After years of discussion documented in this [confluence page| https://confluence.hl7.org/pages/viewpage.action?pageId=51223352 ,] we are proposing these changes:   Encounter. reason 0..*     reason CodableReference 0..* (Condition | Procedure | Observation | ImmunizationRecommendation | HealthcareService)     use CodeableConcept 0..1 (new ValueSet including concepts like: Chief Complaint, Admitting Diagnosis, Reason for Visit, Health Maintenance (including screening)) encounter.reason Definition: The list of medical reasons or symptoms that is expected to be addressed during the encounter. encounter.reason.reason Definition: The medical reason or symptom that is expected to be addressed during the encounter, expressed as a text, code or a reference to another resource. Comments: The reason communicates what medical problem or symptom the patient has that should be addressed during the encounter.  This reason could be patient reported complaint, a clinical indication that was determined in a previous encounter, or some planned care such as an immunization recommendation.  In the case where you have a primary reason, but are expecting to also address other problems, you can list the primary reason with a use code of "Chief Complaint", while the other problems being addressed would have a use code of "Reason for Visit". Examples: annual physical, pediatric checkups would use HealthcareService as the reason surgeries would could use Procedure, or possibly Condition as the reason     Encounter. diagnosis  0..*     condition  CodableReference 0..* (Condition)     use CodeableConcept 0..1 (ValueSet: Rename: https://build.fhir.org/valueset-diagnosis-role.html  to diagnosis-use-code, remove "Billing", add "Working" and "Final") encounter. diagnosis  Definition: The list of medical condition that was addressed during the encounter. encounter. diagnosis .condition Definition: The medical condition that was addressed during the encounter, expressed as a text, code or a reference to another resource. Comments: The diagnosis communicates what medical conditions were actually addressed during the encounter.  If a diagnosis was provided as a reason for visit, and was treated during the encounter, it may be listed in both Encounter.reason and Encounter.diagnosis.  Diagnoses related to billing can be documented on the Account resources which supports ranking for the purpose of reimbursement.