Fix various issues rendering and validating additional bindings with usage contexts

org.hl7.fhir.convertors/src/main/java/org/hl7/fhir/convertors/conv40_50/datatypes40_50/special40_50/ElementDefinition40_50.java

@@ -25,8 +25,10 @@ import org.hl7.fhir.r4.model.StringType;
 import org.hl7.fhir.r5.model.CodeType;
 import org.hl7.fhir.r5.model.ElementDefinition.ElementDefinitionBindingAdditionalComponent;
 import org.hl7.fhir.r5.model.UsageContext;
+import org.hl7.fhir.r5.utils.ToolingExtensions;
 
 public class ElementDefinition40_50 {
+  
   public static org.hl7.fhir.r5.model.ElementDefinition convertElementDefinition(org.hl7.fhir.r4.model.ElementDefinition src) throws FHIRException {
     if (src == null) return null;
     org.hl7.fhir.r5.model.ElementDefinition tgt = new org.hl7.fhir.r5.model.ElementDefinition();
@@ -616,7 +618,7 @@ public class ElementDefinition40_50 {
     if (src == null) return null;
     org.hl7.fhir.r5.model.ElementDefinition.ElementDefinitionBindingComponent tgt = new org.hl7.fhir.r5.model.ElementDefinition.ElementDefinitionBindingComponent();
     ConversionContext40_50.INSTANCE.getVersionConvertor_40_50().copyElement(src, tgt, 
-        "http://hl7.org/fhir/5.0/StructureDefinition/extension-ElementDefinition.binding.additional");
+        "http://hl7.org/fhir/5.0/StructureDefinition/extension-ElementDefinition.binding.additional", ToolingExtensions.EXT_BINDING_ADDITIONAL);
     if (src.hasStrength()) tgt.setStrengthElement(Enumerations40_50.convertBindingStrength(src.getStrengthElement()));
     if (src.hasDescription()) tgt.setDescriptionElement(String40_50.convertStringToMarkdown(src.getDescriptionElement()));
     if (src.hasValueSet()) tgt.setValueSetElement(Canonical40_50.convertCanonical(src.getValueSetElement()));
@@ -624,6 +626,9 @@ public class ElementDefinition40_50 {
     for (org.hl7.fhir.r4.model.Extension ext : src.getExtensionsByUrl("http://hl7.org/fhir/5.0/StructureDefinition/extension-ElementDefinition.binding.additional")) {
       tgt.addAdditional(convertAdditional(ext));
     }
+    for (org.hl7.fhir.r4.model.Extension ext : src.getExtensionsByUrl(ToolingExtensions.EXT_BINDING_ADDITIONAL)) {
+      tgt.addAdditional(convertAdditional(ext));
+    }
     return tgt;
   }
 
@@ -652,12 +657,12 @@ public class ElementDefinition40_50 {
     return tgt;
   }
 
-  private static Extension convertAdditional(ElementDefinitionBindingAdditionalComponent src) {
+  private static org.hl7.fhir.r4.model.Extension convertAdditional(ElementDefinitionBindingAdditionalComponent src) {
     if (src == null) return null;
-    Extension tgt = new Extension();
+    org.hl7.fhir.r4.model.Extension tgt = new Extension(ToolingExtensions.EXT_BINDING_ADDITIONAL);
     ConversionContext40_50.INSTANCE.getVersionConvertor_40_50().copyElement(src, tgt);
     if (src.hasPurpose()) {
-      tgt.addExtension(new Extension("purpose", new CodeType(src.getPurposeElement().primitiveValue())));
+      tgt.addExtension(new Extension("purpose", new org.hl7.fhir.r4.model.CodeType(src.getPurposeElement().primitiveValue())));
     }
     if (src.hasValueSet()) {
       tgt.addExtension(new Extension("valueSet", Canonical40_50.convertCanonical(src.getValueSetElement())));

org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfileUtilities.java

@@ -2923,7 +2923,7 @@ public class ProfileUtilities {
 
   private ElementDefinitionBindingAdditionalComponent getMatchingAdditionalBinding(ElementDefinitionBindingComponent nb,ElementDefinitionBindingAdditionalComponent ab) {
     for (ElementDefinitionBindingAdditionalComponent t : nb.getAdditional()) {
-      if (t.getValueSet() != null && t.getValueSet().equals(ab.getValueSet()) && t.getPurpose() == ab.getPurpose()) {
+      if (t.getValueSet() != null && t.getValueSet().equals(ab.getValueSet()) && t.getPurpose() == ab.getPurpose() && !ab.hasUsage()) {
         return t;
       }
     }

org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/AdditionalBindingsRenderer.java

@@ -36,7 +36,7 @@ public class AdditionalBindingsRenderer {
     private String valueSet;
     private String doco;
     private String docoShort;
-    private UsageContext usage;
+    private List<UsageContext> usages = new ArrayList<UsageContext>();
     private boolean any = false;
     private boolean isUnchanged = false;
     private boolean matched = false;
@@ -72,7 +72,7 @@ public class AdditionalBindingsRenderer {
       isUnchanged = isUnchanged && ((valueSet==null && compare.valueSet==null) || valueSet.equals(compare.valueSet));
       isUnchanged = isUnchanged && ((doco==null && compare.doco==null) || doco.equals(compare.doco));
       isUnchanged = isUnchanged && ((docoShort==null && compare.docoShort==null) || docoShort.equals(compare.docoShort));
-      isUnchanged = isUnchanged && ((usage==null && compare.usage==null) || usage.equals(compare.usage));
+      isUnchanged = isUnchanged && ((usages==null && compare.usages==null) || usages.equals(compare.usages));
       return isUnchanged;
     }
   }
@@ -175,7 +175,11 @@ public class AdditionalBindingsRenderer {
     abr.valueSet =  ext.getExtensionString("valueSet");
     abr.doco =  ext.getExtensionString("documentation");
     abr.docoShort =  ext.getExtensionString("shortDoco");
-    abr.usage =  (ext.hasExtension("usage")) && ext.getExtensionByUrl("usage").hasValueUsageContext() ? ext.getExtensionByUrl("usage").getValueUsageContext() : null;
+    for (Extension x : ext.getExtensionsByUrl("usage")) {
+      if (x.hasValueUsageContext()) {
+        abr.usages.add(x.getValueUsageContext());
+      }
+    }
     abr.any = "any".equals(ext.getExtensionString("scope"));
     abr.isUnchanged = ext.hasUserData(ProfileUtilities.UD_DERIVATION_EQUALS);
     return abr;
@@ -187,7 +191,7 @@ public class AdditionalBindingsRenderer {
     abr.valueSet =  ab.getValueSet();
     abr.doco =  ab.getDocumentation();
     abr.docoShort =  ab.getShortDoco();
-    abr.usage = ab.hasUsage() ? ab.getUsageFirstRep() : null;
+    abr.usages.addAll(ab.getUsage());
     abr.any = ab.getAny();
     abr.isUnchanged = ab.hasUserData(ProfileUtilities.UD_DERIVATION_EQUALS);
     return abr;
@@ -220,7 +224,7 @@ public class AdditionalBindingsRenderer {
     boolean any = false;
     for (AdditionalBindingDetail binding : bindings) {
       doco = doco || binding.getDoco(fullDoco)!=null  || (binding.compare!=null && binding.compare.getDoco(fullDoco)!=null);
-      usage = usage || binding.usage != null || (binding.compare!=null && binding.compare.usage!=null);
+      usage = usage || !binding.usages.isEmpty() || (binding.compare!=null && !binding.compare.usages.isEmpty());
       any = any || binding.any || (binding.compare!=null && binding.compare.any);
     }
 
