In R4 Encounter.diagnosis.condition, the comments make reference to a primaryDiagnosis:
“For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).”
However, I am only able to find this extension in STU3. Is it intentional that this extension is missing in R4?
That is obviously a mistake, and worth a Jira error. To create one follow the Propose a change link at the bottom of any page in the specification. I expect the docco was not updated, but I do not know why the extension was removed.
In R4 there is an extension Preferred that could be used to indicate a preferred diagnosis. But that might be a different concept.
Try asking on the Zulip Implementers stream