertEquals("UK.Core.r4", pkg.name());
+	}
+
 	@Test
 	public void testLoadPackageMetadata() throws Exception {
 		myDaoConfig.setAllowExternalReferences(true);
--- a/hapi-fhir-jpaserver-base/src/test/resources/packages/UK.Core.r4-1.1.0.tgz
+++ b/hapi-fhir-jpaserver-base/src/test/resources/packages/UK.Core.r4-1.1.0.tgz
--- a/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-obs-code-in-valueset.json
+++ b/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-obs-code-in-valueset.json
@ -0,0 +1,22 @@
+{
+  "code": {
+    "coding": [
+      {
+        "code": "L7b8daLEuY",
+        "system": "https://bbl.health"
+      }
+    ]
+  },
+  "meta": {
+    "profile": [
+      "https://bb/StructureDefinition/BBDemographicAge"
+    ]
+  },
+  "resourceType": "Observation",
+  "status": "final",
+	"valueQuantity" : {
+		"system" : "http://unitsofmeasure.org",
+		"code" : "mo",
+		"value" : 8
+	}
+}
--- a/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-obs-code-not-in-valueset.json
+++ b/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-obs-code-not-in-valueset.json
@ -0,0 +1,22 @@
+{
+  "code": {
+    "coding": [
+      {
+        "code": "L7b8daLEuY",
+        "system": "https://bbl.health"
+      }
+    ]
+  },
+  "meta": {
+    "profile": [
+      "https://bb/StructureDefinition/BBDemographicAge"
+    ]
+  },
+  "resourceType": "Observation",
+  "status": "final",
+	"valueQuantity" : {
+		"system" : "http://unitsofmeasure.org",
+		"code" : "cm",
+		"value" : 8
+	}
+}
--- a/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-obs-value-is-not-quantity.json
+++ b/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-obs-value-is-not-quantity.json
@ -0,0 +1,18 @@
+{
+  "meta": {
+    "profile": [
+      "https://bb/StructureDefinition/BBDemographicAge"
+    ]
+  },
+  "code": {
+    "coding": [
+      {
+        "code": "L7b8daLEuY",
+        "system": "https://bbl.health"
+      }
+    ]
+  },
+  "resourceType": "Observation",
+  "status": "final",
+	"valueString" : "test"
+}
--- a/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-obs-value-is-not-quantity2.json
+++ b/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-obs-value-is-not-quantity2.json
@ -0,0 +1,18 @@
+{
+  "meta": {
+    "profile": [
+      "https://bb/StructureDefinition/BBDemographicAge"
+    ]
+  },
+  "code": {
+    "coding": [
+      {
+        "code": "L7b8daLEuY",
+        "system": "https://bbl.health"
+      }
+    ]
+  },
+  "resourceType": "Observation",
+  "status": "final",
+	"valueDecimal" : 1.23
+}
--- a/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-sd.json
+++ b/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-sd.json
--- a/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-vs.json
+++ b/hapi-fhir-jpaserver-base/src/test/resources/r4/bl/bb-vs.json
@ -0,0 +1,42 @@
+{
+  "resourceType": "ValueSet",
+  "id": "BBDemographicAgeUnit",
+  "text": {
+    "status": "generated",
+    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"></div>"
+  },
+  "url": "https://bb/ValueSet/BBDemographicAgeUnit",
+  "name": "BBDemographicAgeUnit",
+  "title": "Babylon Demographic Age Unit",
+  "status": "draft",
+  "version": "20190731",
+  "experimental": false,
+  "description": "Age Unit",
+  "publisher": "Babylon Partners, Ltd.",
+  "immutable": false,
+  "compose": {
+    "include": [
+      {
+        "system": "http://unitsofmeasure.org",
+        "concept": [
+          {
+            "code": "a",
+            "display": "years"
+          },
+          {
+            "code": "mo",
+            "display": "months"
+          },
+          {
+            "code": "wk",
+            "display": "weeks"
+          },
+          {
+            "code": "d",
+            "display": "days"
+          }
+        ]
+      }
+    ]
+  }
+}
--- a/hapi-fhir-jpaserver-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/HapiFhirJpaMigrationTasks.java
+++ b/hapi-fhir-jpaserver-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/HapiFhirJpaMigrationTasks.java
@ -38,6 +38,7 @@ import ca.uhn.fhir.jpa.model.entity.ResourceIndexedSearchParamUri;
 import ca.uhn.fhir.jpa.model.entity.SearchParamPresent;
 import ca.uhn.fhir.util.VersionEnum;

+import javax.persistence.Column;
 import java.util.Arrays;
 import java.util.List;
 import java.util.Optional;
@ -121,6 +122,9 @@ public class HapiFhirJpaMigrationTasks extends BaseMigrationTasks<VersionEnum> {
 		pkgVerRes.addForeignKey("20200610.12", "FK_NPM_PKVR_RESID").toColumn("BINARY_RES_ID").references("HFJ_RESOURCE", "RES_ID");
 		pkgVerRes.addIndex("20200610.13", "IDX_PACKVERRES_URL").unique(false).withColumns("CANONICAL_URL");