@@ -283,9 +287,12 @@ public class AdditionalBindingsRenderer {
         renderPurpose(purpose, binding.compare.purpose);
       }
       if (usage) {
-        if (binding.usage != null) {
+        if (!binding.usages.isEmpty()) {
-          // TODO: This isn't rendered at all yet.  Ideally, we want it to render with comparison...
+          XhtmlNode td = tr.td();
-          new DataRenderer(context).renderBase(new RenderingStatus(), tr.td(), binding.usage);
+          for (UsageContext uc : binding.usages) {
+            td.sep(", ");
+            new DataRenderer(context).renderBase(new RenderingStatus(), td, uc);
+          }
         } else {
           tr.td();          
         }

org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/DataRenderer.java

@@ -1302,6 +1302,10 @@ public class DataRenderer extends Renderer implements CodeResolver {
   } 
 
   protected void renderCoding(RenderingStatus status, XhtmlNode x, ResourceWrapper c) {
+    renderCoding(status, x, c, true);
+  }
+    
+  protected void renderCoding(RenderingStatus status, XhtmlNode x, ResourceWrapper c, boolean details) { 
     String s = ""; 
     if (c.has("display")) 
       s = context.getTranslated(c.child("display")); 
@@ -1311,11 +1315,14 @@ public class DataRenderer extends Renderer implements CodeResolver {
     if (Utilities.noString(s)) 
       s = c.primitiveValue("code"); 
 
-    if (context.isTechnicalMode()) { 
+    if (context.isTechnicalMode() && details) {
-      x.addText(s+" "+context.formatPhrase(RenderingContext.DATA_REND_DETAILS_STATED, displaySystem(c.primitiveValue("system")), c.primitiveValue("code"), " = '", lookupCode(c.primitiveValue("system"), c.primitiveValue("version"), c.primitiveValue("code")), c.primitiveValue("display"), "')")); 
+      String d = c.primitiveValue("display") == null ? lookupCode(c.primitiveValue("system"), c.primitiveValue("version"), c.primitiveValue("code")): c.primitiveValue("display");
-    } else 
+      d = context.formatPhrase(d == null || d.equals(c.primitiveValue("code")) ? RenderingContext.DATA_REND_DETAILS_STATED_ND :  RenderingContext.DATA_REND_DETAILS_STATED, displaySystem(c.primitiveValue("system")), c.primitiveValue("code"), d); 
+      x.addText(s+" "+d);
+    } else { 
       x.span(null, "{"+c.primitiveValue("system")+" "+c.primitiveValue("code")+"}").addText(s);
     }
+  } 
 
   public String displayCodeableConcept(ResourceWrapper cc) { 
     String s = context.getTranslated(cc.child("Text")); 
@@ -1860,8 +1867,8 @@ public class DataRenderer extends Renderer implements CodeResolver {
   } 
 
   public void renderUsageContext(RenderingStatus status, XhtmlNode x, ResourceWrapper u) throws FHIRFormatError, DefinitionException, IOException { 
-    renderCoding(status, x, u.child("code")); 
+    renderCoding(status, x, u.child("code"), false); 
-    x.tx(": "); 
+    x.tx(" = "); 
     renderDataType(status, x, u.child("value"));     
   } 
 

org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java

@@ -18,7 +18,9 @@ public class I18nConstants {
   public static final String BAD_FILE_PATH_ERROR = "Bad_file_path_error";
   public static final String BASE_PROFILE__HAS_NO_TYPE = "Base_profile__has_no_type";
   public static final String BASE__DERIVED_PROFILES_HAVE_DIFFERENT_TYPES____VS___ = "Base__Derived_profiles_have_different_types____vs___";
-  public static final String BINDING_ADDITIONAL = "BINDING_ADDITIONAL";
+  public static final String BINDING_ADDITIONAL_D = "BINDING_ADDITIONAL_D";
+  public static final String BINDING_ADDITIONAL_UC = "BINDING_ADDITIONAL_UC";
+  public static final String BINDING_ADDITIONAL_USAGE = "BINDING_ADDITIONAL_USAGE";
   public static final String BINDING_MAX = "BINDING_MAX";
   public static final String BUNDLE_BUNDLE_ENTRY_CANONICAL = "Bundle_BUNDLE_Entry_Canonical";
   public static final String BUNDLE_BUNDLE_ENTRY_DOCUMENT = "Bundle_BUNDLE_Entry_Document";
@@ -1111,4 +1113,7 @@ public class I18nConstants {
   public static final String SD_BASE_EXPERIMENTAL = "SD_BASE_EXPERIMENTAL";
   public static final String SD_ED_EXPERIMENTAL_BINDING = "SD_ED_EXPERIMENTAL_BINDING";
   public static final String VALIDATION_NO_EXPERIMENTAL_CONTENT = "VALIDATION_NO_EXPERIMENTAL_CONTENT";
+  public static final String SD_ED_ADDITIONAL_BINDING_USAGE_UNKNOWN = "SD_ED_ADDITIONAL_BINDING_USAGE_UNKNOWN";
+  public static final String SD_ED_ADDITIONAL_BINDING_USAGE_INVALID_ELEMENT = "SD_ED_ADDITIONAL_BINDING_USAGE_INVALID_ELEMENT";
+  public static final String SD_ED_ADDITIONAL_BINDING_USAGE_INVALID_TYPE = "SD_ED_ADDITIONAL_BINDING_USAGE_INVALID_TYPE";
 }

org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/RenderingI18nContext.java

@@ -214,6 +214,7 @@ public class RenderingI18nContext extends I18nBase {
   public static final String DATA_REND_DATA = "DATA_REND_DATA";
   public static final String DATA_REND_DETAILS = "DATA_REND_DETAILS";
   public static final String DATA_REND_DETAILS_STATED = "DATA_REND_DETAILS_STATED";
+  public static final String DATA_REND_DETAILS_STATED_ND = "DATA_REND_DETAILS_STATED_ND";
   public static final String DATA_REND_DICOM = "DATA_REND_DICOM";
   public static final String DATA_REND_DIM = "DATA_REND_DIM";
   public static final String DATA_REND_DURATION = "DATA_REND_DURATION";

