Background There are many instances in FHIR where a less-pure-and-more-pragmatic exegesis of the FHIR Standard is needed.  This approach was adopted in US Core 4.0.0 because no binding in FHIR meets all of the US Core requirements. The current guidance reflects a real-world compromise between the standard and what servers are capable of today. It also best represents the ONC's USCDI terminology requirements. Decision After an extensive offline conversation with the Commenter and the Community we will make the following changes: ( mock up attached ) Update the conformance section on extensible Add a conformance section to document the usage of R5 additional binding "current" binding in US Core. update the Condition and Procedure  profiles to use a "current" binding for code Add  bullet to the Condition  and Procedure profiles to call out the binding and link to 2.