+		pkgVerRes.modifyColumn("20200629.1", "PKG_DESC").nullable().withType(ColumnTypeEnum.STRING, 200);
+		pkgVerRes.modifyColumn("20200629.2", "DESC_UPPER").nullable().withType(ColumnTypeEnum.STRING, 200);
+
 	}

 	private void init501() { //20200514 - present
--- a/hapi-fhir-jpaserver-model/src/main/java/ca/uhn/fhir/jpa/model/entity/NpmPackageVersionEntity.java
+++ b/hapi-fhir-jpaserver-model/src/main/java/ca/uhn/fhir/jpa/model/entity/NpmPackageVersionEntity.java
@ -74,9 +74,9 @@ public class NpmPackageVersionEntity {
 	@Temporal(TemporalType.TIMESTAMP)
 	@Column(name = "SAVED_TIME", nullable = false)
 	private Date mySavedTime;
-	@Column(name = "PKG_DESC", nullable = false, length = 200)
+	@Column(name = "PKG_DESC", nullable = true, length = 200)
 	private String myDescription;
-	@Column(name = "DESC_UPPER", nullable = false, length = 200)
+	@Column(name = "DESC_UPPER", nullable = true, length = 200)
 	private String myDescriptionUpper;
 	@Column(name = "CURRENT_VERSION", nullable = false)
 	private boolean myCurrentVersion;
--- a/hapi-fhir-structures-r5/src/main/java/org/hl7/fhir/r5/hapi/ctx/HapiWorkerContext.java
+++ b/hapi-fhir-structures-r5/src/main/java/org/hl7/fhir/r5/hapi/ctx/HapiWorkerContext.java
@ -415,6 +415,16 @@ public final class HapiWorkerContext extends I18nBase implements IWorkerContext
 		throw new UnsupportedOperationException();
 	}

+	@Override
+	public int getClientRetryCount() {
+		throw new UnsupportedOperationException();
+	}
+
+	@Override
+	public IWorkerContext setClientRetryCount(int value) {
+		throw new UnsupportedOperationException();
+	}
+
 	public static ConceptValidationOptions convertConceptValidationOptions(ValidationOptions theOptions) {
 		ConceptValidationOptions retVal = new ConceptValidationOptions();
 		if (theOptions.isGuessSystem()) {
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/CommonCodeSystemsTerminologyService.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/CommonCodeSystemsTerminologyService.java
@ -23,6 +23,7 @@ import java.util.Map;

 import static org.apache.commons.lang3.StringUtils.defaultString;
 import static org.apache.commons.lang3.StringUtils.isBlank;
+import static org.apache.commons.lang3.StringUtils.isNotBlank;

 /**
 * This {@link IValidationSupport validation support module} can be used to validate codes against common
@ -36,8 +37,10 @@ import static org.apache.commons.lang3.StringUtils.isBlank;
 public class CommonCodeSystemsTerminologyService implements IValidationSupport {
 	public static final String LANGUAGES_VALUESET_URL = "http://hl7.org/fhir/ValueSet/languages";
 	public static final String MIMETYPES_VALUESET_URL = "http://hl7.org/fhir/ValueSet/mimetypes";
+	public static final String MIMETYPES_CODESYSTEM_URL = "urn:ietf:bcp:13";
 	public static final String CURRENCIES_CODESYSTEM_URL = "urn:iso:std:iso:4217";
 	public static final String CURRENCIES_VALUESET_URL = "http://hl7.org/fhir/ValueSet/currencies";
+	public static final String COUNTRIES_CODESYSTEM_URL = "urn:iso:std:iso:3166";
 	public static final String UCUM_CODESYSTEM_URL = "http://unitsofmeasure.org";
 	public static final String UCUM_VALUESET_URL = "http://hl7.org/fhir/ValueSet/ucum-units";
 	private static final String USPS_CODESYSTEM_URL = "https://www.usps.com/";
@ -45,6 +48,7 @@ public class CommonCodeSystemsTerminologyService implements IValidationSupport {
 	private static final Logger ourLog = LoggerFactory.getLogger(CommonCodeSystemsTerminologyService.class);
 	private static Map<String, String> USPS_CODES = Collections.unmodifiableMap(buildUspsCodes());
 	private static Map<String, String> ISO_4217_CODES = Collections.unmodifiableMap(buildIso4217Codes());
+	private static Map<String, String> ISO_3166_CODES = Collections.unmodifiableMap(buildIso3166Codes());
 	private final FhirContext myFhirContext;

 	/**
@ -144,7 +148,8 @@ public class CommonCodeSystemsTerminologyService implements IValidationSupport {
 	@Override
 	public LookupCodeResult lookupCode(ValidationSupportContext theValidationSupportContext, String theSystem, String theCode) {

-		if (UCUM_CODESYSTEM_URL.equals(theSystem) && theValidationSupportContext.getRootValidationSupport().getFhirContext().getVersion().getVersion().isEqualOrNewerThan(FhirVersionEnum.DSTU3)) {
+		switch (theSystem) {
+			case UCUM_CODESYSTEM_URL:

 				InputStream input = ClasspathUtil.loadResourceAsStream("/ucum-essence.xml");
 				try {
@ -166,27 +171,81 @@ public class CommonCodeSystemsTerminologyService implements IValidationSupport {
 				} finally {
 					ClasspathUtil.close(input);
 				}
+				break;
+
+			case COUNTRIES_CODESYSTEM_URL:
+
+				String display = ISO_3166_CODES.get(theCode);
+				if (isNotBlank(display)) {
+					LookupCodeResult retVal = new LookupCodeResult();
+					retVal.setSearchedForCode(theCode);
+					retVal.setSearchedForSystem(theSystem);
+					retVal.setFound(true);
+					retVal.setCodeDisplay(display);
+					return retVal;
+				}
+				break;
+
+			case MIMETYPES_CODESYSTEM_URL:
+
+				// This is a pretty naive implementation - Should be enhanced in future
+				LookupCodeResult retVal = new LookupCodeResult();
+				retVal.setSearchedForCode(theCode);
+				retVal.setSearchedForSystem(theSystem);
+				retVal.setFound(true);
+				return retVal;
+
+			default:
+
+				return null;

 		}

-		return null;
+		// If we get here it means we know the codesystem but the code was bad
+		LookupCodeResult retVal = new LookupCodeResult();
+		retVal.setSearchedForCode(theCode);
+		retVal.setSearchedForSystem(theSystem);
+		retVal.setFound(false);
+		return retVal;
+
 	}

 	@Override
 	public boolean isCodeSystemSupported(ValidationSupportContext theValidationSupportContext, String theSystem) {

 		switch (theSystem) {
+			case COUNTRIES_CODESYSTEM_URL:
 			case UCUM_CODESYSTEM_URL:
+			case MIMETYPES_CODESYSTEM_URL:
 				return true;
 		}

 		return false;
 	}

+	@Override
+	public boolean isValueSetSupported(ValidationSupportContext theValidationSupportContext, String theValueSetUrl) {

-	public String getValueSetUrl(@Nonnull IBaseResource theValueSet) {
+		switch (theValueSetUrl) {
+			case CURRENCIES_VALUESET_URL:
+			case LANGUAGES_VALUESET_URL:
+			case MIMETYPES_VALUESET_URL:
+			case UCUM_VALUESET_URL:
+			case USPS_VALUESET_URL:
+				return true;
+		}
+
+		return false;
+	}
+
+	@Override
+	public FhirContext getFhirContext() {
+		return myFhirContext;
+	}
+
+	public static String getValueSetUrl(@Nonnull IBaseResource theValueSet) {
 		String url;
-		switch (getFhirContext().getVersion().getVersion()) {
+		switch (theValueSet.getStructureFhirVersionEnum()) {
 			case DSTU2: {
 				url = ((ca.uhn.fhir.model.dstu2.resource.ValueSet) theValueSet).getUrl();
 				break;
@ -209,16 +268,11 @@ public class CommonCodeSystemsTerminologyService implements IValidationSupport {
 			}
 			case DSTU2_1:
 			default:
-				throw new IllegalArgumentException("Can not handle version: " + getFhirContext().getVersion().getVersion());
+				throw new IllegalArgumentException("Can not handle version: " + theValueSet.getStructureFhirVersionEnum());
 		}
 		return url;
 	}

-	@Override
-	public FhirContext getFhirContext() {
-		return myFhirContext;
-	}
-
 	private static HashMap<String, String> buildUspsCodes() {
 		HashMap<String, String> uspsCodes = new HashMap<>();
 		uspsCodes.put("AK", "Alaska");
@ -471,4 +525,259 @@ public class CommonCodeSystemsTerminologyService implements IValidationSupport {
 		return iso4217Codes;
 	}