org.hl7.fhir.utilities/src/main/resources/Messages.properties

@@ -13,7 +13,9 @@ Attempt_to_a_slice_an_element_that_does_not_repeat__from__in_ = Attempt to a sli
 Attempt_to_replace_element_name_for_a_nonchoice_type=Attempt to replace element name for a non-choice type
 Attempt_to_use_Terminology_server_when_no_Terminology_server_is_available = Attempt to use Terminology server when no Terminology server is available
 Attempt_to_use_a_snapshot_on_profile__as__before_it_is_generated = Attempt to use a snapshot on profile ''{0}'' as {1} before it is generated
-BINDING_ADDITIONAL = {0} specified in an additional binding
+BINDING_ADDITIONAL_D = {0} specified in an additional binding
+BINDING_ADDITIONAL_UC = {0} specified in an additional binding which applies because {1}
+BINDING_ADDITIONAL_USAGE = {0} = {1}
 BINDING_MAX = {0} specified in the max binding
 BUNDLE_BUNDLE_ENTRY_FOUND_MULTIPLE = Found {0} matches for ''{1}'' in the bundle ({2})
 BUNDLE_BUNDLE_ENTRY_FOUND_MULTIPLE_FRAGMENT = Found {0} matches for fragment {2} in resource ''{1}'' in the bundle ({3})
@@ -1143,3 +1145,6 @@ NO_VALID_DISPLAY_AT_ALL = Cannot validate display Name ''{0}'' for {1}#{2}: No d
 SD_BASE_EXPERIMENTAL = The definition builds on ''{0}'' which is experimental, but this definition is not labeled as experimental
 SD_ED_EXPERIMENTAL_BINDING = The definition for the element ''{0}'' binds to the value set ''{1}'' which is experimental, but this structure is not labeled as experimental
 VALIDATION_NO_EXPERIMENTAL_CONTENT = Experimental content is not allowed in this context
+SD_ED_ADDITIONAL_BINDING_USAGE_UNKNOWN = The Usage Context {0}#{1} is not recognised and may not be correct
+SD_ED_ADDITIONAL_BINDING_USAGE_INVALID_ELEMENT = The Usage Context {0}#{1} is a reference to an element that does not exist
+SD_ED_ADDITIONAL_BINDING_USAGE_INVALID_TYPE = The Usage Context value must be of type {1} not {0}

org.hl7.fhir.utilities/src/main/resources/rendering-phrases.properties

@@ -207,7 +207,8 @@ DATA_REND_COND = Condition
 DATA_REND_COUNT = Count {0}
 DATA_REND_DATA = Data: {0}
 DATA_REND_DETAILS = (Details: {0}  code 
-DATA_REND_DETAILS_STATED = (Details: {0} code {1} {2} {3} '', stated as '' {4} {5}
+DATA_REND_DETAILS_STATED = (Details: {0} code {1} = ''{2}'')
+DATA_REND_DETAILS_STATED_ND = (Details: {0} code {1})
 DATA_REND_DICOM = DICOM
 DATA_REND_DIM = Dimensions: {0}
 DATA_REND_DURATION = Duration {0}

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java

@@ -217,6 +217,7 @@ import org.hl7.fhir.validation.instance.type.ValueSetValidator;
 import org.hl7.fhir.validation.instance.utils.*;
 import org.w3c.dom.Document;
 
+
 /**
  * Thinking of using this in a java program? Don't!
  * You should use one of the wrappers instead. Either in HAPI, or use ValidationEngine
@@ -1356,19 +1357,20 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
             BindingStrength strength = binding.getStrength();
             Extension maxVS = binding.getExtensionByUrl(ToolingExtensions.EXT_MAX_VALUESET);
             
-            checkDisp = validateBindingCodeableConcept(errors, path, element, profile, stack, bh, checkDisp, checked, cc, vsRef, valueset, strength, maxVS, true);
+            checkDisp = validateBindingCodeableConcept(errors, path, element, profile, stack, bh, checkDisp, checked, cc, vsRef, valueset, strength, maxVS, true, null);
 //          } else if (binding.hasValueSet()) {
 //            hint(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_BINDING_CANTCHECK);
           } else if (!noBindingMsgSuppressed) {
             hint(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_BINDING_NOSOURCE, path);
           }
           for (ElementDefinitionBindingAdditionalComponent ab : binding.getAdditional()) {
-            if (isTestableBinding(ab) && isInScope(ab)) {
+            StringBuilder b = new StringBuilder();
+            if (isTestableBinding(ab) && isInScope(ab, profile, getResource(stack), b)) {
               String vsRef = ab.getValueSet();
               ValueSet valueset = resolveBindingReference(profile, vsRef, profile.getUrl(), profile);
               BindingStrength strength = convertPurposeToStrength(ab.getPurpose());
               
-              checkDisp = validateBindingCodeableConcept(errors, path, element, profile, stack, bh, checkDisp, checked, cc, vsRef, valueset, strength, null, false) && checkDisp;
+              checkDisp = validateBindingCodeableConcept(errors, path, element, profile, stack, bh, checkDisp, checked, cc, vsRef, valueset, strength, null, false, b.toString()) && checkDisp;
             }
           }
         } catch (CheckCodeOnServerException e) {
@@ -1394,25 +1396,186 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     return checkDisp;
   }
 
-  private boolean isInScope(ElementDefinitionBindingAdditionalComponent ab) {
+  private boolean isInScope(ElementDefinitionBindingAdditionalComponent ab, StructureDefinition profile, Element resource, StringBuilder b) {
+    if (ab.getUsage().isEmpty()) {
+      return true;
+    }
+    boolean ok = true;
     for (UsageContext usage : ab.getUsage()) {
-      if (isInScope(usage)) {
+      if (!isInScope(usage, profile, resource, b)) {
+        ok = false;
+      }
+    }
+    return ok;
+  }
+
+  private boolean isInScope(UsageContext usage, StructureDefinition profile, Element resource, StringBuilder b) {
+    if (isKnownUsage(usage)) {
+      return true;
+    }
+    if (usage.getCode().hasSystem() && (usage.getCode().getSystem().equals(profile.getUrl()) || usage.getCode().getSystem().equals(profile.getVersionedUrl()))) {
+      // if it's not a defined usage from external sources, it might match something in the data content
+      List<Element> items = findDataValue(resource, usage.getCode().getCode());
+      if (matchesUsage(items, usage.getValue())) {
+        b.append(context.formatMessage(I18nConstants.BINDING_ADDITIONAL_USAGE, displayCoding(usage.getCode()), display(usage.getValue())));
         return true;
       }
     }
-    return ab.getUsage().isEmpty();
+    return false;
   }
 
-  private boolean isInScope(UsageContext usage) {
+  private String displayCoding(Coding value) {
-    if (isKnownUsage(usage)) {
+    return value.getCode();
+  }
+
+  private String displayCodeableConcept(CodeableConcept value) {
+    for (Coding c : value.getCoding()) {
+      String s = displayCoding(c);
+      if (s != null) {
+        return s;
+      }
+    }    
+    return value.getText();
+  }
+
+  private String display(DataType value) {
+    switch (value.fhirType()) {
+    case "Coding" : return displayCoding((Coding) value);
+    case "CodeableConcept" : return displayCodeableConcept((CodeableConcept) value);
+    }
+    return value.fhirType();
+  }
+  
+  private boolean matchesUsage(List<Element> items, DataType value) {
+    for (Element item : items) {
+      if (matchesUsage(item, value)) {
+        return true;
+      }
+    }
+    return false;
+  }
+
+
+
+  private String display(List<Element> items) {
+    CommaSeparatedStringBuilder b = new CommaSeparatedStringBuilder();
+    for (Element item : items) {
+      display(b, item);
+    }
+    return b.toString();
+  }
+
+  private void display(CommaSeparatedStringBuilder b, Element item) {
+    if (item.isPrimitive()) {
+      b.append(item.primitiveValue());
+    } else if (item.fhirType().equals("CodeableConcept")) {
+      for (Element c : item.getChildren("coding")) {
+        b.append(c.getNamedChildValue("code"));
+      }
+    } else {
+      b.append(item.toString());
+    }
+      
+  }
+
+  private boolean matchesUsage(Element item, DataType value) {
+    switch (value.fhirType()) {
+    case "CodeableConcept": return matchesUsageCodeableConcept(item, (CodeableConcept) value);
+    case "Quantity": return false;
+    case "Range": return false;
+    case "Reference": return false;
+    default: return false;
+    }
+  }
+
+  private boolean matchesUsageCodeableConcept(Element item, CodeableConcept value) {
+    switch (item.fhirType()) {
+    case "CodeableConcept": return matchesUsageCodeableConceptCodeableConcept(item, value);
+    case "Coding": return matchesUsageCodeableConceptCoding(item, value);
+    default: return false;
+    }
+  }
+
+  private boolean matchesUsageCodeableConceptCoding(Element item, CodeableConcept value) {
+    String system = item.getNamedChildValue("system");
+    String version = item.getNamedChildValue("version");
+    String code = item.getNamedChildValue("code");
+    for (Coding c : value.getCoding()) {
+      if (system == null || !system.equals(c.getSystem())) {
+        return false;
+      }
+      if (code == null || !code.equals(c.getCode())) {
+        return false;
+      }
+      if (c.hasVersion()) {
+        if (version == null || !version.equals(c.getVersion())) {
+          return false;
+        }
+      }
       return true;
     }
     return false;
   }
 
