diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/context/support/IValidationSupport.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/context/support/IValidationSupport.java
index 71d561c1db3d..fdbc4ca31d77 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/context/support/IValidationSupport.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/context/support/IValidationSupport.java
@@ -440,74 +440,259 @@ default String getName() {
 		return "Unknown " + getFhirContext().getVersion().getVersion() + " Validation Support";
 	}
 
+	/**
+	 * Defines codes in system <a href="http://hl7.org/fhir/issue-severity">http://hl7.org/fhir/issue-severity</a>.
+	 */
+	/* this enum would not be needed if we design/refactor to use org.hl7.fhir.r5.terminologies.utilities.ValidationResult */
 	enum IssueSeverity {
 		/**
 		 * The issue caused the action to fail, and no further checking could be performed.
 		 */
-		FATAL,
+		FATAL("fatal"),
 		/**
 		 * The issue is sufficiently important to cause the action to fail.
 		 */
-		ERROR,
+		ERROR("error"),
 		/**
 		 * The issue is not important enough to cause the action to fail, but may cause it to be performed suboptimally or in a way that is not as desired.
 		 */
-		WARNING,
+		WARNING("warning"),
 		/**
 		 * The issue has no relation to the degree of success of the action.
 		 */
-		INFORMATION
+		INFORMATION("information"),
+		/**
+		 * The operation was successful.
+		 */
+		SUCCESS("success");
+		// the spec for OperationOutcome mentions that  a code from http://hl7.org/fhir/issue-severity is required
+
+		private final String myCode;
+
+		IssueSeverity(String theCode) {
+			myCode = theCode;
+		}
+		/**
+		 * Provide mapping to a code in system <a href="http://hl7.org/fhir/issue-severity">http://hl7.org/fhir/issue-severity</a>.
+		 * @return the code
+		 */
+		public String getCode() {
+			return myCode;
+		}
+		/**
+		 * Creates a {@link IssueSeverity} object from the given code.
+		 * @return the {@link IssueSeverity}
+		 */
+		public static IssueSeverity fromCode(String theCode) {
+			switch (theCode) {
+				case "fatal":
+					return FATAL;
+				case "error":
+					return ERROR;
+				case "warning":
+					return WARNING;
+				case "information":
+					return INFORMATION;
+				case "success":
+					return SUCCESS;
+				default:
+					return null;
+			}
+		}
 	}
 
-	enum CodeValidationIssueCode {
-		NOT_FOUND,
-		CODE_INVALID,
-		INVALID,
-		OTHER
+	/**
+	 * Defines codes in system <a href="http://hl7.org/fhir/issue-type">http://hl7.org/fhir/issue-type</a>.
+	 * The binding is enforced as a part of validation logic in the FHIR Core Validation library where an exception is thrown.
+	 * Only a sub-set of these codes are defined as constants because they relate to validation,
+	 * If there are additional ones that come up, for Remote Terminology they are currently supported via
+	 * {@link IValidationSupport.CodeValidationIssue#CodeValidationIssue(String, IssueSeverity, String)}
+	 * while for internal validators, more constants can be added to make things easier and consistent.
+	 * This maps to resource OperationOutcome.issue.code.
+	 */
+	/* this enum would not be needed if we design/refactor to use org.hl7.fhir.r5.terminologies.utilities.ValidationResult */
+	class CodeValidationIssueCode {
+		public static final CodeValidationIssueCode NOT_FOUND = new CodeValidationIssueCode("not-found");
+		public static final CodeValidationIssueCode CODE_INVALID = new CodeValidationIssueCode("code-invalid");
+		public static final CodeValidationIssueCode INVALID = new CodeValidationIssueCode("invalid");
+
+		private final String myCode;
+
+		// this is intentionally not exposed
+		CodeValidationIssueCode(String theCode) {
+			myCode = theCode;
+		}
+
+		/**
+		 * Retrieve the corresponding code from system <a href="http://hl7.org/fhir/issue-type">http://hl7.org/fhir/issue-type</a>.
+		 * @return the code
+		 */
+		public String getCode() {
+			return myCode;
+		}
 	}
 
-	enum CodeValidationIssueCoding {
-		VS_INVALID,
-		NOT_FOUND,
-		NOT_IN_VS,
+	/**
+	 * Holds information about the details of a {@link CodeValidationIssue}.
+	 * This maps to resource OperationOutcome.issue.details.
+	 */
+	/* this enum would not be needed if we design/refactor to use org.hl7.fhir.r5.terminologies.utilities.ValidationResult */
+	class CodeValidationIssueDetails {
+		private final String myText;
+		private List<CodeValidationIssueCoding> myCodings;
+
+		public CodeValidationIssueDetails(String theText) {
+			myText = theText;
+		}
+
+		// intentionally not exposed
+		void addCoding(CodeValidationIssueCoding theCoding) {
+			getCodings().add(theCoding);
+		}
 
-		INVALID_CODE,
-		INVALID_DISPLAY,
-		OTHER
+		public CodeValidationIssueDetails addCoding(String theSystem, String theCode) {
+			if (myCodings == null) {
+				myCodings = new ArrayList<>();
+			}
+			myCodings.add(new CodeValidationIssueCoding(theSystem, theCode));
+			return this;
+		}
+
+		public String getText() {
+			return myText;
+		}
+
+		public List<CodeValidationIssueCoding> getCodings() {
+			if (myCodings == null) {
+				myCodings = new ArrayList<>();
+			}
+			return myCodings;
+		}
 	}
 
-	class CodeValidationIssue {
+	/**
+	 * Defines codes that can be part of the details of an issue.
+	 * There are some constants available (pre-defined) for codes for system <a href="http://hl7.org/fhir/tools/CodeSystem/tx-issue-type">http://hl7.org/fhir/tools/CodeSystem/tx-issue-type</a>.
+	 * This maps to resource OperationOutcome.issue.details.coding[0].code.
+	 */
+	class CodeValidationIssueCoding {
+		public static String TX_ISSUE_SYSTEM = "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type";
+		public static CodeValidationIssueCoding VS_INVALID =
+				new CodeValidationIssueCoding(TX_ISSUE_SYSTEM, "vs-invalid");
+		public static final CodeValidationIssueCoding NOT_FOUND =
+				new CodeValidationIssueCoding(TX_ISSUE_SYSTEM, "not-found");
+		public static final CodeValidationIssueCoding NOT_IN_VS =
+				new CodeValidationIssueCoding(TX_ISSUE_SYSTEM, "not-in-vs");
+		public static final CodeValidationIssueCoding INVALID_CODE =
+				new CodeValidationIssueCoding(TX_ISSUE_SYSTEM, "invalid-code");
+		public static final CodeValidationIssueCoding INVALID_DISPLAY =
+				new CodeValidationIssueCoding(TX_ISSUE_SYSTEM, "vs-display");
+		private final String mySystem, myCode;
+
+		// this is intentionally not exposed
+		CodeValidationIssueCoding(String theSystem, String theCode) {
+			mySystem = theSystem;
+			myCode = theCode;
+		}
+
+		/**
+		 * Retrieve the corresponding code for the details of a validation issue.
+		 * @return the code
+		 */
+		public String getCode() {
+			return myCode;
+		}
+
+		/**
+		 * Retrieve the system for the details of a validation issue.
+		 * @return the system
+		 */
+		public String getSystem() {
+			return mySystem;
+		}
+	}
 
-		private final String myMessage;
+	/**
+	 * This is a hapi-fhir internal version agnostic object holding information about a validation issue.
+	 * An alternative (which requires significant refactoring) would be to use org.hl7.fhir.r5.terminologies.utilities.ValidationResult instead.
+	 */
+	class CodeValidationIssue {
+		private final String myDiagnostics;
 		private final IssueSeverity mySeverity;
 		private final CodeValidationIssueCode myCode;
-		private final CodeValidationIssueCoding myCoding;
+		private CodeValidationIssueDetails myDetails;
 
 		public CodeValidationIssue(
-				String theMessage,
-				IssueSeverity mySeverity,
-				CodeValidationIssueCode theCode,
-				CodeValidationIssueCoding theCoding) {
-			this.myMessage = theMessage;
-			this.mySeverity = mySeverity;
-			this.myCode = theCode;
-			this.myCoding = theCoding;
+				String theDiagnostics, IssueSeverity theSeverity, CodeValidationIssueCode theTypeCode) {
+			this(theDiagnostics, theSeverity, theTypeCode, null);
+		}
+
+		public CodeValidationIssue(String theDiagnostics, IssueSeverity theSeverity, String theTypeCode) {
+			this(theDiagnostics, theSeverity, new CodeValidationIssueCode(theTypeCode), null);
 		}
 
+		public CodeValidationIssue(
+				String theDiagnostics,
+				IssueSeverity theSeverity,
+				CodeValidationIssueCode theType,
+				CodeValidationIssueCoding theDetailsCoding) {
+			myDiagnostics = theDiagnostics;
+			mySeverity = theSeverity;
+			myCode = theType;
+			// reuse the diagnostics message as a detail text message
+			myDetails = new CodeValidationIssueDetails(theDiagnostics);
+			myDetails.addCoding(theDetailsCoding);
+		}
+
+		/**
+		 * @deprecated Please use {@link #getDiagnostics()} instead.
+		 */
+		@Deprecated(since = "7.4.6")
 		public String getMessage() {
-			return myMessage;
+			return getDiagnostics();
+		}
+
+		public String getDiagnostics() {
+			return myDiagnostics;
 		}
 
 		public IssueSeverity getSeverity() {
 			return mySeverity;
 		}
 
+		/**
+		 * @deprecated Please use {@link #getType()} instead.
+		 */
+		@Deprecated(since = "7.4.6")
 		public CodeValidationIssueCode getCode() {
+			return getType();
+		}
+
+		public CodeValidationIssueCode getType() {
 			return myCode;
 		}
 
+		/**
+		 * @deprecated Please use {@link #getDetails()} instead. That has support for multiple codings.
+		 */
+		@Deprecated(since = "7.4.6")
 		public CodeValidationIssueCoding getCoding() {
-			return myCoding;
+			return myDetails != null
+					? myDetails.getCodings().stream().findFirst().orElse(null)
+					: null;
+		}
+
+		public void setDetails(CodeValidationIssueDetails theDetails) {
+			this.myDetails = theDetails;
+		}
+
+		public CodeValidationIssueDetails getDetails() {
+			return myDetails;
+		}
+
+		public boolean hasIssueDetailCode(@Nonnull String theCode) {
+			// this method is system agnostic at the moment but it can be restricted if needed
+			return myDetails.getCodings().stream().anyMatch(coding -> theCode.equals(coding.getCode()));
 		}
 	}
 
@@ -671,6 +856,10 @@ public String getType() {
 		}
 	}
 
+	/**
+	 * This is a hapi-fhir internal version agnostic object holding information about the validation result.
+	 * An alternative (which requires significant refactoring) would be to use org.hl7.fhir.r5.terminologies.utilities.ValidationResult.
+	 */
 	class CodeValidationResult {
 		public static final String SOURCE_DETAILS = "sourceDetails";
 		public static final String RESULT = "result";
@@ -686,7 +875,7 @@ class CodeValidationResult {
 		private String myDisplay;
 		private String mySourceDetails;
 
-		private List<CodeValidationIssue> myCodeValidationIssues;
+		private List<CodeValidationIssue> myIssues;
 
 		public CodeValidationResult() {
 			super();
@@ -771,23 +960,48 @@ public CodeValidationResult setSeverity(IssueSeverity theSeverity) {
 			return this;
 		}
 
+		/**
+		 * @deprecated Please use method {@link #getIssues()} instead.
+		 */
+		@Deprecated(since = "7.4.6")
 		public List<CodeValidationIssue> getCodeValidationIssues() {
-			if (myCodeValidationIssues == null) {
-				myCodeValidationIssues = new ArrayList<>();
-			}
-			return myCodeValidationIssues;
+			return getIssues();
 		}
 
+		/**
+		 * @deprecated Please use method {@link #setIssues(List)} instead.
+		 */
+		@Deprecated(since = "7.4.6")
 		public CodeValidationResult setCodeValidationIssues(List<CodeValidationIssue> theCodeValidationIssues) {
-			myCodeValidationIssues = new ArrayList<>(theCodeValidationIssues);
-			return this;
+			return setIssues(theCodeValidationIssues);
 		}
 
+		/**
+		 * @deprecated Please use method {@link #addIssue(CodeValidationIssue)} instead.
+		 */
+		@Deprecated(since = "7.4.6")
 		public CodeValidationResult addCodeValidationIssue(CodeValidationIssue theCodeValidationIssue) {
 			getCodeValidationIssues().add(theCodeValidationIssue);
 			return this;
 		}
 
+		public List<CodeValidationIssue> getIssues() {
+			if (myIssues == null) {
+				myIssues = new ArrayList<>();
+			}
+			return myIssues;
+		}
+
+		public CodeValidationResult setIssues(List<CodeValidationIssue> theIssues) {
+			myIssues = new ArrayList<>(theIssues);
+			return this;
+		}
+
+		public CodeValidationResult addIssue(CodeValidationIssue theCodeValidationIssue) {
+			getIssues().add(theCodeValidationIssue);
+			return this;
+		}
+
 		public boolean isOk() {
 			return isNotBlank(myCode);
 		}
@@ -811,17 +1025,19 @@ public LookupCodeResult asLookupCodeResult(String theSearchedForSystem, String t
 		public String getSeverityCode() {
 			String retVal = null;
 			if (getSeverity() != null) {
-				retVal = getSeverity().name().toLowerCase();
+				retVal = getSeverity().getCode();
 			}
 			return retVal;
 		}
 
 		/**
-		 * Sets an issue severity as a string code. Value must be the name of
-		 * one of the enum values in {@link IssueSeverity}. Value is case-insensitive.
+		 * Sets an issue severity using a severity code. Please use method {@link #setSeverity(IssueSeverity)} instead.
+		 * @param theSeverityCode the code
+		 * @return the current {@link CodeValidationResult} instance
 		 */
-		public CodeValidationResult setSeverityCode(@Nonnull String theIssueSeverity) {
-			setSeverity(IssueSeverity.valueOf(theIssueSeverity.toUpperCase()));
+		@Deprecated(since = "7.4.6")
+		public CodeValidationResult setSeverityCode(@Nonnull String theSeverityCode) {
+			setSeverity(IssueSeverity.fromCode(theSeverityCode));
 			return this;
 		}
 
@@ -838,6 +1054,11 @@ public IBaseParameters toParameters(FhirContext theContext) {
 			if (isNotBlank(getSourceDetails())) {
 				ParametersUtil.addParameterToParametersString(theContext, retVal, SOURCE_DETAILS, getSourceDetails());
 			}
+			/*
+			should translate issues as well, except that is version specific code, so it requires more refactoring
+			or replace the current class with org.hl7.fhir.r5.terminologies.utilities.ValidationResult
+			@see VersionSpecificWorkerContextWrapper#getIssuesForCodeValidation
+			*/
 
 			return retVal;
 		}
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/BaseParser.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/BaseParser.java
index f0559373e0a9..ce9323338406 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/BaseParser.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/BaseParser.java
@@ -105,7 +105,6 @@ public abstract class BaseParser implements IParser {
 	private static final Set<String> notEncodeForContainedResource =
 			new HashSet<>(Arrays.asList("security", "versionId", "lastUpdated"));
 
-	private FhirTerser.ContainedResources myContainedResources;
 	private boolean myEncodeElementsAppliesToChildResourcesOnly;
 	private final FhirContext myContext;
 	private Collection<String> myDontEncodeElements;
@@ -183,12 +182,15 @@ protected Iterable<CompositeChildElement> compositeChildIterator(
 	}
 
 	private String determineReferenceText(
-			IBaseReference theRef, CompositeChildElement theCompositeChildElement, IBaseResource theResource) {
+			IBaseReference theRef,
+			CompositeChildElement theCompositeChildElement,
+			IBaseResource theResource,
+			EncodeContext theContext) {
 		IIdType ref = theRef.getReferenceElement();
 		if (isBlank(ref.getIdPart())) {
 			String reference = ref.getValue();
 			if (theRef.getResource() != null) {
-				IIdType containedId = getContainedResources().getResourceId(theRef.getResource());
+				IIdType containedId = theContext.getContainedResources().getResourceId(theRef.getResource());
 				if (containedId != null && !containedId.isEmpty()) {
 					if (containedId.isLocal()) {
 						reference = containedId.getValue();
@@ -262,7 +264,8 @@ public String encodeResourceToString(IBaseResource theResource) throws DataForma
 	@Override
 	public final void encodeResourceToWriter(IBaseResource theResource, Writer theWriter)
 			throws IOException, DataFormatException {
-		EncodeContext encodeContext = new EncodeContext(this, myContext.getParserOptions());
+		EncodeContext encodeContext =
+				new EncodeContext(this, myContext.getParserOptions(), new FhirTerser.ContainedResources());
 		encodeResourceToWriter(theResource, theWriter, encodeContext);
 	}
 
@@ -285,7 +288,8 @@ public void encodeToWriter(IBase theElement, Writer theWriter) throws DataFormat
 		} else if (theElement instanceof IPrimitiveType) {
 			theWriter.write(((IPrimitiveType<?>) theElement).getValueAsString());
 		} else {
-			EncodeContext encodeContext = new EncodeContext(this, myContext.getParserOptions());
+			EncodeContext encodeContext =
+					new EncodeContext(this, myContext.getParserOptions(), new FhirTerser.ContainedResources());
 			encodeToWriter(theElement, theWriter, encodeContext);
 		}
 	}
@@ -404,10 +408,6 @@ protected String getCompositeElementId(IBase theElement) {
 		return elementId;
 	}
 
-	FhirTerser.ContainedResources getContainedResources() {
-		return myContainedResources;
-	}
-
 	@Override
 	public Set<String> getDontStripVersionsFromReferencesAtPaths() {
 		return myDontStripVersionsFromReferencesAtPaths;
@@ -539,10 +539,11 @@ public boolean getSuppressNarratives() {
 		return mySuppressNarratives;
 	}
 
-	protected boolean isChildContained(BaseRuntimeElementDefinition<?> childDef, boolean theIncludedResource) {
+	protected boolean isChildContained(
+			BaseRuntimeElementDefinition<?> childDef, boolean theIncludedResource, EncodeContext theContext) {
 		return (childDef.getChildType() == ChildTypeEnum.CONTAINED_RESOURCES
 						|| childDef.getChildType() == ChildTypeEnum.CONTAINED_RESOURCE_LIST)
-				&& getContainedResources().isEmpty() == false
+				&& theContext.getContainedResources().isEmpty() == false
 				&& theIncludedResource == false;
 	}
 
@@ -788,7 +789,8 @@ protected List<? extends IBase> preProcessValues(
 			 */
 			if (next instanceof IBaseReference) {
 				IBaseReference nextRef = (IBaseReference) next;
-				String refText = determineReferenceText(nextRef, theCompositeChildElement, theResource);
+				String refText =
+						determineReferenceText(nextRef, theCompositeChildElement, theResource, theEncodeContext);
 				if (!StringUtils.equals(refText, nextRef.getReferenceElement().getValue())) {
 
 					if (retVal == theValues) {
@@ -980,7 +982,7 @@ protected boolean shouldEncodeResource(String theName, EncodeContext theEncodeCo
 		return true;
 	}
 
-	protected void containResourcesInReferences(IBaseResource theResource) {
+	protected void containResourcesInReferences(IBaseResource theResource, EncodeContext theContext) {
 
 		/*
 		 * If a UUID is present in Bundle.entry.fullUrl but no value is present
@@ -1003,7 +1005,7 @@ protected void containResourcesInReferences(IBaseResource theResource) {
 			}
 		}
 
-		myContainedResources = getContext().newTerser().containResources(theResource);
+		theContext.setContainedResources(getContext().newTerser().containResources(theResource));
 	}
 
 	static class ChildNameAndDef {
@@ -1034,8 +1036,12 @@ class EncodeContext extends EncodeContextPath {
 		private final List<EncodeContextPath> myEncodeElementPaths;
 		private final Set<String> myEncodeElementsAppliesToResourceTypes;
 		private final List<EncodeContextPath> myDontEncodeElementPaths;
+		private FhirTerser.ContainedResources myContainedResources;
 
-		public EncodeContext(BaseParser theParser, ParserOptions theParserOptions) {
+		public EncodeContext(
+				BaseParser theParser,
+				ParserOptions theParserOptions,
+				FhirTerser.ContainedResources theContainedResources) {
 			Collection<String> encodeElements = theParser.myEncodeElements;
 			Collection<String> dontEncodeElements = theParser.myDontEncodeElements;
 			if (isSummaryMode()) {
@@ -1058,6 +1064,8 @@ public EncodeContext(BaseParser theParser, ParserOptions theParserOptions) {
 						dontEncodeElements.stream().map(EncodeContextPath::new).collect(Collectors.toList());
 			}
 
+			myContainedResources = theContainedResources;
+
 			myEncodeElementsAppliesToResourceTypes =
 					ParserUtil.determineApplicableResourceTypesForTerserPaths(myEncodeElementPaths);
 		}
@@ -1065,6 +1073,14 @@ public EncodeContext(BaseParser theParser, ParserOptions theParserOptions) {
 		private Map<Key, List<BaseParser.CompositeChildElement>> getCompositeChildrenCache() {
 			return myCompositeChildrenCache;
 		}
+
+		public FhirTerser.ContainedResources getContainedResources() {
+			return myContainedResources;
+		}
+
+		public void setContainedResources(FhirTerser.ContainedResources theContainedResources) {
+			myContainedResources = theContainedResources;
+		}
 	}
 
 	protected class CompositeChildElement {
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/JsonParser.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/JsonParser.java
index 0b25304ee5fd..5731742ac1fe 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/JsonParser.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/JsonParser.java
@@ -54,6 +54,7 @@
 import ca.uhn.fhir.parser.json.jackson.JacksonStructure;
 import ca.uhn.fhir.rest.api.EncodingEnum;
 import ca.uhn.fhir.util.ElementUtil;
+import ca.uhn.fhir.util.FhirTerser;
 import org.apache.commons.lang3.StringUtils;
 import org.apache.commons.lang3.Validate;
 import org.apache.commons.text.WordUtils;
@@ -386,12 +387,14 @@ public String toString() {
 			}
 			case CONTAINED_RESOURCE_LIST:
 			case CONTAINED_RESOURCES: {
-				List<IBaseResource> containedResources = getContainedResources().getContainedResources();
+				List<IBaseResource> containedResources =
+						theEncodeContext.getContainedResources().getContainedResources();
 				if (containedResources.size() > 0) {
 					beginArray(theEventWriter, theChildName);
 
 					for (IBaseResource next : containedResources) {
-						IIdType resourceId = getContainedResources().getResourceId(next);
+						IIdType resourceId =
+								theEncodeContext.getContainedResources().getResourceId(next);
 						String value = resourceId.getValue();
 						encodeResourceToJsonStreamWriter(
 								theResDef,
@@ -554,7 +557,8 @@ private void encodeCompositeElementChildrenToStreamWriter(
 
 				if (nextValue == null || nextValue.isEmpty()) {
 					if (nextValue instanceof BaseContainedDt) {
-						if (theContainedResource || getContainedResources().isEmpty()) {
+						if (theContainedResource
+								|| theEncodeContext.getContainedResources().isEmpty()) {
 							continue;
 						}
 					} else {
@@ -838,7 +842,8 @@ public void encodeResourceToJsonLikeWriter(IBaseResource theResource, BaseJsonLi
 					+ theResource.getStructureFhirVersionEnum());
 		}
 
-		EncodeContext encodeContext = new EncodeContext(this, getContext().getParserOptions());
+		EncodeContext encodeContext =
+				new EncodeContext(this, getContext().getParserOptions(), new FhirTerser.ContainedResources());
 		String resourceName = getContext().getResourceType(theResource);
 		encodeContext.pushPath(resourceName, true);
 		doEncodeResourceToJsonLikeWriter(theResource, theJsonLikeWriter, encodeContext);
@@ -894,7 +899,7 @@ private void encodeResourceToJsonStreamWriter(
 		}
 
 		if (!theContainedResource) {
-			containResourcesInReferences(theResource);
+			containResourcesInReferences(theResource, theEncodeContext);
 		}
 
 		RuntimeResourceDefinition resDef = getContext().getResourceDefinition(theResource);
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/RDFParser.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/RDFParser.java
index b75ee9c897f8..18572824fee0 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/RDFParser.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/RDFParser.java
@@ -191,7 +191,7 @@ private Resource encodeResourceToRDFStreamWriter(
 		}
 
 		if (!containedResource) {
-			containResourcesInReferences(resource);
+			containResourcesInReferences(resource, encodeContext);
 		}
 
 		if (!(resource instanceof IAnyResource)) {
@@ -354,7 +354,7 @@ private Model encodeChildElementToStreamWriter(
 		try {
 
 			if (element == null || element.isEmpty()) {
-				if (!isChildContained(childDef, includedResource)) {
+				if (!isChildContained(childDef, includedResource, theEncodeContext)) {
 					return rdfModel;
 				}
 			}
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/XmlParser.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/XmlParser.java
index 7a5aaa021bfc..71b83de8d8ec 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/XmlParser.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/XmlParser.java
@@ -295,7 +295,7 @@ private void encodeChildElementToStreamWriter(
 		try {
 
 			if (theElement == null || theElement.isEmpty()) {
-				if (isChildContained(childDef, theIncludedResource)) {
+				if (isChildContained(childDef, theIncludedResource, theEncodeContext)) {
 					// We still want to go in..
 				} else {
 					return;
@@ -359,8 +359,10 @@ private void encodeChildElementToStreamWriter(
 					 * theEventWriter.writeStartElement("contained"); encodeResourceToXmlStreamWriter(next, theEventWriter, true, fixContainedResourceId(next.getId().getValue()));
 					 * theEventWriter.writeEndElement(); }
 					 */
-					for (IBaseResource next : getContainedResources().getContainedResources()) {
-						IIdType resourceId = getContainedResources().getResourceId(next);
+					for (IBaseResource next :
+							theEncodeContext.getContainedResources().getContainedResources()) {
+						IIdType resourceId =
+								theEncodeContext.getContainedResources().getResourceId(next);
 						theEventWriter.writeStartElement("contained");
 						String value = resourceId.getValue();
 						encodeResourceToXmlStreamWriter(
@@ -682,7 +684,7 @@ private void encodeResourceToXmlStreamWriter(
 		}
 
 		if (!theContainedResource) {
-			containResourcesInReferences(theResource);
+			containResourcesInReferences(theResource, theEncodeContext);
 		}
 
 		theEventWriter.writeStartElement(resDef.getName());
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/repository/Repository.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/repository/Repository.java
index e859a9ae569c..c272656f47a2 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/repository/Repository.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/repository/Repository.java
@@ -28,6 +28,8 @@
 import ca.uhn.fhir.rest.server.exceptions.InternalErrorException;
 import ca.uhn.fhir.rest.server.exceptions.NotImplementedOperationException;
 import com.google.common.annotations.Beta;
+import com.google.common.collect.ArrayListMultimap;
+import com.google.common.collect.Multimap;
 import org.hl7.fhir.instance.model.api.IBaseBundle;
 import org.hl7.fhir.instance.model.api.IBaseConformance;
 import org.hl7.fhir.instance.model.api.IBaseParameters;
@@ -231,6 +233,23 @@ <T extends IBaseResource, I extends IIdType> MethodOutcome delete(
 
 	// Querying starts here
 
+	/**
+	 * Searches this repository
+	 *
+	 * @see <a href="https://www.hl7.org/fhir/http.html#search">FHIR search</a>
+	 *
+	 * @param <B> a Bundle type
+	 * @param <T> a Resource type
+	 * @param bundleType the class of the Bundle type to return
+	 * @param resourceType the class of the Resource type to search
+	 * @param searchParameters the searchParameters for this search
+	 * @return a Bundle with the results of the search
+	 */
+	default <B extends IBaseBundle, T extends IBaseResource> B search(
+			Class<B> bundleType, Class<T> resourceType, Multimap<String, List<IQueryParameterType>> searchParameters) {
+		return this.search(bundleType, resourceType, searchParameters, Collections.emptyMap());
+	}
+
 	/**
 	 * Searches this repository
 	 *
@@ -264,9 +283,32 @@ default <B extends IBaseBundle, T extends IBaseResource> B search(
 	<B extends IBaseBundle, T extends IBaseResource> B search(
 			Class<B> bundleType,
 			Class<T> resourceType,
-			Map<String, List<IQueryParameterType>> searchParameters,
+			Multimap<String, List<IQueryParameterType>> searchParameters,
 			Map<String, String> headers);
 