+
+	private static HashMap<String, String> buildIso3166Codes() {
+		HashMap<String, String> codes = new HashMap<>();
+		codes.put("AF", "Afghanistan");
+		codes.put("AX", "Åland Islands");
+		codes.put("AL", "Albania");
+		codes.put("DZ", "Algeria");
+		codes.put("AS", "American Samoa");
+		codes.put("AD", "Andorra");
+		codes.put("AO", "Angola");
+		codes.put("AI", "Anguilla");
+		codes.put("AQ", "Antarctica");
+		codes.put("AG", "Antigua & Barbuda");
+		codes.put("AR", "Argentina");
+		codes.put("AM", "Armenia");
+		codes.put("AW", "Aruba");
+		codes.put("AU", "Australia");
+		codes.put("AT", "Austria");
+		codes.put("AZ", "Azerbaijan");
+		codes.put("BS", "Bahamas");
+		codes.put("BH", "Bahrain");
+		codes.put("BD", "Bangladesh");
+		codes.put("BB", "Barbados");
+		codes.put("BY", "Belarus");
+		codes.put("BE", "Belgium");
+		codes.put("BZ", "Belize");
+		codes.put("BJ", "Benin");
+		codes.put("BM", "Bermuda");
+		codes.put("BT", "Bhutan");
+		codes.put("BO", "Bolivia");
+		codes.put("BA", "Bosnia & Herzegovina");
+		codes.put("BW", "Botswana");
+		codes.put("BV", "Bouvet Island");
+		codes.put("BR", "Brazil");
+		codes.put("IO", "British Indian Ocean Territory");
+		codes.put("VG", "British Virgin Islands");
+		codes.put("BN", "Brunei");
+		codes.put("BG", "Bulgaria");
+		codes.put("BF", "Burkina Faso");
+		codes.put("BI", "Burundi");
+		codes.put("KH", "Cambodia");
+		codes.put("CM", "Cameroon");
+		codes.put("CA", "Canada");
+		codes.put("CV", "Cape Verde");
+		codes.put("BQ", "Caribbean Netherlands");
+		codes.put("KY", "Cayman Islands");
+		codes.put("CF", "Central African Republic");
+		codes.put("TD", "Chad");
+		codes.put("CL", "Chile");
+		codes.put("CN", "China");
+		codes.put("CX", "Christmas Island");
+		codes.put("CC", "Cocos (Keeling) Islands");
+		codes.put("CO", "Colombia");
+		codes.put("KM", "Comoros");
+		codes.put("CG", "Congo - Brazzaville");
+		codes.put("CD", "Congo - Kinshasa");
+		codes.put("CK", "Cook Islands");
+		codes.put("CR", "Costa Rica");
+		codes.put("CI", "Côte d’Ivoire");
+		codes.put("HR", "Croatia");
+		codes.put("CU", "Cuba");
+		codes.put("CW", "Curaçao");
+		codes.put("CY", "Cyprus");
+		codes.put("CZ", "Czechia");
+		codes.put("DK", "Denmark");
+		codes.put("DJ", "Djibouti");
+		codes.put("DM", "Dominica");
+		codes.put("DO", "Dominican Republic");
+		codes.put("EC", "Ecuador");
+		codes.put("EG", "Egypt");
+		codes.put("SV", "El Salvador");
+		codes.put("GQ", "Equatorial Guinea");
+		codes.put("ER", "Eritrea");
+		codes.put("EE", "Estonia");
+		codes.put("SZ", "Eswatini");
+		codes.put("ET", "Ethiopia");
+		codes.put("FK", "Falkland Islands");
+		codes.put("FO", "Faroe Islands");
+		codes.put("FJ", "Fiji");
+		codes.put("FI", "Finland");
+		codes.put("FR", "France");
+		codes.put("GF", "French Guiana");
+		codes.put("PF", "French Polynesia");
+		codes.put("TF", "French Southern Territories");
+		codes.put("GA", "Gabon");
+		codes.put("GM", "Gambia");
+		codes.put("GE", "Georgia");
+		codes.put("DE", "Germany");
+		codes.put("GH", "Ghana");
+		codes.put("GI", "Gibraltar");
+		codes.put("GR", "Greece");
+		codes.put("GL", "Greenland");
+		codes.put("GD", "Grenada");
+		codes.put("GP", "Guadeloupe");
+		codes.put("GU", "Guam");
+		codes.put("GT", "Guatemala");
+		codes.put("GG", "Guernsey");
+		codes.put("GN", "Guinea");
+		codes.put("GW", "Guinea-Bissau");
+		codes.put("GY", "Guyana");
+		codes.put("HT", "Haiti");
+		codes.put("HM", "Heard & McDonald Islands");
+		codes.put("HN", "Honduras");
+		codes.put("HK", "Hong Kong SAR China");
+		codes.put("HU", "Hungary");
+		codes.put("IS", "Iceland");
+		codes.put("IN", "India");
+		codes.put("ID", "Indonesia");
+		codes.put("IR", "Iran");
+		codes.put("IQ", "Iraq");
+		codes.put("IE", "Ireland");
+		codes.put("IM", "Isle of Man");
+		codes.put("IL", "Israel");
+		codes.put("IT", "Italy");
+		codes.put("JM", "Jamaica");
+		codes.put("JP", "Japan");
+		codes.put("JE", "Jersey");
+		codes.put("JO", "Jordan");
+		codes.put("KZ", "Kazakhstan");
+		codes.put("KE", "Kenya");
+		codes.put("KI", "Kiribati");
+		codes.put("KW", "Kuwait");
+		codes.put("KG", "Kyrgyzstan");
+		codes.put("LA", "Laos");
+		codes.put("LV", "Latvia");
+		codes.put("LB", "Lebanon");
+		codes.put("LS", "Lesotho");
+		codes.put("LR", "Liberia");
+		codes.put("LY", "Libya");
+		codes.put("LI", "Liechtenstein");
+		codes.put("LT", "Lithuania");
+		codes.put("LU", "Luxembourg");
