# hl7.fhir.us.davinci-pas 2.0.1 → 2.2.1 — version-difference evidence pack

The largest requirement delta in the set — 1,007 changes across 70 profiles present in both versions, including 191 new must-support expectations.

This pack is the downloadable form of the public report at `/ig-gap/davinci-pas-2-0-1-to-2-2-1`. It is per-pair and carries public content only; the cross-pair rollup and arbitrary-pair export remain a separate, gated capability (IG-115 / Suite B).

## Inputs

| Side | Package | sha256 |
|---|---|---|
| Baseline | `hl7.fhir.us.davinci-pas#2.0.1` | `1ba4159f2a1ea000dfb1685601bfc902c603a1c59ce2127118ee0a7aec694218` |
| Target | `hl7.fhir.us.davinci-pas#2.2.1` | `da2aac8e480ce66fe27812af18e3c9bc190b08a33d5d7e1c850caf9097fb210e` |

Engines: comparison 1.0.0 · normalization 1.3.0 · schema v2 · generator 1.1.0 · inputs hash `0d152adea100b3b5c8a2c2f0012f5102`

These two archives, identified by SHA-256, are the complete input. Anyone can fetch them and confirm they are looking at the same bytes this analysis read. The analysis itself is ImOnFHIR's.

There is deliberately no generation timestamp: the report is a pure function of the two archives, so the digests date it better than a clock would.

## The shape of the change

1,007 element-level requirement changes, each graded to exactly one tier — every count in this pack is complete, computed over the full change set.

| Tier | Count |
|---|---|
| Critical | 54 |
| Needs review | 647 |
| Indeterminate | 0 |
| Informational | 306 |
| **Total** | **1,007** |

### Read the element counts as a floor

11 profiles exist only in 2.2.1, and 1 only in 2.0.1. Those have no counterpart to compare against, so they contribute no element-level rows — the element comparison covers the 70 profiles present in both versions. Neither number is a total on its own.

The 60 mandatory or must-support elements attributed to added profiles are counted from each profile’s effective element list; where a profile ships no snapshot that list is reconstructed by merging its differential onto its base, so treat the figure as indicative rather than audited.

## Where the change concentrates

Most breaking changes (absolute critical count):

- `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update` — 11 critical of 106 changes
- `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim` — 7 critical of 95 changes
- `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse` — 5 critical of 84 changes

Most sharply changed (critical share; profiles with at least 5 changes — the floor keeps one-change profiles from scoring 100%):

- `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-identifier` — 33% of 6 changes critical
- `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle` — 19% of 16 changes critical
- `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-request-bundle` — 14% of 14 changes critical

## The other planes

| Plane | Changes | Highest severity present |
|---|---|---|
| Operations | 1 | needs review |
| Value sets | 19 | needs review |
| Capability statements | 0 | — |

## Profile coverage

Compared in both versions: 70 · added in target: 11 · removed from baseline: 1

- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-quantity`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemCategory`
- PROFILE_REMOVED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-admissionDates`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-authorizedProviderType`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-TransmissionIdentifiers`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-documentreference`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscription`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-revenueCode`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-dischargeDate`
- PROFILE_ADDED `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-documentInformation`

## Changes by effect

| Effect | Count |
|---|---|
| binding added | 2 |
| binding removed | 1 |
| informational change | 35 |
| invariant added | 46 |
| invariant changed | 12 |
| invariant removed | 28 |
| newly required | 34 |
| new support expectation | 191 |
| no longer required | 8 |
| profile inheritance changed | 16 |
| reference requirement changed | 166 |
| slice added | 139 |
| slice cardinality changed | 12 |
| slice removed | 2 |
| support expectation removed | 12 |
| target profile expanded | 4 |
| target profile narrowed | 10 |
| type expanded | 7 |
| type narrowed | 2 |
| unknown | 2 |
| valueset reference changed | 278 |

## Sampled evidence rows

Every count above is complete. The rows below are a bounded, deterministic sample of 40 (967 further changes are counted above but not sampled here), chosen so every kind of change and the most-affected profiles are each represented. Each row carries its stable change id — cite the id, not the prose; the id survives regeneration, the prose may not.

- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base|Claim.careTeam.provider|ItemClaimMember|TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base`
  - element: `Claim.careTeam.provider` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Practitioner","http://hl7.org/fhir/StructureDefinition/PractitionerRole","http://hl7.org/fhir/StructureDefinition/Organization"] → ["http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-organization|2.2.1","http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole|2.2.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base|Claim.supportingInfo.timing[x]|DischargeDates|TYPE||:TYPE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base`
  - element: `Claim.supportingInfo.timing[x]` · type narrowed · critical
  - ["Period","date"] → ["date"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-inquiry|Claim.careTeam.provider|ItemClaimMember|TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-inquiry`
  - element: `Claim.careTeam.provider` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Practitioner","http://hl7.org/fhir/StructureDefinition/PractitionerRole","http://hl7.org/fhir/StructureDefinition/Organization"] → ["http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-organization|2.2.1","http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole|2.2.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-inquiry|Claim.identifier||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-inquiry`
  - element: `Claim.identifier` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-inquiry|Claim.supportingInfo.timing[x]|DischargeDates|TYPE||:TYPE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-inquiry`
  - element: `Claim.supportingInfo.timing[x]` · type narrowed · critical
  - ["Period","date"] → ["date"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update|Claim.careTeam.provider|ItemClaimMember|TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update`
  - element: `Claim.careTeam.provider` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Practitioner","http://hl7.org/fhir/StructureDefinition/PractitionerRole","http://hl7.org/fhir/StructureDefinition/Organization"] → ["http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-organization|2.2.1","http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole|2.2.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update|Claim.item.extension|certificationType|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update`
  - element: `Claim.item.extension` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse|ClaimResponse.addItem.itemSequence||MAX_CARDINALITY||:INFORMATIONAL_CHANGE`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claiminquiryresponse`
  - element: `ClaimResponse.addItem.itemSequence` · informational change · critical
  - * → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse-base|ClaimResponse.addItem.itemSequence||MAX_CARDINALITY||:INFORMATIONAL_CHANGE`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse-base`
  - element: `ClaimResponse.addItem.itemSequence` · informational change · critical
  - * → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse|ClaimResponse.addItem.itemSequence||MAX_CARDINALITY||:INFORMATIONAL_CHANGE`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse`
  - element: `ClaimResponse.addItem.itemSequence` · informational change · critical
  - * → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim|Claim.careTeam.provider|ItemClaimMember|TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim`
  - element: `Claim.careTeam.provider` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Practitioner","http://hl7.org/fhir/StructureDefinition/PractitionerRole","http://hl7.org/fhir/StructureDefinition/Organization"] → ["http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-organization|2.2.1","http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole|2.2.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage|Coverage.identifier||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-coverage`
  - element: `Coverage.identifier` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-encounter|Encounter.serviceProvider||TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-encounter`
  - element: `Encounter.serviceProvider` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Organization"] → ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|7.0.0"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-identifier|Identifier.system||MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-identifier`
  - element: `Identifier.system` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-medicationrequest|MedicationRequest.encounter||TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-medicationrequest`
  - element: `MedicationRequest.encounter` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Encounter"] → ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter|7.0.0"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-request-bundle|Bundle.entry.fullUrl|Claim|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-request-bundle`
  - element: `Bundle.entry.fullUrl` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-response-bundle|Bundle.entry.fullUrl|ClaimResponse|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-inquiry-response-bundle`
  - element: `Bundle.entry.fullUrl` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle|Bundle.entry.fullUrl|Claim|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-request-bundle`
  - element: `Bundle.entry.fullUrl` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle|Bundle.entry.fullUrl|ClaimResponse|MIN_CARDINALITY||:NEWLY_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle`
  - element: `Bundle.entry.fullUrl` · newly required · critical
  - 0 → 1
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole|PractitionerRole.location||TARGET_PROFILE||:TARGET_PROFILE_NARROWED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-practitionerrole`
  - element: `PractitionerRole.location` · target profile narrowed · critical
  - ["http://hl7.org/fhir/StructureDefinition/Location"] → ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-location|7.0.0"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/PASMetricData|PASMetricData.source||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/PASMetricData`
  - element: `PASMetricData.source` · valueset reference changed · needs review
  - {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource"} → {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-pas/ValueSet/MetricDataSource|2.2.1"}
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis|Extension.value[x]||VALUESET_REFERENCE||:VALUESET_REFERENCE_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-communicatedDiagnosis`
  - element: `Extension.value[x]` · valueset reference changed · needs review
  - {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278DiagnosisCodes"} → {"strength":"required","valueSet":"http://hl7.org/fhir/us/davinci-pas/ValueSet/X12278DiagnosisCodes|2.2.1"}
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary|Patient.extension|genderIdentity|SLICING|genderIdentity|:SLICE_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary`