+	/**
+	 * Searches this repository
+	 *
+	 * @see <a href="https://www.hl7.org/fhir/http.html#search">FHIR search</a>
+	 *
+	 * @param <B> a Bundle type
+	 * @param <T> a Resource type
+	 * @param bundleType the class of the Bundle type to return
+	 * @param resourceType the class of the Resource type to search
+	 * @param searchParameters the searchParameters for this search
+	 * @param headers headers for this request, typically key-value pairs of HTTP headers
+	 * @return a Bundle with the results of the search
+	 */
+	default <B extends IBaseBundle, T extends IBaseResource> B search(
+			Class<B> bundleType,
+			Class<T> resourceType,
+			Map<String, List<IQueryParameterType>> searchParameters,
+			Map<String, String> headers) {
+		ArrayListMultimap<String, List<IQueryParameterType>> multimap = ArrayListMultimap.create();
+		searchParameters.forEach(multimap::put);
+		return this.search(bundleType, resourceType, multimap, headers);
+	}
+
 	// Paging starts here
 
 	/**
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/FhirTerser.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/FhirTerser.java
index 6eab1ce9ed37..eebb07b63c3b 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/FhirTerser.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/FhirTerser.java
@@ -38,7 +38,6 @@
 import ca.uhn.fhir.model.api.ISupportsUndeclaredExtensions;
 import ca.uhn.fhir.model.base.composite.BaseContainedDt;
 import ca.uhn.fhir.model.base.composite.BaseResourceReferenceDt;
-import ca.uhn.fhir.model.primitive.IdDt;
 import ca.uhn.fhir.model.primitive.StringDt;
 import ca.uhn.fhir.parser.DataFormatException;
 import com.google.common.collect.Lists;
@@ -61,6 +60,7 @@
 import java.util.Arrays;
 import java.util.Collection;
 import java.util.Collections;
+import java.util.Comparator;
 import java.util.HashMap;
 import java.util.HashSet;
 import java.util.IdentityHashMap;
@@ -70,6 +70,7 @@
 import java.util.Objects;
 import java.util.Optional;
 import java.util.Set;
+import java.util.UUID;
 import java.util.regex.Matcher;
 import java.util.regex.Pattern;
 import java.util.stream.Collectors;
@@ -77,16 +78,28 @@
 import static org.apache.commons.lang3.StringUtils.defaultString;
 import static org.apache.commons.lang3.StringUtils.isBlank;
 import static org.apache.commons.lang3.StringUtils.isNotBlank;
-import static org.apache.commons.lang3.StringUtils.substring;
 
 public class FhirTerser {
 
 	private static final Pattern COMPARTMENT_MATCHER_PATH =
 			Pattern.compile("([a-zA-Z.]+)\\.where\\(resolve\\(\\) is ([a-zA-Z]+)\\)");
+
 	private static final String USER_DATA_KEY_CONTAIN_RESOURCES_COMPLETED =
 			FhirTerser.class.getName() + "_CONTAIN_RESOURCES_COMPLETED";
+
 	private final FhirContext myContext;
 
+	/**
+	 * This comparator sorts IBaseReferences, and places any that are missing an ID at the end. Those with an ID go to the front.
+	 */
+	private static final Comparator<IBaseReference> REFERENCES_WITH_IDS_FIRST =
+			Comparator.nullsLast(Comparator.comparing(ref -> {
+				if (ref.getResource() == null) return true;
+				if (ref.getResource().getIdElement() == null) return true;
+				if (ref.getResource().getIdElement().getValue() == null) return true;
+				return false;
+			}));
+
 	public FhirTerser(FhirContext theContext) {
 		super();
 		myContext = theContext;
@@ -1418,6 +1431,13 @@ public boolean acceptUndeclaredExtension(
 	private void containResourcesForEncoding(
 			ContainedResources theContained, IBaseResource theResource, boolean theModifyResource) {
 		List<IBaseReference> allReferences = getAllPopulatedChildElementsOfType(theResource, IBaseReference.class);
+
+		// Note that we process all contained resources that have arrived here with an ID contained resources first, so
+		// that we don't accidentally auto-assign an ID
+		// which may collide with a resource we have yet to process.
+		// See: https://github.com/hapifhir/hapi-fhir/issues/6403
+		allReferences.sort(REFERENCES_WITH_IDS_FIRST);
+
 		for (IBaseReference next : allReferences) {
 			IBaseResource resource = next.getResource();
 			if (resource == null && next.getReferenceElement().isLocal()) {
@@ -1437,11 +1457,11 @@ private void containResourcesForEncoding(
 			IBaseResource resource = next.getResource();
 			if (resource != null) {
 				if (resource.getIdElement().isEmpty() || resource.getIdElement().isLocal()) {
-					if (theContained.getResourceId(resource) != null) {
-						// Prevent infinite recursion if there are circular loops in the contained resources
+
+					IIdType id = theContained.addContained(resource);
+					if (id == null) {
 						continue;
 					}
-					IIdType id = theContained.addContained(resource);
 					if (theModifyResource) {
 						getContainedResourceList(theResource).add(resource);
 						next.setReference(id.getValue());
@@ -1768,8 +1788,6 @@ private interface ICompartmentOwnerVisitor {
 	}
 
 	public static class ContainedResources {
-		private long myNextContainedId = 1;
-
 		private List<IBaseResource> myResourceList;
 		private IdentityHashMap<IBaseResource, IIdType> myResourceToIdMap;
 		private Map<String, IBaseResource> myExistingIdToContainedResourceMap;
@@ -1782,6 +1800,11 @@ public Map<String, IBaseResource> getExistingIdToContainedResource() {
 		}
 
 		public IIdType addContained(IBaseResource theResource) {
+			if (this.getResourceId(theResource) != null) {
+				// Prevent infinite recursion if there are circular loops in the contained resources
+				return null;
+			}
+
 			IIdType existing = getResourceToIdMap().get(theResource);
 			if (existing != null) {
 				return existing;
@@ -1789,16 +1812,7 @@ public IIdType addContained(IBaseResource theResource) {
 
 			IIdType newId = theResource.getIdElement();
 			if (isBlank(newId.getValue())) {
-				newId.setValue("#" + myNextContainedId++);
-			} else {
-				// Avoid auto-assigned contained IDs colliding with pre-existing ones
-				String idPart = newId.getValue();
-				if (substring(idPart, 0, 1).equals("#")) {
-					idPart = idPart.substring(1);
-					if (StringUtils.isNumeric(idPart)) {
-						myNextContainedId = Long.parseLong(idPart) + 1;
-					}
-				}
+				newId.setValue("#" + UUID.randomUUID());
 			}
 
 			getResourceToIdMap().put(theResource, newId);
@@ -1862,45 +1876,5 @@ public boolean isEmpty() {
 		public boolean hasExistingIdToContainedResource() {
 			return myExistingIdToContainedResourceMap != null;
 		}
-
-		public void assignIdsToContainedResources() {
-
-			if (!getContainedResources().isEmpty()) {
-
-				/*
-				 * The idea with the code block below:
-				 *
-				 * We want to preserve any IDs that were user-assigned, so that if it's really
-				 * important to someone that their contained resource have the ID of #FOO
-				 * or #1 we will keep that.
-				 *
-				 * For any contained resources where no ID was assigned by the user, we
-				 * want to manually create an ID but make sure we don't reuse an existing ID.
-				 */
-
-				Set<String> ids = new HashSet<>();
-
-				// Gather any user assigned IDs
-				for (IBaseResource nextResource : getContainedResources()) {
-					if (getResourceToIdMap().get(nextResource) != null) {
-						ids.add(getResourceToIdMap().get(nextResource).getValue());
-					}
-				}
-
-				// Automatically assign IDs to the rest
-				for (IBaseResource nextResource : getContainedResources()) {
-
-					while (getResourceToIdMap().get(nextResource) == null) {
-						String nextCandidate = "#" + myNextContainedId;
-						myNextContainedId++;
-						if (!ids.add(nextCandidate)) {
-							continue;
-						}
-
-						getResourceToIdMap().put(nextResource, new IdDt(nextCandidate));
-					}
-				}
-			}
-		}
 	}
 }
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/VersionEnum.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/VersionEnum.java
index 8d4867594cf0..0f89ed04d071 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/VersionEnum.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/VersionEnum.java
@@ -170,6 +170,7 @@ public enum VersionEnum {
 
 	V7_5_0,
 	V7_6_0,
+	V7_6_1,
 	V7_7_0,
 	V7_8_0;
 
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/AdapterManager.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/AdapterManager.java
new file mode 100644
index 000000000000..93a7b054a39f
--- /dev/null
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/AdapterManager.java
@@ -0,0 +1,62 @@
+/*-
+ * #%L
+ * HAPI FHIR - Core Library
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.util.adapters;
+
+import jakarta.annotation.Nonnull;
+
+import java.util.HashSet;
+import java.util.Optional;
+import java.util.Set;
+import java.util.stream.Stream;
+
+public class AdapterManager implements IAdapterManager {
+	public static final AdapterManager INSTANCE = new AdapterManager();
+
+	Set<IAdapterFactory> myAdapterFactories = new HashSet<>();
+
+	/**
+	 * Hidden to force shared use of the public INSTANCE.
+	 */
+	AdapterManager() {}
+
+	public <T> @Nonnull Optional<T> getAdapter(Object theObject, Class<T> theTargetType) {
+		// todo this can be sped up with a cache of type->Factory.
+		return myAdapterFactories.stream()
+				.filter(nextFactory -> nextFactory.getAdapters().stream().anyMatch(theTargetType::isAssignableFrom))
+				.flatMap(nextFactory -> {
+					var adapter = nextFactory.getAdapter(theObject, theTargetType);
+					// can't use Optional.stream() because of our Android target is API level 26/JDK 8.
+					if (adapter.isPresent()) {
+						return Stream.of(adapter.get());
+					} else {
+						return Stream.empty();
+					}
+				})
+				.findFirst();
+	}
+
+	public void registerFactory(@Nonnull IAdapterFactory theFactory) {
+		myAdapterFactories.add(theFactory);
+	}
+
+	public void unregisterFactory(@Nonnull IAdapterFactory theFactory) {
+		myAdapterFactories.remove(theFactory);
+	}
+}
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/AdapterUtils.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/AdapterUtils.java
new file mode 100644
index 000000000000..369b7ab324e1
--- /dev/null
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/AdapterUtils.java
@@ -0,0 +1,48 @@
+/*-
+ * #%L
+ * HAPI FHIR - Core Library
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.util.adapters;
+
+import java.util.Optional;
+
+public class AdapterUtils {
+
+	/**
+	 * Main entry point for adapter calls.
+	 * Implements three conversions: cast to the target type, use IAdaptable if present, or lastly try the AdapterManager.INSTANCE.
+	 * @param theObject the object to be adapted
+	 * @param theTargetType the type of the adapter requested
+	 */
+	static <T> Optional<T> adapt(Object theObject, Class<T> theTargetType) {
+		if (theTargetType.isInstance(theObject)) {
+			//noinspection unchecked
+			return Optional.of((T) theObject);
+		}
+
+		if (theObject instanceof IAdaptable) {
+			IAdaptable adaptable = (IAdaptable) theObject;
+			var adapted = adaptable.getAdapter(theTargetType);
+			if (adapted.isPresent()) {
+				return adapted;
+			}
+		}
+
+		return AdapterManager.INSTANCE.getAdapter(theObject, theTargetType);
+	}
+}
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdaptable.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdaptable.java
new file mode 100644
index 000000000000..4310c294fbaf
--- /dev/null
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdaptable.java
@@ -0,0 +1,38 @@
+/*-
+ * #%L
+ * HAPI FHIR - Core Library
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.util.adapters;
+
+import jakarta.annotation.Nonnull;
+
+import java.util.Optional;
+
+/**
+ * Generic version of Eclipse IAdaptable interface.
+ */
+public interface IAdaptable {
+	/**
+	 * Get an adapter of requested type.
+	 * @param theTargetType the desired type of the adapter
+	 * @return an adapter of theTargetType if possible, or empty.
+	 */
+	default <T> @Nonnull Optional<T> getAdapter(@Nonnull Class<T> theTargetType) {
+		return AdapterUtils.adapt(this, theTargetType);
+	}
+}
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdapterFactory.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdapterFactory.java
new file mode 100644
index 000000000000..f4aa88edde56
--- /dev/null
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdapterFactory.java
@@ -0,0 +1,44 @@
+/*-
+ * #%L
+ * HAPI FHIR - Core Library
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.util.adapters;
+
+import java.util.Collection;
+import java.util.Optional;
+
+/**
+ * Interface for external service that builds adaptors for targets.
+ */
+public interface IAdapterFactory {
+	/**
+	 * Build an adaptor for the target.
+	 * May return empty() even if the target type is listed in getAdapters() when
+	 * the factory fails to convert a particular instance.
+	 *
+	 * @param theObject the object to be adapted.
+	 * @param theAdapterType the target type
+	 * @return the adapter, if possible.
+	 */
+	<T> Optional<T> getAdapter(Object theObject, Class<T> theAdapterType);
+
+	/**
+	 * @return the collection of adapter target types handled by this factory.
+	 */
+	Collection<Class<?>> getAdapters();
+}
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdapterManager.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdapterManager.java
new file mode 100644
index 000000000000..d199267f9277
--- /dev/null
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/IAdapterManager.java
@@ -0,0 +1,29 @@
+/*-
+ * #%L
+ * HAPI FHIR - Core Library
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.util.adapters;
+
+import java.util.Optional;
+
+/**
+ * Get an adaptor
+ */
+public interface IAdapterManager {
+	<T> Optional<T> getAdapter(Object theTarget, Class<T> theAdapter);
+}
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/package-info.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/package-info.java
new file mode 100644
index 000000000000..c053c1b0248d
--- /dev/null
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/util/adapters/package-info.java
@@ -0,0 +1,39 @@
+/*-
+ * #%L
+ * HAPI FHIR - Core Library
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+/**
+ * Implements the Adapter pattern to allow external classes to extend/adapt existing classes.
+ * Useful for extending interfaces that are closed to modification, or restricted for classpath reasons.
+ * <p>
+ *     For clients, the main entry point is {@link ca.uhn.fhir.util.adapters.AdapterUtils#adapt(java.lang.Object, java.lang.Class)}
+ *     which will attempt to cast to the target type, or build an adapter of the target type.
+ * </p>
+ * <p>
+ *     For implementors, you can support adaptation via two mechanisms:
+ *     <ul>
+ *         <li>by implementing {@link ca.uhn.fhir.util.adapters.IAdaptable} directly on a class to provide supported adapters,
+ *         <li>or when the class is closed to direct modification, you can implement
+ *         an instance of {@link ca.uhn.fhir.util.adapters.IAdapterFactory} and register
+ *         it with the public {@link ca.uhn.fhir.util.adapters.AdapterManager#INSTANCE}.</li>
+ *     </ul>
+ *     The AdapterUtils.adapt() supports both of these.
+ * </p>
+ * Inspired by the Eclipse runtime.
+ */
+package ca.uhn.fhir.util.adapters;
diff --git a/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/adapters/AdapterManagerTest.java b/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/adapters/AdapterManagerTest.java
new file mode 100644
index 000000000000..ee621533587c
--- /dev/null
+++ b/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/adapters/AdapterManagerTest.java
@@ -0,0 +1,78 @@
+package ca.uhn.fhir.util.adapters;
+
+import org.junit.jupiter.api.AfterAll;
+import org.junit.jupiter.api.Test;
+
+import java.util.Collection;
+import java.util.List;
+import java.util.Optional;
+
+import static org.assertj.core.api.Assertions.assertThat;
+
+public class AdapterManagerTest {
+	AdapterManager myAdapterManager = new AdapterManager();
+
+	@AfterAll
+	static void tearDown() {
+		assertThat(AdapterManager.INSTANCE.myAdapterFactories)
+			.withFailMessage("Don't dirty the public instance").isEmpty();
+	}
+
+	@Test
+	void testRegisterFactory_providesAdapter() {
+	    // given
+		myAdapterManager.registerFactory(new StringToIntFactory());
+
+	    // when
+		var result = myAdapterManager.getAdapter("22", Integer.class);
+
+	    // then
+	    assertThat(result).contains(22);
+	}
+
+	@Test
+	void testRegisterFactory_wrongTypeStillEmpty() {
+		// given
+		myAdapterManager.registerFactory(new StringToIntFactory());
+
+		// when
+		var result = myAdapterManager.getAdapter("22", Float.class);
+
+		// then
+		assertThat(result).isEmpty();
+	}
+
+	@Test
+	void testUnregisterFactory_providesEmpty() {
+		// given active factory, now gone.
+		StringToIntFactory factory = new StringToIntFactory();
+		myAdapterManager.registerFactory(factory);
+		myAdapterManager.getAdapter("22", Integer.class);
+		myAdapterManager.unregisterFactory(factory);
+
+		// when
+		var result = myAdapterManager.getAdapter("22", Integer.class);
+
+		// then
+		assertThat(result).isEmpty();
+	}
+
+
+	static class StringToIntFactory implements IAdapterFactory {
+		@Override
+		public <T> Optional<T> getAdapter(Object theObject, Class<T> theAdapterType) {
+			if (theObject instanceof String s) {
+				if (theAdapterType.isAssignableFrom(Integer.class)) {
+					@SuppressWarnings("unchecked")
+					T i = (T) Integer.valueOf(s);
+					return Optional.of(i);
+				}
+			}
+			return Optional.empty();
+		}
+
+		public Collection<Class<?>> getAdapters() {
+			return List.of(Integer.class);
+		}
+	}
+}
diff --git a/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/adapters/AdapterUtilsTest.java b/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/adapters/AdapterUtilsTest.java
new file mode 100644
index 000000000000..c7dfef8661bb
--- /dev/null
+++ b/hapi-fhir-base/src/test/java/ca/uhn/fhir/util/adapters/AdapterUtilsTest.java
@@ -0,0 +1,123 @@
+package ca.uhn.fhir.util.adapters;
+
+import jakarta.annotation.Nonnull;
+import org.junit.jupiter.api.AfterEach;
+import org.junit.jupiter.api.Test;
+
+import java.util.Collection;
+import java.util.Optional;
+import java.util.Set;
+
+import static org.assertj.core.api.Assertions.assertThat;
+
+class AdapterUtilsTest {
+
+	final private IAdapterFactory myTestFactory = new TestAdaptorFactory();
+
+	@AfterEach
+	void tearDown() {
+		AdapterManager.INSTANCE.unregisterFactory(myTestFactory);
+	}
+
+	@Test
+	void testNullDoesNotAdapt() {
+
+		// when
+		var adapted = AdapterUtils.adapt(null, InterfaceA.class);
+
+		// then
+		assertThat(adapted).isEmpty();
+	}
+
+	@Test
+	void testAdaptObjectImplementingInterface() {
+		// given
+		var object = new ClassB();
+
+		// when
+		var adapted = AdapterUtils.adapt(object, InterfaceA.class);
+
+		// then
+		assertThat(adapted)
+			.isPresent()
+			.get().isInstanceOf(InterfaceA.class);
+		assertThat(adapted.get()).withFailMessage("Use object since it implements interface").isSameAs(object);
+	}
+
+	@Test
+	void testAdaptObjectImplementingAdaptorSupportingInterface() {
+		// given
+		var object = new SelfAdaptableClass();
+
+		// when
+		var adapted = AdapterUtils.adapt(object, InterfaceA.class);
+
+		// then
+		assertThat(adapted)
+			.isPresent()
+			.get().isInstanceOf(InterfaceA.class);
+	}
+
+	@Test
+	void testAdaptObjectViaAdapterManager() {
+		// given
+		var object = new ManagerAdaptableClass();
+		AdapterManager.INSTANCE.registerFactory(myTestFactory);
+
+		// when
+		var adapted = AdapterUtils.adapt(object, InterfaceA.class);
+
+		// then
+		assertThat(adapted)
+			.isPresent()
+			.get().isInstanceOf(InterfaceA.class);
+	}
+
+	interface InterfaceA {
+
+	}
+
+	static class ClassB implements InterfaceA {
+
+	}
+
+	/** class that can adapt itself to IAdaptable */
+	static class SelfAdaptableClass implements IAdaptable {
+
+		@Nonnull
+		@Override
+		public <T> Optional<T> getAdapter(@Nonnull Class<T> theTargetType) {
+			if (theTargetType.isAssignableFrom(InterfaceA.class)) {
+				T value = theTargetType.cast(buildInterfaceAWrapper(this));
+				return Optional.of(value);
+			}
+			return Optional.empty();
+		}
+	}
+
+	private static @Nonnull InterfaceA buildInterfaceAWrapper(Object theObject) {
+		return new InterfaceA() {};
+	}
+
+	/** Class that relies on an external IAdapterFactory */
+	static class ManagerAdaptableClass {
+	}
+
+
+	static class TestAdaptorFactory implements IAdapterFactory {
+
+		@Override
+		public <T> Optional<T> getAdapter(Object theObject, Class<T> theAdapterType) {
+			if (theObject instanceof ManagerAdaptableClass && theAdapterType == InterfaceA.class) {
+				T adapter = theAdapterType.cast(buildInterfaceAWrapper(theObject));
+				return Optional.of(adapter);
+			}
+			return Optional.empty();
+		}
+
+		@Override
+		public Collection<Class<?>> getAdapters() {
+			return Set.of(InterfaceA.class);
+		}
+	}
+}
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6403-json-parser-bugs-again.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6403-json-parser-bugs-again.yaml
new file mode 100644
index 000000000000..8ef5947d66e8
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6403-json-parser-bugs-again.yaml
@@ -0,0 +1,4 @@
+---
+type: change
+jira: SMILE-9161
+title: "Contained resources which arrive without assigned IDs are now assigned GUIDs, as opposed to monotonically increasing numeric IDs. This avoids a whole class of issues related to processing order and collisions."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6403-json-parser-bugs.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6403-json-parser-bugs.yaml
new file mode 100644
index 000000000000..1c76ceaa3a8b
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6403-json-parser-bugs.yaml
@@ -0,0 +1,6 @@
+---
+type: fix
+jira: SMILE-9161
+title: "Fixed a rare bug in the JSON Parser, wherein client-assigned contained resource IDs could collide with server-assigned contained IDs. For example if a 
+resource had a client-assigned contained ID of `#2`, and a contained resource with no ID, then depending on the processing order, the parser could occasionally 
+provide duplicate contained resource IDs, leading to non-deterministic behaviour."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6419-fix-reindex-optimize-storage-all-versions-posgtres.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6419-fix-reindex-optimize-storage-all-versions-posgtres.yaml
new file mode 100644
index 000000000000..4d0100526ad8
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6419-fix-reindex-optimize-storage-all-versions-posgtres.yaml
@@ -0,0 +1,6 @@
+---
+type: fix
+issue: 6419
+title: "Previously, on Postgres, the `$reindex` operation with `optimizeStorage` set to `ALL_VERSIONS` would process 
+only a subset of versions if there were more than 100 versions to be processed for a resource. This has been fixed 
+so that all versions of the resource are now processed."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6420-fix-reindex-optimize-storage-all-versions-for-a-single-resource.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6420-fix-reindex-optimize-storage-all-versions-for-a-single-resource.yaml
new file mode 100644
index 000000000000..ee409dc43ee1
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6420-fix-reindex-optimize-storage-all-versions-for-a-single-resource.yaml
@@ -0,0 +1,5 @@
+---
+type: fix
+issue: 6420
+title: "Previously, when the `$reindex` operation is run for a single FHIR resource with `optimizeStorage` set to 
+`ALL_VERSIONS`, none of the versions of the resource were processed in `hfj_res_ver` table. This has been fixed."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6422-fixes-remote-terminology-issues.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6422-fixes-remote-terminology-issues.yaml
new file mode 100644
index 000000000000..9b6dc6320ce9
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6422-fixes-remote-terminology-issues.yaml
@@ -0,0 +1,7 @@
+---
+type: fix
+issue: 6422
+title: "Previously, since 7.4.4 the validation issue detail codes were not translated correctly for Remote Terminology 
+validateCode calls. The detail code used was `invalid-code` for all use-cases which resulted in profile binding strength 
+not being applied to the issue severity as expected when validating resources against a profile. 
+This has been fixed and issue detail codes are translated correctly."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6440-fix-hooks-not-called-for-precheck-for-cached-search.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6440-fix-hooks-not-called-for-precheck-for-cached-search.yaml
new file mode 100644
index 000000000000..86f16018012d
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6440-fix-hooks-not-called-for-precheck-for-cached-search.yaml
@@ -0,0 +1,8 @@
+---
+type: fix
+issue: 6440
+title: "Previously, if an `IInterceptorBroadcaster` was set in a `RequestDetails` object,
+`STORAGE_PRECHECK_FOR_CACHED_SEARCH` hooks that were registered to that `IInterceptorBroadcaster` were not
+called. Also, if an `IInterceptorBroadcaster` was set in the `RequestDetails` object, the boolean return value of the hooks
+registered to that `IInterceptorBroadcaster` were not taken into account. This second issue existed for all pointcuts 
+that returned a boolean type, not just for `STORAGE_PRECHECK_FOR_CACHED_SEARCH`. These issues have now been fixed."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6445-repository-api-multimap.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6445-repository-api-multimap.yaml
new file mode 100644
index 000000000000..841287f278d4
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6445-repository-api-multimap.yaml
@@ -0,0 +1,4 @@
+---
+type: add
+issue: 6445
+title: "Add Multimap versions of the search() methods to Repository to support queries like `Patient?_tag=a&_tag=b`"
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6451-bulk-import-job-status-not-changing-after-activation.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6451-bulk-import-job-status-not-changing-after-activation.yaml
new file mode 100644
index 000000000000..ce62822d3707
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6451-bulk-import-job-status-not-changing-after-activation.yaml
@@ -0,0 +1,6 @@
+---
+type: fix
+issue: 6451
+jira: SMILE-9089
+title: "Previously, activating `BulkDataImport` job would not change jobs status to `RUNNING`, 
+causing it to be processed multiple times instead of single time. This has been fixed."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6467-hibernate-search-lucene-version-incompatibility.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6467-hibernate-search-lucene-version-incompatibility.yaml
new file mode 100644
index 000000000000..f5c95876cd11
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6467-hibernate-search-lucene-version-incompatibility.yaml
@@ -0,0 +1,5 @@
+---
+type: fix
+issue: 6467
+title: "Fixed an incompatibility between Hibernate Search and Lucene versions that caused ValueSet expansion to fail 
+when Hibernate Search was configured to use Lucene."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6489-change-index-add-concurrency-default.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6489-change-index-add-concurrency-default.yaml
new file mode 100644
index 000000000000..86a4c3d7a59f
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/6489-change-index-add-concurrency-default.yaml
@@ -0,0 +1,4 @@
+---
+type: perf
+issue: 6489
+title: "Change the migrator to avoid table locks when adding an index.  This allows systems to continue running during upgrade."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/changes.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/changes.yaml
index c900db52e430..ac97e01fc904 100644
--- a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/changes.yaml
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_6_0/changes.yaml
@@ -4,7 +4,7 @@
       title: "The version of a few dependencies have been bumped to more recent versions
       (dependent HAPI modules listed in brackets):
       <ul>
-      <li>org.hl7.fhir.core (Base): 6.3.18 -&gt; 6.3.25</li>
+      <li>org.hl7.fhir.core (Base): 6.3.18 -&gt; 6.4.0</li>
       <li>Bower/Moment.js (hapi-fhir-testpage-overlay): 2.27.0 -&gt; 2.29.4</li>
       <li>htmlunit (Base): 3.9.0 -&gt; 3.11.0</li>
       <li>Elasticsearch (Base): 8.11.1 -&gt; 8.14.3</li>
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_8_0/6502-profile-can-be-reference-param.yaml b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_8_0/6502-profile-can-be-reference-param.yaml
new file mode 100644
index 000000000000..a0a8d5d1d429
--- /dev/null
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/changelog/7_8_0/6502-profile-can-be-reference-param.yaml
@@ -0,0 +1,5 @@
+---
+type: fix
+issue: 6502
+backport: 7.6.1
+title: "Support ReferenceParam in addition to UriParam for `_profile` in queries using the SearchParameterMap to match the change in the specification from DSTU3 to R4."
diff --git a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/docs/clinical_reasoning/questionnaires.md b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/docs/clinical_reasoning/questionnaires.md
index 8b2426a7d65d..d409d2545824 100644
--- a/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/docs/clinical_reasoning/questionnaires.md
+++ b/hapi-fhir-docs/src/main/resources/ca/uhn/hapi/fhir/docs/clinical_reasoning/questionnaires.md
@@ -48,24 +48,24 @@ Additional parameters have been added to support CQL evaluation.
 
