diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/NarrativeGenerator.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/NarrativeGenerator.java
index b7a3932ca..d3386f7ee 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/NarrativeGenerator.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/NarrativeGenerator.java
@@ -185,6 +185,7 @@ import org.hl7.fhir.r5.terminologies.CodeSystemUtilities.CodeSystemNavigator;
 import org.hl7.fhir.r5.terminologies.ValueSetExpander.ValueSetExpansionOutcome;
 import org.hl7.fhir.r5.utils.FHIRPathEngine.IEvaluationContext;
 import org.hl7.fhir.r5.utils.LiquidEngine.LiquidDocument;
+import org.hl7.fhir.r5.utils.XVerExtensionManager.XVerExtensionStatus;
 import org.hl7.fhir.utilities.CommaSeparatedStringBuilder;
 import org.hl7.fhir.utilities.MarkDownProcessor;
 import org.hl7.fhir.utilities.MarkDownProcessor.Dialect;
@@ -1126,6 +1127,7 @@ public class NarrativeGenerator implements INarrativeGenerator {
   private boolean noSlowLookup;
   private List<String> codeSystemPropList = new ArrayList<>();
   private ProfileUtilities profileUtilities;
+  private XVerExtensionManager xverManager;
 
   public NarrativeGenerator(String prefix, String basePath, IWorkerContext context) {
     super();
@@ -1396,6 +1398,16 @@ public class NarrativeGenerator implements INarrativeGenerator {
             Extension ex  = (Extension) v.getBase();
             String url = ex.getUrl();
             StructureDefinition ed = context.fetchResource(StructureDefinition.class, url);
+            if (ed == null) {
+              if (xverManager == null) {
+                xverManager = new XVerExtensionManager(context);
+              }
+              if (xverManager.matchingUrl(url) && xverManager.status(url) == XVerExtensionStatus.Valid) {
+                ed = xverManager.makeDefinition(url);
+                context.generateSnapshot(ed);
+                context.cacheResource(ed);
+              }
+            }
             if (p.getName().equals("modifierExtension") && ed == null)
               throw new DefinitionException("Unknown modifier extension "+url);
             PropertyWrapper pe = map.get(p.getName()+"["+url+"]");
diff --git a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/XVerExtensionManager.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/XVerExtensionManager.java
similarity index 97%
rename from org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/XVerExtensionManager.java
rename to org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/XVerExtensionManager.java
index ef658c4de..f7f04adf5 100644
--- a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/XVerExtensionManager.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/XVerExtensionManager.java
@@ -1,4 +1,4 @@
-package org.hl7.fhir.validation;
+package org.hl7.fhir.r5.utils;
 
 import java.io.IOException;
 import java.util.Date;
@@ -7,6 +7,7 @@ import java.util.Map;
 
 import org.hl7.fhir.exceptions.FHIRException;
 import org.hl7.fhir.r5.context.IWorkerContext;
+import org.hl7.fhir.r5.model.Constants;
 import org.hl7.fhir.r5.model.ElementDefinition;
 import org.hl7.fhir.r5.model.ElementDefinition.TypeRefComponent;
 import org.hl7.fhir.r5.model.Enumerations.FHIRVersion;
@@ -38,6 +39,9 @@ public class XVerExtensionManager {
 
   public XVerExtensionStatus status(String url) throws FHIRException {
     String v = url.substring(20, 23);
+    if ("5.0".equals(v)) {
+      v = Constants.VERSION_MM;
+    }
     String e = url.substring(54);
     if (!lists.containsKey(v)) {
       if (context.getBinaries().containsKey("xver-paths-"+v+".json")) {
@@ -68,6 +72,9 @@ public class XVerExtensionManager {
 
   public StructureDefinition makeDefinition(String url) {
     String verSource = url.substring(20, 23);
+    if ("5.0".equals(verSource)) {
+      verSource = Constants.VERSION_MM;
+    }
     String verTarget = VersionUtilities.getMajMin(context.getVersion());
     String e = url.substring(54);
     JsonObject root = lists.get(verSource);
diff --git a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java
index 9f18f133b..ed8f93a6a 100644
--- a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java
+++ b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/ValidationEngine.java
@@ -341,7 +341,7 @@ public class ValidationEngine implements IValidatorResourceFetcher {
     context = SimpleWorkerContext.fromDefinitions(source, loaderForVersion(), new PackageVersion(src));
     context.setAllowLoadingDuplicates(true); // because of Forge
     context.setExpansionProfile(makeExpProfile());
-    NpmPackage npm = pcm.loadPackage("hl7.fhir.xver-extensions", "0.0.2");
+    NpmPackage npm = pcm.loadPackage("hl7.fhir.xver-extensions", "0.0.3");
     context.loadFromPackage(npm, null);
     grabNatives(source, "http://hl7.org/fhir");
   }
diff --git a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
index e6de73840..e0cffc8c5 100644
--- a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
+++ b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
@@ -134,13 +134,13 @@ import org.hl7.fhir.r5.utils.FHIRPathEngine.IEvaluationContext;
 import org.hl7.fhir.r5.utils.IResourceValidator;
 import org.hl7.fhir.r5.utils.NarrativeGenerator;
 import org.hl7.fhir.r5.utils.ToolingExtensions;
+import org.hl7.fhir.r5.utils.XVerExtensionManager;
 import org.hl7.fhir.utilities.i18n.I18nConstants;
 import org.hl7.fhir.validation.BaseValidator;
 import org.hl7.fhir.validation.TimeTracker;
 import org.hl7.fhir.validation.instance.EnableWhenEvaluator.QStack;
 import org.hl7.fhir.validation.instance.type.MeasureValidator;
 import org.hl7.fhir.validation.instance.type.QuestionnaireValidator;
-import org.hl7.fhir.validation.XVerExtensionManager;
 import org.hl7.fhir.utilities.CommaSeparatedStringBuilder;
 import org.hl7.fhir.utilities.Utilities;
 import org.hl7.fhir.utilities.Utilities.DecimalStatus;