+		codes.put("MO", "Macao SAR China");
+		codes.put("MG", "Madagascar");
+		codes.put("MW", "Malawi");
+		codes.put("MY", "Malaysia");
+		codes.put("MV", "Maldives");
+		codes.put("ML", "Mali");
+		codes.put("MT", "Malta");
+		codes.put("MH", "Marshall Islands");
+		codes.put("MQ", "Martinique");
+		codes.put("MR", "Mauritania");
+		codes.put("MU", "Mauritius");
+		codes.put("YT", "Mayotte");
+		codes.put("MX", "Mexico");
+		codes.put("FM", "Micronesia");
+		codes.put("MD", "Moldova");
+		codes.put("MC", "Monaco");
+		codes.put("MN", "Mongolia");
+		codes.put("ME", "Montenegro");
+		codes.put("MS", "Montserrat");
+		codes.put("MA", "Morocco");
+		codes.put("MZ", "Mozambique");
+		codes.put("MM", "Myanmar (Burma)");
+		codes.put("NA", "Namibia");
+		codes.put("NR", "Nauru");
+		codes.put("NP", "Nepal");
+		codes.put("NL", "Netherlands");
+		codes.put("NC", "New Caledonia");
+		codes.put("NZ", "New Zealand");
+		codes.put("NI", "Nicaragua");
+		codes.put("NE", "Niger");
+		codes.put("NG", "Nigeria");
+		codes.put("NU", "Niue");
+		codes.put("NF", "Norfolk Island");
+		codes.put("KP", "North Korea");
+		codes.put("MK", "North Macedonia");
+		codes.put("MP", "Northern Mariana Islands");
+		codes.put("NO", "Norway");
+		codes.put("OM", "Oman");
+		codes.put("PK", "Pakistan");
+		codes.put("PW", "Palau");
+		codes.put("PS", "Palestinian Territories");
+		codes.put("PA", "Panama");
+		codes.put("PG", "Papua New Guinea");
+		codes.put("PY", "Paraguay");
+		codes.put("PE", "Peru");
+		codes.put("PH", "Philippines");
+		codes.put("PN", "Pitcairn Islands");
+		codes.put("PL", "Poland");
+		codes.put("PT", "Portugal");
+		codes.put("PR", "Puerto Rico");
+		codes.put("QA", "Qatar");
+		codes.put("RE", "Réunion");
+		codes.put("RO", "Romania");
+		codes.put("RU", "Russia");
+		codes.put("RW", "Rwanda");
+		codes.put("WS", "Samoa");
+		codes.put("SM", "San Marino");
+		codes.put("ST", "São Tomé & Príncipe");
+		codes.put("SA", "Saudi Arabia");
+		codes.put("SN", "Senegal");
+		codes.put("RS", "Serbia");
+		codes.put("SC", "Seychelles");
+		codes.put("SL", "Sierra Leone");
+		codes.put("SG", "Singapore");
+		codes.put("SX", "Sint Maarten");
+		codes.put("SK", "Slovakia");
+		codes.put("SI", "Slovenia");
+		codes.put("SB", "Solomon Islands");
+		codes.put("SO", "Somalia");
+		codes.put("ZA", "South Africa");
+		codes.put("GS", "South Georgia & South Sandwich Islands");
+		codes.put("KR", "South Korea");
+		codes.put("SS", "South Sudan");
+		codes.put("ES", "Spain");
+		codes.put("LK", "Sri Lanka");
+		codes.put("BL", "St. Barthélemy");
+		codes.put("SH", "St. Helena");
+		codes.put("KN", "St. Kitts & Nevis");
+		codes.put("LC", "St. Lucia");
+		codes.put("MF", "St. Martin");
+		codes.put("PM", "St. Pierre & Miquelon");
+		codes.put("VC", "St. Vincent & Grenadines");
+		codes.put("SD", "Sudan");
+		codes.put("SR", "Suriname");
+		codes.put("SJ", "Svalbard & Jan Mayen");
+		codes.put("SE", "Sweden");
+		codes.put("CH", "Switzerland");
+		codes.put("SY", "Syria");
+		codes.put("TW", "Taiwan");
+		codes.put("TJ", "Tajikistan");
+		codes.put("TZ", "Tanzania");
+		codes.put("TH", "Thailand");
+		codes.put("TL", "Timor-Leste");
+		codes.put("TG", "Togo");
+		codes.put("TK", "Tokelau");
+		codes.put("TO", "Tonga");
+		codes.put("TT", "Trinidad & Tobago");
+		codes.put("TN", "Tunisia");
+		codes.put("TR", "Turkey");
+		codes.put("TM", "Turkmenistan");
+		codes.put("TC", "Turks & Caicos Islands");
+		codes.put("TV", "Tuvalu");
+		codes.put("UM", "U.S. Outlying Islands");
+		codes.put("VI", "U.S. Virgin Islands");
+		codes.put("UG", "Uganda");
+		codes.put("UA", "Ukraine");
+		codes.put("AE", "United Arab Emirates");
+		codes.put("GB", "United Kingdom");
+		codes.put("US", "United States");
+		codes.put("UY", "Uruguay");
+		codes.put("UZ", "Uzbekistan");
+		codes.put("VU", "Vanuatu");
+		codes.put("VA", "Vatican City");
+		codes.put("VE", "Venezuela");
+		codes.put("VN", "Vietnam");
+		codes.put("WF", "Wallis & Futuna");
+		codes.put("EH", "Western Sahara");
+		codes.put("YE", "Yemen");
+		codes.put("ZM", "Zambia");
+		codes.put("ZW", "Zimbabwe");
+		return codes;
+	}
+
 }
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/InMemoryTerminologyServerValidationSupport.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/InMemoryTerminologyServerValidationSupport.java
@ -119,7 +119,8 @@ public class InMemoryTerminologyServerValidationSupport implements IValidationSu
 	}