 The following parameters are supported for the `Questionnaire/$populate` operation:
 
-| Parameter           | Type          | Description |
-|---------------------|---------------|-------------|
-| questionnaire       | Questionnaire | The Questionnaire to populate. Used when the operation is invoked at the 'type' level. |
-| canonical           | canonical     | The canonical identifier for the Questionnaire (optionally version-specific). |
-| url                 | uri           | Canonical URL of the Questionnaire when invoked at the resource type level. This is exclusive with the questionnaire and canonical parameters. |
-| version             | string        | Version of the Questionnaire when invoked at the resource type level. This is exclusive with the questionnaire and canonical parameters. |
-| subject             | Reference     | The resource that is to be the QuestionnaireResponse.subject. The QuestionnaireResponse instance will reference the provided subject. |
-| context             |               | Resources containing information to be used to help populate the QuestionnaireResponse. | 
-| context.name        | string        | The name of the launchContext or root Questionnaire variable the passed content should be used as for population purposes. The name SHALL correspond to a launchContext or variable delared at the root of the Questionnaire. | 
-| context.reference   | Reference     | The actual resource (or resources) to use as the value of the launchContext or variable. | 
-| local               | boolean       | Whether the server should use what resources and other knowledge it has about the referenced subject when pre-populating answers to questions. |
-| launchContext       | Extension     | The [Questionnaire Launch Context](https://hl7.org/fhir/uv/sdc/StructureDefinition-sdc-questionnaire-launchContext.html) extension containing Resources that provide context for form processing logic (pre-population) when creating/displaying/editing a QuestionnaireResponse. |
-| parameters          | Parameters    | Any input parameters defined in libraries referenced by the Questionnaire. |
-| useServerData       | boolean       | Whether to use data from the server performing the evaluation. |
-| data                | Bundle        | Data to be made available during CQL evaluation. |
-| dataEndpoint        | Endpoint      | An endpoint to use to access data referenced by retrieve operations in libraries referenced by the Questionnaire. |
-| contentEndpoint     | Endpoint      | An endpoint to use to access content (i.e. libraries) referenced by the Questionnaire. |
-| terminologyEndpoint | Endpoint      | An endpoint to use to access terminology (i.e. valuesets, codesystems, and membership testing) referenced by the Questionnaire. |
+| Parameter           | Type               | Description |
+|---------------------|--------------------|-------------|
+| questionnaire       | Questionnaire      | The Questionnaire to populate. Used when the operation is invoked at the 'type' level. |
+| canonical           | canonical          | The canonical identifier for the Questionnaire (optionally version-specific). |
+| url                 | uri                | Canonical URL of the Questionnaire when invoked at the resource type level. This is exclusive with the questionnaire and canonical parameters. |
+| version             | string             | Version of the Questionnaire when invoked at the resource type level. This is exclusive with the questionnaire and canonical parameters. |
+| subject             | Reference          | The resource that is to be the QuestionnaireResponse.subject. The QuestionnaireResponse instance will reference the provided subject. |
+| context             |                    | Resources containing information to be used to help populate the QuestionnaireResponse. | 
+| context.name        | string             | The name of the launchContext or root Questionnaire variable the passed content should be used as for population purposes. The name SHALL correspond to a launchContext or variable declared at the root of the Questionnaire. | 
+| context.content     | Reference/Resource | The actual resource (or reference) to use as the value of the launchContext or variable. | 
+| local               | boolean            | Whether the server should use what resources and other knowledge it has about the referenced subject when pre-populating answers to questions. |
+| launchContext       | Extension          | The [Questionnaire Launch Context](https://hl7.org/fhir/uv/sdc/StructureDefinition-sdc-questionnaire-launchContext.html) extension containing Resources that provide context for form processing logic (pre-population) when creating/displaying/editing a QuestionnaireResponse. |
+| parameters          | Parameters         | Any input parameters defined in libraries referenced by the Questionnaire. |
+| useServerData       | boolean            | Whether to use data from the server performing the evaluation. |
+| data                | Bundle             | Data to be made available during CQL evaluation. |
+| dataEndpoint        | Endpoint           | An endpoint to use to access data referenced by retrieve operations in libraries referenced by the Questionnaire. |
+| contentEndpoint     | Endpoint           | An endpoint to use to access content (i.e. libraries) referenced by the Questionnaire. |
+| terminologyEndpoint | Endpoint           | An endpoint to use to access terminology (i.e. valuesets, codesystems, and membership testing) referenced by the Questionnaire. |
  
 ## Extract
 
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/bulk/imprt/svc/BulkDataImportSvcImpl.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/bulk/imprt/svc/BulkDataImportSvcImpl.java
index 42eba8257550..bf72dbf645ce 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/bulk/imprt/svc/BulkDataImportSvcImpl.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/bulk/imprt/svc/BulkDataImportSvcImpl.java
@@ -217,6 +217,12 @@ private ActivateJobResult doActivateNextReadyJob() {
 		String biJobId = null;
 		try {
 			biJobId = processJob(bulkImportJobEntity);
+			// set job status to RUNNING so it would not be processed again
+			myTxTemplate.execute(t -> {
+				bulkImportJobEntity.setStatus(BulkImportJobStatusEnum.RUNNING);
+				myJobDao.save(bulkImportJobEntity);
+				return null;
+			});
 		} catch (Exception e) {
 			ourLog.error("Failure while preparing bulk export extract", e);
 			myTxTemplate.execute(t -> {
@@ -256,6 +262,7 @@ public BulkImportJobJson fetchJob(String theBiJobId) {
 	}
 
 	@Override
+	@Transactional
 	public JobInfo getJobStatus(String theBiJobId) {
 		BulkImportJobEntity theJob = findJobByBiJobId(theBiJobId);
 		return new JobInfo()
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/BaseHapiFhirResourceDao.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/BaseHapiFhirResourceDao.java
index c7fc08cae7cb..95f8cdbe480e 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/BaseHapiFhirResourceDao.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/BaseHapiFhirResourceDao.java
@@ -134,6 +134,7 @@
 import org.springframework.beans.factory.annotation.Autowired;
 import org.springframework.data.domain.PageRequest;
 import org.springframework.data.domain.Slice;
+import org.springframework.data.domain.Sort;
 import org.springframework.transaction.PlatformTransactionManager;
 import org.springframework.transaction.annotation.Propagation;
 import org.springframework.transaction.annotation.Transactional;
@@ -1697,9 +1698,15 @@ private void reindexOptimizeStorage(
 			if (theOptimizeStorageMode == ReindexParameters.OptimizeStorageModeEnum.ALL_VERSIONS) {
 				int pageSize = 100;
 				for (int page = 0; ((long) page * pageSize) < entity.getVersion(); page++) {
+
+					// We need to sort the pages, because we are updating the same data we are paging through.
+					// If not sorted explicitly, a database like Postgres returns the same data multiple times on
+					// different pages as the underlying data gets updated.
+					PageRequest pageRequest = PageRequest.of(page, pageSize, Sort.by("myId"));
 					Slice<ResourceHistoryTable> historyEntities =
 							myResourceHistoryTableDao.findForResourceIdAndReturnEntitiesAndFetchProvenance(
-									PageRequest.of(page, pageSize), entity.getId(), historyEntity.getVersion());
+									pageRequest, entity.getId(), historyEntity.getVersion());
+
 					for (ResourceHistoryTable next : historyEntities) {
 						reindexOptimizeStorageHistoryEntity(entity, next);
 					}
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/BaseHapiFhirSystemDao.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/BaseHapiFhirSystemDao.java
index fde57c39836f..d21dff545d32 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/BaseHapiFhirSystemDao.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/BaseHapiFhirSystemDao.java
@@ -205,7 +205,7 @@ public <P extends IResourcePersistentId> void preFetchResources(
 			 *
 			 * However, for realistic average workloads, this should reduce the number of round trips.
 			 */
-			if (idChunk.size() >= 2) {
+			if (!idChunk.isEmpty()) {
 				List<ResourceTable> entityChunk = prefetchResourceTableHistoryAndProvenance(idChunk);
 
 				if (thePreFetchIndexes) {
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/IBatch2WorkChunkRepository.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/IBatch2WorkChunkRepository.java
index e9611614e45b..2b6462072957 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/IBatch2WorkChunkRepository.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/dao/data/IBatch2WorkChunkRepository.java
@@ -150,6 +150,6 @@ List<String> fetchAllChunkIdsForStepWithStatus(
 			@Param("status") WorkChunkStatusEnum theStatus);
 
 	@Query(
-			"SELECT new ca.uhn.fhir.batch2.model.BatchWorkChunkStatusDTO(e.myTargetStepId, e.myStatus, min(e.myStartTime), max(e.myEndTime), avg(e.myEndTime - e.myStartTime), count(*)) FROM Batch2WorkChunkEntity e WHERE e.myInstanceId=:instanceId GROUP BY e.myTargetStepId, e.myStatus")
+			"SELECT new ca.uhn.fhir.batch2.model.BatchWorkChunkStatusDTO(e.myTargetStepId, e.myStatus, min(e.myStartTime), max(e.myEndTime), avg(cast((e.myEndTime - e.myStartTime) as long)), count(*)) FROM Batch2WorkChunkEntity e WHERE e.myInstanceId=:instanceId GROUP BY e.myTargetStepId, e.myStatus")
 	List<BatchWorkChunkStatusDTO> fetchWorkChunkStatusForInstance(@Param("instanceId") String theInstanceId);
 }
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/search/SearchCoordinatorSvcImpl.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/search/SearchCoordinatorSvcImpl.java
index 477999b3d3eb..f169fba81d84 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/search/SearchCoordinatorSvcImpl.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/search/SearchCoordinatorSvcImpl.java
@@ -605,12 +605,12 @@ private PersistedJpaBundleProvider findCachedQuery(
 							.add(SearchParameterMap.class, theParams)
 							.add(RequestDetails.class, theRequestDetails)
 							.addIfMatchesType(ServletRequestDetails.class, theRequestDetails);
-					Object outcome = CompositeInterceptorBroadcaster.doCallHooksAndReturnObject(
+					boolean canUseCache = CompositeInterceptorBroadcaster.doCallHooks(
 							myInterceptorBroadcaster,
 							theRequestDetails,
 							Pointcut.STORAGE_PRECHECK_FOR_CACHED_SEARCH,
 							params);
-					if (Boolean.FALSE.equals(outcome)) {
+					if (!canUseCache) {
 						return null;
 					}
 
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/search/builder/QueryStack.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/search/builder/QueryStack.java
index 5eadee42cb1f..e7d688624d22 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/search/builder/QueryStack.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/search/builder/QueryStack.java
@@ -210,7 +210,7 @@ public void addSortOnCoordsNear(String theParamName, boolean theAscending, Searc
 				CoordsPredicateBuilder coordsBuilder = (CoordsPredicateBuilder) builder;
 
 				List<List<IQueryParameterType>> params = theParams.get(theParamName);
-				if (params.size() > 0 && params.get(0).size() > 0) {
+				if (!params.isEmpty() && !params.get(0).isEmpty()) {
 					IQueryParameterType param = params.get(0).get(0);
 					ParsedLocationParam location = ParsedLocationParam.from(theParams, param);
 					double latitudeValue = location.getLatitudeValue();
@@ -2134,6 +2134,10 @@ private boolean populateTokens(
 				if (nextParam.getModifier() == TokenParamModifier.NOT) {
 					paramInverted = true;
 				}
+			} else if (nextOrParam instanceof ReferenceParam) {
+				ReferenceParam nextParam = (ReferenceParam) nextOrParam;
+				code = nextParam.getValue();
+				system = null;
 			} else {
 				UriParam nextParam = (UriParam) nextOrParam;
 				code = nextParam.getValue();
@@ -2160,8 +2164,10 @@ private boolean checkHaveTags(List<? extends IQueryParameterType> theParams, Str
 				}
 			}
 
-			UriParam nextParam = (UriParam) nextParamUncasted;
-			if (isNotBlank(nextParam.getValue())) {
+			if (nextParamUncasted instanceof ReferenceParam
+					&& isNotBlank(((ReferenceParam) nextParamUncasted).getValue())) {
+				return true;
+			} else if (nextParamUncasted instanceof UriParam && isNotBlank(((UriParam) nextParamUncasted).getValue())) {
 				return true;
 			}
 		}
diff --git a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/TermReadSvcImpl.java b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/TermReadSvcImpl.java
index 8cd06745910c..972255d93762 100644
--- a/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/TermReadSvcImpl.java
+++ b/hapi-fhir-jpaserver-base/src/main/java/ca/uhn/fhir/jpa/term/TermReadSvcImpl.java
@@ -1056,7 +1056,8 @@ private void expandValueSetHandleIncludeOrExclude(
 					if (theExpansionOptions != null
 							&& !theExpansionOptions.isFailOnMissingCodeSystem()
 							// Code system is unknown, therefore NOT_FOUND
-							&& e.getCodeValidationIssue().getCoding() == CodeValidationIssueCoding.NOT_FOUND) {
+							&& e.getCodeValidationIssue()
+									.hasIssueDetailCode(CodeValidationIssueCoding.NOT_FOUND.getCode())) {
 						return;
 					}
 					throw new InternalErrorException(Msg.code(888) + e);
@@ -2203,7 +2204,7 @@ private CodeValidationResult createFailureCodeValidationResult(
 				.setSeverity(IssueSeverity.ERROR)
 				.setCodeSystemVersion(theCodeSystemVersion)
 				.setMessage(theMessage)
-				.addCodeValidationIssue(new CodeValidationIssue(
+				.addIssue(new CodeValidationIssue(
 						theMessage,
 						IssueSeverity.ERROR,
 						CodeValidationIssueCode.CODE_INVALID,
diff --git a/hapi-fhir-jpaserver-mdm/src/test/java/ca/uhn/fhir/jpa/mdm/helper/BaseMdmHelper.java b/hapi-fhir-jpaserver-mdm/src/test/java/ca/uhn/fhir/jpa/mdm/helper/BaseMdmHelper.java
index 33a288ee811a..ee0e08ef7eae 100644
--- a/hapi-fhir-jpaserver-mdm/src/test/java/ca/uhn/fhir/jpa/mdm/helper/BaseMdmHelper.java
+++ b/hapi-fhir-jpaserver-mdm/src/test/java/ca/uhn/fhir/jpa/mdm/helper/BaseMdmHelper.java
@@ -1,6 +1,7 @@
 package ca.uhn.fhir.jpa.mdm.helper;
 
 import ca.uhn.fhir.context.FhirContext;
+import ca.uhn.fhir.interceptor.api.HookParams;
 import ca.uhn.fhir.interceptor.api.IInterceptorBroadcaster;
 import ca.uhn.fhir.interceptor.api.IInterceptorService;
 import ca.uhn.fhir.interceptor.api.Pointcut;
@@ -23,6 +24,7 @@
 import java.util.function.Supplier;
 
 import static org.awaitility.Awaitility.await;
+import static org.mockito.ArgumentMatchers.any;
 import static org.mockito.Mockito.when;
 
 /**
@@ -78,6 +80,7 @@ public void beforeEach(ExtensionContext context) throws Exception {
 		//they are coming from an external HTTP Request.
 		MockitoAnnotations.initMocks(this);
 		when(myMockSrd.getInterceptorBroadcaster()).thenReturn(myMockInterceptorBroadcaster);
+		when(myMockInterceptorBroadcaster.callHooks(any(Pointcut.class), any(HookParams.class))).thenReturn(true);
 		when(myMockSrd.getServletRequest()).thenReturn(myMockServletRequest);
 		when(myMockSrd.getServer()).thenReturn(myMockRestfulServer);
 		when(myMockSrd.getRequestId()).thenReturn("MOCK_REQUEST");
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/batch2/JpaJobPersistenceImplTest.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/batch2/JpaJobPersistenceImplTest.java
index d7f85325a7f6..ab890c96853e 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/batch2/JpaJobPersistenceImplTest.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/batch2/JpaJobPersistenceImplTest.java
@@ -881,6 +881,11 @@ public void testPrestorageInterceptor_whenModifyingJobInstance_modifiedJobInstan
 	public void testFetchInstanceAndWorkChunkStatus() {
 		// Setup
 
+		Date date1 = new Date();
+		Date date2 = new Date();
+
+
+
 		List<String> chunkIds = new ArrayList<>();
 		JobInstance instance = createInstance();
 		String instanceId = mySvc.storeNewInstance(instance);
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/bulk/imprt/svc/BulkDataImportR4Test.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/bulk/imprt/svc/BulkDataImportR4Test.java
index dec666c0c157..7c3a6e67c46e 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/bulk/imprt/svc/BulkDataImportR4Test.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/bulk/imprt/svc/BulkDataImportR4Test.java
@@ -17,6 +17,7 @@
 import ca.uhn.fhir.jpa.bulk.imprt.model.ActivateJobResult;
 import ca.uhn.fhir.jpa.bulk.imprt.model.BulkImportJobFileJson;
 import ca.uhn.fhir.jpa.bulk.imprt.model.BulkImportJobJson;
+import ca.uhn.fhir.jpa.bulk.imprt.model.BulkImportJobStatusEnum;
 import ca.uhn.fhir.jpa.bulk.imprt.model.JobFileRowProcessingModeEnum;
 import ca.uhn.fhir.jpa.searchparam.SearchParameterMap;
 import ca.uhn.fhir.jpa.subscription.channel.api.ChannelConsumerSettings;
@@ -166,6 +167,8 @@ public void testFlow_TransactionRows() {
 
 		ActivateJobResult activateJobOutcome = mySvc.activateNextReadyJob();
 		assertTrue(activateJobOutcome.isActivated);
+		// validate that job changed status from READY to RUNNING
+		assertEquals(BulkImportJobStatusEnum.RUNNING, mySvc.getJobStatus(jobId).getStatus());
 
 		JobInstance instance = myBatch2JobHelper.awaitJobCompletion(activateJobOutcome.jobId, 60);
 		assertNotNull(instance);
@@ -196,6 +199,8 @@ public void testFlow_WithTenantNamesInInput() {
 
 			ActivateJobResult activateJobOutcome = mySvc.activateNextReadyJob();
 			assertTrue(activateJobOutcome.isActivated);
+			// validate that job changed status from READY to RUNNING
+			assertEquals(BulkImportJobStatusEnum.RUNNING, mySvc.getJobStatus(jobId).getStatus());
 
 			JobInstance instance = myBatch2JobHelper.awaitJobCompletion(activateJobOutcome.jobId);
 			assertNotNull(instance);
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/BaseComboParamsR4Test.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/BaseComboParamsR4Test.java
index f73670fbddc8..2eb8a60aa2e8 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/BaseComboParamsR4Test.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/BaseComboParamsR4Test.java
@@ -62,6 +62,9 @@ public void before() throws Exception {
 			myMessages.add("REUSING CACHED SEARCH");
 			return null;
 		});
+
+		// allow searches to use cached results
+		when(myInterceptorBroadcaster.callHooks(eq(Pointcut.STORAGE_PRECHECK_FOR_CACHED_SEARCH), ArgumentMatchers.any(HookParams.class))).thenReturn(true);
 	}
 
 	@AfterEach
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4ContainedTest.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4ContainedTest.java
index 636ffd02b401..6b10598174b5 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4ContainedTest.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4ContainedTest.java
@@ -1,6 +1,7 @@
 package ca.uhn.fhir.jpa.dao.r4;
 
 import ca.uhn.fhir.i18n.Msg;
+import ca.uhn.fhir.jpa.api.model.DaoMethodOutcome;
 import ca.uhn.fhir.jpa.searchparam.SearchParameterMap;
 import ca.uhn.fhir.jpa.test.BaseJpaR4Test;
 import ca.uhn.fhir.rest.api.server.IBundleProvider;
@@ -23,6 +24,8 @@
 import org.hl7.fhir.r4.model.ServiceRequest;
 import org.hl7.fhir.r4.model.ServiceRequest.ServiceRequestIntent;
 import org.hl7.fhir.r4.model.ServiceRequest.ServiceRequestStatus;
+import org.hl7.fhir.r4.model.Specimen;
+import org.hl7.fhir.r4.model.StringType;
 import org.junit.jupiter.api.AfterEach;
 import org.junit.jupiter.api.BeforeEach;
 import org.junit.jupiter.api.Test;
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4CreateTest.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4CreateTest.java
index c09eed9cb620..c8b4bdbe41bb 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4CreateTest.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4CreateTest.java
@@ -28,6 +28,7 @@
 import ca.uhn.fhir.rest.server.exceptions.ResourceNotFoundException;
 import ca.uhn.fhir.rest.server.exceptions.ResourceVersionConflictException;
 import ca.uhn.fhir.rest.server.exceptions.UnprocessableEntityException;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.BundleBuilder;
 import ca.uhn.fhir.util.ClasspathUtil;
 import org.apache.commons.lang3.StringUtils;
@@ -81,6 +82,7 @@
 import java.util.concurrent.Future;
 import java.util.stream.Collectors;
 
+import static ca.uhn.fhir.test.utilities.UuidUtils.HASH_UUID_PATTERN;
 import static org.assertj.core.api.Assertions.assertThat;
 import static org.assertj.core.api.Assertions.assertThatThrownBy;
 import static org.junit.jupiter.api.Assertions.assertEquals;
@@ -738,7 +740,8 @@ public void testTagsInContainedResourcesPreserved() {
 
 		String encoded = myFhirContext.newJsonParser().setPrettyPrint(true).encodeResourceToString(p);
 		ourLog.info("Input: {}", encoded);
-		assertThat(encoded).contains("#1");
+		String organizationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(organizationUuid);
 
 		IIdType id = myPatientDao.create(p).getId().toUnqualifiedVersionless();
 
@@ -746,10 +749,12 @@ public void testTagsInContainedResourcesPreserved() {
 
 		encoded = myFhirContext.newJsonParser().setPrettyPrint(true).encodeResourceToString(p);
 		ourLog.info("Output: {}", encoded);
-		assertThat(encoded).contains("#1");
+		String organizationUuidParsed = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(organizationUuidParsed);
+		assertEquals(organizationUuid, organizationUuidParsed);
 
 		Organization org = (Organization) p.getManagingOrganization().getResource();
-		assertEquals("#1", org.getId());
+		assertEquals("#" + organizationUuid, org.getId());
 		assertThat(org.getMeta().getTag()).hasSize(1);
 
 	}
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4QueryCountTest.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4QueryCountTest.java
index 635e847d5dcb..aa5fd85af49f 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4QueryCountTest.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4QueryCountTest.java
@@ -2722,7 +2722,7 @@ public void testTransactionWithCreateClientAssignedIdAndReference() {
 		ourLog.debug(myFhirContext.newJsonParser().setPrettyPrint(true).encodeResourceToString(output));
 
 		myCaptureQueriesListener.logSelectQueriesForCurrentThread();
-		assertEquals(3, myCaptureQueriesListener.countSelectQueriesForCurrentThread());
+		assertEquals(2, myCaptureQueriesListener.countSelectQueriesForCurrentThread());
 		myCaptureQueriesListener.logInsertQueriesForCurrentThread();
 		assertEquals(2, myCaptureQueriesListener.countInsertQueriesForCurrentThread());
 		myCaptureQueriesListener.logUpdateQueriesForCurrentThread();
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4VersionedReferenceTest.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4VersionedReferenceTest.java
index 4ad723edfa30..f835c300c199 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4VersionedReferenceTest.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirResourceDaoR4VersionedReferenceTest.java
@@ -428,7 +428,7 @@ public void testInsertVersionedReferenceAtPath_InTransaction_TargetUpdate() {
 			IdType observationId = new IdType(outcome.getEntry().get(1).getResponse().getLocation());
 
 			// Make sure we're not introducing any extra DB operations
-			assertThat(myCaptureQueriesListener.logSelectQueries()).hasSize(3);
+			assertThat(myCaptureQueriesListener.logSelectQueries()).hasSize(2);
 
 			// Read back and verify that reference is now versioned
 			observation = myObservationDao.read(observationId);
@@ -463,7 +463,7 @@ public void testInsertVersionedReferenceAtPath_InTransaction_TargetUpdateConditi
 			IdType observationId = new IdType(outcome.getEntry().get(1).getResponse().getLocation());
 
 			// Make sure we're not introducing any extra DB operations
-			assertThat(myCaptureQueriesListener.logSelectQueries()).hasSize(4);
+			assertThat(myCaptureQueriesListener.logSelectQueries()).hasSize(3);
 
 			// Read back and verify that reference is now versioned
 			observation = myObservationDao.read(observationId);
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirSystemDaoR4Test.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirSystemDaoR4Test.java
index 88a8def13c86..f36a093e147c 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirSystemDaoR4Test.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/dao/r4/FhirSystemDaoR4Test.java
@@ -1,5 +1,6 @@
 package ca.uhn.fhir.jpa.dao.r4;
 
+import static ca.uhn.fhir.test.utilities.UuidUtils.HASH_UUID_PATTERN;
 import static org.junit.jupiter.api.Assertions.assertNull;
 import static org.junit.jupiter.api.Assertions.assertTrue;
 import static org.junit.jupiter.api.Assertions.assertFalse;
@@ -3219,8 +3220,8 @@ public void testTransactionWithContainedResource() {
 		String id = outcome.getEntry().get(0).getResponse().getLocation();
 		patient = myPatientDao.read(new IdType(id));
 
-		assertEquals("#1", patient.getManagingOrganization().getReference());
-		assertEquals("#1", patient.getContained().get(0).getId());
+		assertThat(patient.getManagingOrganization().getReference()).containsPattern(HASH_UUID_PATTERN);
+		assertEquals(patient.getManagingOrganization().getReference(), patient.getContained().get(0).getId());
 	}
 
 	@Nonnull
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/provider/r4/ResourceProviderR4Test.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/provider/r4/ResourceProviderR4Test.java
index 1ddb1cca9d32..8f3e849719f1 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/provider/r4/ResourceProviderR4Test.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/provider/r4/ResourceProviderR4Test.java
@@ -263,6 +263,8 @@ public void before() throws Exception {
 		myStorageSettings.setSearchPreFetchThresholds(new JpaStorageSettings().getSearchPreFetchThresholds());
 	}
 
+
+
 	@Test
 	public void testParameterWithNoValueThrowsError_InvalidChainOnCustomSearch() throws IOException {
 		SearchParameter searchParameter = new SearchParameter();
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/reindex/ReindexTaskTest.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/reindex/ReindexTaskTest.java
index c04a40f1ac7f..290dfcdf9b4b 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/reindex/ReindexTaskTest.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/reindex/ReindexTaskTest.java
@@ -180,6 +180,59 @@ public void testOptimizeStorage_AllVersions() {
 