+  private boolean matchesUsageCodeableConceptCodeableConcept(Element item, CodeableConcept value) {
+    for (Element code : item.getChildren("coding")) {
+      if (matchesUsageCodeableConceptCoding(code, value)) {
+        return true;
+      }
+    }
+    return false;    
+  }
+
+  private List<Element> findDataValue(Element resource, String code) {
+    List<Element> items = new ArrayList<Element>();
+    if (resource != null) {
+      findDataValues(items, resource, code);
+    }
+    return items;
+  }
+
+  private void findDataValues(List<Element> items, Element element, String path) {
+    if (element.getPath() == null) {
+      return;
+    }
+    if (pathMatches(element.getPath(), path)) {
+      items.add(element);
+    } else if (element.hasChildren() && path.startsWith(element.getPath())) {
+      for (Element child : element.getChildren()) {
+        findDataValues(items, child, path);
+      }
+    }    
+  }
+
+  private boolean pathMatches(String actualPath, String pathSpec) {
+    String[] ap = actualPath.split("\\.");
+    String[] ps = pathSpec.split("\\.");
+    if (ap.length != ps.length) {
+      return false;
+    }
+    for (int i = 0; i < ap.length; i++) {
+      if (!pathSegmentMatches(ap[i], ps[i])) {
+        return false;
+      }
+    }
+    return true;
+  }
+
+  private boolean pathSegmentMatches(String ap, String ps) {
+    if (ps.contains("[")) {
+      return ap.equals(ps);
+    } else {
+      if (ap.contains("[")) {
+        ap = ap.substring(0, ap.indexOf("["));
+      }
+      return ap.equals(ps);
+    } 
+  }
+
   private BindingStrength convertPurposeToStrength(AdditionalBindingPurposeVS purpose) {
     switch (purpose) {
     case MAXIMUM: return BindingStrength.REQUIRED;
+    case EXTENSIBLE: return BindingStrength.EXTENSIBLE;
     case PREFERRED: return BindingStrength.PREFERRED;
     case REQUIRED: return BindingStrength.REQUIRED;
     default: return null;    
@@ -1424,7 +1587,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
   }
 
   private boolean validateBindingCodeableConcept(List<ValidationMessage> errors, String path, Element element, StructureDefinition profile, NodeStack stack, BooleanHolder bh, boolean checkDisp, BooleanHolder checked,
-      CodeableConcept cc, String vsRef, ValueSet valueset, BindingStrength strength, Extension maxVS, boolean base) throws CheckCodeOnServerException {
+      CodeableConcept cc, String vsRef, ValueSet valueset, BindingStrength strength, Extension maxVS, boolean base, String usageNote) throws CheckCodeOnServerException {
     if (valueset == null) {
       CodeSystem cs = context.fetchCodeSystem(vsRef);
       if (rule(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, cs == null, I18nConstants.TERMINOLOGY_TX_VALUESET_NOTFOUND_CS, describeReference(vsRef))) {
@@ -1436,12 +1599,12 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
       BindingContext bc = base ? BindingContext.BASE : BindingContext.ADDITIONAL;
       if (!cc.hasCoding()) {
         if (strength == BindingStrength.REQUIRED)
-          bh.see(rule(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CODE_VALUESET, describeReference(vsRef, valueset, bc)));
+          bh.see(rule(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CODE_VALUESET, describeReference(vsRef, valueset, bc, usageNote)));
         else if (strength == BindingStrength.EXTENSIBLE) {
           if (maxVS != null)
             bh.see(rule(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CODE_VALUESETMAX, describeReference(ToolingExtensions.readStringFromExtension(maxVS)), valueset.getVersionedUrl()));
           else if (!noExtensibleWarnings) {
-            warning(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CODE_VALUESET_EXT, describeReference(vsRef, valueset, bc));
+            warning(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CODE_VALUESET_EXT, describeReference(vsRef, valueset, bc, usageNote));
           }
         }
       } else {
@@ -1493,15 +1656,15 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
                 // we've already handled the warnings / errors about this, and set the status correctly. We don't need to do anything more?
               } else {
                 if (strength == BindingStrength.REQUIRED) {
-                  bh.see(txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_1_CC, describeReference(vsRef, valueset, bc), ccSummary(cc)));
+                  bh.see(txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_1_CC, describeReference(vsRef, valueset, bc, usageNote), ccSummary(cc)));
                 } else if (strength == BindingStrength.EXTENSIBLE) {
                   if (maxVS != null)
                     bh.see(checkMaxValueSet(errors, path, element, profile, ToolingExtensions.readStringFromExtension(maxVS), cc, stack));
                   if (!noExtensibleWarnings)
-                    txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_2_CC, describeReference(vsRef, valueset, bc), ccSummary(cc));
+                    txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_2_CC, describeReference(vsRef, valueset, bc, usageNote), ccSummary(cc));
                 } else if (strength == BindingStrength.PREFERRED) {
                   if (baseOnly) {
-                    txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_3_CC, describeReference(vsRef, valueset, bc), ccSummary(cc));
+                    txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_3_CC, describeReference(vsRef, valueset, bc, usageNote), ccSummary(cc));
                   }
                 }
               }
@@ -1648,7 +1811,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
             BindingStrength strength = binding.getStrength();
             Extension vsMax = binding.getExtensionByUrl(ToolingExtensions.EXT_MAX_VALUESET);
             
-            validateBindingCodeableConcept(errors, path, element, profile, stack, ok, false, new BooleanHolder(), cc, vsRef, valueset, strength, vsMax, true);
+            validateBindingCodeableConcept(errors, path, element, profile, stack, ok, false, new BooleanHolder(), cc, vsRef, valueset, strength, vsMax, true, null);
 
