Observation Screening Assessment profile in US Core v6.1.0 has a must support slicing on Observation.category which has an required binding on ValueSet US Core Screening Assessment Observation Category . This ValueSet has four codes:

• sdoh
• functional-status
• disability-status
• cognitive-status

which map to four data elements in USCDI v3 :

• SDOH Assessment
• Functional Status
• Disability Status
• Mental/Cognitive Status

Chapter 2.2 Must Support Conformance does not provides a speicifc rules for Must Support on value set binding. Our understanding is that server implmenetation must support populating the element using at least one code from the binding value set conforming to FHIR binidng rules. For example, Condition.clinicalStatus has required binding of 6 status code. Server need to demonstrate it support at least of these 6 status code but don't have to support all of them.

This binding on Screening Assessment is a little different since all four codes have corresponding USCDI data element requirements. We think it is reasonable to say that Server shall demonstrate supporting of all four codes, instead of just one. (Note: This value set has six codes in US Core v7)

This is similar to the Clinical Notes Guidenace where server shall support all eight Clinical Note Type codes in DocumentReference and all three Report Category codes in DiagnosticReport.

Note: This question is not tied to granular scopes introduced in US Core v7 though one of the category codes, sdoh, is required by the grandular scopes guidance.