 	}
 
+	@Test
+	public void testOptimizeStorage_AllVersions_SingleResourceWithMultipleVersion() {
+
+		// this difference of this test from testOptimizeStorage_AllVersions is that this one has only 1 resource
+		// (with multiple versions) in the db. There was a bug where if only one resource were being re-indexed, the
+		// resource wasn't processed for optimize storage.
+
+		// Setup
+		IIdType patientId = createPatient(withActiveTrue());
+		for (int i = 0; i < 10; i++) {
+			Patient p = new Patient();
+			p.setId(patientId.toUnqualifiedVersionless());
+			p.setActive(true);
+			p.addIdentifier().setValue(String.valueOf(i));
+			myPatientDao.update(p, mySrd);
+		}
+
+		// Move resource text to compressed storage, which we don't write to anymore but legacy
+		// data may exist that was previously stored there, so we're simulating that.
+		List<ResourceHistoryTable> allHistoryEntities = runInTransaction(() -> myResourceHistoryTableDao.findAll());
+		allHistoryEntities.forEach(t->relocateResourceTextToCompressedColumn(t.getResourceId(), t.getVersion()));
+
+		runInTransaction(()->{
+			assertEquals(11, myResourceHistoryTableDao.count());
+			for (ResourceHistoryTable history : myResourceHistoryTableDao.findAll()) {
+				assertNull(history.getResourceTextVc());
+				assertNotNull(history.getResource());
+			}
+		});
+
+		// execute
+		JobInstanceStartRequest startRequest = new JobInstanceStartRequest();
+		startRequest.setJobDefinitionId(JOB_REINDEX);
+		startRequest.setParameters(
+			new ReindexJobParameters()
+				.setOptimizeStorage(ReindexParameters.OptimizeStorageModeEnum.ALL_VERSIONS)
+				.setReindexSearchParameters(ReindexParameters.ReindexSearchParametersEnum.NONE)
+		);
+		Batch2JobStartResponse startResponse = myJobCoordinator.startInstance(mySrd, startRequest);
+		myBatch2JobHelper.awaitJobCompletion(startResponse);
+
+		// validate
+		runInTransaction(()->{
+			assertEquals(11, myResourceHistoryTableDao.count());
+			for (ResourceHistoryTable history : myResourceHistoryTableDao.findAll()) {
+				assertNotNull(history.getResourceTextVc());
+				assertNull(history.getResource());
+			}
+		});
+		Patient patient = myPatientDao.read(patientId, mySrd);
+		assertTrue(patient.getActive());
+	}
+
 	@Test
 	public void testOptimizeStorage_AllVersions_CopyProvenanceEntityData() {
 		// Setup
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/provider/r4/ValidateCodeOperationWithRemoteTerminologyR4Test.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/validation/ValidateCodeWithRemoteTerminologyR4Test.java
similarity index 59%
rename from hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/provider/r4/ValidateCodeOperationWithRemoteTerminologyR4Test.java
rename to hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/validation/ValidateCodeWithRemoteTerminologyR4Test.java
index 4da204217f05..3787c611eb75 100644
--- a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/provider/r4/ValidateCodeOperationWithRemoteTerminologyR4Test.java
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/validation/ValidateCodeWithRemoteTerminologyR4Test.java
@@ -1,29 +1,21 @@
-package ca.uhn.fhir.jpa.provider.r4;
+package ca.uhn.fhir.jpa.validation;
 
 import ca.uhn.fhir.context.FhirContext;
 import ca.uhn.fhir.jpa.config.JpaConfig;
 import ca.uhn.fhir.jpa.model.util.JpaConstants;
 import ca.uhn.fhir.jpa.provider.BaseResourceProviderR4Test;
-import ca.uhn.fhir.rest.annotation.IdParam;
-import ca.uhn.fhir.rest.annotation.Operation;
-import ca.uhn.fhir.rest.annotation.OperationParam;
-import ca.uhn.fhir.rest.annotation.RequiredParam;
-import ca.uhn.fhir.rest.annotation.Search;
-import ca.uhn.fhir.rest.param.UriParam;
-import ca.uhn.fhir.rest.server.IResourceProvider;
 import ca.uhn.fhir.rest.server.exceptions.InvalidRequestException;
 import ca.uhn.fhir.test.utilities.server.RestfulServerExtension;
-import jakarta.servlet.http.HttpServletRequest;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
+import ca.uhn.fhir.test.utilities.validation.IValidationProvidersR4;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
 import org.hl7.fhir.common.hapi.validation.support.ValidationSupportChain;
-import org.hl7.fhir.instance.model.api.IBaseResource;
+import org.hl7.fhir.instance.model.api.IBaseParameters;
 import org.hl7.fhir.r4.model.BooleanType;
 import org.hl7.fhir.r4.model.CodeSystem;
 import org.hl7.fhir.r4.model.CodeType;
 import org.hl7.fhir.r4.model.Coding;
-import org.hl7.fhir.r4.model.IdType;
 import org.hl7.fhir.r4.model.Parameters;
-import org.hl7.fhir.r4.model.StringType;
 import org.hl7.fhir.r4.model.UriType;
 import org.hl7.fhir.r4.model.ValueSet;
 import org.junit.jupiter.api.AfterEach;
@@ -33,9 +25,7 @@
 import org.springframework.beans.factory.annotation.Autowired;
 import org.springframework.beans.factory.annotation.Qualifier;
 
-import java.util.ArrayList;
-import java.util.List;
-
+import static ca.uhn.fhir.jpa.model.util.JpaConstants.OPERATION_VALIDATE_CODE;
 import static org.assertj.core.api.Assertions.assertThat;
 import static org.assertj.core.api.AssertionsForClassTypes.assertThatExceptionOfType;
 import static org.junit.jupiter.api.Assertions.assertEquals;
@@ -43,15 +33,15 @@
 import static org.junit.jupiter.api.Assertions.assertTrue;
 import static org.junit.jupiter.api.Assertions.fail;
 
-/*
+/**
  * This set of integration tests that instantiates and injects an instance of
  * {@link org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport}
  * into the ValidationSupportChain, which tests the logic of dynamically selecting the correct Remote Terminology
- * implementation. It also exercises the code found in
- * {@link org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport#invokeRemoteValidateCode}
+ * implementation. It also exercises the validateCode output translation code found in
+ * {@link org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport}
  */
-public class ValidateCodeOperationWithRemoteTerminologyR4Test extends BaseResourceProviderR4Test {
-	private static final org.slf4j.Logger ourLog = org.slf4j.LoggerFactory.getLogger(ValidateCodeOperationWithRemoteTerminologyR4Test.class);
+public class ValidateCodeWithRemoteTerminologyR4Test extends BaseResourceProviderR4Test {
+	private static final org.slf4j.Logger ourLog = org.slf4j.LoggerFactory.getLogger(ValidateCodeWithRemoteTerminologyR4Test.class);
 	private static final String DISPLAY = "DISPLAY";
 	private static final String DISPLAY_BODY_MASS_INDEX = "Body mass index (BMI) [Ratio]";
 	private static final String CODE_BODY_MASS_INDEX = "39156-5";
@@ -64,8 +54,8 @@ public class ValidateCodeOperationWithRemoteTerminologyR4Test extends BaseResour
 	protected static RestfulServerExtension ourRestfulServerExtension = new RestfulServerExtension(ourCtx);
 
 	private RemoteTerminologyServiceValidationSupport mySvc;
-	private MyCodeSystemProvider myCodeSystemProvider;
-	private MyValueSetProvider myValueSetProvider;
+	private IValidationProviders.MyValidationProvider<CodeSystem> myCodeSystemProvider;
+	private IValidationProviders.MyValidationProvider<ValueSet> myValueSetProvider;
 
 	@Autowired
 	@Qualifier(JpaConfig.JPA_VALIDATION_SUPPORT_CHAIN)
@@ -76,8 +66,8 @@ public void before() throws Exception {
 		String baseUrl = "http://localhost:" + ourRestfulServerExtension.getPort();
 		mySvc = new RemoteTerminologyServiceValidationSupport(ourCtx, baseUrl);
 		myValidationSupportChain.addValidationSupport(0, mySvc);
-		myCodeSystemProvider = new MyCodeSystemProvider();
-		myValueSetProvider = new MyValueSetProvider();
+		myCodeSystemProvider = new IValidationProvidersR4.MyCodeSystemProviderR4();
+		myValueSetProvider = new IValidationProvidersR4.MyValueSetProviderR4();
 		ourRestfulServerExtension.registerProvider(myCodeSystemProvider);
 		ourRestfulServerExtension.registerProvider(myValueSetProvider);
 	}
@@ -103,11 +93,11 @@ public void validateCodeOperationOnCodeSystem_byCodingAndUrlWhereSystemIsDiffere
 
 	@Test
 	public void validateCodeOperationOnCodeSystem_byCodingAndUrl_usingBuiltInCodeSystems() {
-		myCodeSystemProvider.myReturnCodeSystems = new ArrayList<>();
-		myCodeSystemProvider.myReturnCodeSystems.add((CodeSystem) new CodeSystem().setId("CodeSystem/v2-0247"));
-		myCodeSystemProvider.myReturnParams = new Parameters();
-		myCodeSystemProvider.myReturnParams.addParameter("result", true);
-		myCodeSystemProvider.myReturnParams.addParameter("display", DISPLAY);
+		final String code = "P";
+		final String system = CODE_SYSTEM_V2_0247_URI;;
+
+		Parameters params = new Parameters().addParameter("result", true).addParameter("display", DISPLAY);
+		setupCodeSystemValidateCode(system, code, params);
 
 		logAllConcepts();
 
@@ -115,8 +105,8 @@ public void validateCodeOperationOnCodeSystem_byCodingAndUrl_usingBuiltInCodeSys
 			.operation()
 			.onType(CodeSystem.class)
 			.named(JpaConstants.OPERATION_VALIDATE_CODE)
-			.withParameter(Parameters.class, "coding", new Coding().setSystem(CODE_SYSTEM_V2_0247_URI).setCode("P"))
-			.andParameter("url", new UriType(CODE_SYSTEM_V2_0247_URI))
+			.withParameter(Parameters.class, "coding", new Coding().setSystem(system).setCode(code))
+			.andParameter("url", new UriType(system))
 			.execute();
 
 		String resp = myFhirContext.newXmlParser().setPrettyPrint(true).encodeResourceToString(respParam);
@@ -128,7 +118,7 @@ public void validateCodeOperationOnCodeSystem_byCodingAndUrl_usingBuiltInCodeSys
 
 	@Test
 	public void validateCodeOperationOnCodeSystem_byCodingAndUrlWhereCodeSystemIsUnknown_returnsFalse() {
-		myCodeSystemProvider.myReturnCodeSystems = new ArrayList<>();
+		myCodeSystemProvider.setShouldThrowExceptionForResourceNotFound(false);
 
 		Parameters respParam = myClient
 			.operation()
@@ -166,21 +156,21 @@ public void validateCodeOperationOnValueSet_byCodingAndUrlWhereSystemIsDifferent
 
 	@Test
 	public void validateCodeOperationOnValueSet_byUrlAndSystem_usingBuiltInCodeSystems() {
-		myCodeSystemProvider.myReturnCodeSystems = new ArrayList<>();
-		myCodeSystemProvider.myReturnCodeSystems.add((CodeSystem) new CodeSystem().setId("CodeSystem/list-example-use-codes"));
-		myValueSetProvider.myReturnValueSets = new ArrayList<>();
-		myValueSetProvider.myReturnValueSets.add((ValueSet) new ValueSet().setId("ValueSet/list-example-codes"));
-		myValueSetProvider.myReturnParams = new Parameters();
-		myValueSetProvider.myReturnParams.addParameter("result", true);
-		myValueSetProvider.myReturnParams.addParameter("display", DISPLAY);
+		final String code = "alerts";
+		final String system = "http://terminology.hl7.org/CodeSystem/list-example-use-codes";
+		final String valueSetUrl = "http://hl7.org/fhir/ValueSet/list-example-codes";
+
+		Parameters params = new Parameters().addParameter("result", true).addParameter("display", DISPLAY);
+		setupValueSetValidateCode(valueSetUrl, system, code, params);
+		setupCodeSystemValidateCode(system, code, params);
 
 		Parameters respParam = myClient
 			.operation()
 			.onType(ValueSet.class)
 			.named(JpaConstants.OPERATION_VALIDATE_CODE)
-			.withParameter(Parameters.class, "code", new CodeType("alerts"))
-			.andParameter("system", new UriType("http://terminology.hl7.org/CodeSystem/list-example-use-codes"))
-			.andParameter("url", new UriType("http://hl7.org/fhir/ValueSet/list-example-codes"))
+			.withParameter(Parameters.class, "code", new CodeType(code))
+			.andParameter("system", new UriType(system))
+			.andParameter("url", new UriType(valueSetUrl))
 			.useHttpGet()
 			.execute();
 
@@ -193,21 +183,20 @@ public void validateCodeOperationOnValueSet_byUrlAndSystem_usingBuiltInCodeSyste
 
 	@Test
 	public void validateCodeOperationOnValueSet_byUrlSystemAndCode() {
-		myCodeSystemProvider.myReturnCodeSystems = new ArrayList<>();
-		myCodeSystemProvider.myReturnCodeSystems.add((CodeSystem) new CodeSystem().setId("CodeSystem/list-example-use-codes"));
-		myValueSetProvider.myReturnValueSets = new ArrayList<>();
-		myValueSetProvider.myReturnValueSets.add((ValueSet) new ValueSet().setId("ValueSet/list-example-codes"));
-		myValueSetProvider.myReturnParams = new Parameters();
-		myValueSetProvider.myReturnParams.addParameter("result", true);
-		myValueSetProvider.myReturnParams.addParameter("display", DISPLAY_BODY_MASS_INDEX);
+		final String code = CODE_BODY_MASS_INDEX;
+		final String system = "http://terminology.hl7.org/CodeSystem/list-example-use-codes";
+		final String valueSetUrl = "http://hl7.org/fhir/ValueSet/list-example-codes";
+
+		Parameters params = new Parameters().addParameter("result", true).addParameter("display", DISPLAY_BODY_MASS_INDEX);
+		setupValueSetValidateCode(valueSetUrl, system, code, params);
 
 		Parameters respParam = myClient
 			.operation()
 			.onType(ValueSet.class)
 			.named(JpaConstants.OPERATION_VALIDATE_CODE)
-			.withParameter(Parameters.class, "code", new CodeType(CODE_BODY_MASS_INDEX))
-			.andParameter("url", new UriType("https://loinc.org"))
-			.andParameter("system", new UriType("http://loinc.org"))
+			.withParameter(Parameters.class, "code", new CodeType(code))
+			.andParameter("url", new UriType(valueSetUrl))
+			.andParameter("system", new UriType(system))
 			.execute();
 
 		String resp = myFhirContext.newXmlParser().setPrettyPrint(true).encodeResourceToString(respParam);
@@ -219,7 +208,7 @@ public void validateCodeOperationOnValueSet_byUrlSystemAndCode() {
 
 	@Test
 	public void validateCodeOperationOnValueSet_byCodingAndUrlWhereValueSetIsUnknown_returnsFalse() {
-		myValueSetProvider.myReturnValueSets = new ArrayList<>();
+		myValueSetProvider.setShouldThrowExceptionForResourceNotFound(false);
 
 		Parameters respParam = myClient
 			.operation()
@@ -238,70 +227,18 @@ public void validateCodeOperationOnValueSet_byCodingAndUrlWhereValueSetIsUnknown
 			" - Unknown or unusable ValueSet[" + UNKNOWN_VALUE_SYSTEM_URI + "]");
 	}
 
-	@SuppressWarnings("unused")
-	private static class MyCodeSystemProvider implements IResourceProvider {
-		private List<CodeSystem> myReturnCodeSystems;
-		private Parameters myReturnParams;
-
-		@Operation(name = "validate-code", idempotent = true, returnParameters = {
-			@OperationParam(name = "result", type = BooleanType.class, min = 1),
-			@OperationParam(name = "message", type = StringType.class),
-			@OperationParam(name = "display", type = StringType.class)
-		})
-		public Parameters validateCode(
-			HttpServletRequest theServletRequest,
-			@IdParam(optional = true) IdType theId,
-			@OperationParam(name = "url", min = 0, max = 1) UriType theCodeSystemUrl,
-			@OperationParam(name = "code", min = 0, max = 1) CodeType theCode,
-			@OperationParam(name = "display", min = 0, max = 1) StringType theDisplay
-		) {
-			return myReturnParams;
-		}
-
-		@Search
-		public List<CodeSystem> find(@RequiredParam(name = "url") UriParam theUrlParam) {
-			assert myReturnCodeSystems != null;
-			return myReturnCodeSystems;
-		}
+	private void setupValueSetValidateCode(String theUrl, String theSystem, String theCode, IBaseParameters theResponseParams) {
+		ValueSet valueSet = myValueSetProvider.addTerminologyResource(theUrl);
+		myValueSetProvider.addTerminologyResource(theSystem);
+		myValueSetProvider.addTerminologyResponse(OPERATION_VALIDATE_CODE, valueSet.getUrl(), theCode, theResponseParams);
 
-		@Override
-		public Class<? extends IBaseResource> getResourceType() {
-			return CodeSystem.class;
-		}
+		// we currently do this because VersionSpecificWorkerContextWrapper has logic to infer the system when missing
+		// based on the ValueSet by calling ValidationSupportUtils#extractCodeSystemForCode.
+		valueSet.getCompose().addInclude().setSystem(theSystem);
 	}
 
