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DirectTrust Code System
DirectTrust concepts consolidated from seven newly developed CodeSystems. Eleven established CodeSystems remain separate and unchanged. Concepts are organized by a family property; membership is organizational and does not assert an is-a relationship.
| Canonical URL | http://objects.directtrust.org/standards/terminology/CodeSystem/DTCodeSystem |
| Name | DirectTrustCodeSystem |
| Status | draft |
| Date | 2026-11-05 |
| Publisher | DirectTrust |
Concepts
| Code | Display | Definition |
|---|---|---|
receive | Receive | Receipt of the target by an actor or managed environment, sufficient for evaluation; does not assert acceptance, import, or service fulfillment. |
register | Register | Registration of the target in a registry, repository, or other managed information environment. |
replace | Replace | Replacement of one target by another; distinct from obsolescence and nullification. |
retrieve | Retrieve | Retrieval of the target from a repository or other managed information environment. |
seal | Seal | Application of a seal or equivalent integrity or authenticity mechanism to the target. |
store | Store | Storage of the target. |
import | Import | Incorporation of the target data or information into a system or managed information environment; distinct from receipt and acceptance. |
append | Append | Addition or addendum to the target without changing existing information. |
sign | Sign | Signing of the target by an identified signer. |
deliver | Deliver | Delivery of the target to its intended delivery destination; does not assert workflow acceptance. |
assemble | Assemble | Assembly of the target from its constituent content and applicable metadata or relationships; the target identifies whether this is a document or transaction package. |
accept | Accept | Acceptance of the target into the intended workflow for the processing specified by the originating transaction. For MAP TX8, the target is the whole originating SubmissionSet/List, including its Task and all included information objects. Receipt sufficient to determine disposition is implied. Does not assert import, clinical review, or fulfillment of downstream services. |
reject | Reject | Rejection of the target from the intended workflow, with an explanation. For MAP TX8, the target is the whole originating SubmissionSet/List, including its Task and all included information objects; no partial acceptance is asserted. Receipt sufficient to determine disposition is implied. Does not assert that every object was individually evaluated. |
notarize | Notarize | Notarization of the signature identified by the target. |
witness | Witness | Witnessing of the signature identified by the target. |
witness-agent | Witness | An agent that directly observed the Provenance Activity and can attest that the activity occurred, but did not principally perform the activity. |
recorder | Recorder | An agent that recorded the assertion that the Provenance Activity occurred, but did not necessarily perform or directly observe the activity. |
notary | Notary | An agent that participated in the activity in the legally or officially authorized capacity of a notary. |
send-outpatient-visit-notification | Send Outpatient Visit Notification | Notify about completion of an outpatient encounter. |
send-admission-notification | Send Admission Notification | Notify about admission or registration. |
send-birth-notification | Send Birth Notification | Notify designated maternal-health recipients about a birth event using maternal-facing information. |
send-discharge-notification | Send Discharge Notification | Notify about discharge. |
send-documents | Send Documents | Send clinical or workflow documents. |
query-for-documents | Query for Documents | Discover available documents. |
send-patient-update | Send Patient Update | Communicate updated patient information. |
send-workflow-status | Send Workflow Status | Report terminal Payload Receipt or Payload Rejection for an originating MaP transaction. |
add | Add | Add the targeted value to the current patient information. |
remove | Remove the targeted value from the current patient information; preserve audit history. This does not delete the Patient resource. | |
patient-demographic-identifier-changes | Patient demographic and identifier changes | A TX7 change list describing additions and removals of supported patient demographic and patient identifier values. |
sender-not-authorized | Sender not authorized | The sending entity is not authorized to initiate the requested workflow activity, and the required authorization prevents processing. |
unsupported-use-case | Unsupported use case | The recipient does not support the declared use case or requested transaction or lacks the capability required to perform the requested workflow activity. |
payload-not-processable | Payload not processable | A defect in the package, metadata, required information object, or content, or a processing limitation, prevents performance of the requested workflow activity. |
patient-not-found | Patient not found | The patient identity required to perform the workflow activity cannot be resolved or established. An unknown patient is not automatically a failure when the transaction permits registration. Patient identifiers must not be manufactured to conceal this condition. |
context-not-found | Context not found | An established Context required to perform the workflow activity cannot be resolved. Absence of optional Context alone is not a failure. Context identifiers must not be manufactured to conceal this condition. |
use-case | Use case | Identifies the declared use case for the requested workflow activity. The corresponding Task.input value is a Coding drawn from the applicable use-case terminology, such as DirectTrust ServDescCS. |
information-recipient | Information Recipient | Identifies the party intended to receive and act on the healthcare communication. The corresponding Task.input value is a Reference to the recipient resource. MAP recipient constraints are defined by the consuming implementation guide. |
