The current modeling for many QI-Core NotDone profile code elements is confusing to implementers and considered potentially ambiguous. Other NotDone profile specify code cardinality of 0..1 but then require a cardinality of 1..1 for referencing the notDoneValueSet. MedicationNotAdministered does include a code cardinality of 1..1. However, it specifically addresses a single use case that none of a group of items was done. Consistent with the evaluation for ProcedureNotDone FHIR 31930, it is suggested that a more generic option with a specific slice for the eCQM use case to express that none of the value set items occurred.

Will need to maintain MedicationAdministrationNotDone.code as cardinality 1..1 (as it currently states), but change MedicationAdministrationNotDone.code.coding.valueSetReference to cardinality 0..1
AND
create a slice on coding specific to the use case where the reference is to indicate the entire value set is negated and not a specific code. That slice is specific to using the value set cardinality of the extension 1..1 (the code.coding.code cardinality to be 0..0)