-	@SuppressWarnings("unused")
-	private static class MyValueSetProvider implements IResourceProvider {
-		private Parameters myReturnParams;
-		private List<ValueSet> myReturnValueSets;
-
-		@Operation(name = "validate-code", idempotent = true, returnParameters = {
-			@OperationParam(name = "result", type = BooleanType.class, min = 1),
-			@OperationParam(name = "message", type = StringType.class),
-			@OperationParam(name = "display", type = StringType.class)
-		})
-		public Parameters validateCode(
-			HttpServletRequest theServletRequest,
-			@IdParam(optional = true) IdType theId,
-			@OperationParam(name = "url", min = 0, max = 1) UriType theValueSetUrl,
-			@OperationParam(name = "code", min = 0, max = 1) CodeType theCode,
-			@OperationParam(name = "system", min = 0, max = 1) UriType theSystem,
-			@OperationParam(name = "display", min = 0, max = 1) StringType theDisplay,
-			@OperationParam(name = "valueSet") ValueSet theValueSet
-		) {
-			return myReturnParams;
-		}
-
-		@Search
-		public List<ValueSet> find(@RequiredParam(name = "url") UriParam theUrlParam) {
-			assert myReturnValueSets != null;
-			return myReturnValueSets;
-		}
-
-		@Override
-		public Class<? extends IBaseResource> getResourceType() {
-			return ValueSet.class;
-		}
-
+	private void setupCodeSystemValidateCode(String theUrl, String theCode, IBaseParameters theResponseParams) {
+		CodeSystem codeSystem = myCodeSystemProvider.addTerminologyResource(theUrl);
+		myCodeSystemProvider.addTerminologyResponse(OPERATION_VALIDATE_CODE, codeSystem.getUrl(), theCode, theResponseParams);
 	}
 }
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/validation/ValidateWithRemoteTerminologyTest.java b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/validation/ValidateWithRemoteTerminologyTest.java
new file mode 100644
index 000000000000..79a656db39c7
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/java/ca/uhn/fhir/jpa/validation/ValidateWithRemoteTerminologyTest.java
@@ -0,0 +1,261 @@
+package ca.uhn.fhir.jpa.validation;
+
+import ca.uhn.fhir.context.FhirContext;
+import ca.uhn.fhir.jpa.config.JpaConfig;
+import ca.uhn.fhir.jpa.provider.BaseResourceProviderR4Test;
+import ca.uhn.fhir.rest.api.MethodOutcome;
+import ca.uhn.fhir.test.utilities.server.RestfulServerExtension;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
+import ca.uhn.fhir.test.utilities.validation.IValidationProvidersR4;
+import ca.uhn.fhir.util.ClasspathUtil;
+import org.apache.commons.lang3.StringUtils;
+import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
+import org.hl7.fhir.common.hapi.validation.support.ValidationSupportChain;
+import org.hl7.fhir.instance.model.api.IBaseResource;
+import org.hl7.fhir.r4.model.CodeSystem;
+import org.hl7.fhir.r4.model.Encounter;
+import org.hl7.fhir.r4.model.Observation;
+import org.hl7.fhir.r4.model.OperationOutcome;
+import org.hl7.fhir.r4.model.Procedure;
+import org.hl7.fhir.r4.model.Reference;
+import org.hl7.fhir.r4.model.StructureDefinition;
+import org.hl7.fhir.r4.model.ValueSet;
+import org.junit.jupiter.api.AfterEach;
+import org.junit.jupiter.api.BeforeEach;
+import org.junit.jupiter.api.Test;
+import org.junit.jupiter.api.extension.RegisterExtension;
+import org.springframework.beans.factory.annotation.Autowired;
+import org.springframework.beans.factory.annotation.Qualifier;
+
+import java.util.List;
+
+import static ca.uhn.fhir.jpa.model.util.JpaConstants.OPERATION_VALIDATE_CODE;
+import static org.assertj.core.api.Assertions.assertThat;
+
+/**
+ * Tests resource validation with Remote Terminology bindings.
+ * To create a new test, you need to do 3 things:
+ * (1) the resource profile, if any custom one is needed should be stored in the FHIR repository
+ * (2) all the CodeSystem and ValueSet terminology resources need to be added to the corresponding resource provider.
+ * At the moment only placeholder CodeSystem/ValueSet resources are returned with id and url populated. For the moment
+ * there was no need to load the full resource, but that can be done if there is logic run which requires it.
+ * This is a minimal setup.
+ * (3) the Remote Terminology operation responses that are needed for the test need to be added to the corresponding
+ * resource provider. The intention is to record and use the responses of an actual terminology server
+ * e.g. <a href="https://r4.ontoserver.csiro.au/fhir/">OntoServer</a>.
+ * This is done as a result of the fact that unit test cannot always catch bugs which are introduced as a result of
+ * changes in the OntoServer or FHIR Validator library, or both.
+ * @see #setupValueSetValidateCode
+ * @see #setupCodeSystemValidateCode
+ * The responses are in Parameters resource format where issues is an OperationOutcome resource.
+ */
+public class ValidateWithRemoteTerminologyTest extends BaseResourceProviderR4Test {
+	private static final FhirContext ourCtx = FhirContext.forR4Cached();
+
+	@RegisterExtension
+	protected static RestfulServerExtension ourRestfulServerExtension = new RestfulServerExtension(ourCtx);
+	private RemoteTerminologyServiceValidationSupport mySvc;
+	@Autowired
+	@Qualifier(JpaConfig.JPA_VALIDATION_SUPPORT_CHAIN)
+	private ValidationSupportChain myValidationSupportChain;
+	private IValidationProviders.MyValidationProvider<CodeSystem> myCodeSystemProvider;
+	private IValidationProviders.MyValidationProvider<ValueSet> myValueSetProvider;
+
+	@BeforeEach
+	public void before() {
+		String baseUrl = "http://localhost:" + ourRestfulServerExtension.getPort();
+		mySvc = new RemoteTerminologyServiceValidationSupport(ourCtx, baseUrl);
+		myValidationSupportChain.addValidationSupport(0, mySvc);
+		myCodeSystemProvider = new IValidationProvidersR4.MyCodeSystemProviderR4();
+		myValueSetProvider = new IValidationProvidersR4.MyValueSetProviderR4();
+		ourRestfulServerExtension.registerProvider(myCodeSystemProvider);
+		ourRestfulServerExtension.registerProvider(myValueSetProvider);
+	}
+
+	@AfterEach
+	public void after() {
+		myValidationSupportChain.removeValidationSupport(mySvc);
+		ourRestfulServerExtension.getRestfulServer().getInterceptorService().unregisterAllInterceptors();
+		ourRestfulServerExtension.unregisterProvider(myCodeSystemProvider);
+		ourRestfulServerExtension.unregisterProvider(myValueSetProvider);
+	}
+
+	@Test
+	public void validate_withProfileWithValidCodesFromAllBindingTypes_returnsNoErrors() {
+		// setup
+		final StructureDefinition profileEncounter = ClasspathUtil.loadResource(ourCtx, StructureDefinition.class, "validation/encounter/profile-encounter-custom.json");
+		myClient.update().resource(profileEncounter).execute();
+
+		final String statusCode = "planned";
+		final String classCode = "IMP";
+		final String identifierTypeCode = "VN";
+
+		final String statusSystem = "http://hl7.org/fhir/encounter-status"; // implied system
+		final String classSystem = "http://terminology.hl7.org/CodeSystem/v3-ActCode";
+		final String identifierTypeSystem = "http://terminology.hl7.org/CodeSystem/v2-0203";
+
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/encounter-status", "http://hl7.org/fhir/encounter-status", statusCode, "validation/encounter/validateCode-ValueSet-encounter-status.json");
+		setupValueSetValidateCode("http://terminology.hl7.org/ValueSet/v3-ActEncounterCode", "http://terminology.hl7.org/CodeSystem/v3-ActCode", classCode, "validation/encounter/validateCode-ValueSet-v3-ActEncounterCode.json");
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/identifier-type", "http://hl7.org/fhir/identifier-type", identifierTypeCode, "validation/encounter/validateCode-ValueSet-identifier-type.json");
+
+		setupCodeSystemValidateCode(statusSystem, statusCode, "validation/encounter/validateCode-CodeSystem-encounter-status.json");
+		setupCodeSystemValidateCode(classSystem, classCode, "validation/encounter/validateCode-CodeSystem-v3-ActCode.json");
+		setupCodeSystemValidateCode(identifierTypeSystem, identifierTypeCode, "validation/encounter/validateCode-CodeSystem-v2-0203.json");
+
+		Encounter encounter = new Encounter();
+		encounter.getMeta().addProfile("http://example.ca/fhir/StructureDefinition/profile-encounter");
+
+		// required binding
+		encounter.setStatus(Encounter.EncounterStatus.fromCode(statusCode));
+
+		// preferred binding
+		encounter.getClass_()
+				.setSystem(classSystem)
+				.setCode(classCode)
+				.setDisplay("inpatient encounter");
+
+		// extensible binding
+		encounter.addIdentifier()
+				.getType().addCoding()
+				.setSystem(identifierTypeSystem)
+				.setCode(identifierTypeCode)
+				.setDisplay("Visit number");
+
+		// execute
+		List<String> errors = getValidationErrors(encounter);
+
+		// verify
+		assertThat(errors).isEmpty();
+	}
+
+	@Test
+	public void validate_withInvalidCode_returnsErrors() {
+		// setup
+		final String statusCode = "final";
+		final String code = "10xx";
+
+		final String statusSystem = "http://hl7.org/fhir/observation-status";
+		final String loincSystem = "http://loinc.org";
+		final String system = "http://fhir.infoway-inforoute.ca/io/psca/CodeSystem/ICD9CM";
+
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/observation-status", statusSystem, statusCode, "validation/observation/validateCode-ValueSet-observation-status.json");
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/observation-codes", loincSystem, statusCode, "validation/observation/validateCode-ValueSet-codes.json");
+
+		setupCodeSystemValidateCode(statusSystem, statusCode, "validation/observation/validateCode-CodeSystem-observation-status.json");
+		setupCodeSystemValidateCode(system, code, "validation/observation/validateCode-CodeSystem-ICD9CM.json");
+
+		Observation obs = new Observation();
+		obs.setStatus(Observation.ObservationStatus.fromCode(statusCode));
+		obs.getCode().addCoding().setCode(code).setSystem(system);
+
+		// execute
+		List<String> errors = getValidationErrors(obs);
+		assertThat(errors).hasSize(1);
+
+		// verify
+		assertThat(errors.get(0))
+				.contains("Unknown code '10xx' in the CodeSystem 'http://fhir.infoway-inforoute.ca/io/psca/CodeSystem/ICD9CM");
+	}
+
+	@Test
+	public void validate_withProfileWithInvalidCode_returnsErrors() {
+		// setup
+		String profile = "http://example.ca/fhir/StructureDefinition/profile-procedure";
+		StructureDefinition profileProcedure = ClasspathUtil.loadResource(myFhirContext, StructureDefinition.class, "validation/procedure/profile-procedure.json");
+		myClient.update().resource(profileProcedure).execute();
+
+		final String statusCode = "completed";
+		final String procedureCode1 = "417005";
+		final String procedureCode2 = "xx417005";
+
+		final String statusSystem = "http://hl7.org/fhir/event-status";
+		final String snomedSystem = "http://snomed.info/sct";
+
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/event-status", statusSystem, statusCode, "validation/procedure/validateCode-ValueSet-event-status.json");
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/procedure-code", snomedSystem, procedureCode1, "validation/procedure/validateCode-ValueSet-procedure-code-valid.json");
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/procedure-code", snomedSystem, procedureCode2, "validation/procedure/validateCode-ValueSet-procedure-code-invalid.json");
+
+		setupCodeSystemValidateCode(statusSystem, statusCode, "validation/procedure/validateCode-CodeSystem-event-status.json");
+		setupCodeSystemValidateCode(snomedSystem, procedureCode1, "validation/procedure/validateCode-CodeSystem-snomed-valid.json");
+		setupCodeSystemValidateCode(snomedSystem, procedureCode2, "validation/procedure/validateCode-CodeSystem-snomed-invalid.json");
+
+		Procedure procedure = new Procedure();
+		procedure.setSubject(new Reference("Patient/P1"));
+		procedure.setStatus(Procedure.ProcedureStatus.fromCode(statusCode));
+		procedure.getCode().addCoding().setSystem(snomedSystem).setCode(procedureCode1);
+		procedure.getCode().addCoding().setSystem(snomedSystem).setCode(procedureCode2);
+		procedure.getMeta().addProfile(profile);
+
+		// execute
+		List<String> errors = getValidationErrors(procedure);
+		// TODO: there is currently some duplication in the errors returned. This needs to be investigated and fixed.
+		// assertThat(errors).hasSize(1);
+
+		// verify
+		// note that we're not selecting an explicit versions (using latest) so the message verification does not include it.
+		assertThat(StringUtils.join("", errors))
+				.contains("Unknown code 'xx417005' in the CodeSystem 'http://snomed.info/sct'")
+				.doesNotContain("The provided code 'http://snomed.info/sct#xx417005' was not found in the value set 'http://hl7.org/fhir/ValueSet/procedure-code")
+				.doesNotContain("http://snomed.info/sct#417005");
+	}
+
+	@Test
+	public void validate_withProfileWithSlicingWithValidCode_returnsNoErrors() {
+		// setup
+		String profile = "http://example.ca/fhir/StructureDefinition/profile-procedure-with-slicing";
+		StructureDefinition profileProcedure = ClasspathUtil.loadResource(myFhirContext, StructureDefinition.class, "validation/procedure/profile-procedure-slicing.json");
+		myClient.update().resource(profileProcedure).execute();
+
+		final String statusCode = "completed";
+		final String procedureCode = "no-procedure-info";
+
+		final String statusSystem = "http://hl7.org/fhir/event-status";
+		final String snomedSystem = "http://snomed.info/sct";
+		final String absentUnknownSystem = "http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips";
+
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/event-status", statusSystem, statusCode, "validation/procedure/validateCode-ValueSet-event-status.json");
+		setupValueSetValidateCode("http://hl7.org/fhir/ValueSet/procedure-code", snomedSystem, procedureCode, "validation/procedure/validateCode-ValueSet-procedure-code-invalid-slice.json");
+		setupValueSetValidateCode("http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-procedures-uv-ips", absentUnknownSystem, procedureCode, "validation/procedure/validateCode-ValueSet-absent-or-unknown-procedure.json");
+
+		setupCodeSystemValidateCode(statusSystem, statusCode, "validation/procedure/validateCode-CodeSystem-event-status.json");
+		setupCodeSystemValidateCode(absentUnknownSystem, procedureCode, "validation/procedure/validateCode-CodeSystem-absent-or-unknown.json");
+
+		Procedure procedure = new Procedure();
+		procedure.setSubject(new Reference("Patient/P1"));
+		procedure.setStatus(Procedure.ProcedureStatus.fromCode(statusCode));
+		procedure.getCode().addCoding().setSystem(absentUnknownSystem).setCode(procedureCode);
+		procedure.getMeta().addProfile(profile);
+
+		// execute
+		List<String> errors = getValidationErrors(procedure);
+		assertThat(errors).hasSize(0);
+	}
+
+	private void setupValueSetValidateCode(String theUrl, String theSystem, String theCode, String theTerminologyResponseFile) {
+		ValueSet valueSet = myValueSetProvider.addTerminologyResource(theUrl);
+		myCodeSystemProvider.addTerminologyResource(theSystem);
+		myValueSetProvider.addTerminologyResponse(OPERATION_VALIDATE_CODE, valueSet.getUrl(), theCode, ourCtx, theTerminologyResponseFile);
+
+		// we currently do this because VersionSpecificWorkerContextWrapper has logic to infer the system when missing
+		// based on the ValueSet by calling ValidationSupportUtils#extractCodeSystemForCode.
+		valueSet.getCompose().addInclude().setSystem(theSystem);
+
+		// you will notice each of these calls require also a call to setupCodeSystemValidateCode
+		// that is necessary because VersionSpecificWorkerContextWrapper#validateCodeInValueSet
+		// which also attempts a validateCode against the CodeSystem after the validateCode against the ValueSet
+	}
+
+	private void setupCodeSystemValidateCode(String theUrl, String theCode, String theTerminologyResponseFile) {
+		CodeSystem codeSystem = myCodeSystemProvider.addTerminologyResource(theUrl);
+		myCodeSystemProvider.addTerminologyResponse(OPERATION_VALIDATE_CODE, codeSystem.getUrl(), theCode, ourCtx, theTerminologyResponseFile);
+	}
+
+	private List<String> getValidationErrors(IBaseResource theResource) {
+		MethodOutcome resultProcedure = myClient.validate().resource(theResource).execute();
+		OperationOutcome operationOutcome = (OperationOutcome) resultProcedure.getOperationOutcome();
+		return operationOutcome.getIssue().stream()
+				.filter(issue -> issue.getSeverity() == OperationOutcome.IssueSeverity.ERROR)
+				.map(OperationOutcome.OperationOutcomeIssueComponent::getDiagnostics)
+				.toList();
+	}
+}
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/profile-encounter-custom.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/profile-encounter-custom.json
new file mode 100644
index 000000000000..a553a61a1c20
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/profile-encounter-custom.json
@@ -0,0 +1,49 @@
+{
+  "resourceType": "StructureDefinition",
+  "id": "profile-encounter",
+  "url": "http://example.ca/fhir/StructureDefinition/profile-encounter",
+  "version": "0.11.0",
+  "name": "EncounterProfile",
+  "title": "Encounter Profile",
+  "status": "active",
+  "date": "2022-10-15T12:00:00+00:00",
+  "publisher": "Example Organization",
+  "fhirVersion": "4.0.1",
+  "kind": "resource",
+  "abstract": false,
+  "type": "Encounter",
+  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Encounter",
+  "derivation": "constraint",
+  "differential": {
+    "element":  [
+		 {
+			 "id": "Encounter.identifier.type.coding",
+			 "path": "Encounter.identifier.type.coding",
+			 "min": 1,
+			 "max": "1",
+			 "mustSupport": true
+		 },
+		 {
+			 "id": "Encounter.identifier.type.coding.system",
+			 "path": "Encounter.identifier.type.coding.system",
+			 "min": 1,
+			 "fixedUri": "http://terminology.hl7.org/CodeSystem/v2-0203",
+			 "mustSupport": true
+		 },
+		 {
+			 "id": "Encounter.identifier.type.coding.code",
+			 "path": "Encounter.identifier.type.coding.code",
+			 "min": 1,
+			 "fixedCode": "VN",
+			 "mustSupport": true
+		 },
+		 {
+			 "id": "Encounter.identifier.type.coding.display",
+			 "path": "Encounter.identifier.type.coding.display",
+			 "min": 1,
+			 "fixedString": "Visit number",
+			 "mustSupport": true
+		 }
+	 ]
+  }
+}
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-encounter-status.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-encounter-status.json
new file mode 100644
index 000000000000..2399dc870ec8
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-encounter-status.json
@@ -0,0 +1,59 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "planned"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://hl7.org/fhir/encounter-status"
+    },
+    {
+      "name": "version",
+      "valueString": "5.0.0-ballot"
+    },
+    {
+      "name": "display",
+      "valueString": "Planned"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to trial-use CodeSystem http://hl7.org/fhir/encounter-status|5.0.0-ballot"
+            }
+          },
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to draft CodeSystem http://hl7.org/fhir/encounter-status|5.0.0-ballot"
+            }
+          }
+        ]
+      }
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-v2-0203.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-v2-0203.json
new file mode 100644
index 000000000000..10747c14ee38
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-v2-0203.json
@@ -0,0 +1,25 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "VN"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://terminology.hl7.org/CodeSystem/v2-0203"
+    },
+    {
+      "name": "version",
+      "valueString": "3.0.0"
+    },
+    {
+      "name": "display",
+      "valueString": "Visit number"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-v3-ActCode.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-v3-ActCode.json
new file mode 100644
index 000000000000..b692847e0fbb
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-CodeSystem-v3-ActCode.json
@@ -0,0 +1,46 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "IMP"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://terminology.hl7.org/CodeSystem/v3-ActCode"
+    },
+    {
+      "name": "version",
+      "valueString": "2018-08-12"
+    },
+    {
+      "name": "display",
+      "valueString": "inpatient encounter"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to draft CodeSystem http://terminology.hl7.org/CodeSystem/v3-ActCode|2018-08-12"
+            }
+          }
+        ]
+      }
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-encounter-status.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-encounter-status.json
new file mode 100644
index 000000000000..2399dc870ec8
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-encounter-status.json
@@ -0,0 +1,59 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "planned"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://hl7.org/fhir/encounter-status"
+    },
+    {
+      "name": "version",
+      "valueString": "5.0.0-ballot"
+    },
+    {
+      "name": "display",
+      "valueString": "Planned"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to trial-use CodeSystem http://hl7.org/fhir/encounter-status|5.0.0-ballot"
+            }
+          },
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to draft CodeSystem http://hl7.org/fhir/encounter-status|5.0.0-ballot"
+            }
+          }
+        ]
+      }
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-identifier-type.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-identifier-type.json
new file mode 100644
index 000000000000..b0767dc2f188
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-identifier-type.json
@@ -0,0 +1,52 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": false
+    },
+    {
+      "name": "code",
+      "valueCode": "VN"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://terminology.hl7.org/CodeSystem/v2-0203"
+    },
+    {
+      "name": "version",
+      "valueString": "3.0.0"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "error",
+            "code": "code-invalid",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "not-in-vs"
+                }
+              ],
+              "text": "The provided code 'http://terminology.hl7.org/CodeSystem/v2-0203#VN' was not found in the value set 'http://hl7.org/fhir/ValueSet/identifier-type|5.0.0-ballot'"
+            },
+            "location": [
+              "code"
+            ],
+            "expression": [
+              "code"
+            ]
+          }
+        ]
+      }
+    },
+    {
+      "name": "message",
+      "valueString": "The provided code 'http://terminology.hl7.org/CodeSystem/v2-0203#VN' was not found in the value set 'http://hl7.org/fhir/ValueSet/identifier-type|5.0.0-ballot'"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-v3-ActEncounterCode.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-v3-ActEncounterCode.json
new file mode 100644
index 000000000000..083dbffae43d
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/encounter/validateCode-ValueSet-v3-ActEncounterCode.json
@@ -0,0 +1,59 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "IMP"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://terminology.hl7.org/CodeSystem/v3-ActCode"
+    },
+    {
+      "name": "version",
+      "valueString": "2018-08-12"
+    },
+    {
+      "name": "display",
+      "valueString": "inpatient encounter"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to trial-use ValueSet http://terminology.hl7.org/ValueSet/v3-ActEncounterCode|2014-03-26"
+            }
+          },
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to draft CodeSystem http://terminology.hl7.org/CodeSystem/v3-ActCode|2018-08-12"
+            }
+          }
+        ]
+      }
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-CodeSystem-ICD9CM.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-CodeSystem-ICD9CM.json
new file mode 100644
index 000000000000..831ac6660fa6
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-CodeSystem-ICD9CM.json
@@ -0,0 +1,48 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": false
+    },
+    {
+      "name": "code",
+      "valueCode": "10xx"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://fhir.infoway-inforoute.ca/io/psca/CodeSystem/ICD9CM"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "error",
+            "code": "code-invalid",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "invalid-code"
+                }
+              ],
+              "text": "Unknown code '10xx' in the CodeSystem 'http://fhir.infoway-inforoute.ca/io/psca/CodeSystem/ICD9CM' version '0.1.0'"
+            },
+            "location": [
+              "code"
+            ],
+            "expression": [
+              "code"
+            ]
+          }
+        ]
+      }
+    },
+    {
+      "name": "message",
+      "valueString": "Unknown code '10xx' in the CodeSystem 'http://fhir.infoway-inforoute.ca/io/psca/CodeSystem/ICD9CM' version '0.1.0'"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-CodeSystem-observation-status.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-CodeSystem-observation-status.json
new file mode 100644
index 000000000000..7914321876c3
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-CodeSystem-observation-status.json
@@ -0,0 +1,25 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "final"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://hl7.org/fhir/observation-status"
+    },
+    {
+      "name": "version",
+      "valueString": "5.0.0-ballot"
+    },
+    {
+      "name": "display",
+      "valueString": "Final"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-ValueSet-codes.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-ValueSet-codes.json
new file mode 100644
index 000000000000..4571362033f0
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-ValueSet-codes.json
@@ -0,0 +1,48 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": false
+    },
+    {
+      "name": "code",
+      "valueCode": "10xx"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://fhir.infoway-inforoute.ca/io/psca/CodeSystem/ICD9CM"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "error",
+            "code": "code-invalid",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "not-in-vs"
+                }
+              ],
+              "text": "The provided code 'http://fhir.infoway-inforoute.ca/io/psca/CodeSystem/ICD9CM#10xx' was not found in the value set 'http://hl7.org/fhir/ValueSet/observation-codes|5.0.0-ballot'"
+            },
+            "location": [
+              "code"
+            ],
+            "expression": [
+              "code"
+            ]
+          }
+        ]
+      }
+    },
+    {
+      "name": "message",
+      "valueString": "The provided code 'http://fhir.infoway-inforoute.ca/io/psca/CodeSystem/ICD9CM#10xx' was not found in the value set 'http://hl7.org/fhir/ValueSet/observation-codes|5.0.0-ballot'"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-ValueSet-observation-status.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-ValueSet-observation-status.json
new file mode 100644
index 000000000000..7914321876c3
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/observation/validateCode-ValueSet-observation-status.json
@@ -0,0 +1,25 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "final"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://hl7.org/fhir/observation-status"
+    },
+    {
+      "name": "version",
+      "valueString": "5.0.0-ballot"
+    },
+    {
+      "name": "display",
+      "valueString": "Final"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/profile-procedure-slicing.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/profile-procedure-slicing.json
new file mode 100644
index 000000000000..8bc05c70cf00
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/profile-procedure-slicing.json
@@ -0,0 +1,79 @@
+{
+  "resourceType": "StructureDefinition",
+  "id": "profile-procedure-with-slicing",
+  "url": "http://example.ca/fhir/StructureDefinition/profile-procedure-with-slicing",
+  "version": "0.11.0",
+  "name": "ProcedureProfile",
+  "title": "Procedure Profile",
+  "status": "active",
+  "date": "2022-10-15T12:00:00+00:00",
+  "publisher": "Example Organization",
+  "fhirVersion": "4.0.1",
+  "kind": "resource",
+  "abstract": false,
+  "type": "Procedure",
+  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Procedure",
+  "derivation": "constraint",
+  "differential": {
+    "element":  [
+      {
+        "id": "Procedure.code.coding",
+        "path": "Procedure.code.coding",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "pattern",
+              "path": "$this"
+            }
+          ],
+          "description": "Discriminated by the bound value set",
+          "rules": "open"
+        },
+        "mustSupport": true,
+        "binding": {
+          "strength": "preferred",
+          "valueSet": "http://hl7.org/fhir/ValueSet/procedure-code"
+        }
+      },
+      {
+        "id": "Procedure.code.coding.display.extension:translation",
+        "path": "Procedure.code.coding.display.extension",
+        "sliceName": "translation"
+      },
+      {
+        "id": "Procedure.code.coding.display.extension:translation.extension",
+        "path": "Procedure.code.coding.display.extension.extension",
+        "min": 2
+      },
+      {
+        "id": "Procedure.code.coding:absentOrUnknownProcedure",
+        "path": "Procedure.code.coding",
+        "sliceName": "absentOrUnknownProcedure",
+        "short": "Optional slice for representing a code for absent problem or for unknown procedure",
+        "definition": "Code representing the statement \"absent problem\" or the statement \"procedures unknown\"",
+        "mustSupport": true,
+        "binding": {
+          "extension":  [
+            {
+              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
+              "valueString": "absentOrUnknownProcedure"
+            }
+          ],
+          "strength": "required",
+          "description": "A code to identify absent or unknown procedures",
+          "valueSet": "http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-procedures-uv-ips"
+        }
+      },
+      {
+        "id": "Procedure.code.coding:absentOrUnknownProcedure.display.extension:translation",
+        "path": "Procedure.code.coding.display.extension",
+        "sliceName": "translation"
+      },
+      {
+        "id": "Procedure.code.coding:absentOrUnknownProcedure.display.extension:translation.extension",
+        "path": "Procedure.code.coding.display.extension.extension",
+        "min": 2
+      }
+    ]
+  }
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/profile-procedure.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/profile-procedure.json
new file mode 100644
index 000000000000..5315694dece4
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/profile-procedure.json
@@ -0,0 +1,50 @@
+{
+  "resourceType": "StructureDefinition",
+  "id": "profile-procedure",
+  "url": "http://example.ca/fhir/StructureDefinition/profile-procedure",
+  "version": "0.11.0",
+  "name": "ProcedureProfile",
+  "title": "Procedure Profile",
+  "status": "active",
+  "date": "2022-10-15T12:00:00+00:00",
+  "publisher": "Example Organization",
+  "fhirVersion": "4.0.1",
+  "kind": "resource",
+  "abstract": false,
+  "type": "Procedure",
+  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Procedure",
+  "derivation": "constraint",
+  "differential": {
+    "element":  [
+      {
+        "id": "Procedure.code.coding",
+        "path": "Procedure.code.coding",
+        "slicing": {
+          "discriminator": [
+            {
+              "type": "pattern",
+              "path": "$this"
+            }
+          ],
+          "description": "Discriminated by the bound value set",
+          "rules": "open"
+        },
+        "mustSupport": true,
+        "binding": {
+          "strength": "preferred",
+          "valueSet": "http://hl7.org/fhir/ValueSet/procedure-code"
+        }
+      },
+      {
+        "id": "Procedure.code.coding.display.extension:translation",
+        "path": "Procedure.code.coding.display.extension",
+        "sliceName": "translation"
+      },
+      {
+        "id": "Procedure.code.coding.display.extension:translation.extension",
+        "path": "Procedure.code.coding.display.extension.extension",
+        "min": 2
+      }
+    ]
+  }
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-absent-or-unknown.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-absent-or-unknown.json
new file mode 100644
index 000000000000..4d7b20f0881d
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-absent-or-unknown.json
@@ -0,0 +1,46 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "no-procedure-info"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips"
+    },
+    {
+      "name": "version",
+      "valueString": "1.1.0"
+    },
+    {
+      "name": "display",
+      "valueString": "No information about past history of procedures"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to trial-use CodeSystem http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips|1.1.0"
+            }
+          }
+        ]
+      }
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-event-status.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-event-status.json
new file mode 100644
index 000000000000..620624a991e9
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-event-status.json
@@ -0,0 +1,59 @@
+{
+    "resourceType": "Parameters",
+    "parameter": [
+        {
+            "name": "result",
+            "valueBoolean": true
+        },
+        {
+            "name": "code",
+            "valueCode": "completed"
+        },
+        {
+            "name": "system",
+            "valueUri": "http://hl7.org/fhir/event-status"
+        },
+        {
+            "name": "version",
+            "valueString": "5.0.0-ballot"
+        },
+        {
+            "name": "display",
+            "valueString": "Completed"
+        },
+        {
+            "name": "issues",
+            "resource": {
+                "resourceType": "OperationOutcome",
+                "issue": [
+                    {
+                        "severity": "information",
+                        "code": "business-rule",
+                        "details": {
+                            "coding": [
+                                {
+                                    "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                                    "code": "status-check"
+                                }
+                            ],
+                            "text": "Reference to trial-use CodeSystem http://hl7.org/fhir/event-status|5.0.0-ballot"
+                        }
+                    },
+                    {
+                        "severity": "information",
+                        "code": "business-rule",
+                        "details": {
+                            "coding": [
+                                {
+                                    "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                                    "code": "status-check"
+                                }
+                            ],
+                            "text": "Reference to experimental CodeSystem http://hl7.org/fhir/event-status|5.0.0-ballot"
+                        }
+                    }
+                ]
+            }
+        }
+    ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-snomed-invalid.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-snomed-invalid.json
new file mode 100644
index 000000000000..f6a86048d6e8
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-snomed-invalid.json
@@ -0,0 +1,48 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": false
+    },
+    {
+      "name": "code",
+      "valueCode": "xx417005"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://snomed.info/sct"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "error",
+            "code": "code-invalid",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "invalid-code"
+                }
+              ],
+              "text": "Unknown code 'xx417005' in the CodeSystem 'http://snomed.info/sct' version 'http://snomed.info/sct/32506021000036107/version/20241031'"
+            },
+            "location": [
+              "code"
+            ],
+            "expression": [
+              "code"
+            ]
+          }
+        ]
+      }
+    },
+    {
+      "name": "message",
+      "valueString": "Unknown code 'xx417005' in the CodeSystem 'http://snomed.info/sct' version 'http://snomed.info/sct/32506021000036107/version/20241031'"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-snomed-valid.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-snomed-valid.json
new file mode 100644
index 000000000000..a602bfda9f00
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-CodeSystem-snomed-valid.json
@@ -0,0 +1,25 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "417005"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://snomed.info/sct"
+    },
+    {
+      "name": "version",
+      "valueString": "http://snomed.info/sct/32506021000036107/version/20241031"
+    },
+    {
+      "name": "display",
+      "valueString": "Hospital re-admission"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-absent-or-unknown-procedure.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-absent-or-unknown-procedure.json
new file mode 100644
index 000000000000..aaee02a00233
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-absent-or-unknown-procedure.json
@@ -0,0 +1,59 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "no-procedure-info"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips"
+    },
+    {
+      "name": "version",
+      "valueString": "1.1.0"
+    },
+    {
+      "name": "display",
+      "valueString": "No information about past history of procedures"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to trial-use CodeSystem http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips|1.1.0"
+            }
+          },
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to trial-use ValueSet http://hl7.org/fhir/uv/ips/ValueSet/absent-or-unknown-procedures-uv-ips|1.1.0"
+            }
+          }
+        ]
+      }
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-event-status.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-event-status.json
new file mode 100644
index 000000000000..aaad08b83e8e
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-event-status.json
@@ -0,0 +1,25 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "final"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://hl7.org/fhir/procedure-status"
+    },
+    {
+      "name": "version",
+      "valueString": "5.0.0-ballot"
+    },
+    {
+      "name": "display",
+      "valueString": "Final"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-invalid-slice.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-invalid-slice.json
new file mode 100644
index 000000000000..4dcb4791944e
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-invalid-slice.json
@@ -0,0 +1,48 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": false
+    },
+    {
+      "name": "code",
+      "valueCode": "no-procedure-info"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "error",
+            "code": "code-invalid",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "not-in-vs"
+                }
+              ],
+              "text": "The provided code 'http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips#no-procedure-info' was not found in the value set 'http://hl7.org/fhir/ValueSet/procedure-code|5.0.0-ballot'"
+            },
+            "location": [
+              "code"
+            ],
+            "expression": [
+              "code"
+            ]
+          }
+        ]
+      }
+    },
+    {
+      "name": "message",
+      "valueString": "The provided code 'http://hl7.org/fhir/uv/ips/CodeSystem/absent-unknown-uv-ips#no-procedure-info' was not found in the value set 'http://hl7.org/fhir/ValueSet/procedure-code|5.0.0-ballot'"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-invalid.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-invalid.json
new file mode 100644
index 000000000000..fac3785fe2d2
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-invalid.json
@@ -0,0 +1,67 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": false
+    },
+    {
+      "name": "code",
+      "valueCode": "xx417005"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://snomed.info/sct"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "error",
+            "code": "code-invalid",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "not-in-vs"
+                }
+              ],
+              "text": "The provided code 'http://snomed.info/sct#xx417005' was not found in the value set 'http://hl7.org/fhir/ValueSet/procedure-code|5.0.0-ballot'"
+            },
+            "location": [
+              "code"
+            ],
+            "expression": [
+              "code"
+            ]
+          },
+          {
+            "severity": "error",
+            "code": "code-invalid",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "invalid-code"
+                }
+              ],
+              "text": "Unknown code 'xx417005' in the CodeSystem 'http://snomed.info/sct' version 'http://snomed.info/sct/32506021000036107/version/20241031'"
+            },
+            "location": [
+              "code"
+            ],
+            "expression": [
+              "code"
+            ]
+          }
+        ]
+      }
+    },
+    {
+      "name": "message",
+      "valueString": "Unknown code 'xx417005' in the CodeSystem 'http://snomed.info/sct' version 'http://snomed.info/sct/32506021000036107/version/20241031'; The provided code 'http://snomed.info/sct#xx417005' was not found in the value set 'http://hl7.org/fhir/ValueSet/procedure-code|5.0.0-ballot'"
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-valid.json b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-valid.json
new file mode 100644
index 000000000000..4554379edadf
--- /dev/null
+++ b/hapi-fhir-jpaserver-test-r4/src/test/resources/validation/procedure/validateCode-ValueSet-procedure-code-valid.json
@@ -0,0 +1,59 @@
+{
+  "resourceType": "Parameters",
+  "parameter": [
+    {
+      "name": "result",
+      "valueBoolean": true
+    },
+    {
+      "name": "code",
+      "valueCode": "417005"
+    },
+    {
+      "name": "system",
+      "valueUri": "http://snomed.info/sct"
+    },
+    {
+      "name": "version",
+      "valueString": "http://snomed.info/sct/32506021000036107/version/20241031"
+    },
+    {
+      "name": "display",
+      "valueString": "Hospital re-admission"
+    },
+    {
+      "name": "issues",
+      "resource": {
+        "resourceType": "OperationOutcome",
+        "issue": [
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to draft ValueSet http://hl7.org/fhir/ValueSet/procedure-code|5.0.0-ballot"
+            }
+          },
+          {
+            "severity": "information",
+            "code": "business-rule",
+            "details": {
+              "coding": [
+                {
+                  "system": "http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
+                  "code": "status-check"
+                }
+              ],
+              "text": "Reference to experimental ValueSet http://hl7.org/fhir/ValueSet/procedure-code|5.0.0-ballot"
+            }
+          }
+        ]
+      }
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/H2_EMBEDDED.sql b/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/H2_EMBEDDED.sql
index fd2eb6c3c988..095d79d0fb33 100644
--- a/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/H2_EMBEDDED.sql
+++ b/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/H2_EMBEDDED.sql
@@ -51,3 +51,33 @@ INSERT INTO TRM_CONCEPT_DESIG (
    54,
    150
 );
+
+INSERT INTO HFJ_RES_LINK (
+   PID,
+   PARTITION_DATE,
+   PARTITION_ID,
+   SRC_PATH,
+   SRC_RESOURCE_ID,
+   SOURCE_RESOURCE_TYPE,
+   TARGET_RESOURCE_ID,
+   TARGET_RESOURCE_TYPE,
+   TARGET_RESOURCE_URL,
+   TARGET_RESOURCE_VERSION,
+   SP_UPDATED,
+   TARGET_RES_PARTITION_ID,
+   TARGET_RES_PARTITION_DATE
+) VALUES (
+   702,
+   '2024-11-05',
+   1,
+   'Observation.subject.where(resolve() is Patient)',
+   1656,
+   'Observation',
+   1906,
+   'Patient',
+   'http://localhost:8000/Patient/123',
+   1,
+   '2024-11-01 18:01:12.921',
+   1,
+   '2024-11-05'
+);
diff --git a/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/MSSQL_2012.sql b/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/MSSQL_2012.sql
index fd2eb6c3c988..82df69243933 100644
--- a/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/MSSQL_2012.sql
+++ b/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/MSSQL_2012.sql
@@ -51,3 +51,33 @@ INSERT INTO TRM_CONCEPT_DESIG (
    54,
    150
 );
+
+INSERT INTO HFJ_RES_LINK (
+   PID,
+   PARTITION_DATE,
+   PARTITION_ID,
+   SRC_PATH,
+   SRC_RESOURCE_ID,
+   SOURCE_RESOURCE_TYPE,
+   TARGET_RESOURCE_ID,
+   TARGET_RESOURCE_TYPE,
+   TARGET_RESOURCE_URL,
+   TARGET_RESOURCE_VERSION,
+   SP_UPDATED,
+   TARGET_RES_PARTITION_ID,
+   TARGET_RES_PARTITION_DATE
+) VALUES (
+   702,
+   '2024-11-05',
+   1,
+   'Observation.subject.where(resolve() is Patient)',
+   1653,
+   'Observation',
+   1906,
+   'Patient',
+   'http://localhost:8000/Patient/123',
+   1,
+   '2024-11-01 18:01:12.921',
+   1,
+   '2024-11-05'
+);
diff --git a/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/ORACLE_12C.sql b/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/ORACLE_12C.sql
index 442d66619194..ecb31b3d5878 100644
--- a/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/ORACLE_12C.sql
+++ b/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/ORACLE_12C.sql
@@ -51,3 +51,33 @@ INSERT INTO TRM_CONCEPT_DESIG (
    54,
    150
 );
+
+INSERT INTO HFJ_RES_LINK (
+   PID,
+   PARTITION_DATE,
+   PARTITION_ID,
+   SRC_PATH,
+   SRC_RESOURCE_ID,
+   SOURCE_RESOURCE_TYPE,
+   TARGET_RESOURCE_ID,
+   TARGET_RESOURCE_TYPE,
+   TARGET_RESOURCE_URL,
+   TARGET_RESOURCE_VERSION,
+   SP_UPDATED,
+   TARGET_RES_PARTITION_ID,
+   TARGET_RES_PARTITION_DATE
+) VALUES (
+   702,
+   SYSDATE,
+   1,
+   'Observation.subject.where(resolve() is Patient)',
+   1653,
+   'Observation',
+   1906,
+   'Patient',
+   'http://localhost:8000/Patient/123',
+   1,
+   SYSDATE,
+   1,
+   SYSDATE
+);
diff --git a/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/POSTGRES_9_4.sql b/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/POSTGRES_9_4.sql
index fd2eb6c3c988..82df69243933 100644
--- a/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/POSTGRES_9_4.sql
+++ b/hapi-fhir-jpaserver-test-utilities/src/main/resources/migration/releases/V7_4_0/data/POSTGRES_9_4.sql
@@ -51,3 +51,33 @@ INSERT INTO TRM_CONCEPT_DESIG (
    54,
    150
 );
+
+INSERT INTO HFJ_RES_LINK (
+   PID,
+   PARTITION_DATE,
+   PARTITION_ID,
+   SRC_PATH,
+   SRC_RESOURCE_ID,
+   SOURCE_RESOURCE_TYPE,
+   TARGET_RESOURCE_ID,
+   TARGET_RESOURCE_TYPE,
+   TARGET_RESOURCE_URL,
+   TARGET_RESOURCE_VERSION,
+   SP_UPDATED,
+   TARGET_RES_PARTITION_ID,
+   TARGET_RES_PARTITION_DATE
+) VALUES (
+   702,
+   '2024-11-05',
+   1,
+   'Observation.subject.where(resolve() is Patient)',
+   1653,
+   'Observation',
+   1906,
+   'Patient',
+   'http://localhost:8000/Patient/123',
+   1,
+   '2024-11-01 18:01:12.921',
+   1,
+   '2024-11-05'
+);
diff --git a/hapi-fhir-server/src/main/java/ca/uhn/fhir/rest/server/util/CompositeInterceptorBroadcaster.java b/hapi-fhir-server/src/main/java/ca/uhn/fhir/rest/server/util/CompositeInterceptorBroadcaster.java
index 39d75793f28d..6670ab15a4c1 100644
--- a/hapi-fhir-server/src/main/java/ca/uhn/fhir/rest/server/util/CompositeInterceptorBroadcaster.java
+++ b/hapi-fhir-server/src/main/java/ca/uhn/fhir/rest/server/util/CompositeInterceptorBroadcaster.java
@@ -81,7 +81,7 @@ public boolean callHooks(Pointcut thePointcut, HookParams theParams) {
 				}
 				if (theRequestDetails != null && theRequestDetails.getInterceptorBroadcaster() != null && retVal) {
 					IInterceptorBroadcaster interceptorBroadcaster = theRequestDetails.getInterceptorBroadcaster();
-					interceptorBroadcaster.callHooks(thePointcut, theParams);
+					retVal = interceptorBroadcaster.callHooks(thePointcut, theParams);
 				}
 				return retVal;
 			}
diff --git a/hapi-fhir-server/src/test/java/ca/uhn/fhir/rest/server/util/CompositeInterceptorBroadcasterTest.java b/hapi-fhir-server/src/test/java/ca/uhn/fhir/rest/server/util/CompositeInterceptorBroadcasterTest.java
new file mode 100644
index 000000000000..2a670d158113
--- /dev/null
+++ b/hapi-fhir-server/src/test/java/ca/uhn/fhir/rest/server/util/CompositeInterceptorBroadcasterTest.java
@@ -0,0 +1,161 @@
+package ca.uhn.fhir.rest.server.util;
+
+import ca.uhn.fhir.interceptor.api.HookParams;
+import ca.uhn.fhir.interceptor.api.IInterceptorBroadcaster;
+import ca.uhn.fhir.interceptor.api.Pointcut;
+import ca.uhn.fhir.rest.api.server.RequestDetails;
+import org.junit.jupiter.api.Test;
+import org.junit.jupiter.api.extension.ExtendWith;
+import org.mockito.Mock;
+import org.mockito.junit.jupiter.MockitoExtension;
+
+import static org.assertj.core.api.Assertions.assertThat;
+import static org.mockito.Mockito.never;
+import static org.mockito.Mockito.verify;
+import static org.mockito.Mockito.when;
+
+@ExtendWith(MockitoExtension.class)
+class CompositeInterceptorBroadcasterTest {
+
+	@Mock
+	private IInterceptorBroadcaster myModuleBroadcasterMock;
+	@Mock
+	private IInterceptorBroadcaster myReqDetailsBroadcasterMock;
+	@Mock
+	private Pointcut myPointcutMock;
+	@Mock
+	private HookParams myHookParamsMock;
+	@Mock
+	private RequestDetails myRequestDetailsMock;
+
+
+	@Test
+	void doCallHooks_WhenModuleBroadcasterReturnsTrue_And_RequestDetailsBroadcasterReturnsTrue_ThenReturnsTrue() {
+		when(myRequestDetailsMock.getInterceptorBroadcaster()).thenReturn(myReqDetailsBroadcasterMock);
+
+		when(myModuleBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(true);
+		when(myReqDetailsBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(true);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(myModuleBroadcasterMock, myRequestDetailsMock,
+			myPointcutMock,	myHookParamsMock);
+
+		assertThat(retVal).isTrue();
+
+		verify(myModuleBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+		verify(myReqDetailsBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+	}
+
+	@Test
+	void doCallHooks_WhenModuleBroadcasterReturnsTrue_And_RequestDetailsBroadcasterReturnsFalse_ThenReturnsFalse() {
+		when(myRequestDetailsMock.getInterceptorBroadcaster()).thenReturn(myReqDetailsBroadcasterMock);
+
+		when(myModuleBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(true);
+		when(myReqDetailsBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(false);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(myModuleBroadcasterMock, myRequestDetailsMock,
+			myPointcutMock,	myHookParamsMock);
+
+		assertThat(retVal).isFalse();
+
+		verify(myModuleBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+		verify(myReqDetailsBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+	}
+
+	@Test
+	void doCallHooks_WhenModuleBroadcasterReturnsFalse_ThenSkipsBroadcasterInRequestDetails_And_ReturnsFalse() {
+		when(myRequestDetailsMock.getInterceptorBroadcaster()).thenReturn(myReqDetailsBroadcasterMock);
+
+		when(myModuleBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(false);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(myModuleBroadcasterMock, myRequestDetailsMock,
+			myPointcutMock,	myHookParamsMock);
+
+		assertThat(retVal).isFalse();
+
+		verify(myModuleBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+		verify(myReqDetailsBroadcasterMock, never()).callHooks(myPointcutMock, myHookParamsMock);
+	}
+
+	@Test
+	void doCallHooks_WhenModuleBroadcasterReturnsTrue_And_NullRequestDetailsBroadcaster_ThenReturnsTrue() {
+
+		when(myModuleBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(true);
+		when(myRequestDetailsMock.getInterceptorBroadcaster()).thenReturn(null);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(myModuleBroadcasterMock, myRequestDetailsMock, myPointcutMock,
+			myHookParamsMock);
+
+		assertThat(retVal).isTrue();
+
+		verify(myModuleBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+	}
+
+	@Test
+	void doCallHooks_WhenModuleBroadcasterReturnsFalse_And_NullRequestDetailsBroadcaster_ThenReturnsFalse() {
+
+		when(myModuleBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(false);
+		when(myRequestDetailsMock.getInterceptorBroadcaster()).thenReturn(null);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(myModuleBroadcasterMock, myRequestDetailsMock, myPointcutMock,
+			myHookParamsMock);
+
+		assertThat(retVal).isFalse();
+
+		verify(myModuleBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+	}
+
+	@Test
+	void doCallHooks_WhenModuleBroadcasterReturnsTrue_And_NullRequestDetails_ThenReturnsTrue() {
+
+		when(myModuleBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(true);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(myModuleBroadcasterMock, null, myPointcutMock,	myHookParamsMock);
+
+		assertThat(retVal).isTrue();
+
+		verify(myModuleBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+	}
+
+	@Test
+	void doCallHooks_WhenModuleBroadcasterReturnsFalse_And_NullRequestDetails_ThenReturnsFalse() {
+
+		when(myModuleBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(false);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(myModuleBroadcasterMock, null, myPointcutMock,	myHookParamsMock);
+
+		assertThat(retVal).isFalse();
+
+		verify(myModuleBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+	}
+
+	@Test
+	void doCallHooks_WhenNullModuleBroadcaster_And_NullRequestDetails_ThenReturnsTrue() {
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(null, null, myPointcutMock,	myHookParamsMock);
+
+		assertThat(retVal).isTrue();
+	}
+
+	@Test
+	void doCallHooks_WhenNullModuleBroadcaster_And_RequestDetailsBroadcasterReturnsTrue_ThenReturnsTrue() {
+		when(myRequestDetailsMock.getInterceptorBroadcaster()).thenReturn(myReqDetailsBroadcasterMock);
+		when(myReqDetailsBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(true);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(null, myRequestDetailsMock, myPointcutMock, myHookParamsMock);
+
+		assertThat(retVal).isTrue();
+		verify(myReqDetailsBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+	}
+
+
+	@Test
+	void doCallHooks_WhenNullModuleBroadcaster_And_RequestDetailsBroadcasterReturnsFalse_ThenReturnsFalse() {
+		when(myRequestDetailsMock.getInterceptorBroadcaster()).thenReturn(myReqDetailsBroadcasterMock);
+		when(myReqDetailsBroadcasterMock.callHooks(myPointcutMock, myHookParamsMock)).thenReturn(false);
+
+		boolean retVal = CompositeInterceptorBroadcaster.doCallHooks(null, myRequestDetailsMock, myPointcutMock, myHookParamsMock);
+
+		assertThat(retVal).isFalse();
+		verify(myReqDetailsBroadcasterMock).callHooks(myPointcutMock, myHookParamsMock);
+	}
+}
diff --git a/hapi-fhir-sql-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/api/Builder.java b/hapi-fhir-sql-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/api/Builder.java
index 88269f41756e..c3489d3f6312 100644
--- a/hapi-fhir-sql-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/api/Builder.java
+++ b/hapi-fhir-sql-migrate/src/main/java/ca/uhn/fhir/jpa/migrate/tasks/api/Builder.java
@@ -397,7 +397,7 @@ public class BuilderAddIndexUnique {
 				private final String myVersion;
 				private final boolean myUnique;
 				private String[] myIncludeColumns;
-				private boolean myOnline;
+				private boolean myOnline = true;
 