             // special case: if the logical model has both CodeableConcept and Coding mappings, we'll also check the first coding.
             if (getMapping("http://hl7.org/fhir/terminology-pattern", logical, logical.getSnapshot().getElementFirstRep()).contains("Coding")) {
@@ -1660,11 +1823,12 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
             hint(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_BINDING_NOSOURCE, path);
           }
           for (ElementDefinitionBindingAdditionalComponent ab : binding.getAdditional()) {
-            if (isTestableBinding(ab) && isInScope(ab)) {
+            StringBuilder b = new StringBuilder();
+            if (isTestableBinding(ab) && isInScope(ab, profile, getResource(stack), b)) {
               String vsRef = ab.getValueSet();
               ValueSet valueset = resolveBindingReference(profile, vsRef, profile.getUrl(), profile);
               BindingStrength strength = convertPurposeToStrength(ab.getPurpose());
-              validateBindingCodeableConcept(errors, path, element, profile, stack, ok, false, new BooleanHolder(), cc, vsRef, valueset, strength, null, false);
+              validateBindingCodeableConcept(errors, path, element, profile, stack, ok, false, new BooleanHolder(), cc, vsRef, valueset, strength, null, false, b.toString());
             }
           }
         }
@@ -1698,18 +1862,19 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
                 BindingStrength strength = binding.getStrength();
                 Extension vsMax = binding.getExtensionByUrl(ToolingExtensions.EXT_MAX_VALUESET);
                 
-                ok = validateBindingTerminologyCoding(errors, path, element, profile, stack, ok, c, code, system, display, vsRef, valueset, strength, vsMax, true);
+                ok = validateBindingTerminologyCoding(errors, path, element, profile, stack, ok, c, code, system, display, vsRef, valueset, strength, vsMax, true, null);
               } else if (binding.hasValueSet()) {
                 hint(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_BINDING_CANTCHECK);
               } else if (!inCodeableConcept && !noBindingMsgSuppressed) {
                 hint(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_BINDING_NOSOURCE, path);
               }
               for (ElementDefinitionBindingAdditionalComponent ab : binding.getAdditional()) {
-                if (isTestableBinding(ab) && isInScope(ab)) {
+                StringBuilder b = new StringBuilder();
+                if (isTestableBinding(ab) && isInScope(ab, profile, getResource(stack), b)) {
                   String vsRef = ab.getValueSet();
                   ValueSet valueset = resolveBindingReference(profile, vsRef, profile.getUrl(), profile);
                   BindingStrength strength = convertPurposeToStrength(ab.getPurpose());
-                  ok = validateBindingTerminologyCoding(errors, path, element, profile, stack, ok, c, code, system, display, vsRef, valueset, strength, null, true) && ok;
+                  ok = validateBindingTerminologyCoding(errors, path, element, profile, stack, ok, c, code, system, display, vsRef, valueset, strength, null, true, b.toString()) && ok;
                 }
               }
             }
@@ -1728,7 +1893,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
 
   private boolean validateBindingTerminologyCoding(List<ValidationMessage> errors, String path, Element element,
       StructureDefinition profile, NodeStack stack, boolean ok, Coding c, String code, String system, String display,
-      String vsRef, ValueSet valueset, BindingStrength strength, Extension vsMax, boolean base) {
+      String vsRef, ValueSet valueset, BindingStrength strength, Extension vsMax, boolean base, String usageNote) {
     if (valueset == null) {
       CodeSystem cs = context.fetchCodeSystem(vsRef);
       if (rule(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, cs == null, I18nConstants.TERMINOLOGY_TX_VALUESET_NOTFOUND_CS, describeReference(vsRef))) {
@@ -1754,27 +1919,27 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
             txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_BINDING_NOSERVER, system+"#"+code);
           else if (vr.getErrorClass() != null && vr.getErrorClass().isInfrastructure()) {
             if (strength == BindingStrength.REQUIRED)
-              txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_4a, describeReference(vsRef, valueset, bc), vr.getMessage(), system+"#"+code);
+              txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_4a, describeReference(vsRef, valueset, bc, usageNote), vr.getMessage(), system+"#"+code);
             else if (strength == BindingStrength.EXTENSIBLE) {
               if (vsMax != null)
                 checkMaxValueSet(errors, path, element, profile, ToolingExtensions.readStringFromExtension(vsMax), c, stack);
               else if (!noExtensibleWarnings)
-                txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_5, describeReference(vsRef, valueset, bc));
+                txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_5, describeReference(vsRef, valueset, bc, usageNote));
             } else if (strength == BindingStrength.PREFERRED) {
               if (baseOnly) {
-                txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_6, describeReference(vsRef, valueset, bc));
+                txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_6, describeReference(vsRef, valueset, bc, usageNote));
               }
             }
           } else if (strength == BindingStrength.REQUIRED)
-            ok= txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_4, describeReference(vsRef, valueset, bc), (vr.getMessage() != null ? " (error message = " + vr.getMessage() + ")" : ""), system+"#"+code) && ok;
+            ok= txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_4, describeReference(vsRef, valueset, bc, usageNote), (vr.getMessage() != null ? " (error message = " + vr.getMessage() + ")" : ""), system+"#"+code) && ok;
           else if (strength == BindingStrength.EXTENSIBLE) {
             if (vsMax != null)
               ok = checkMaxValueSet(errors, path, element, profile, ToolingExtensions.readStringFromExtension(vsMax), c, stack) && ok;
             else
-              txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_5, describeReference(vsRef, valueset, bc), (vr.getMessage() != null ? " (error message = " + vr.getMessage() + ")" : ""), system+"#"+code);
+              txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_5, describeReference(vsRef, valueset, bc, usageNote), (vr.getMessage() != null ? " (error message = " + vr.getMessage() + ")" : ""), system+"#"+code);
           } else if (strength == BindingStrength.PREFERRED) {
             if (baseOnly) {
-              txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_6, describeReference(vsRef, valueset, bc), (vr.getMessage() != null ? " (error message = " + vr.getMessage() + ")" : ""), system+"#"+code);
+              txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_6, describeReference(vsRef, valueset, bc, usageNote), (vr.getMessage() != null ? " (error message = " + vr.getMessage() + ")" : ""), system+"#"+code);
             }
           }
         } else if (vr != null && vr.getMessage() != null){
@@ -1896,9 +2061,9 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
         timeTracker.tx(t, "vc "+cc.toString());
         if (!vr.isOk()) {
           if (vr.getErrorClass() != null && vr.getErrorClass().isInfrastructure())
-            txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_7, describeReference(maxVSUrl, valueset, BindingContext.MAXVS), vr.getMessage());
+            txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_7, describeReference(maxVSUrl, valueset, BindingContext.MAXVS, null), vr.getMessage());
           else
-            ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_8, describeReference(maxVSUrl, valueset, BindingContext.MAXVS), ccSummary(cc)) && ok;
+            ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_8, describeReference(maxVSUrl, valueset, BindingContext.MAXVS, null), ccSummary(cc)) && ok;
         }
       } catch (CheckCodeOnServerException e) {
         if (STACK_TRACE) e.getCause().printStackTrace();
@@ -1936,9 +2101,9 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
         timeTracker.tx(t, "vc "+c.getSystem()+"#"+c.getCode()+" '"+c.getDisplay()+"'");
         if (!vr.isOk()) {
           if (vr.getErrorClass() != null && vr.getErrorClass().isInfrastructure())
-            txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_9, describeReference(maxVSUrl, valueset, BindingContext.MAXVS), vr.getMessage(), c.getSystem()+"#"+c.getCode());
+            txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_9, describeReference(maxVSUrl, valueset, BindingContext.MAXVS, null), vr.getMessage(), c.getSystem()+"#"+c.getCode());
           else
-            ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_10, describeReference(maxVSUrl, valueset, BindingContext.MAXVS), c.getSystem(), c.getCode()) && ok;
+            ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_10, describeReference(maxVSUrl, valueset, BindingContext.MAXVS, null), c.getSystem(), c.getCode()) && ok;
         }
       } catch (Exception e) {
         if (STACK_TRACE) e.printStackTrace();
@@ -1966,9 +2131,9 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
         timeTracker.tx(t, "vc "+value);
         if (!vr.isOk()) {
           if (vr.getErrorClass() != null && vr.getErrorClass().isInfrastructure())
-            txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_9, describeReference(maxVSUrl, valueset, BindingContext.BASE), vr.getMessage(), value);
+            txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_9, describeReference(maxVSUrl, valueset, BindingContext.BASE, null), vr.getMessage(), value);
           else {
-            ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_11, describeReference(maxVSUrl, valueset, BindingContext.BASE), vr.getMessage()) && ok;
+            ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_11, describeReference(maxVSUrl, valueset, BindingContext.BASE, null), vr.getMessage()) && ok;
           }
         }
       } catch (Exception e) {
@@ -2029,7 +2194,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
                 BindingStrength strength = binding.getStrength();
                 Extension vsMax = binding.getExtensionByUrl(ToolingExtensions.EXT_MAX_VALUESET);
                 