 	@Override
-	public CodeValidationResult validateCodeInValueSet(ValidationSupportContext theValidationSupportContext, ConceptValidationOptions theOptions, String theCodeSystem, String theCode, String theDisplay, @Nonnull IBaseResource theValueSet) {
+	public CodeValidationResult
+	validateCodeInValueSet(ValidationSupportContext theValidationSupportContext, ConceptValidationOptions theOptions, String theCodeSystem, String theCode, String theDisplay, @Nonnull IBaseResource theValueSet) {
 	org.hl7.fhir.r5.model.ValueSet expansion = expandValueSetToCanonical(theValidationSupportContext, theValueSet, theCodeSystem, theCode);
 		if (expansion == null) {
 			return null;
@ -439,9 +440,10 @@ public class InMemoryTerminologyServerValidationSupport implements IValidationSu
 				}

 				boolean ableToHandleCode = false;
-				if (codeSystem == null) {
+				if (codeSystem == null || codeSystem.getContent() == CodeSystem.CodeSystemContentMode.NOTPRESENT) {

 					if (theWantCode != null) {
+						if (theValidationSupportContext.getRootValidationSupport().isCodeSystemSupported(theValidationSupportContext, system)) {
 							LookupCodeResult lookup = theValidationSupportContext.getRootValidationSupport().lookupCode(theValidationSupportContext, system, theWantCode);
 							if (lookup != null && lookup.isFound()) {
 								CodeSystem.ConceptDefinitionComponent conceptDefinition = new CodeSystem.ConceptDefinitionComponent()
@ -453,25 +455,18 @@ public class InMemoryTerminologyServerValidationSupport implements IValidationSu
 								ableToHandleCode = true;
 							}
 						}
+					}

 				} else {
-
 					ableToHandleCode = true;
-
 				}

 				if (!ableToHandleCode) {
 					throw new ExpansionCouldNotBeCompletedInternallyException();
 				}

-				if (codeSystem != null) {
-
-					if (codeSystem.getContent() == CodeSystem.CodeSystemContentMode.NOTPRESENT) {
-						throw new ExpansionCouldNotBeCompletedInternallyException();
-					}
-
+				if (codeSystem != null && codeSystem.getContent() != CodeSystem.CodeSystemContentMode.NOTPRESENT) {
 					addCodes(system, codeSystem.getConcept(), nextCodeList, wantCodes);
-
 				}

 			}
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/ValidationSupportChain.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/ValidationSupportChain.java
@ -231,6 +231,7 @@ public class ValidationSupportChain implements IValidationSupport {
 	@Override
 	public CodeValidationResult validateCode(ValidationSupportContext theValidationSupportContext, ConceptValidationOptions theOptions, String theCodeSystem, String theCode, String theDisplay, String theValueSetUrl) {
 		for (IValidationSupport next : myChain) {
+			if (isBlank(theValueSetUrl) || next.isValueSetSupported(theValidationSupportContext, theValueSetUrl)) {
 				if (theOptions.isInferSystem() || (theCodeSystem != null && next.isCodeSystemSupported(theValidationSupportContext, theCodeSystem))) {
 					CodeValidationResult retVal = next.validateCode(theValidationSupportContext, theOptions, theCodeSystem, theCode, theDisplay, theValueSetUrl);
 					if (retVal != null) {
@ -238,13 +239,15 @@ public class ValidationSupportChain implements IValidationSupport {
 					}
 				}
 			}
+		}
 		return null;
 	}

 	@Override
 	public CodeValidationResult validateCodeInValueSet(ValidationSupportContext theValidationSupportContext, ConceptValidationOptions theOptions, String theCodeSystem, String theCode, String theDisplay, @Nonnull IBaseResource theValueSet) {
 		for (IValidationSupport next : myChain) {
-			if (theOptions.isInferSystem() || (theCodeSystem != null && next.isCodeSystemSupported(theValidationSupportContext, theCodeSystem))) {
+			String url = CommonCodeSystemsTerminologyService.getValueSetUrl(theValueSet);
+			if (isBlank(url) || next.isValueSetSupported(theValidationSupportContext, url)) {
 				CodeValidationResult retVal = next.validateCodeInValueSet(theValidationSupportContext, theOptions, theCodeSystem, theCode, theDisplay, theValueSet);
 				if (retVal != null) {
 					return retVal;
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapper.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapper.java
@ -131,6 +131,16 @@ public class VersionSpecificWorkerContextWrapper extends I18nBase implements IWo
 		return false;
 	}

+	@Override
+	public int getClientRetryCount() {
+		throw new UnsupportedOperationException();
+	}
+
+	@Override
+	public IWorkerContext setClientRetryCount(int value) {
+		throw new UnsupportedOperationException();
+	}
+
 	@Override
 	public void generateSnapshot(StructureDefinition input) throws FHIRException {
 		if (input.hasSnapshot()) {
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/FhirInstanceValidatorDstu3Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/FhirInstanceValidatorDstu3Test.java
@ -167,6 +167,18 @@ public class FhirInstanceValidatorDstu3Test {
 				return retVal;
 			}
 		});
+//		when(mockSupport.isValueSetSupported(any(), nullable(String.class))).thenAnswer(new Answer<Boolean>() {
+//			@Override
+//			public Boolean answer(InvocationOnMock theInvocation) {
+//				String url = (String) theInvocation.getArguments()[1];
+//				boolean retVal = myValueSets.containsKey(url);
+//				return retVal;
+//			}
+//		});
+		when(mockSupport.fetchValueSet(any())).thenAnswer(t->{
+			String url = t.getArgument(0, String.class);
+			return myValueSets.get(url);
+		});
 		when(mockSupport.fetchResource(nullable(Class.class), nullable(String.class))).thenAnswer(new Answer<IBaseResource>() {
 			@Override
 			public IBaseResource answer(InvocationOnMock theInvocation) throws Throwable {
@ -212,7 +224,7 @@ public class FhirInstanceValidatorDstu3Test {
 				if (myValidConcepts.contains(system + "___" + code)) {
 					retVal = new IValidationSupport.CodeValidationResult().setCode(code);
 				} else if (myValidSystems.contains(system)) {
-					return new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.WARNING.toCode()).setMessage("Unknown code: " + system + " / " + code);
+					return new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage("Unknown code");
 				} else if (myCodeSystems.containsKey(system)) {
 					CodeSystem cs = myCodeSystems.get(system);
 					Optional<ConceptDefinitionComponent> found = cs.getConcept().stream().filter(t -> t.getCode().equals(code)).findFirst();
@ -1035,8 +1047,8 @@ public class FhirInstanceValidatorDstu3Test {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnAll(output);