 				public BuilderAddIndexUnique(String theVersion, boolean theUnique) {
 					myVersion = theVersion;
diff --git a/hapi-fhir-storage-batch2-jobs/src/main/java/ca/uhn/fhir/batch2/jobs/reindex/v1/ReindexV1Config.java b/hapi-fhir-storage-batch2-jobs/src/main/java/ca/uhn/fhir/batch2/jobs/reindex/v1/ReindexV1Config.java
index fe8f736aef52..4dd956389370 100644
--- a/hapi-fhir-storage-batch2-jobs/src/main/java/ca/uhn/fhir/batch2/jobs/reindex/v1/ReindexV1Config.java
+++ b/hapi-fhir-storage-batch2-jobs/src/main/java/ca/uhn/fhir/batch2/jobs/reindex/v1/ReindexV1Config.java
@@ -92,7 +92,7 @@ public JobDefinition<ReindexJobParameters> reindexJobDefinitionV1() {
 						"Load IDs of resources to reindex",
 						ResourceIdListWorkChunkJson.class,
 						myReindexLoadIdsStep)
-				.addLastStep("reindex-start", "Start the resource reindex", reindexStepV1())
+				.addLastStep("reindex", "Start the resource reindex", reindexStepV1())
 				.build();
 	}
 
diff --git a/hapi-fhir-storage-batch2/src/main/java/ca/uhn/fhir/batch2/model/BatchWorkChunkStatusDTO.java b/hapi-fhir-storage-batch2/src/main/java/ca/uhn/fhir/batch2/model/BatchWorkChunkStatusDTO.java
index 4f00448aa764..6c1918f28eea 100644
--- a/hapi-fhir-storage-batch2/src/main/java/ca/uhn/fhir/batch2/model/BatchWorkChunkStatusDTO.java
+++ b/hapi-fhir-storage-batch2/src/main/java/ca/uhn/fhir/batch2/model/BatchWorkChunkStatusDTO.java
@@ -26,6 +26,7 @@ public class BatchWorkChunkStatusDTO {
 	public final WorkChunkStatusEnum status;
 	public final Date start;
 	public final Date stop;
+
 	public final Double avg;
 	public final Long totalChunks;
 
diff --git a/hapi-fhir-storage-cr/src/main/java/ca/uhn/fhir/cr/config/dstu3/EvaluateOperationConfig.java b/hapi-fhir-storage-cr/src/main/java/ca/uhn/fhir/cr/config/dstu3/EvaluateOperationConfig.java
index 22867e527edd..6598ab08d9ca 100644
--- a/hapi-fhir-storage-cr/src/main/java/ca/uhn/fhir/cr/config/dstu3/EvaluateOperationConfig.java
+++ b/hapi-fhir-storage-cr/src/main/java/ca/uhn/fhir/cr/config/dstu3/EvaluateOperationConfig.java
@@ -21,15 +21,20 @@
 
 import ca.uhn.fhir.context.FhirContext;
 import ca.uhn.fhir.context.FhirVersionEnum;
+import ca.uhn.fhir.cr.config.CrProcessorConfig;
 import ca.uhn.fhir.cr.config.ProviderLoader;
 import ca.uhn.fhir.cr.config.ProviderSelector;
 import ca.uhn.fhir.rest.server.RestfulServer;
 import org.springframework.context.ApplicationContext;
 import org.springframework.context.annotation.Bean;
+import org.springframework.context.annotation.Configuration;
+import org.springframework.context.annotation.Import;
 
 import java.util.Arrays;
 import java.util.Map;
 
+@Configuration
+@Import(CrProcessorConfig.class)
 public class EvaluateOperationConfig {
 	@Bean
 	ca.uhn.fhir.cr.dstu3.library.LibraryEvaluateProvider dstu3LibraryEvaluateProvider() {
diff --git a/hapi-fhir-storage-cr/src/main/java/ca/uhn/fhir/cr/config/r4/EvaluateOperationConfig.java b/hapi-fhir-storage-cr/src/main/java/ca/uhn/fhir/cr/config/r4/EvaluateOperationConfig.java
index c0d0ae48faca..8cf8ecf76533 100644
--- a/hapi-fhir-storage-cr/src/main/java/ca/uhn/fhir/cr/config/r4/EvaluateOperationConfig.java
+++ b/hapi-fhir-storage-cr/src/main/java/ca/uhn/fhir/cr/config/r4/EvaluateOperationConfig.java
@@ -21,15 +21,20 @@
 
 import ca.uhn.fhir.context.FhirContext;
 import ca.uhn.fhir.context.FhirVersionEnum;
+import ca.uhn.fhir.cr.config.CrProcessorConfig;
 import ca.uhn.fhir.cr.config.ProviderLoader;
 import ca.uhn.fhir.cr.config.ProviderSelector;
 import ca.uhn.fhir.rest.server.RestfulServer;
 import org.springframework.context.ApplicationContext;
 import org.springframework.context.annotation.Bean;
+import org.springframework.context.annotation.Configuration;
+import org.springframework.context.annotation.Import;
 
 import java.util.Arrays;
 import java.util.Map;
 
+@Configuration
+@Import(CrProcessorConfig.class)
 public class EvaluateOperationConfig {
 	@Bean
 	ca.uhn.fhir.cr.r4.library.LibraryEvaluateProvider r4LibraryEvaluateProvider() {
diff --git a/hapi-fhir-storage-cr/src/test/java/ca/uhn/fhir/cr/r4/HapiFhirRepositoryR4Test.java b/hapi-fhir-storage-cr/src/test/java/ca/uhn/fhir/cr/r4/HapiFhirRepositoryR4Test.java
index 76996239ee5a..144822283712 100644
--- a/hapi-fhir-storage-cr/src/test/java/ca/uhn/fhir/cr/r4/HapiFhirRepositoryR4Test.java
+++ b/hapi-fhir-storage-cr/src/test/java/ca/uhn/fhir/cr/r4/HapiFhirRepositoryR4Test.java
@@ -25,6 +25,7 @@
 import java.util.Map;
 
 import static org.assertj.core.api.Assertions.assertThat;
+import static org.junit.jupiter.api.Assertions.assertDoesNotThrow;
 import static org.junit.jupiter.api.Assertions.assertEquals;
 import static org.junit.jupiter.api.Assertions.assertThrows;
 import static org.junit.jupiter.api.Assertions.assertTrue;
@@ -54,6 +55,25 @@ void repositoryTests(){
 		assertTrue(crudTest(repository));
 	}
 
+	@Test
+	void _profileCanBeReferenceParam() {
+		// as per https://www.hl7.org/fhir/r4/search.html#all _profile is a reference param
+		var repository = new HapiFhirRepository(myDaoRegistry, setupRequestDetails(), myRestfulServer);
+		var profileToFind = "http://www.a-test-profile.com";
+		var encounterWithProfile = new Encounter();
+		encounterWithProfile.getMeta().addProfile(profileToFind);
+		repository.create(encounterWithProfile);
+		repository.create(new Encounter());
+		Map<String, List<IQueryParameterType>> map = new HashMap<>();
+		map.put("_profile", Collections.singletonList(new ReferenceParam(profileToFind)));
+		assertDoesNotThrow(() -> {
+			var returnBundle = repository.search(Bundle.class, Encounter.class, map);
+			assertTrue(returnBundle.hasEntry());
+			assertEquals(1,returnBundle.getEntry().size());
+			assertEquals(profileToFind, returnBundle.getEntryFirstRep().getResource().getMeta().getProfile().get(0).getValue());
+		});
+	}
+
 
 	Boolean crudTest(HapiFhirRepository theRepository) {
 
diff --git a/hapi-fhir-structures-dstu2.1/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2_1Test.java b/hapi-fhir-structures-dstu2.1/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2_1Test.java
index e03d8d6c187f..18c74d8617b8 100644
--- a/hapi-fhir-structures-dstu2.1/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2_1Test.java
+++ b/hapi-fhir-structures-dstu2.1/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2_1Test.java
@@ -11,6 +11,7 @@
 import ca.uhn.fhir.parser.IParserErrorHandler.IParseLocation;
 import ca.uhn.fhir.parser.PatientWithExtendedContactDstu3.CustomContactComponent;
 import ca.uhn.fhir.parser.XmlParserDstu2_1Test.TestPatientFor327;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.ClasspathUtil;
 import ca.uhn.fhir.util.TestUtil;
 import com.google.common.collect.Sets;
@@ -407,6 +408,8 @@ public void testEncodeContainedResource() {
 
 		String encoded = ourCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		//@formatter:off
 		assertThat(encoded).containsSubsequence(
@@ -415,14 +418,14 @@ public void testEncodeContainedResource() {
 			"\"contained\": [",
 			"{",
 			"\"resourceType\": \"Condition\",",
-			"\"id\": \"1\"",
+			"\"id\": \"" + conditionUuid + "\"",
 			"}",
 			"],",
 			"\"extension\": [",
 			"{",
 			"\"url\": \"test\",",
 			"\"valueReference\": {",
-			"\"reference\": \"#1\"",
+			"\"reference\": \"#" + conditionUuid + "\"",
 			"}",
 			"}",
 			"],",
@@ -632,19 +635,21 @@ public void testEncodeExtensionWithContainedResource() {
 
 		String encoded = ourCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		//@formatter:off
 		assertThat(encoded).containsSubsequence(
 			"\"resourceType\": \"Patient\"",
 			"\"contained\": [",
 			"\"resourceType\": \"Condition\"",
-			"\"id\": \"1\"",
+			"\"id\": \"" + conditionUuid + "\"",
 			"\"bodySite\": [",
 			"\"text\": \"BODY SITE\"",
 			"\"extension\": [",
 			"\"url\": \"testCondition\",",
 			"\"valueReference\": {",
-			"\"reference\": \"#1\"",
+			"\"reference\": \"#" + conditionUuid + "\"",
 			"\"birthDate\": \"2016-04-14\"",
 			"}"
 		);
diff --git a/hapi-fhir-structures-dstu2.1/src/test/java/ca/uhn/fhir/parser/XmlParserDstu2_1Test.java b/hapi-fhir-structures-dstu2.1/src/test/java/ca/uhn/fhir/parser/XmlParserDstu2_1Test.java
index 7b3fbd7a4598..4c6fea901d86 100644
--- a/hapi-fhir-structures-dstu2.1/src/test/java/ca/uhn/fhir/parser/XmlParserDstu2_1Test.java
+++ b/hapi-fhir-structures-dstu2.1/src/test/java/ca/uhn/fhir/parser/XmlParserDstu2_1Test.java
@@ -13,6 +13,7 @@
 import ca.uhn.fhir.parser.IParserErrorHandler.IParseLocation;
 import ca.uhn.fhir.parser.PatientWithCustomCompositeExtension.FooParentExtension;
 import ca.uhn.fhir.rest.api.Constants;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.ClasspathUtil;
 import ca.uhn.fhir.util.TestUtil;
 import com.google.common.collect.Sets;
@@ -378,8 +379,11 @@ public void testEncodeAndParseContained() {
 
 		String encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String organizationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(organizationUuid);
+
 		assertThat(encoded).contains("<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// Create a bundle with just the patient resource
 		Bundle b = new Bundle();
@@ -388,35 +392,35 @@ public void testEncodeAndParseContained() {
 		// Encode the bundle
 		encoded = xmlParser.encodeResourceToString(b);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<id value=\"1\"/>", "</contained>"));
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<id value=\"" + organizationUuid + "\"/>", "</contained>"));
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 		assertThat(encoded).containsSubsequence(Arrays.asList("<entry>", "</entry>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<entry>.*</entry>.*<entry>");
 
 		// Re-parse the bundle
 		patient = (Patient) xmlParser.parseResource(xmlParser.encodeResourceToString(patient));
-		assertEquals("#1", patient.getManagingOrganization().getReference());
+		assertEquals("#" + organizationUuid, patient.getManagingOrganization().getReference());
 
 		assertNotNull(patient.getManagingOrganization().getResource());
 		org = (Organization) patient.getManagingOrganization().getResource();
-		assertEquals("#1", org.getIdElement().getValue());
+		assertEquals("#" + organizationUuid, org.getIdElement().getValue());
 		assertEquals("Contained Test Organization", org.getName());
 
 		// And re-encode a second time
 		encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"1\"/>", "</Organization", "</contained>", "<reference value=\"#1\"/>"));
+		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"" + organizationUuid + "\"/>", "</Organization", "</contained>", "<reference value=\"#" + organizationUuid + "\"/>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<contained>.*<Org.*<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// And re-encode once more, with the references cleared
 		patient.getContained().clear();
 		patient.getManagingOrganization().setReference(null);
 		encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"1\"/>", "</Organization", "</contained>", "<reference value=\"#1\"/>"));
+		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"" + organizationUuid + "\"/>", "</Organization", "</contained>", "<reference value=\"#" + organizationUuid + "\"/>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<contained>.*<Org.*<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// And re-encode once more, with the references cleared and a manually set local ID
 		patient.getContained().clear();
@@ -447,6 +451,8 @@ public void testEncodeAndParseContainedCustomTypes() {
 
 		String output = parser.encodeResourceToString(dr);
 		ourLog.info(output);
+		String observationUuid = UuidUtils.findFirstUUID(output);
+		assertNotNull(observationUuid);
 
 		//@formatter:off
 		assertThat(output).containsSubsequence(
@@ -456,7 +462,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 				"</meta>",
 				"<contained>",
 					"<Observation xmlns=\"http://hl7.org/fhir\">",
-						"<id value=\"1\"/>",
+						"<id value=\"" + observationUuid + "\"/>",
 						"<meta>",
 							"<profile value=\"http://custom_Observation\"/>",
 						"</meta>",
@@ -465,7 +471,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 				"</contained>",
 				"<status value=\"final\"/>",
 				"<result>",
-					"<reference value=\"#1\"/>",
+					"<reference value=\"#" + observationUuid + "\"/>",
 				"</result>",
 			"</DiagnosticReport>");
 		//@formatter:on
@@ -477,7 +483,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 		dr = (CustomDiagnosticReport) parser.parseResource(output);
 		assertEquals(DiagnosticReportStatus.FINAL, dr.getStatus());
 
-		assertEquals("#1", dr.getResult().get(0).getReference());
+		assertEquals("#" + observationUuid, dr.getResult().get(0).getReference());
 		obs = (CustomObservation) dr.getResult().get(0).getResource();
 		assertEquals(ObservationStatus.FINAL, obs.getStatus());
 
@@ -500,19 +506,21 @@ public void testEncodeAndParseContainedNonCustomTypes() {
 
 		String output = parser.encodeResourceToString(dr);
 		ourLog.info(output);
+		String observationUuid = UuidUtils.findFirstUUID(output);
+		assertNotNull(observationUuid);
 
 		//@formatter:off
 		assertThat(output).containsSubsequence(
 			"<DiagnosticReport xmlns=\"http://hl7.org/fhir\">",
 				"<contained>",
 					"<Observation xmlns=\"http://hl7.org/fhir\">",
-						"<id value=\"1\"/>",
+						"<id value=\"" + observationUuid + "\"/>",
 						"<status value=\"final\"/>",
 					"</Observation>",
 				"</contained>",
 				"<status value=\"final\"/>",
 				"<result>",
-					"<reference value=\"#1\"/>",
+					"<reference value=\"#" + observationUuid + "\"/>",
 				"</result>",
 			"</DiagnosticReport>");
 		//@formatter:on
@@ -524,7 +532,7 @@ public void testEncodeAndParseContainedNonCustomTypes() {
 		dr = (DiagnosticReport) parser.parseResource(output);
 		assertEquals(DiagnosticReportStatus.FINAL, dr.getStatus());
 
-		assertEquals("#1", dr.getResult().get(0).getReference());
+		assertEquals("#" + observationUuid, dr.getResult().get(0).getReference());
 		obs = (Observation) dr.getResult().get(0).getResource();
 		assertEquals(ObservationStatus.FINAL, obs.getStatus());
 