-                ok = validateBindingCodedElement(errors, path, element, profile, stack, theCode, theSystem, ok, checked, c, vsRef, valueset, strength, vsMax, true);
+                ok = validateBindingCodedElement(errors, path, element, profile, stack, theCode, theSystem, ok, checked, c, vsRef, valueset, strength, vsMax, true, null);
 //              } else if (binding.hasValueSet()) {
 //                hint(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_BINDING_CANTCHECK);
                 
@@ -2038,12 +2203,13 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
               }
 
               for (ElementDefinitionBindingAdditionalComponent ab : binding.getAdditional()) {
-                if (isTestableBinding(ab) && isInScope(ab)) {
+                StringBuilder b = new StringBuilder();
+                if (isTestableBinding(ab) && isInScope(ab, profile, getResource(stack), b)) {
                   String vsRef = ab.getValueSet();
                   ValueSet valueset = resolveBindingReference(profile, vsRef, profile.getUrl(), profile);
                   BindingStrength strength = convertPurposeToStrength(ab.getPurpose());
                   
-                  ok = validateBindingCodedElement(errors, path, element, profile, stack, theCode, theSystem, ok, checked, c, vsRef, valueset, strength, null, false) && ok;
+                  ok = validateBindingCodedElement(errors, path, element, profile, stack, theCode, theSystem, ok, checked, c, vsRef, valueset, strength, null, false, b.toString()) && ok;
                 }
               }
             } catch (Exception e) {
@@ -2068,9 +2234,19 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     return ok;
   }
 
+  private Element getResource(NodeStack stack) {
+    if (stack.getElement().isResource()) {
+      return stack.getElement();
+    }
+    if (stack.getParent() == null) {
+      return null;
+    }
+    return getResource(stack.getParent());
+  }
+
   private boolean validateBindingCodedElement(List<ValidationMessage> errors, String path, Element element,
       StructureDefinition profile, NodeStack stack, String theCode, String theSystem, boolean ok, BooleanHolder checked,
-      Coding c, String vsRef, ValueSet valueset, BindingStrength strength, Extension vsMax, boolean base) {
+      Coding c, String vsRef, ValueSet valueset, BindingStrength strength, Extension vsMax, boolean base, String usageNote) {
     if (valueset == null) {
       CodeSystem cs = context.fetchCodeSystem(vsRef);
       if (rule(errors, NO_RULE_DATE, IssueType.CODEINVALID, element.line(), element.col(), path, cs == null, I18nConstants.TERMINOLOGY_TX_VALUESET_NOTFOUND_CS, describeReference(vsRef))) {
@@ -2098,28 +2274,28 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
           txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_BINDING_NOSERVER, theSystem+"#"+theCode);
         else if (vr.getErrorClass() != null && !vr.getErrorClass().isInfrastructure()) {
           if (strength == BindingStrength.REQUIRED)
-            ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_4a, describeReference(vsRef, valueset, bc), vr.getMessage(), theSystem+"#"+theCode) && ok;
+            ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_4a, describeReference(vsRef, valueset, bc, usageNote), vr.getMessage(), theSystem+"#"+theCode) && ok;
           else if (strength == BindingStrength.EXTENSIBLE) {
             if (vsMax != null)
               checkMaxValueSet(errors, path, element, profile, ToolingExtensions.readStringFromExtension(vsMax), c, stack);
             else if (!noExtensibleWarnings)
-              txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_5, describeReference(vsRef, valueset, bc), theSystem+"#"+theCode);
+              txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_5, describeReference(vsRef, valueset, bc, usageNote), theSystem+"#"+theCode);
           } else if (strength == BindingStrength.PREFERRED) {
             if (baseOnly) {
-              txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_6, describeReference(vsRef, valueset, bc), theSystem+"#"+theCode);
+              txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_CONFIRM_6, describeReference(vsRef, valueset, bc, usageNote), theSystem+"#"+theCode);
             }
           }
         } else if (strength == BindingStrength.REQUIRED)
-          ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_12, describeReference(vsRef, valueset, bc), getErrorMessage(vr.getMessage()), theSystem+"#"+theCode) && ok;
+          ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_12, describeReference(vsRef, valueset, bc, usageNote), getErrorMessage(vr.getMessage()), theSystem+"#"+theCode) && ok;
         else if (strength == BindingStrength.EXTENSIBLE) {
           if (vsMax != null)
             ok = checkMaxValueSet(errors, path, element, profile, ToolingExtensions.readStringFromExtension(vsMax), c, stack) && ok;
           else if (!noExtensibleWarnings) {
-            txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_13, describeReference(vsRef, valueset, bc), getErrorMessage(vr.getMessage()), c.getSystem()+"#"+c.getCode());
+            txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_13, describeReference(vsRef, valueset, bc, usageNote), getErrorMessage(vr.getMessage()), c.getSystem()+"#"+c.getCode());
           }
         } else if (strength == BindingStrength.PREFERRED) {
           if (baseOnly) {
-            txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_14, describeReference(vsRef, valueset, bc), getErrorMessage(vr.getMessage()), theSystem+"#"+theCode);
+            txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_14, describeReference(vsRef, valueset, bc, usageNote), getErrorMessage(vr.getMessage()), theSystem+"#"+theCode);
           }
         }
       } else if (vr != null && vr.getMessage() != null) {
@@ -3563,15 +3739,15 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
             } else if (vr.getErrorClass() != null && vr.getErrorClass() == TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED) {
               txWarning(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, vr.getMessage());
             } else if (binding.getStrength() == BindingStrength.REQUIRED) {
-              ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_16, value, describeReference(binding.getValueSet(), vs, BindingContext.BASE), getErrorMessage(vr.getMessage())) && ok;
+              ok = txRule(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_16, value, describeReference(binding.getValueSet(), vs, BindingContext.BASE, null), getErrorMessage(vr.getMessage())) && ok;
             } else if (binding.getStrength() == BindingStrength.EXTENSIBLE) {
               if (binding.hasExtension(ToolingExtensions.EXT_MAX_VALUESET))
                 ok = checkMaxValueSet(errors, path, element, profile, ToolingExtensions.readStringExtension(binding, ToolingExtensions.EXT_MAX_VALUESET), value, stack) && ok;
               else if (!noExtensibleWarnings && !isOkExtension(value, vs))
-                txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_17, value, describeReference(binding.getValueSet(), vs, BindingContext.BASE), getErrorMessage(vr.getMessage()));
+                txWarningForLaterRemoval(element, errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_17, value, describeReference(binding.getValueSet(), vs, BindingContext.BASE, null), getErrorMessage(vr.getMessage()));
             } else if (binding.getStrength() == BindingStrength.PREFERRED) {
               if (baseOnly) {
-                txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_18, value, describeReference(binding.getValueSet(), vs, BindingContext.BASE), getErrorMessage(vr.getMessage()));
+                txHint(errors, NO_RULE_DATE, vr.getTxLink(), IssueType.CODEINVALID, element.line(), element.col(), path, false, I18nConstants.TERMINOLOGY_TX_NOVALID_18, value, describeReference(binding.getValueSet(), vs, BindingContext.BASE, null), getErrorMessage(vr.getMessage()));
               }
             }
           } else if (vr != null && vr.getMessage() != null){
@@ -4279,7 +4455,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     return false;
   }
 