  - element: `Patient.extension` · slice added · needs review
  - — → {"sliceName":"genderIdentity","min":0,"max":"*"}
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary|Patient.extension|race|INVARIANT|us-core-23|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary`
  - element: `Patient.extension` · invariant added · needs review
  - — → {"key":"us-core-23","severity":"error","human":"If \"ASKU\" or \"UNK\" are present, then no other OMB race categories can be present.","expression":"extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1","source":"http://hl7.org/fhir/StructureDefinition/Patient"}
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary|Patient.name||INVARIANT|us-core-6|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary`
  - element: `Patient.name` · invariant added · needs review
  - — → {"key":"us-core-6","severity":"error","human":"At least name.given and/or name.family are present or, if neither is available, the Data Absent Reason Extension is present.","expression":"(family.exists() or given.exists()) xor extension.where(url='http://hl7.org/fhir/StructureDefinition/data-absent-reason').exists()","xpath":"(/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason' and not(/f:family or /f:given)) or (not(/f:extension/@url='http://hl7.org/fhir/StructureDefinition/data-absent-reason') and (/f:family or /f:given))","source":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0"}
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base|Claim.accident.location[x]||MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base`
  - element: `Claim.accident.location[x]` · new support expectation · needs review
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base|Claim.careTeam.extension.value[x]|ItemClaimMember/careTeamClaimScope|MUST_SUPPORT||:NEW_SUPPORT_EXPECTATION`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base`
  - element: `Claim.careTeam.extension.value[x]` · new support expectation · needs review
  - false → true
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest|CommunicationRequest.about||TARGET_PROFILE||:REFERENCE_REQUIREMENT_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-communicationrequest`
  - element: `CommunicationRequest.about` · reference requirement changed · needs review
  - ["http://hl7.org/fhir/StructureDefinition/Resource"] → ["http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-devicerequest|DeviceRequest.basedOn||TARGET_PROFILE||:REFERENCE_REQUIREMENT_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-devicerequest`
  - element: `DeviceRequest.basedOn` · reference requirement changed · needs review
  - ["http://hl7.org/fhir/StructureDefinition/Resource"] → ["http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer|Organization.identifier|CLIA|INVARIANT|us-core-18|:INVARIANT_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer`
  - element: `Organization.identifier` · invariant added · needs review
  - — → {"key":"us-core-18","severity":"error","human":"CLIA number must be 10 digits with a letter \"D\" in third position","expression":"value.matches('^[0-9]{2}D[0-9]{7}$')","xpath":"f:value/f:matches(value,/^[0-9]{2}D[0-9]{7}$/)","source":"http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|7.0.0"}
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-nutritionorder|NutritionOrder.allergyIntolerance||TARGET_PROFILE||:REFERENCE_REQUIREMENT_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-nutritionorder`
  - element: `NutritionOrder.allergyIntolerance` · reference requirement changed · needs review
  - ["http://hl7.org/fhir/StructureDefinition/AllergyIntolerance"] → ["http://hl7.org/fhir/StructureDefinition/AllergyIntolerance|4.0.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest|ServiceRequest.basedOn||TARGET_PROFILE||:REFERENCE_REQUIREMENT_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest`
  - element: `ServiceRequest.basedOn` · reference requirement changed · needs review
  - ["http://hl7.org/fhir/StructureDefinition/CarePlan","http://hl7.org/fhir/StructureDefinition/ServiceRequest","http://hl7.org/fhir/StructureDefinition/MedicationRequest"] → ["http://hl7.org/fhir/StructureDefinition/CarePlan|4.0.1","http://hl7.org/fhir/StructureDefinition/ServiceRequest|4.0.1","http://hl7.org/fhir/StructureDefinition/MedicationRequest|4.0.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber|Patient.extension|genderIdentity|SLICING|genderIdentity|:SLICE_ADDED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber`
  - element: `Patient.extension` · slice added · needs review
  - — → {"sliceName":"genderIdentity","min":0,"max":"*"}
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task|Task.basedOn||TARGET_PROFILE||:REFERENCE_REQUIREMENT_CHANGED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-task`
  - element: `Task.basedOn` · reference requirement changed · needs review
  - ["http://hl7.org/fhir/StructureDefinition/Resource"] → ["http://hl7.org/fhir/StructureDefinition/Resource|4.0.1"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement|Extension.extension||MAX_CARDINALITY||:INFORMATIONAL_CHANGE`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement`
  - element: `Extension.extension` · informational change · informational
  - 0 → *
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement|Extension.value[x]||TYPE||:TYPE_EXPANDED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-errorElement`
  - element: `Extension.value[x]` · type expanded · informational
  - ["string"] → ["Address","Age","Annotation","Attachment","CodeableConcept","Coding","ContactDetail","ContactPoint","Contributor","Count","DataRequirement","Distance","Dosage","Duration","Expression","HumanName","Identifier","Meta","Money","ParameterDefinition","Period","Quantity","Range","Ratio","Reference","RelatedArtifact","SampledData","Signature","Timing","TriggerDefinition","UsageContext","base64Binary","boolean","canonical","code","date","dateTime","decimal","id","instant","integer","markdown","oid","positiveInt","string","time","unsignedInt","uri","url","uuid"]
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary|Patient.address.period||MUST_SUPPORT||:SUPPORT_EXPECTATION_REMOVED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary`
  - element: `Patient.address.period` · support expectation removed · informational
  - true → false
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary|Patient.communication||MUST_SUPPORT||:SUPPORT_EXPECTATION_REMOVED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary`
  - element: `Patient.communication` · support expectation removed · informational
  - true → false
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base|Claim.item||MIN_CARDINALITY||:NO_LONGER_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-base`
  - element: `Claim.item` · no longer required · informational
  - 1 → 0
- `req:http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-inquiry|Claim.item||MIN_CARDINALITY||:NO_LONGER_REQUIRED`
  - profile: `http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-inquiry`
  - element: `Claim.item` · no longer required · informational
  - 1 → 0