request-workflow-status | Request successful Workflow Status reporting | Indicates whether reporting of successful structured payload acceptance into the intended workflow is requested. The corresponding Workflow Activity Task.input value is a boolean. True requests successful acceptance reporting; false or absence does not suppress failure reporting required by the applicable MAP Transaction Definition and does not request recursive reporting of a send-workflow-status outcome. |
workflow-status-update-endpoint | Workflow Status Update Endpoint | Identifies an endpoint to which workflow status reports are to be sent. The corresponding Workflow Activity Task.input value is a Reference to a FHIR Endpoint resource. Endpoint eligibility, cardinality, routing and reporting obligations are governed by the applicable MAP requirements; this is distinct from Direct transport delivery notifications. |
Full Resource
json
{
"resourceType": "CodeSystem",
"id": "DTCodeSystem",
"url": "http://objects.directtrust.org/standards/terminology/CodeSystem/DTCodeSystem",
"name": "DirectTrustCodeSystem",
"title": "DirectTrust Code System",
"status": "draft",
"date": "2026-11-05",
"publisher": "DirectTrust",
"description": "DirectTrust concepts consolidated from seven newly developed CodeSystems. Eleven established CodeSystems remain separate and unchanged. Concepts are organized by a family property; membership is organizational and does not assert an is-a relationship.",
"caseSensitive": true,
"content": "complete",
"count": 38,
"property": [
{
"code": "family",
"description": "Organizational concept family; permitted values are documented in DT_PACKAGE_VERSION_2.md.",
"type": "code"
}
],
"concept": [
{
"code": "receive",
"display": "Receive",
"definition": "Receipt of the target by an actor or managed environment, sufficient for evaluation; does not assert acceptance, import, or service fulfillment.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "register",
"display": "Register",
"definition": "Registration of the target in a registry, repository, or other managed information environment.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "replace",
"display": "Replace",
"definition": "Replacement of one target by another; distinct from obsolescence and nullification.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "retrieve",
"display": "Retrieve",
"definition": "Retrieval of the target from a repository or other managed information environment.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "seal",
"display": "Seal",
"definition": "Application of a seal or equivalent integrity or authenticity mechanism to the target.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "store",
"display": "Store",
"definition": "Storage of the target.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "import",
"display": "Import",
"definition": "Incorporation of the target data or information into a system or managed information environment; distinct from receipt and acceptance.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "append",
"display": "Append",
"definition": "Addition or addendum to the target without changing existing information.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "sign",
"display": "Sign",
"definition": "Signing of the target by an identified signer.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "deliver",
"display": "Deliver",
"definition": "Delivery of the target to its intended delivery destination; does not assert workflow acceptance.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "assemble",
"display": "Assemble",
"definition": "Assembly of the target from its constituent content and applicable metadata or relationships; the target identifies whether this is a document or transaction package.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "accept",
"display": "Accept",
"definition": "Acceptance of the target into the intended workflow for the processing specified by the originating transaction. For MAP TX8, the target is the whole originating SubmissionSet/List, including its Task and all included information objects. Receipt sufficient to determine disposition is implied. Does not assert import, clinical review, or fulfillment of downstream services.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "reject",
"display": "Reject",
"definition": "Rejection of the target from the intended workflow, with an explanation. For MAP TX8, the target is the whole originating SubmissionSet/List, including its Task and all included information objects; no partial acceptance is asserted. Receipt sufficient to determine disposition is implied. Does not assert that every object was individually evaluated.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "notarize",
"display": "Notarize",
"definition": "Notarization of the signature identified by the target.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "witness",
"display": "Witness",
"definition": "Witnessing of the signature identified by the target.",
"property": [
{
"code": "family",
"valueCode": "provenance-activity"
}
]
},
{
"code": "witness-agent",
"display": "Witness",
"definition": "An agent that directly observed the Provenance Activity and can attest that the activity occurred, but did not principally perform the activity.",
"property": [
{
"code": "family",
"valueCode": "provenance-agent-role"
}
]
},
{
"code": "recorder",
"display": "Recorder",
"definition": "An agent that recorded the assertion that the Provenance Activity occurred, but did not necessarily perform or directly observe the activity.",
"property": [
{
"code": "family",
"valueCode": "provenance-agent-role"
}
]
},
{
"code": "notary",
"display": "Notary",
"definition": "An agent that participated in the activity in the legally or officially authorized capacity of a notary.",
"property": [
{
"code": "family",
"valueCode": "provenance-agent-role"
}
]
},
{
"code": "send-outpatient-visit-notification",