-  private String describeReference(String reference, CanonicalResource target, BindingContext ctxt) {
+  private String describeReference(String reference, CanonicalResource target, BindingContext ctxt, String usageNote) {
     if (reference == null && target == null)
       return "null";
     String res = null;
@@ -4297,7 +4473,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
       }
     }
     switch (ctxt) {
-    case ADDITIONAL: return context.formatMessage(I18nConstants.BINDING_ADDITIONAL, res);
+    case ADDITIONAL: return context.formatMessage(Utilities.noString(usageNote) ? I18nConstants.BINDING_ADDITIONAL_D : I18nConstants.BINDING_ADDITIONAL_UC, res, usageNote);
     case MAXVS: return context.formatMessage(I18nConstants.BINDING_MAX, res);
     default: return res;
     }

org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/type/StructureDefinitionValidator.java

@@ -525,7 +525,7 @@ public class StructureDefinitionValidator extends BaseValidator {
         ok = rule(errors, NO_RULE_DATE, IssueType.BUSINESSRULE, stack.getLiteralPath(), characteristics.contains("can-bind") , I18nConstants.SD_ILLEGAL_CHARACTERISTICS, "Binding", typeCodes) && ok;
       }
       Element binding = element.getNamedChild("binding", false);
-      ok = validateBinding(errors, binding, stack.push(binding, -1, null, null), typeCodes, snapshot, path, experimental) && ok;
+      ok = validateBinding(errors, binding, stack.push(binding, -1, null, null), typeCodes, snapshot, path, experimental, sd) && ok;
     } else {
       // this is a good idea but there's plenty of cases where the rule isn't met; maybe one day it's worth investing the time to exclude these cases and bring this rule back
       //      String bt = boundType(typeCodes);
@@ -989,7 +989,7 @@ public class StructureDefinitionValidator extends BaseValidator {
     return null;
   }
 
-  private boolean validateBinding(List<ValidationMessage> errors, Element binding, NodeStack stack, Set<String> typeCodes, boolean snapshot, String path, boolean experimental) {
+  private boolean validateBinding(List<ValidationMessage> errors, Element binding, NodeStack stack, Set<String> typeCodes, boolean snapshot, String path, boolean experimental, StructureDefinition profile) {
     boolean ok = true;
     if (bindableType(typeCodes) == null) {
       ok = rule(errors, NO_RULE_DATE, IssueType.BUSINESSRULE, stack.getLiteralPath(), !snapshot, I18nConstants.SD_ED_BIND_NO_BINDABLE, path, typeCodes.toString()) && ok;
@@ -1019,6 +1019,119 @@ public class StructureDefinitionValidator extends BaseValidator {
         }
       }
     } 
+    if (binding.hasChildren("additional")) {
+      int i = 0;
+      for (Element ab : binding.getChildren("additional")) {
+         ok = validateAdditionalBinding(errors, ab, stack.push(ab, i, null, null), snapshot, path, experimental) && ok;
+         i++;
+      }
+    }
+    if (binding.hasExtension(ToolingExtensions.EXT_BINDING_ADDITIONAL)) {
+      int i = 0;
+      for (Element ab : binding.getChildren("extension")) {
+        String url = ab.getNamedChildValue("url");
+        if (ToolingExtensions.EXT_BINDING_ADDITIONAL.equals(url)) {
+           ok = validateAdditionalBindingExtension(errors, ab, stack.push(ab, i, null, null), snapshot, path, experimental, profile) && ok;
+        }
+        i++;
+      }      
+    }
+    return ok;
+  }
+  
+  private boolean validateAdditionalBinding(List<ValidationMessage> errors, Element binding, NodeStack stack, boolean snapshot, String path, boolean experimental) {
+    boolean ok = true;
+
+    if (binding.hasChild("valueSet", false)) {
+      Element valueSet = binding.getNamedChild("valueSet", false);
+      String ref = valueSet.hasPrimitiveValue() ? valueSet.primitiveValue() : valueSet.getNamedChildValue("reference", false);
+      if (warning(errors, NO_RULE_DATE, IssueType.BUSINESSRULE, stack.getLiteralPath(), !snapshot || ref != null, I18nConstants.SD_ED_SHOULD_BIND_WITH_VS, path)) {
+        Resource vs = context.fetchResource(Resource.class, ref);
+
+        // just because we can't resolve it directly doesn't mean that terminology server can't. Check with it
+
+        if (warning(errors, NO_RULE_DATE, IssueType.BUSINESSRULE, stack.getLiteralPath(), vs != null || serverSupportsValueSet(ref), I18nConstants.SD_ED_BIND_UNKNOWN_VS, path, ref)) {
+          if (vs != null) {
+            if (rule(errors, NO_RULE_DATE, IssueType.BUSINESSRULE, stack.getLiteralPath(), vs instanceof ValueSet, I18nConstants.SD_ED_BIND_NOT_VS, path, ref, vs.fhirType())) {              
+              ValueSet vsr = (ValueSet) vs;
+              warning(errors, "2024-09-17", IssueType.BUSINESSRULE, stack.getLiteralPath(), !vsr.getExperimental() || experimental, I18nConstants.SD_ED_EXPERIMENTAL_BINDING, path, ref);
+            } else {
+              ok = false;
+            }
+          }
+        }
+      }
+    } 
+    if (binding.hasChildren("usage")) {
+      for (Element usage : binding.getChildren("usage")) {
+        warning(errors, "2024-09-20", IssueType.BUSINESSRULE, stack.getLiteralPath(), false, "test");        
+      }
+    }
+    return ok;
+  }
+
+  private boolean validateAdditionalBindingExtension(List<ValidationMessage> errors, Element binding, NodeStack stack, boolean snapshot, String path, boolean experimental, StructureDefinition profile) {
+    boolean ok = true;
+
+    if (binding.hasExtension("valueSet")) {
+      Element valueSet = binding.getExtension("valueSet");
+      Element vv = valueSet.getNamedChild("value");
+      String ref = vv.hasPrimitiveValue() ? vv.primitiveValue() : vv.getNamedChildValue("reference", false);
+      if (warning(errors, NO_RULE_DATE, IssueType.BUSINESSRULE, stack.getLiteralPath(), !snapshot || ref != null, I18nConstants.SD_ED_SHOULD_BIND_WITH_VS, path)) {
+        Resource vs = context.fetchResource(Resource.class, ref);
+
+        // just because we can't resolve it directly doesn't mean that terminology server can't. Check with it
+
+        if (warning(errors, NO_RULE_DATE, IssueType.BUSINESSRULE, stack.getLiteralPath(), vs != null || serverSupportsValueSet(ref), I18nConstants.SD_ED_BIND_UNKNOWN_VS, path, ref)) {
+          if (vs != null) {
+            if (rule(errors, NO_RULE_DATE, IssueType.BUSINESSRULE, stack.getLiteralPath(), vs instanceof ValueSet, I18nConstants.SD_ED_BIND_NOT_VS, path, ref, vs.fhirType())) {              
+              ValueSet vsr = (ValueSet) vs;
+              warning(errors, "2024-09-17", IssueType.BUSINESSRULE, stack.getLiteralPath(), !vsr.getExperimental() || experimental, I18nConstants.SD_ED_EXPERIMENTAL_BINDING, path, ref);
+            } else {
+              ok = false;
+            }
+          }
+        }
+      }
+    } 
+    if (binding.hasExtension("usage")) {
+      int i = 0;
+      for (Element usage : binding.getChildren("extension")) {
+        String url = usage.getNamedChildValue("url");
+        if ("usage".equals(url)) {
+          Element uv = usage.getNamedChild("value");  
+          ok = validateAdditionalBindingUsage(errors, uv, stack.push(uv, -1, null, null), path, profile) && ok;
+        }
+        i++;
+      }      
+    }
+    return ok;
+  }
+
+  private boolean validateAdditionalBindingUsage(List<ValidationMessage> errors, Element usage, NodeStack stack, String path, StructureDefinition profile) {
+    boolean ok = true;
+    Element cc = usage.getNamedChild("code");
+    if (cc != null) {
+      String system = cc.getNamedChildValue("system");
+      String code = cc.getNamedChildValue("code");
+      if (system != null && system.equals(profile.getUrl())) {
+        ElementDefinition ed = profile.getDifferential().getElementByPath(code);
+        if (ed == null) {
+          ed = profile.getSnapshot().getElementByPath(code);          
+        }
+        if (ed == null) {
+          ok = false;
+          rule(errors, "2024-09-17", IssueType.BUSINESSRULE, stack.getLiteralPath(), false, I18nConstants.SD_ED_ADDITIONAL_BINDING_USAGE_INVALID_ELEMENT, system, code);
+        } else {
+          if (usage.hasChild("value")) {
+            String t = usage.getNamedChild("value").fhirType();
+            ok = rule(errors, "2024-09-20", IssueType.BUSINESSRULE, stack.getLiteralPath(), "CodeableConcept".equals(t), I18nConstants.SD_ED_ADDITIONAL_BINDING_USAGE_INVALID_TYPE, t, "CodeableConcept") && ok;
+          }
+        }
+      } else {
+        warning(errors, "2024-09-17", IssueType.BUSINESSRULE, stack.getLiteralPath(), false, I18nConstants.SD_ED_ADDITIONAL_BINDING_USAGE_UNKNOWN, system, code);
+      }
+    }
     return ok;
   }
   