@@ -832,18 +840,20 @@ public void testEncodeContainedResource() {
 
 		String encoded = ourCtx.newXmlParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		//@formatter:off
 		assertThat(encoded).containsSubsequence(
 			"<Patient xmlns=\"http://hl7.org/fhir\">", 
 				"<contained>", 
 					"<Condition xmlns=\"http://hl7.org/fhir\">", 
-					"<id value=\"1\"/>",
+					"<id value=\"" + conditionUuid + "\"/>",
 					"</Condition>",
 				"</contained>",
 				"<extension url=\"test\">",
 					"<valueReference>",
-					"<reference value=\"#1\"/>", 
+					"<reference value=\"#" + conditionUuid + "\"/>",
 					"</valueReference>",
 				"</extension>",
 				"<birthDate value=\"2016-04-05\"/>", 
@@ -911,10 +921,12 @@ public void testEncodeContainedResourcesAutomatic() {
 		IParser p = ourCtx.newXmlParser().setPrettyPrint(true);
 		String encoded = p.encodeResourceToString(medicationPrescript);
 		ourLog.info(encoded);
+		String medicationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(medicationUuid);
 		
 		//@formatter:on
-		assertThat(encoded).containsSubsequence("<MedicationOrder xmlns=\"http://hl7.org/fhir\">", "<contained>", "<Medication xmlns=\"http://hl7.org/fhir\">", "<id value=\"1\"/>", "<code>", "<coding>",
-						"<system value=\"urn:sys\"/>", "<code value=\"code1\"/>", "</coding>", "</code>", "</Medication>", "</contained>", "<medicationReference>", "<reference value=\"#1\"/>",
+		assertThat(encoded).containsSubsequence("<MedicationOrder xmlns=\"http://hl7.org/fhir\">", "<contained>", "<Medication xmlns=\"http://hl7.org/fhir\">", "<id value=\"" + medicationUuid + "\"/>", "<code>", "<coding>",
+						"<system value=\"urn:sys\"/>", "<code value=\"code1\"/>", "</coding>", "</code>", "</Medication>", "</contained>", "<medicationReference>", "<reference value=\"#" + medicationUuid + "\"/>",
 						"<display value=\"MedRef\"/>", "</medicationReference>", "</MedicationOrder>");
 		//@formatter:off
 	}
@@ -1185,13 +1197,15 @@ public void testEncodeExtensionWithContainedResource() {
 
 		String encoded = ourCtx.newXmlParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		//@formatter:off
 		assertThat(encoded).containsSubsequence(
 			"<Patient xmlns=\"http://hl7.org/fhir\">", 
 				"<contained>", 
 					"<Condition xmlns=\"http://hl7.org/fhir\">", 
-						"<id value=\"1\"/>", 
+						"<id value=\"" + conditionUuid + "\"/>",
 						"<bodySite>", 
 							"<text value=\"BODY SITE\"/>", 
 						"</bodySite>", 
@@ -1199,7 +1213,7 @@ public void testEncodeExtensionWithContainedResource() {
 				"</contained>", 
 				"<extension url=\"testCondition\">",
 					"<valueReference>", 
-						"<reference value=\"#1\"/>", 
+						"<reference value=\"#" + conditionUuid + "\"/>",
 					"</valueReference>", 
 				"</extension>", 
 				"<birthDate value=\"2016-04-14\"/>", 
diff --git a/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/CustomTypeDstu2Test.java b/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/CustomTypeDstu2Test.java
index 5862838b5b10..e3f230440f1b 100644
--- a/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/CustomTypeDstu2Test.java
+++ b/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/CustomTypeDstu2Test.java
@@ -16,6 +16,7 @@
 import ca.uhn.fhir.model.primitive.DateTimeDt;
 import ca.uhn.fhir.model.primitive.StringDt;
 import ca.uhn.fhir.parser.CustomResource364Dstu2.CustomResource364CustomDate;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.ElementUtil;
 import ca.uhn.fhir.util.TestUtil;
 import org.junit.jupiter.api.AfterAll;
@@ -54,20 +55,23 @@ public void testConstrainedFieldContainedResource() {
 		
 		String string = ourCtx.newXmlParser().setPrettyPrint(true).encodeResourceToString(mo);
 		ourLog.info(string);
-		
+
+		String medicationUuid = UuidUtils.findFirstUUID(string);
+		assertNotNull(medicationUuid);
+
 		//@formatter:on
 		assertThat(string).containsSubsequence(
 				"<MedicationOrder xmlns=\"http://hl7.org/fhir\">", 
 				"   <contained>", 
-				"      <Medication xmlns=\"http://hl7.org/fhir\">", 
-				"         <id value=\"1\"/>", 
+				"      <Medication xmlns=\"http://hl7.org/fhir\">",
+				"         <id value=\"" + medicationUuid + "\"/>",
 				"         <code>", 
 				"            <text value=\"MED TEXT\"/>", 
 				"         </code>", 
 				"      </Medication>", 
 				"   </contained>", 
 				"   <medication>", 
-				"      <reference value=\"#1\"/>", 
+				"      <reference value=\"#" + medicationUuid + "\"/>",
 				"   </medication>", 
 				"</MedicationOrder>");
 		//@formatter:on
@@ -76,7 +80,7 @@ public void testConstrainedFieldContainedResource() {
 		
 		medication = (Medication) mo.getMedication().getResource();
 		assertNotNull(medication);
-		assertEquals("#1", medication.getId().getValue());
+		assertEquals("#" + medicationUuid, medication.getId().getValue());
 		assertEquals("MED TEXT", medication.getCode().getText());
 		
 	}
diff --git a/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2Test.java b/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2Test.java
index 85fa64620f51..ef7737273957 100644
--- a/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2Test.java
+++ b/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2Test.java
@@ -50,6 +50,7 @@
 import ca.uhn.fhir.parser.testprofile.CommunicationProfile;
 import ca.uhn.fhir.parser.testprofile.PatientProfile;
 import ca.uhn.fhir.rest.api.Constants;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.TestUtil;
 import ch.qos.logback.classic.Level;
 import ch.qos.logback.classic.Logger;
@@ -1705,14 +1706,16 @@ public void testParseContained() {
 
 		String enc = parser.encodeResourceToString(o);
 		ourLog.info(enc);
+		String patientUuid = UuidUtils.findFirstUUID(enc);
+		assertNotNull(patientUuid);
 
 		//@formatter:off
 		assertThat(enc).containsSubsequence(
 			"\"resourceType\": \"Observation\"",
 			"\"contained\": [",
 			"\"resourceType\": \"Patient\",",
-			"\"id\": \"1\"",
-			"\"reference\": \"#1\""
+			"\"id\": \"" + patientUuid + "\"",
+			"\"reference\": \"#" + patientUuid + "\""
 		);
 		//@formatter:on
 
diff --git a/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/XmlParserDstu2Test.java b/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/XmlParserDstu2Test.java
index 9d48d2fc8301..b5586fd64455 100644
--- a/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/XmlParserDstu2Test.java
+++ b/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/XmlParserDstu2Test.java
@@ -62,6 +62,7 @@
 import ca.uhn.fhir.parser.IParserErrorHandler.IParseLocation;
 import ca.uhn.fhir.rest.api.Constants;
 import ca.uhn.fhir.rest.client.api.IGenericClient;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.ClasspathUtil;
 import ca.uhn.fhir.util.TestUtil;
 import com.google.common.collect.Sets;
@@ -512,8 +513,10 @@ public void testEncodeAndParseContained() {
 
 		String encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String organizationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(organizationUuid);
 		assertThat(encoded).contains("<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// Create a bundle with just the patient resource
 		ca.uhn.fhir.model.dstu2.resource.Bundle b = new ca.uhn.fhir.model.dstu2.resource.Bundle();
@@ -522,35 +525,37 @@ public void testEncodeAndParseContained() {
 		// Encode the bundle
 		encoded = xmlParser.encodeResourceToString(b);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<id value=\"1\"/>", "</contained>"));
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<id value=\"" + organizationUuid + "\"/>", "</contained>"));
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 		assertThat(encoded).containsSubsequence(Arrays.asList("<entry>", "</entry>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<entry>.*</entry>.*<entry>");
 
 		// Re-parse the bundle
 		patient = (Patient) xmlParser.parseResource(xmlParser.encodeResourceToString(patient));
-		assertEquals("#1", patient.getManagingOrganization().getReference().getValue());
+		assertEquals("#" + organizationUuid, patient.getManagingOrganization().getReference().getValue());
 
 		assertNotNull(patient.getManagingOrganization().getResource());
 		org = (Organization) patient.getManagingOrganization().getResource();
-		assertEquals("#1", org.getId().getValue());
+		assertEquals("#" + organizationUuid, org.getId().getValue());
 		assertEquals("Contained Test Organization", org.getName());
 
 		// And re-encode a second time
 		encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"1\"/>", "</Organization", "</contained>", "<reference value=\"#1\"/>"));
+		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\""
+			+ organizationUuid + "\"/>", "</Organization", "</contained>", "<reference value=\"#" + organizationUuid + "\"/>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<contained>.*<Org.*<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// And re-encode once more, with the references cleared
 		patient.getContained().getContainedResources().clear();
 		patient.getManagingOrganization().setReference((String) null);
 		encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"1\"/>", "</Organization", "</contained>", "<reference value=\"#1\"/>"));
+		assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"" + organizationUuid +
+			"\"/>", "</Organization", "</contained>", "<reference value=\"#" + organizationUuid + "\"/>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<contained>.*<Org.*<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// And re-encode once more, with the references cleared and a manually set local ID
 		patient.getContained().getContainedResources().clear();
@@ -581,6 +586,8 @@ public void testEncodeAndParseContainedCustomTypes() {
 
 		String output = parser.encodeResourceToString(dr);
 		ourLog.info(output);
+		String observationUuid = UuidUtils.findFirstUUID(output);
+		assertNotNull(observationUuid);
 
 		//@formatter:off
 		assertThat(output).containsSubsequence(
@@ -590,7 +597,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 			"</meta>",
 			"<contained>",
 			"<Observation xmlns=\"http://hl7.org/fhir\">",
-			"<id value=\"1\"/>",
+			"<id value=\"" + observationUuid + "\"/>",
 			"<meta>",
 			"<profile value=\"http://custom_Observation\"/>",
 			"</meta>",
@@ -599,7 +606,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 			"</contained>",
 			"<status value=\"final\"/>",
 			"<result>",
-			"<reference value=\"#1\"/>",
+			"<reference value=\"#" + observationUuid + "\"/>",
 			"</result>",
 			"</DiagnosticReport>");
 		//@formatter:on
@@ -611,7 +618,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 		dr = (CustomDiagnosticReportDstu2) parser.parseResource(output);
 		assertEquals(DiagnosticReportStatusEnum.FINAL, dr.getStatusElement().getValueAsEnum());
 
-		assertEquals("#1", dr.getResult().get(0).getReference().getValueAsString());
+		assertEquals("#" + observationUuid, dr.getResult().get(0).getReference().getValueAsString());
 		obs = (CustomObservationDstu2) dr.getResult().get(0).getResource();
 		assertEquals(ObservationStatusEnum.FINAL, obs.getStatusElement().getValueAsEnum());
 
@@ -665,19 +672,21 @@ public void testEncodeAndParseContainedNonCustomTypes() {
 
 		String output = parser.encodeResourceToString(dr);
 		ourLog.info(output);
+		String observationUuid = UuidUtils.findFirstUUID(output);
+		assertNotNull(observationUuid);
 
 		//@formatter:off
 		assertThat(output).containsSubsequence(
 			"<DiagnosticReport xmlns=\"http://hl7.org/fhir\">",
 			"<contained>",
 			"<Observation xmlns=\"http://hl7.org/fhir\">",
-			"<id value=\"1\"/>",
+			"<id value=\"" + observationUuid + "\"/>",
 			"<status value=\"final\"/>",
 			"</Observation>",
 			"</contained>",
 			"<status value=\"final\"/>",
 			"<result>",
-			"<reference value=\"#1\"/>",
+			"<reference value=\"#" + observationUuid + "\"/>",
 			"</result>",
 			"</DiagnosticReport>");
 		//@formatter:on
@@ -689,7 +698,7 @@ public void testEncodeAndParseContainedNonCustomTypes() {
 		dr = (DiagnosticReport) parser.parseResource(output);
 		assertEquals(DiagnosticReportStatusEnum.FINAL, dr.getStatusElement().getValueAsEnum());
 
-		assertEquals("#1", dr.getResult().get(0).getReference().getValueAsString());
+		assertEquals("#" + observationUuid, dr.getResult().get(0).getReference().getValueAsString());
 		obs = (Observation) dr.getResult().get(0).getResource();
 		assertEquals(ObservationStatusEnum.FINAL, obs.getStatusElement().getValueAsEnum());
 
@@ -1305,10 +1314,12 @@ public void testEncodeContainedResourcesAutomatic() {
 		IParser p = ourCtx.newXmlParser().setPrettyPrint(true);
 		String encoded = p.encodeResourceToString(medicationPrescript);
 		ourLog.info(encoded);
+		String medicationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(medicationUuid);
 
 		//@formatter:on
-		assertThat(encoded).containsSubsequence("<MedicationOrder xmlns=\"http://hl7.org/fhir\">", "<contained>", "<Medication xmlns=\"http://hl7.org/fhir\">", "<id value=\"1\"/>", "<code>", "<coding>",
-				"<system value=\"urn:sys\"/>", "<code value=\"code1\"/>", "</coding>", "</code>", "</Medication>", "</contained>", "<medicationReference>", "<reference value=\"#1\"/>",
+		assertThat(encoded).containsSubsequence("<MedicationOrder xmlns=\"http://hl7.org/fhir\">", "<contained>", "<Medication xmlns=\"http://hl7.org/fhir\">", "<id value=\"" + medicationUuid + "\"/>", "<code>", "<coding>",
+				"<system value=\"urn:sys\"/>", "<code value=\"code1\"/>", "</coding>", "</code>", "</Medication>", "</contained>", "<medicationReference>", "<reference value=\"#" + medicationUuid + "\"/>",
 				"<display value=\"MedRef\"/>", "</medicationReference>", "</MedicationOrder>");
 		//@formatter:off
 	}
@@ -1561,13 +1572,15 @@ public void testEncodeExtensionWithContainedResource() {
 
 		String encoded = ourCtx.newXmlParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		//@formatter:off
 		assertThat(encoded).containsSubsequence(
 			"<Patient xmlns=\"http://hl7.org/fhir\">",
 			"<contained>",
 			"<Condition xmlns=\"http://hl7.org/fhir\">",
-			"<id value=\"1\"/>",
+			"<id value=\"" + conditionUuid + "\"/>",
 			"<bodySite>",
 			"<text value=\"BODY SITE\"/>",
 			"</bodySite>",
@@ -1575,7 +1588,7 @@ public void testEncodeExtensionWithContainedResource() {
 			"</contained>",
 			"<extension url=\"testCondition\">",
 			"<valueReference>",
-			"<reference value=\"#1\"/>",
+			"<reference value=\"#" + conditionUuid + "\"/>",
 			"</valueReference>",
 			"</extension>",
 			"<birthDate value=\"2016-04-17\"/>",
@@ -2535,15 +2548,17 @@ public void testParseContained() {
 
 		String enc = parser.encodeResourceToString(o);
 		ourLog.info(enc);
+		String patientUuid = UuidUtils.findFirstUUID(enc);
+		assertNotNull(patientUuid);
 
 		//@formatter:off
 		assertThat(enc).containsSubsequence(
 			"<Observation xmlns=\"http://hl7.org/fhir\">",
 			"<contained>",
 			"<Patient xmlns=\"http://hl7.org/fhir\">",
-			"<id value=\"1\"/>",
+			"<id value=\"" + patientUuid + "\"/>",
 			"</contained>",
-			"<reference value=\"#1\"/>"
+			"<reference value=\"#" + patientUuid + "\"/>"
 		);
 		//@formatter:on
 
diff --git a/hapi-fhir-structures-dstu3/src/test/java/ca/uhn/fhir/parser/JsonParserDstu3Test.java b/hapi-fhir-structures-dstu3/src/test/java/ca/uhn/fhir/parser/JsonParserDstu3Test.java
index 268a5bbcc7b2..a0de44b0fde5 100644
--- a/hapi-fhir-structures-dstu3/src/test/java/ca/uhn/fhir/parser/JsonParserDstu3Test.java
+++ b/hapi-fhir-structures-dstu3/src/test/java/ca/uhn/fhir/parser/JsonParserDstu3Test.java
@@ -13,6 +13,7 @@
 import ca.uhn.fhir.parser.XmlParserDstu3Test.TestPatientFor327;
 import ca.uhn.fhir.parser.json.BaseJsonLikeValue.ScalarType;
 import ca.uhn.fhir.parser.json.BaseJsonLikeValue.ValueType;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.ClasspathUtil;
 import ca.uhn.fhir.util.TestUtil;
 import ca.uhn.fhir.validation.FhirValidator;
@@ -648,6 +649,8 @@ public void testEncodeContainedResource() {
 
 		String encoded = ourCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		//@formatter:off
 		assertThat(encoded).contains(
@@ -656,14 +659,14 @@ public void testEncodeContainedResource() {
 			"\"contained\": [",
 			"{",
 			"\"resourceType\": \"Condition\",",
-			"\"id\": \"1\"",
+			"\"id\": \"" + conditionUuid + "\"",
 			"}",
 			"],",
 			"\"extension\": [",
 			"{",
 			"\"url\": \"test\",",
 			"\"valueReference\": {",
-			"\"reference\": \"#1\"",
+			"\"reference\": \"#" + conditionUuid + "\"",
 			"}",
 			"}",
 			"],",
@@ -920,19 +923,21 @@ public void testEncodeExtensionWithContainedResource() {
 
 		String encoded = ourCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		//@formatter:off
 		assertThat(encoded).contains(
 			"\"resourceType\": \"Patient\"",
 			"\"contained\": [",
 			"\"resourceType\": \"Condition\"",
-			"\"id\": \"1\"",
+			"\"id\": \"" + conditionUuid + "\"",
 			"\"bodySite\": [",
 			"\"text\": \"BODY SITE\"",
 			"\"extension\": [",
 			"\"url\": \"testCondition\",",
 			"\"valueReference\": {",
-			"\"reference\": \"#1\"",
+			"\"reference\": \"#" + conditionUuid + "\"",
 			"\"birthDate\": \"2016-04-14\"",
 			"}"
 		);
diff --git a/hapi-fhir-structures-dstu3/src/test/java/ca/uhn/fhir/parser/XmlParserDstu3Test.java b/hapi-fhir-structures-dstu3/src/test/java/ca/uhn/fhir/parser/XmlParserDstu3Test.java
index 58e1477e361c..2388fa72413d 100644
--- a/hapi-fhir-structures-dstu3/src/test/java/ca/uhn/fhir/parser/XmlParserDstu3Test.java
+++ b/hapi-fhir-structures-dstu3/src/test/java/ca/uhn/fhir/parser/XmlParserDstu3Test.java
@@ -13,6 +13,7 @@
 import ca.uhn.fhir.parser.FooMessageHeaderWithExplicitField.FooMessageSourceComponent;
 import ca.uhn.fhir.parser.IParserErrorHandler.IParseLocation;
 import ca.uhn.fhir.parser.PatientWithCustomCompositeExtension.FooParentExtension;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.ClasspathUtil;
 import ca.uhn.fhir.util.TestUtil;
 import com.google.common.collect.Sets;
@@ -560,8 +561,11 @@ public void testEncodeAndParseContained() {
 
 		String encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String organizationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(organizationUuid);
+
 		assertThat(encoded).contains("<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// Create a bundle with just the patient resource
 		Bundle b = new Bundle();
@@ -570,35 +574,35 @@ public void testEncodeAndParseContained() {
 		// Encode the bundle
 		encoded = xmlParser.encodeResourceToString(b);
 		ourLog.info(encoded);
-		assertThat(encoded).contains(Arrays.asList("<contained>", "<id value=\"1\"/>", "</contained>"));
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains(Arrays.asList("<contained>", "<id value=\"" + organizationUuid + "\"/>", "</contained>"));
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 		assertThat(encoded).contains(Arrays.asList("<entry>", "</entry>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<entry>.*</entry>.*<entry>");
 
 		// Re-parse the bundle
 		patient = (Patient) xmlParser.parseResource(xmlParser.encodeResourceToString(patient));
-		assertEquals("#1", patient.getManagingOrganization().getReference());
+		assertEquals("#" + organizationUuid, patient.getManagingOrganization().getReference());
 
 		assertNotNull(patient.getManagingOrganization().getResource());
 		org = (Organization) patient.getManagingOrganization().getResource();
-		assertEquals("#1", org.getIdElement().getValue());
+		assertEquals("#" + organizationUuid, org.getIdElement().getValue());
 		assertEquals("Contained Test Organization", org.getName());
 
 		// And re-encode a second time
 		encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).contains(Arrays.asList("<contained>", "<Organization ", "<id value=\"1\"/>", "</Organization", "</contained>", "<reference value=\"#1\"/>"));
+		assertThat(encoded).contains(Arrays.asList("<contained>", "<Organization ", "<id value=\"" + organizationUuid + "\"/>", "</Organization", "</contained>", "<reference value=\"#" + organizationUuid + "\"/>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<contained>.*<Org.*<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// And re-encode once more, with the references cleared
 		patient.getContained().clear();
 		patient.getManagingOrganization().setReference(null);
 		encoded = xmlParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).contains(Arrays.asList("<contained>", "<Organization ", "<id value=\"1\"/>", "</Organization", "</contained>", "<reference value=\"#1\"/>"));
+		assertThat(encoded).contains(Arrays.asList("<contained>", "<Organization ", "<id value=\"" + organizationUuid + "\"/>", "</Organization", "</contained>", "<reference value=\"#" + organizationUuid + "\"/>"));
 		assertThat(encoded).doesNotContainPattern("(?s)<contained>.*<Org.*<contained>");
-		assertThat(encoded).contains("<reference value=\"#1\"/>");
+		assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
 		// And re-encode once more, with the references cleared and a manually set local ID
 		patient.getContained().clear();
@@ -629,6 +633,8 @@ public void testEncodeAndParseContainedCustomTypes() {
 
 		String output = parser.encodeResourceToString(dr);
 		ourLog.info(output);
+		String observationUuid = UuidUtils.findFirstUUID(output);
+		assertNotNull(observationUuid);
 
 		assertThat(output).contains(
 			"<DiagnosticReport xmlns=\"http://hl7.org/fhir\">",
@@ -637,7 +643,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 			"</meta>",
 			"<contained>",
 			"<Observation xmlns=\"http://hl7.org/fhir\">",
-			"<id value=\"1\"/>",
+			"<id value=\"" + observationUuid + "\"/>",
 			"<meta>",
 			"<profile value=\"http://custom_Observation\"/>",
 			"</meta>",
@@ -646,7 +652,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 			"</contained>",
 			"<status value=\"final\"/>",
 			"<result>",
-			"<reference value=\"#1\"/>",
+			"<reference value=\"#" + observationUuid + "\"/>",
 			"</result>",
 			"</DiagnosticReport>");
 
@@ -657,7 +663,7 @@ public void testEncodeAndParseContainedCustomTypes() {
 		dr = (CustomDiagnosticReport) parser.parseResource(output);
 		assertEquals(DiagnosticReportStatus.FINAL, dr.getStatus());
 
-		assertEquals("#1", dr.getResult().get(0).getReference());
+		assertEquals("#" + observationUuid, dr.getResult().get(0).getReference());
 		obs = (CustomObservation) dr.getResult().get(0).getResource();
 		assertEquals(ObservationStatus.FINAL, obs.getStatus());
 
@@ -680,18 +686,20 @@ public void testEncodeAndParseContainedNonCustomTypes() {
 
 		String output = parser.encodeResourceToString(dr);
 		ourLog.info(output);
+		String observationUuid = UuidUtils.findFirstUUID(output);
+		assertNotNull(observationUuid);
 
 		assertThat(output).contains(
 			"<DiagnosticReport xmlns=\"http://hl7.org/fhir\">",
 			"<contained>",
 			"<Observation xmlns=\"http://hl7.org/fhir\">",
-			"<id value=\"1\"/>",
+			"<id value=\"" + observationUuid + "\"/>",
 			"<status value=\"final\"/>",
 			"</Observation>",
 			"</contained>",
 			"<status value=\"final\"/>",
 			"<result>",
-			"<reference value=\"#1\"/>",
+			"<reference value=\"#" + observationUuid + "\"/>",
 			"</result>",
 			"</DiagnosticReport>");
 
@@ -702,7 +710,7 @@ public void testEncodeAndParseContainedNonCustomTypes() {
 		dr = (DiagnosticReport) parser.parseResource(output);
 		assertEquals(DiagnosticReportStatus.FINAL, dr.getStatus());
 
-		assertEquals("#1", dr.getResult().get(0).getReference());
+		assertEquals("#" + observationUuid, dr.getResult().get(0).getReference());
 		obs = (Observation) dr.getResult().get(0).getResource();
 		assertEquals(ObservationStatus.FINAL, obs.getStatus());
 
@@ -1282,17 +1290,19 @@ public void testEncodeContainedResource() {
 
 		String encoded = ourCtx.newXmlParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		assertThat(encoded).contains(
 			"<Patient xmlns=\"http://hl7.org/fhir\">",
 			"<contained>",
 			"<Condition xmlns=\"http://hl7.org/fhir\">",
-			"<id value=\"1\"/>",
+			"<id value=\"" + conditionUuid + "\"/>",
 			"</Condition>",
 			"</contained>",
 			"<extension url=\"test\">",
 			"<valueReference>",
-			"<reference value=\"#1\"/>",
+			"<reference value=\"#" + conditionUuid + "\"/>",
 			"</valueReference>",
 			"</extension>",
 			"<birthDate value=\"2016-04-05\"/>",
@@ -1359,10 +1369,12 @@ public void testEncodeContainedResourcesAutomatic() {
 		IParser p = ourCtx.newXmlParser().setPrettyPrint(true);
 		String encoded = p.encodeResourceToString(medicationPrescript);
 		ourLog.info(encoded);
+		String medicationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(medicationUuid);
 
 		assertThat(encoded).contains
-			("<MedicationRequest xmlns=\"http://hl7.org/fhir\">", "<contained>", "<Medication xmlns=\"http://hl7.org/fhir\">", "<id value=\"1\"/>", "<code>", "<coding>",
-				"<system value=\"urn:sys\"/>", "<code value=\"code1\"/>", "</coding>", "</code>", "</Medication>", "</contained>", "<medicationReference>", "<reference value=\"#1\"/>",
+			("<MedicationRequest xmlns=\"http://hl7.org/fhir\">", "<contained>", "<Medication xmlns=\"http://hl7.org/fhir\">", "<id value=\"" + medicationUuid + "\"/>", "<code>", "<coding>",
+				"<system value=\"urn:sys\"/>", "<code value=\"code1\"/>", "</coding>", "</code>", "</Medication>", "</contained>", "<medicationReference>", "<reference value=\"#" + medicationUuid + "\"/>",
 				"<display value=\"MedRef\"/>", "</medicationReference>", "</MedicationRequest>");
 
 	}
@@ -1726,12 +1738,14 @@ public void testEncodeExtensionWithContainedResource() {
 
