<problem code="363346000" codeSystem="[sct]" displayName="Cancer">
<qualifier>
<code code="363698007" displayName="finding site"/>
<value code="39607008" displayName="Lung"/>
</qualifier>
<qualifier>
<code code="408729009" displayName="finding status"/>
<value code="415684004" displayName="suspected"/>
</qualifier>
</problem>
Concerning this, the R1 specification says: “Qualifiers constrain the meaning of the primary code, but cannot negate it or change it’s meaning to that of another value in the primary coding system”. I’ll leave argument to the comments about whether the finding status of “suspected” counts as negation or not (and also whether it matters that they actually do change it’s meaning to that of another value in the primary coding system).