-		assertThat(errors.toString(), containsString("warning"));
-		assertThat(errors.toString(), containsString("Unknown code: http://loinc.org / 12345"));
+		assertEquals(ResultSeverityEnum.ERROR, errors.get(0).getSeverity());
+		assertEquals("Unknown code for \"http://loinc.org#12345\"", errors.get(0).getMessage());
 	}

 	@Test
@ -1058,7 +1070,6 @@ public class FhirInstanceValidatorDstu3Test {
 		assertThat(errors.toString(), containsString("Element 'Observation.subject': minimum required = 1, but only found 0"));
 		assertThat(errors.toString(), containsString("Element 'Observation.context': max allowed = 0, but found 1"));
 		assertThat(errors.toString(), containsString("Element 'Observation.device': minimum required = 1, but only found 0"));
-		assertThat(errors.toString(), containsString(""));
 	}

 	@Test
@ -1150,7 +1161,7 @@ public class FhirInstanceValidatorDstu3Test {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnAll(output);
 		assertThat(errors.toString(), errors.size(), greaterThan(0));
-		assertEquals("Unknown code: http://acme.org / 9988877", errors.get(0).getMessage());
+		assertEquals("Unknown code for \"http://acme.org#9988877\"", errors.get(0).getMessage());

 	}

@ -1186,7 +1197,7 @@ public class FhirInstanceValidatorDstu3Test {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnNonInformationalOnes(output);
 		assertEquals(1, errors.size());
-		assertEquals("Unknown code: http://loinc.org / 1234", errors.get(0).getMessage());
+		assertEquals("Unknown code for \"http://loinc.org#1234\"", errors.get(0).getMessage());
 	}

 	@Test
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/QuestionnaireResponseValidatorDstu3Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/QuestionnaireResponseValidatorDstu3Test.java
@ -1038,6 +1038,8 @@ public class QuestionnaireResponseValidatorDstu3Test {
 		options.getCompose().addInclude().setSystem("http://codesystems.com/system2").addConcept().setCode("code2");
 		when(myValSupport.fetchResource(eq(ValueSet.class), eq("http://somevalueset"))).thenReturn(options);

+		when(myValSupport.isValueSetSupported(any(), eq("http://somevalueset"))).thenReturn(true);
+
 		when(myValSupport.validateCodeInValueSet(any(), any(), eq("http://codesystems.com/system"), eq("code0"), any(), any(IBaseResource.class))).thenReturn(new IValidationSupport.CodeValidationResult().setCode("code0"));

 		QuestionnaireResponse qa;
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/FhirInstanceValidatorR4Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/FhirInstanceValidatorR4Test.java
@ -206,7 +206,7 @@ public class FhirInstanceValidatorR4Test extends BaseTest {
 				if (myValidConcepts.contains(system + "___" + code)) {
 					retVal = new IValidationSupport.CodeValidationResult().setCode(code);
 				} else if (myValidSystems.contains(system)) {
-					return new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.WARNING.toCode()).setMessage("Unknown code: " + system + " / " + code);
+					return new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage("Unknown code");
 				} else {
 					retVal = myDefaultValidationSupport.validateCode(new ValidationSupportContext(myDefaultValidationSupport), options, system, code, display, valueSetUrl);
 				}
@ -1110,8 +1110,8 @@ public class FhirInstanceValidatorR4Test extends BaseTest {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnAll(output);

-		assertThat(errors.toString(), containsString("warning"));
-		assertThat(errors.toString(), containsString("Unknown code: http://loinc.org / 12345"));
+		assertEquals(ResultSeverityEnum.ERROR, errors.get(0).getSeverity());
+		assertEquals("Unknown code for \"http://loinc.org#12345\"", errors.get(0).getMessage());
 	}

 	@Test
@ -1266,7 +1266,7 @@ public class FhirInstanceValidatorR4Test extends BaseTest {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnAll(output);
 		assertThat(errors.toString(), errors.size(), greaterThan(0));
-		assertEquals("Unknown code: http://acme.org / 9988877", errors.get(0).getMessage());
+		assertEquals("Unknown code for \"http://acme.org#9988877\"", errors.get(0).getMessage());

 	}

@ -1304,7 +1304,7 @@ public class FhirInstanceValidatorR4Test extends BaseTest {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnNonInformationalOnes(output);
 		assertEquals(1, errors.size());
-		assertEquals("Unknown code: http://loinc.org / 1234", errors.get(0).getMessage());
+		assertEquals("Unknown code for \"http://loinc.org#1234\"", errors.get(0).getMessage());
 	}