## Where rules we track mention this guide

Context only, quoted from our mandate register. None of it changes the comparison above, which depends on the two packages and nothing else.

- CMS-0057-F (by 2027-01-01) — register records a recommended version of `2.2.1` — compliance 2027-01-01 — https://www.cms.gov/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f
- CMS-0062-P (proposed — no adopted date) — PROPOSED 2026-04-14, comments closed 2026-06-15 — not final as of 2026-07-26, no adopted compliance date — https://www.federalregister.gov/documents/2026/04/14/2026-07205/medicare-and-medicaid-programs-patient-protection-and-affordable-care-act-interoperability-standards · https://www.cms.gov/priorities/burden-reduction/overview/interoperability/policies-regulations/cms-interoperability-standards-prior-authorization-drugs-proposed-rule-cms-0062-p

## Who maintains this guide, per our register

Where standards work on this guide happens — the room a ballot comment or a question should go to. Quoted from our workgroup register; sourced from the guide's own published footer attribution.

- HL7 International / Financial Management (owner) — https://www.hl7.org/Special/committees/fm · https://hl7.org/fhir/us/davinci-pas/en/index.html — reviewed 2026-07-26

## What this pack is not

Not a compliance assessment. The comparison carries no deadline and renders no verdict about any organization or implementation. Observed validator differences are not automatic proof of official IG requirement changes.