"display": "Send Outpatient Visit Notification",
"definition": "Notify about completion of an outpatient encounter.",
"property": [
{
"code": "family",
"valueCode": "transaction-type"
}
]
},
{
"code": "send-admission-notification",
"display": "Send Admission Notification",
"definition": "Notify about admission or registration.",
"property": [
{
"code": "family",
"valueCode": "transaction-type"
}
]
},
{
"code": "send-birth-notification",
"display": "Send Birth Notification",
"definition": "Notify designated maternal-health recipients about a birth event using maternal-facing information.",
"property": [
{
"code": "family",
"valueCode": "transaction-type"
}
]
},
{
"code": "send-discharge-notification",
"display": "Send Discharge Notification",
"definition": "Notify about discharge.",
"property": [
{
"code": "family",
"valueCode": "transaction-type"
}
]
},
{
"code": "send-documents",
"display": "Send Documents",
"definition": "Send clinical or workflow documents.",
"property": [
{
"code": "family",
"valueCode": "transaction-type"
}
]
},
{
"code": "query-for-documents",
"display": "Query for Documents",
"definition": "Discover available documents.",
"property": [
{
"code": "family",
"valueCode": "transaction-type"
}
]
},
{
"code": "send-patient-update",
"display": "Send Patient Update",
"definition": "Communicate updated patient information.",
"property": [
{
"code": "family",
"valueCode": "transaction-type"
}
]
},
{
"code": "send-workflow-status",
"display": "Send Workflow Status",
"definition": "Report terminal Payload Receipt or Payload Rejection for an originating MaP transaction.",
"property": [
{
"code": "family",
"valueCode": "transaction-type"
}
]
},
{
"code": "add",
"display": "Add",
"definition": "Add the targeted value to the current patient information.",
"property": [
{
"code": "family",
"valueCode": "patient-change-action"
}
]
},
{
"code": "remove",
"display": "Remove the targeted value from the current patient information; preserve audit history. This does not delete the Patient resource.",
"property": [
{
"code": "family",
"valueCode": "patient-change-action"
}
]
},
{
"code": "patient-demographic-identifier-changes",
"display": "Patient demographic and identifier changes",
"definition": "A TX7 change list describing additions and removals of supported patient demographic and patient identifier values.",
"property": [
{
"code": "family",
"valueCode": "patient-change-list-type"
}
]
},
{
"code": "sender-not-authorized",
"display": "Sender not authorized",
"definition": "The sending entity is not authorized to initiate the requested workflow activity, and the required authorization prevents processing.",
"property": [
{
"code": "family",
"valueCode": "failure-reason"
}
]
},
{
"code": "unsupported-use-case",
"display": "Unsupported use case",
"definition": "The recipient does not support the declared use case or requested transaction or lacks the capability required to perform the requested workflow activity.",
"property": [
{
"code": "family",
"valueCode": "failure-reason"
}
]
},
{
"code": "payload-not-processable",
"display": "Payload not processable",
"definition": "A defect in the package, metadata, required information object, or content, or a processing limitation, prevents performance of the requested workflow activity.",
"property": [
{
"code": "family",
"valueCode": "failure-reason"
}
]
},
{
"code": "patient-not-found",
"display": "Patient not found",
"definition": "The patient identity required to perform the workflow activity cannot be resolved or established. An unknown patient is not automatically a failure when the transaction permits registration. Patient identifiers must not be manufactured to conceal this condition.",
"property": [
{
"code": "family",
"valueCode": "failure-reason"
}
]
},
{
"code": "context-not-found",
"display": "Context not found",
"definition": "An established Context required to perform the workflow activity cannot be resolved. Absence of optional Context alone is not a failure. Context identifiers must not be manufactured to conceal this condition.",
"property": [
{
"code": "family",
"valueCode": "failure-reason"
}
]
},
{
"code": "use-case",
"display": "Use case",
"definition": "Identifies the declared use case for the requested workflow activity. The corresponding Task.input value is a Coding drawn from the applicable use-case terminology, such as DirectTrust ServDescCS.",
"property": [
{
"code": "family",
"valueCode": "task-input-type"
}
]
},
{
"code": "information-recipient",
"display": "Information Recipient",
"definition": "Identifies the party intended to receive and act on the healthcare communication. The corresponding Task.input value is a Reference to the recipient resource. MAP recipient constraints are defined by the consuming implementation guide.",
"property": [
{
"code": "family",
"valueCode": "task-input-type"
}
]
},
{
"code": "request-workflow-status",
"display": "Request successful Workflow Status reporting",
"definition": "Indicates whether reporting of successful structured payload acceptance into the intended workflow is requested. The corresponding Workflow Activity Task.input value is a boolean. True requests successful acceptance reporting; false or absence does not suppress failure reporting required by the applicable MAP Transaction Definition and does not request recursive reporting of a send-workflow-status outcome.",
"property": [
{
"code": "family",
"valueCode": "task-input-type"
}
]
},
{
"code": "workflow-status-update-endpoint",
"display": "Workflow Status Update Endpoint",
"definition": "Identifies an endpoint to which workflow status reports are to be sent. The corresponding Workflow Activity Task.input value is a Reference to a FHIR Endpoint resource. Endpoint eligibility, cardinality, routing and reporting obligations are governed by the applicable MAP requirements; this is distinct from Direct transport delivery notifications.",
"property": [
{
"code": "family",
"valueCode": "task-input-type"
}
]
}
],
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:1.3.6.1.4.1.41179.4.1.1"
}
]
}