 	@Test
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/QuestionnaireResponseValidatorR4Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/QuestionnaireResponseValidatorR4Test.java
@ -9,6 +9,7 @@ import ca.uhn.fhir.validation.FhirValidator;
 import ca.uhn.fhir.validation.ResultSeverityEnum;
 import ca.uhn.fhir.validation.SingleValidationMessage;
 import ca.uhn.fhir.validation.ValidationResult;
+import org.hl7.fhir.common.hapi.validation.support.CommonCodeSystemsTerminologyService;
 import org.hl7.fhir.common.hapi.validation.support.InMemoryTerminologyServerValidationSupport;
 import org.hl7.fhir.common.hapi.validation.support.ValidationSupportChain;
 import org.hl7.fhir.common.hapi.validation.validator.FhirInstanceValidator;
@ -61,7 +62,7 @@ public class QuestionnaireResponseValidatorR4Test {
 		myVal.setValidateAgainstStandardSchema(false);
 		myVal.setValidateAgainstStandardSchematron(false);

-		ValidationSupportChain validationSupport = new ValidationSupportChain(myDefaultValidationSupport, myValSupport, new InMemoryTerminologyServerValidationSupport(ourCtx));
+		ValidationSupportChain validationSupport = new ValidationSupportChain(myDefaultValidationSupport, myValSupport, new InMemoryTerminologyServerValidationSupport(ourCtx), new CommonCodeSystemsTerminologyService(ourCtx));
 		myInstanceVal = new FhirInstanceValidator(validationSupport);

 		myVal.registerValidatorModule(myInstanceVal);
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r5/validation/FhirInstanceValidatorR5Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r5/validation/FhirInstanceValidatorR5Test.java
@ -163,7 +163,7 @@ public class FhirInstanceValidatorR5Test {
 				if (myValidConcepts.contains(system + "___" + code)) {
 					retVal = new IValidationSupport.CodeValidationResult().setCode(code);
 				} else if (myValidSystems.contains(system)) {
-					return new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.WARNING).setMessage("Unknown code: " + system + " / " + code);
+					return new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage("Unknown code");
 				} else {
 					retVal = myDefaultValidationSupport.validateCode(new ValidationSupportContext(myDefaultValidationSupport), options, system, code, display, valueSetUrl);
 				}
@ -754,8 +754,8 @@ public class FhirInstanceValidatorR5Test {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnAll(output);

-		assertThat(errors.toString(), containsString("warning"));
-		assertThat(errors.toString(), containsString("Unknown code: http://loinc.org / 12345"));
+		assertEquals(ResultSeverityEnum.ERROR, errors.get(0).getSeverity());
+		assertEquals("Unknown code for \"http://loinc.org#12345\"", errors.get(0).getMessage());
 	}

 	@Test
@ -877,7 +877,7 @@ public class FhirInstanceValidatorR5Test {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnAll(output);
 		assertThat(errors.toString(), errors.size(), greaterThan(0));
-		assertEquals("Unknown code: http://acme.org / 9988877", errors.get(0).getMessage());
+		assertEquals("Unknown code for \"http://acme.org#9988877\"", errors.get(0).getMessage());

 	}

@ -915,7 +915,7 @@ public class FhirInstanceValidatorR5Test {
 		ValidationResult output = myVal.validateWithResult(input);
 		List<SingleValidationMessage> errors = logResultsAndReturnNonInformationalOnes(output);
 		assertEquals(1, errors.size());
-		assertEquals("Unknown code: http://loinc.org / 1234", errors.get(0).getMessage());
+		assertEquals("Unknown code for \"http://loinc.org#1234\"", errors.get(0).getMessage());
 	}

 	@Test
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r5/validation/QuestionnaireResponseValidatorR5Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r5/validation/QuestionnaireResponseValidatorR5Test.java
@ -9,6 +9,7 @@ import ca.uhn.fhir.validation.FhirValidator;
 import ca.uhn.fhir.validation.ResultSeverityEnum;
 import ca.uhn.fhir.validation.SingleValidationMessage;
 import ca.uhn.fhir.validation.ValidationResult;
+import org.hl7.fhir.common.hapi.validation.support.CommonCodeSystemsTerminologyService;
 import org.hl7.fhir.common.hapi.validation.support.InMemoryTerminologyServerValidationSupport;
 import org.hl7.fhir.common.hapi.validation.support.ValidationSupportChain;
 import org.hl7.fhir.common.hapi.validation.validator.FhirInstanceValidator;
@ -65,7 +66,7 @@ public class QuestionnaireResponseValidatorR5Test {
 		myVal.setValidateAgainstStandardSchema(false);
 		myVal.setValidateAgainstStandardSchematron(false);

-		ValidationSupportChain validationSupport = new ValidationSupportChain(myDefaultValidationSupport, myValSupport, new InMemoryTerminologyServerValidationSupport(ourCtx));
+		ValidationSupportChain validationSupport = new ValidationSupportChain(myDefaultValidationSupport, myValSupport, new InMemoryTerminologyServerValidationSupport(ourCtx), new CommonCodeSystemsTerminologyService(ourCtx));
 		myInstanceVal = new FhirInstanceValidator(validationSupport);

 		myVal.registerValidatorModule(myInstanceVal);
--- a/pom.xml
+++ b/pom.xml
@ -674,7 +674,7 @@

 	<properties>

-		<fhir_core_version>5.0.7-SNAPSHOT</fhir_core_version>
+		<fhir_core_version>5.0.9</fhir_core_version>
 		<ucum_version>1.0.2</ucum_version>

 		<surefire_jvm_args>-Dfile.encoding=UTF-8 -Xmx2048m</surefire_jvm_args>