org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/testStructureDefinitionadditional-bindings-profile-cs.cache

@@ -0,0 +1,42 @@
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://hl7.org/fhir/test/StructureDefinition/additional-bindings-profile-cs",
+  "code" : "digital-access"
+}, "valueSet" :null, "langs":"en-US", "useServer":"true", "useClient":"false", "guessSystem":"false", "activeOnly":"false", "membershipOnly":"false", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "code" : "digital-access",
+  "system" : "http://hl7.org/fhir/test/StructureDefinition/additional-bindings-profile-cs",
+  "severity" : "error",
+  "error" : "A definition for CodeSystem 'http://hl7.org/fhir/test/StructureDefinition/additional-bindings-profile-cs' could not be found, so the code cannot be validated",
+  "class" : "CODESYSTEM_UNSUPPORTED",
+  "server" : "http://tx-dev.fhir.org/r4",
+  "unknown-systems" : "http://hl7.org/fhir/test/StructureDefinition/additional-bindings-profile-cs",
+  "issues" : {
+  "resourceType" : "OperationOutcome",
+  "issue" : [{
+    "extension" : [{
+      "url" : "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-server",
+      "valueUrl" : "http://tx-dev.fhir.org/r4"
+    }],
+    "severity" : "error",
+    "code" : "not-found",
+    "details" : {
+      "coding" : [{
+        "system" : "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+        "code" : "not-found"
+      }],
+      "text" : "A definition for CodeSystem 'http://hl7.org/fhir/test/StructureDefinition/additional-bindings-profile-cs' could not be found, so the code cannot be validated"
+    },
+    "location" : ["Coding.system"],
+    "expression" : ["Coding.system"]
+  }]
+}
+
+}
+-------------------------------------------------------------------------------------

org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/ussdoh-clinicalcareCodeSystemSDOHCC-CodeSystemTemporaryCodes.cache

@@ -0,0 +1,83 @@
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes",
+  "code" : "digital-access-x"
+}, "valueSet" :null, "langs":"en-US", "useServer":"true", "useClient":"false", "guessSystem":"false", "activeOnly":"false", "membershipOnly":"false", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "code" : "digital-access-x",
+  "system" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes",
+  "severity" : "error",
+  "error" : "A definition for CodeSystem 'http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes' could not be found, so the code cannot be validated",
+  "class" : "CODESYSTEM_UNSUPPORTED",
+  "server" : "http://tx-dev.fhir.org/r4",
+  "unknown-systems" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes",
+  "issues" : {
+  "resourceType" : "OperationOutcome",
+  "issue" : [{
+    "extension" : [{
+      "url" : "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-server",
+      "valueUrl" : "http://tx-dev.fhir.org/r4"
+    }],
+    "severity" : "error",
+    "code" : "not-found",
+    "details" : {
+      "coding" : [{
+        "system" : "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+        "code" : "not-found"
+      }],
+      "text" : "A definition for CodeSystem 'http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes' could not be found, so the code cannot be validated"
+    },
+    "location" : ["Coding.system"],
+    "expression" : ["Coding.system"]
+  }]
+}
+
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes",
+  "code" : "digital-access"
+}, "valueSet" :null, "langs":"en-US", "useServer":"true", "useClient":"false", "guessSystem":"false", "activeOnly":"false", "membershipOnly":"false", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "code" : "digital-access",
+  "system" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes",
+  "severity" : "error",
+  "error" : "A definition for CodeSystem 'http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes' could not be found, so the code cannot be validated",
+  "class" : "CODESYSTEM_UNSUPPORTED",
+  "server" : "http://tx-dev.fhir.org/r4",
+  "unknown-systems" : "http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes",
+  "issues" : {
+  "resourceType" : "OperationOutcome",
+  "issue" : [{
+    "extension" : [{
+      "url" : "http://hl7.org/fhir/StructureDefinition/operationoutcome-issue-server",
+      "valueUrl" : "http://tx-dev.fhir.org/r4"
+    }],
+    "severity" : "error",
+    "code" : "not-found",
+    "details" : {
+      "coding" : [{
+        "system" : "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+        "code" : "not-found"
+      }],
+      "text" : "A definition for CodeSystem 'http://hl7.org/fhir/us/sdoh-clinicalcare/CodeSystem/SDOHCC-CodeSystemTemporaryCodes' could not be found, so the code cannot be validated"
+    },
+    "location" : ["Coding.system"],
+    "expression" : ["Coding.system"]
+  }]
+}
+
+}
+-------------------------------------------------------------------------------------