 		String encoded = ourCtx.newXmlParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
+		String conditionUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(conditionUuid);
 
 		assertThat(encoded).contains(
 			"<Patient xmlns=\"http://hl7.org/fhir\">",
 			"<contained>",
 			"<Condition xmlns=\"http://hl7.org/fhir\">",
-			"<id value=\"1\"/>",
+			"<id value=\"" + conditionUuid + "\"/>",
 			"<bodySite>",
 			"<text value=\"BODY SITE\"/>",
 			"</bodySite>",
@@ -1739,7 +1753,7 @@ public void testEncodeExtensionWithContainedResource() {
 			"</contained>",
 			"<extension url=\"testCondition\">",
 			"<valueReference>",
-			"<reference value=\"#1\"/>",
+			"<reference value=\"#" + conditionUuid + "\"/>",
 			"</valueReference>",
 			"</extension>",
 			"<birthDate value=\"2016-04-14\"/>",
diff --git a/hapi-fhir-structures-hl7org-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserHl7OrgDstu2Test.java b/hapi-fhir-structures-hl7org-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserHl7OrgDstu2Test.java
index 6889414f15bf..6a5ead67c1cf 100644
--- a/hapi-fhir-structures-hl7org-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserHl7OrgDstu2Test.java
+++ b/hapi-fhir-structures-hl7org-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserHl7OrgDstu2Test.java
@@ -4,6 +4,7 @@
 import ca.uhn.fhir.model.api.annotation.Child;
 import ca.uhn.fhir.model.api.annotation.ResourceDef;
 import ca.uhn.fhir.rest.api.Constants;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import ca.uhn.fhir.util.ClasspathUtil;
 import ca.uhn.fhir.util.TestUtil;
 import net.sf.json.JSON;
@@ -58,6 +59,7 @@
 import java.util.Arrays;
 import java.util.List;
 
+import static ca.uhn.fhir.test.utilities.UuidUtils.UUID_PATTERN;
 import static org.assertj.core.api.Assertions.assertThat;
 import static org.junit.jupiter.api.Assertions.assertEquals;
 import static org.junit.jupiter.api.Assertions.assertFalse;
@@ -408,7 +410,10 @@ public void testEncodeContained() {
 		
 		String encoded = jsonParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\": [", "\"id\": \"1\"", "\"identifier\"", "\"reference\": \"#1\""));
+		String organizationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(organizationUuid);
+
+		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\": [", "\"id\": \"" + organizationUuid + "\"", "\"identifier\"", "\"reference\": \"#" + organizationUuid + "\""));
 		
 		// Create a bundle with just the patient resource
 		Bundle b = new Bundle();
@@ -417,21 +422,21 @@ public void testEncodeContained() {
 		// Encode the bundle
 		encoded = jsonParser.encodeResourceToString(b);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\": [", "\"id\": \"1\"", "\"identifier\"", "\"reference\": \"#1\""));
+		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\": [", "\"id\": \"" + organizationUuid + "\"", "\"identifier\"", "\"reference\": \"#" + organizationUuid + "\""));
 		
 		// Re-parse the bundle
 		patient = (Patient) jsonParser.parseResource(jsonParser.encodeResourceToString(patient));
-		assertEquals("#1", patient.getManagingOrganization().getReference());
+		assertEquals("#" + organizationUuid, patient.getManagingOrganization().getReference());
 
 		assertNotNull(patient.getManagingOrganization().getResource());
 		org = (Organization) patient.getManagingOrganization().getResource();
-		assertEquals("#1", org.getIdElement().getValue());
+		assertEquals("#" + organizationUuid, org.getIdElement().getValue());
 		assertEquals("Contained Test Organization", org.getName());
 		
 		// And re-encode a second time
 		encoded = jsonParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\": [", "\"id\": \"1\"", "\"identifier\"", "\"reference\": \"#1\""));
+		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\": [", "\"id\": \"" + organizationUuid + "\"", "\"identifier\"", "\"reference\": \"#" + organizationUuid + "\""));
 		assertThat(encoded).doesNotContainPattern("(?s)\"contained\":.*\\[.*\"contained\":");
 
 		// And re-encode once more, with the references cleared
@@ -439,7 +444,7 @@ public void testEncodeContained() {
 		patient.getManagingOrganization().setReference(null);
 		encoded = jsonParser.encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\": [", "\"id\": \"1\"", "\"identifier\"", "\"reference\": \"#1\""));
+		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\": [", "\"id\": \"" + organizationUuid + "\"", "\"identifier\"", "\"reference\": \"#" + organizationUuid + "\""));
     assertThat(encoded).doesNotContainPattern("(?s).*\"contained\":.*\\[.*\"contained\":");
 
 		// And re-encode once more, with the references cleared and a manually set local ID
@@ -472,13 +477,16 @@ public void testEncodeContained__() {
 		// Encode the buntdle
 		String encoded = ourCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(b);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\"", "resourceType\": \"Organization", "id\": \"1\""));
-		assertThat(encoded).contains("reference\": \"#1\"");
+		String organizationUuid = UuidUtils.findFirstUUID(encoded);
+		assertNotNull(organizationUuid);
+
+		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\"", "resourceType\": \"Organization", "id\": \"" + organizationUuid + "\""));
+		assertThat(encoded).contains("reference\": \"#" + organizationUuid + "\"");
 		
 		encoded = ourCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(patient);
 		ourLog.info(encoded);
-		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\"", "resourceType\": \"Organization", "id\": \"1\""));
-		assertThat(encoded).contains("reference\": \"#1\"");
+		assertThat(encoded).containsSubsequence(Arrays.asList("\"contained\"", "resourceType\": \"Organization", "id\": \"" + organizationUuid + "\""));
+		assertThat(encoded).contains("reference\": \"#" + organizationUuid + "\"");
 	}
 
 	@Test
@@ -696,7 +704,7 @@ public void testEncodeIds() {
 		String enc = ourCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(list);
 		ourLog.info(enc);
 
-		assertThat(enc).contains("\"id\": \"1\"");
+		assertThat(enc).containsPattern("\"id\": \"" + UUID_PATTERN);
 		
 		List_ parsed = ourCtx.newJsonParser().parseResource(List_.class,enc);
 		assertEquals(Patient.class, parsed.getEntry().get(0).getItem().getResource().getClass());
diff --git a/hapi-fhir-structures-hl7org-dstu2/src/test/java/ca/uhn/fhir/parser/XmlParserHl7OrgDstu2Test.java b/hapi-fhir-structures-hl7org-dstu2/src/test/java/ca/uhn/fhir/parser/XmlParserHl7OrgDstu2Test.java
index 4356a997a060..d9582e02ba23 100644
--- a/hapi-fhir-structures-hl7org-dstu2/src/test/java/ca/uhn/fhir/parser/XmlParserHl7OrgDstu2Test.java
+++ b/hapi-fhir-structures-hl7org-dstu2/src/test/java/ca/uhn/fhir/parser/XmlParserHl7OrgDstu2Test.java
@@ -9,6 +9,7 @@
 import ca.uhn.fhir.parser.JsonParserHl7OrgDstu2Test.MyPatientWithOneDeclaredAddressExtension;
 import ca.uhn.fhir.parser.JsonParserHl7OrgDstu2Test.MyPatientWithOneDeclaredExtension;
 import ca.uhn.fhir.rest.api.Constants;
+import ca.uhn.fhir.test.utilities.UuidUtils;
 import net.sf.json.JSON;
 import net.sf.json.JSONSerializer;
 import org.apache.commons.io.IOUtils;
@@ -216,8 +217,11 @@ public void testEncodeAndParseContained() {
 
     String encoded = xmlParser.encodeResourceToString(patient);
     ourLog.info(encoded);
+    String organizationUuid = UuidUtils.findFirstUUID(encoded);
+    assertNotNull(organizationUuid);
+
     assertThat(encoded).contains("<contained>");
-    assertThat(encoded).contains("<reference value=\"#1\"/>");
+    assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
     // Create a bundle with just the patient resource
     Bundle b = new Bundle();
@@ -226,37 +230,37 @@ public void testEncodeAndParseContained() {
     // Encode the bundle
     encoded = xmlParser.encodeResourceToString(b);
     ourLog.info(encoded);
-    assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<id value=\"1\"/>", "</contained>"));
-    assertThat(encoded).contains("<reference value=\"#1\"/>");
+    assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<id value=\"" + organizationUuid + "\"/>", "</contained>"));
+    assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
     assertThat(encoded).containsSubsequence(Arrays.asList("<entry>", "</entry>"));
     assertThat(encoded).doesNotContainPattern("(?s)<entry>.*</entry>.*<entry>");
 
     // Re-parse the bundle
     patient = (Patient) xmlParser.parseResource(xmlParser.encodeResourceToString(patient));
-    assertEquals("#1", patient.getManagingOrganization().getReferenceElement().getValue());
+    assertEquals("#" + organizationUuid, patient.getManagingOrganization().getReferenceElement().getValue());
 
     assertNotNull(patient.getManagingOrganization().getResource());
     org = (Organization) patient.getManagingOrganization().getResource();
-    assertEquals("#1", org.getIdElement().getValue());
+    assertEquals("#" + organizationUuid, org.getIdElement().getValue());
     assertEquals("Contained Test Organization", org.getName());
 
     // And re-encode a second time
     encoded = xmlParser.encodeResourceToString(patient);
     ourLog.info(encoded);
-    assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"1\"/>",
-        "</Organization", "</contained>", "<reference value=\"#1\"/>"));
+    assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"" + organizationUuid + "\"/>",
+        "</Organization", "</contained>", "<reference value=\"#" + organizationUuid + "\"/>"));
     assertThat(encoded).doesNotContainPattern("(?s)<contained>.*<Org.*<contained>");
-    assertThat(encoded).contains("<reference value=\"#1\"/>");
+    assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
     // And re-encode once more, with the references cleared
     patient.getContained().clear();
     patient.getManagingOrganization().setReference(null);
     encoded = xmlParser.encodeResourceToString(patient);
     ourLog.info(encoded);
-    assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"1\"/>",
-        "</Organization", "</contained>", "<reference value=\"#1\"/>"));
+    assertThat(encoded).containsSubsequence(Arrays.asList("<contained>", "<Organization ", "<id value=\"" + organizationUuid + "\"/>",
+        "</Organization", "</contained>", "<reference value=\"#" + organizationUuid + "\"/>"));
     assertThat(encoded).doesNotContainPattern("(?s)<contained>.*<Org.*<contained>");
-    assertThat(encoded).contains("<reference value=\"#1\"/>");
+    assertThat(encoded).contains("<reference value=\"#" + organizationUuid + "\"/>");
 
     // And re-encode once more, with the references cleared and a manually set
     // local ID
@@ -969,13 +973,15 @@ public void testEncodeExtensionWithContainedResource() {
 
     String encoded = ourCtx.newXmlParser().setPrettyPrint(true).encodeResourceToString(patient);
     ourLog.info(encoded);
+    String conditionUuid = UuidUtils.findFirstUUID(encoded);
+    assertNotNull(conditionUuid);
 
     //@formatter:off
     assertThat(encoded).containsSubsequence(
       "<Patient xmlns=\"http://hl7.org/fhir\">", 
         "<contained>", 
           "<Condition xmlns=\"http://hl7.org/fhir\">", 
-            "<id value=\"1\"/>", 
+            "<id value=\"" + conditionUuid + "\"/>",
             "<bodySite>", 
               "<text value=\"BODY SITE\"/>", 
             "</bodySite>", 
@@ -983,7 +989,7 @@ public void testEncodeExtensionWithContainedResource() {
         "</contained>", 
         "<extension url=\"testCondition\">", 
           "<valueReference>", 
-            "<reference value=\"#1\"/>", 
+            "<reference value=\"#" + conditionUuid + "\"/>",
           "</valueReference>", 
         "</extension>", 
         "<birthDate value=\"2016-04-14\"/>", 
diff --git a/hapi-fhir-structures-r4/src/test/java/ca/uhn/fhir/parser/JsonParserR4Test.java b/hapi-fhir-structures-r4/src/test/java/ca/uhn/fhir/parser/JsonParserR4Test.java
index 251004846491..b80251d29108 100644
--- a/hapi-fhir-structures-r4/src/test/java/ca/uhn/fhir/parser/JsonParserR4Test.java
+++ b/hapi-fhir-structures-r4/src/test/java/ca/uhn/fhir/parser/JsonParserR4Test.java
@@ -7,6 +7,7 @@
 import ca.uhn.fhir.model.api.annotation.DatatypeDef;
 import ca.uhn.fhir.rest.api.Constants;
 import ca.uhn.fhir.test.BaseTest;
+import ca.uhn.fhir.util.BundleBuilder;
 import ca.uhn.fhir.util.StopWatch;
 import ca.uhn.fhir.util.TestUtil;
 import com.google.common.collect.Sets;
@@ -23,10 +24,12 @@
 import org.hl7.fhir.r4.model.DateTimeType;
 import org.hl7.fhir.r4.model.DecimalType;
 import org.hl7.fhir.r4.model.Device;
+import org.hl7.fhir.r4.model.DiagnosticReport;
 import org.hl7.fhir.r4.model.DocumentReference;
 import org.hl7.fhir.r4.model.Encounter;
 import org.hl7.fhir.r4.model.Extension;
 import org.hl7.fhir.r4.model.HumanName;
+import org.hl7.fhir.r4.model.IdType;
 import org.hl7.fhir.r4.model.Identifier;
 import org.hl7.fhir.r4.model.Medication;
 import org.hl7.fhir.r4.model.MedicationDispense;
@@ -43,6 +46,7 @@
 import org.hl7.fhir.r4.model.Quantity;
 import org.hl7.fhir.r4.model.QuestionnaireResponse;
 import org.hl7.fhir.r4.model.Reference;
+import org.hl7.fhir.r4.model.Specimen;
 import org.hl7.fhir.r4.model.StringType;
 import org.hl7.fhir.r4.model.Type;
 import org.hl7.fhir.r4.model.codesystems.DataAbsentReason;
@@ -55,7 +59,10 @@
 import org.slf4j.LoggerFactory;
 
 import jakarta.annotation.Nonnull;
+import org.testcontainers.shaded.com.trilead.ssh2.packets.PacketDisconnect;
+
 import java.io.IOException;
+import java.sql.Ref;
 import java.util.ArrayList;
 import java.util.Date;
 import java.util.HashSet;
@@ -261,6 +268,36 @@ public void testDuplicateContainedResourcesNotOutputtedTwice() {
 
 		idx = encoded.indexOf("\"Medication\"", idx + 1);
 		assertEquals(-1, idx);
+	}
+
+	@Test
+	public void testDuplicateContainedResourcesAcrossABundleAreReplicated() {
+		Bundle b = new Bundle();
+		Specimen specimen = new Specimen();
+		Practitioner practitioner = new Practitioner();
+		DiagnosticReport report = new DiagnosticReport();
+		report.addSpecimen(new Reference(specimen));
+		b.addEntry().setResource(report).getRequest().setMethod(Bundle.HTTPVerb.POST).setUrl("/DiagnosticReport");
+
+		Observation obs = new Observation();
+		obs.addPerformer(new Reference(practitioner));
+		obs.setSpecimen(new Reference(specimen));
+
+		b.addEntry().setResource(obs).getRequest().setMethod(Bundle.HTTPVerb.POST).setUrl("/Observation");
+
+		String encoded = ourCtx.newJsonParser().setPrettyPrint(false).encodeResourceToString(b);
+		//Then: Diag should contain one local contained specimen
+		assertThat(encoded).contains("[{\"resource\":{\"resourceType\":\"DiagnosticReport\",\"contained\":[{\"resourceType\":\"Specimen\",\"id\":\""+ specimen.getId().replaceFirst("#", "") +"\"}]");
+		//Then: Obs should contain one local contained specimen, and one local contained pract
+		assertThat(encoded).contains("\"resource\":{\"resourceType\":\"Observation\",\"contained\":[{\"resourceType\":\"Specimen\",\"id\":\""+ specimen.getId().replaceFirst("#", "") +"\"},{\"resourceType\":\"Practitioner\",\"id\":\"" + practitioner.getId().replaceAll("#","") + "\"}]");
+		assertThat(encoded).contains("\"performer\":[{\"reference\":\""+practitioner.getId()+"\"}],\"specimen\":{\"reference\":\""+specimen.getId()+"\"}");
+
+		//Also, reverting the operation should work too!
+		Bundle bundle = ourCtx.newJsonParser().parseResource(Bundle.class, encoded);
+		IBaseResource resource1 = ((DiagnosticReport) bundle.getEntry().get(0).getResource()).getSpecimenFirstRep().getResource();
+		IBaseResource resource = ((Observation) bundle.getEntry().get(1).getResource()).getSpecimen().getResource();
+		assertThat(resource1.getIdElement().getIdPart()).isEqualTo(resource.getIdElement().getIdPart());
+		assertThat(resource1).isNotSameAs(resource);
 
 	}
 
@@ -279,8 +316,9 @@ public void testContainedResourcesNotAutoContainedWhenConfiguredNotToDoSo() {
 
 		ourCtx.getParserOptions().setAutoContainReferenceTargetsWithNoId(true);
 		encoded = ourCtx.newJsonParser().setPrettyPrint(false).encodeResourceToString(md);
-		assertEquals("{\"resourceType\":\"MedicationDispense\",\"contained\":[{\"resourceType\":\"Medication\",\"id\":\"1\",\"code\":{\"text\":\"MED\"}}],\"identifier\":[{\"value\":\"DISPENSE\"}],\"medicationReference\":{\"reference\":\"#1\"}}", encoded);
-
+		String guidWithHash = med.getId();
+		String withoutHash = guidWithHash.replace("#", "");
+		assertThat(encoded).contains("{\"resourceType\":\"MedicationDispense\",\"contained\":[{\"resourceType\":\"Medication\",\"id\":\"" + withoutHash + "\",\"code\":{\"text\":\"MED\"}}],\"identifier\":[{\"value\":\"DISPENSE\"}],\"medicationReference\":{\"reference\":\"" + guidWithHash +"\"}}"); //Note we dont check exact ID since its a GUID
 	}
 
 	@Test
@@ -571,7 +609,7 @@ public void testEncodeResourceWithMixedManualAndAutomaticContainedResourcesLocal
 
 		obs = ourCtx.newJsonParser().parseResource(Observation.class, encoded);
 		assertEquals("#1", obs.getContained().get(0).getId());
-		assertEquals("#2", obs.getContained().get(1).getId());
+		assertEquals(enc.getId(), obs.getContained().get(1).getId());
 
 		pt = (Patient) obs.getSubject().getResource();
 		assertEquals("FAM", pt.getNameFirstRep().getFamily());
@@ -600,7 +638,7 @@ public void testEncodeResourceWithMixedManualAndAutomaticContainedResourcesLocal
 
 		obs = ourCtx.newJsonParser().parseResource(Observation.class, encoded);
 		assertEquals("#1", obs.getContained().get(0).getId());
-		assertEquals("#2", obs.getContained().get(1).getId());
+		assertEquals(pt.getId(), obs.getContained().get(1).getId());
 
 		pt = (Patient) obs.getSubject().getResource();
 		assertEquals("FAM", pt.getNameFirstRep().getFamily());
@@ -620,13 +658,14 @@ public void testEncodeResourceWithMixedManualAndAutomaticContainedResourcesLocal
 		ourLog.info(encoded);
 		mr = ourCtx.newJsonParser().parseResource(MedicationRequest.class, encoded);
 
-		mr.setMedication(new Reference(new Medication().setStatus(Medication.MedicationStatus.ACTIVE)));
+		Medication med = new Medication().setStatus(Medication.MedicationStatus.ACTIVE);
+		mr.setMedication(new Reference(med));
 		encoded = ourCtx.newJsonParser().setPrettyPrint(true).encodeResourceToString(mr);
 		ourLog.info(encoded);
 		mr = ourCtx.newJsonParser().parseResource(MedicationRequest.class, encoded);
 
-		assertEquals("#1", mr.getContained().get(0).getId());
-		assertEquals("#2", mr.getContained().get(1).getId());
+		assertEquals(pract.getId(), mr.getContained().get(0).getId());
+		assertEquals(med.getId(), mr.getContained().get(1).getId());
 
 	}
 
diff --git a/hapi-fhir-structures-r4/src/test/java/ca/uhn/fhir/util/FhirTerserR4Test.java b/hapi-fhir-structures-r4/src/test/java/ca/uhn/fhir/util/FhirTerserR4Test.java
index 87a33805db63..0f2e122fd6f9 100644
--- a/hapi-fhir-structures-r4/src/test/java/ca/uhn/fhir/util/FhirTerserR4Test.java
+++ b/hapi-fhir-structures-r4/src/test/java/ca/uhn/fhir/util/FhirTerserR4Test.java
@@ -6,7 +6,10 @@
 import ca.uhn.fhir.i18n.Msg;
 import ca.uhn.fhir.model.api.annotation.Block;
 import ca.uhn.fhir.parser.DataFormatException;
+import ca.uhn.fhir.parser.IParser;
+import ca.uhn.fhir.parser.JsonParser;
 import com.google.common.collect.Lists;
+import org.apache.jena.base.Sys;
 import org.hl7.fhir.instance.model.api.IBase;
 import org.hl7.fhir.instance.model.api.IBaseExtension;
 import org.hl7.fhir.instance.model.api.IBaseReference;
@@ -47,6 +50,8 @@
 import org.mockito.ArgumentCaptor;
 import org.slf4j.Logger;
 import org.slf4j.LoggerFactory;
+import org.testcontainers.shaded.com.fasterxml.jackson.core.JsonProcessingException;
+import org.testcontainers.shaded.com.fasterxml.jackson.databind.ObjectMapper;
 
 import java.lang.reflect.ParameterizedType;
 import java.lang.reflect.Type;
@@ -62,6 +67,7 @@
 import java.util.concurrent.atomic.AtomicBoolean;
 import java.util.stream.Collectors;
 
+import static ca.uhn.fhir.test.utilities.UuidUtils.HASH_UUID_PATTERN;
 import static org.assertj.core.api.Assertions.assertThat;
 import static org.junit.jupiter.api.Assertions.assertEquals;
 import static org.junit.jupiter.api.Assertions.assertFalse;
@@ -188,12 +194,12 @@ public void testContainResourcesWithModify() {
 
 		FhirTerser.ContainedResources contained = myCtx.newTerser().containResources(mr, FhirTerser.OptionsEnum.MODIFY_RESOURCE, FhirTerser.OptionsEnum.STORE_AND_REUSE_RESULTS);
 
-		assertEquals("#1", mr.getContained().get(0).getId());
-		assertEquals("#2", mr.getContained().get(1).getId());
+		assertThat(mr.getContained().get(0).getId()).containsPattern(HASH_UUID_PATTERN);
+		assertThat(mr.getContained().get(1).getId()).containsPattern(HASH_UUID_PATTERN);
 		assertEquals(ResourceType.Medication, mr.getContained().get(0).getResourceType());
 		assertEquals(ResourceType.Practitioner, mr.getContained().get(1).getResourceType());
-		assertEquals("#1", mr.getMedicationReference().getReference());
-		assertEquals("#2", mr.getRequester().getReference());
+		assertEquals(mr.getContained().get(0).getId(), mr.getMedicationReference().getReference());
+		assertEquals(mr.getContained().get(1).getId(), mr.getRequester().getReference());
 
 		FhirTerser.ContainedResources secondPass = myCtx.newTerser().containResources(mr, FhirTerser.OptionsEnum.MODIFY_RESOURCE, FhirTerser.OptionsEnum.STORE_AND_REUSE_RESULTS);
 		assertThat(secondPass).isSameAs(contained);
@@ -212,12 +218,12 @@ public void testContainedResourcesWithModify_DoubleLink() {
 
 		myCtx.newTerser().containResources(medAdmin, FhirTerser.OptionsEnum.MODIFY_RESOURCE, FhirTerser.OptionsEnum.STORE_AND_REUSE_RESULTS);
 
-		assertEquals("#1", medAdmin.getContained().get(0).getId());
-		assertEquals("#2", medAdmin.getContained().get(1).getId());
+		assertThat(medAdmin.getContained().get(0).getId()).containsPattern(HASH_UUID_PATTERN);
+		assertThat(medAdmin.getContained().get(1).getId()).containsPattern(HASH_UUID_PATTERN);
 		assertEquals(ResourceType.Medication, medAdmin.getContained().get(0).getResourceType());
 		assertEquals(ResourceType.Substance, medAdmin.getContained().get(1).getResourceType());
-		assertEquals("#1", medAdmin.getMedicationReference().getReference());
-		assertEquals("#2", ((Medication) (medAdmin.getContained().get(0))).getIngredientFirstRep().getItemReference().getReference());
+		assertEquals(medAdmin.getContained().get(0).getId(), medAdmin.getMedicationReference().getReference());
+		assertEquals(medAdmin.getContained().get(1).getId(), ((Medication) (medAdmin.getContained().get(0))).getIngredientFirstRep().getItemReference().getReference());
 
 	}
 
@@ -1545,23 +1551,29 @@ private List<String> toStrings(List<StringType> theStrings) {
 
 	@Test
 	void copyingAndParsingCreatesDuplicateContainedResources() {
-		var input = new Library();
+		var library = new Library();
 		var params = new Parameters();
 		var id = "#expansion-parameters-ecr";
 		params.setId(id);
 		params.addParameter("system-version", new StringType("test2"));
 		var paramsExt = new Extension();
+
 		paramsExt.setUrl("test").setValue(new Reference(id));
-		input.addContained(params);
-		input.addExtension(paramsExt);
+		library.addContained(params);
+		library.addExtension(paramsExt);
+
 		final var parser = FhirContext.forR4Cached().newJsonParser();
-		var stringified = parser.encodeResourceToString(input);
+		var stringified = parser.encodeResourceToString(library);
+
+
 		var parsed = parser.parseResource(stringified);
 		var copy = ((Library) parsed).copy();
+
 		assertEquals(1, copy.getContained().size());
-		var stringifiedCopy = parser.encodeResourceToString(copy);
-		var parsedCopy = parser.parseResource(stringifiedCopy);
-		assertEquals(1, ((Library) parsedCopy).getContained().size());
+
+		String stringifiedCopy = FhirContext.forR4Cached().newJsonParser().encodeResourceToString(copy);
+		Library parsedCopy = (Library) parser.parseResource(stringifiedCopy);
+		assertEquals(1, parsedCopy.getContained().size());
 	}
 
 	/**
diff --git a/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/UuidUtils.java b/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/UuidUtils.java
new file mode 100644
index 000000000000..7cd9e85f2138
--- /dev/null
+++ b/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/UuidUtils.java
@@ -0,0 +1,47 @@
+/*-
+ * #%L
+ * HAPI FHIR Test Utilities
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.test.utilities;
+
+import java.util.regex.Matcher;
+import java.util.regex.Pattern;
+
+public class UuidUtils {
+
+	private UuidUtils() {
+	}
+
+	public static final String UUID_PATTERN = "[0-9a-fA-F]{8}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{4}-[0-9a-fA-F]{12}";
+	public static final String HASH_UUID_PATTERN = "#" + UUID_PATTERN;
+	private static final Pattern COMPILED_UUID_PATTERN = Pattern.compile(UUID_PATTERN);
+
+	/**
+	 * Extracts first UUID from String.
+	 * Returns null if no UUID present in the String.
+	 */
+	public static String findFirstUUID(String input) {
+		Matcher matcher = COMPILED_UUID_PATTERN.matcher(input);
+
+		if (matcher.find()) {
+			return matcher.group();
+		}
+		return null;
+	}
+
+}
diff --git a/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProviders.java b/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProviders.java
new file mode 100644
index 000000000000..d9933708e477
--- /dev/null
+++ b/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProviders.java
@@ -0,0 +1,123 @@
+/*-
+ * #%L
+ * HAPI FHIR Test Utilities
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.test.utilities.validation;
+
+import ca.uhn.fhir.context.FhirContext;
+import ca.uhn.fhir.context.support.IValidationSupport;
+import ca.uhn.fhir.rest.annotation.RequiredParam;
+import ca.uhn.fhir.rest.annotation.Search;
+import ca.uhn.fhir.rest.param.UriParam;
+import ca.uhn.fhir.rest.server.IResourceProvider;
+import ca.uhn.fhir.util.ClasspathUtil;
+import org.hl7.fhir.instance.model.api.IBaseParameters;
+import org.hl7.fhir.instance.model.api.IDomainResource;
+
+import java.util.HashMap;
+import java.util.List;
+import java.util.Map;
+
+public interface IValidationProviders {
+	String CODE_SYSTEM = "http://code.system/url";
+	String CODE_SYSTEM_VERSION = "1.0.0";
+	String CODE_SYSTEM_NAME = "Test Code System";
+	String CODE = "CODE";
+	String VALUE_SET_URL = "http://value.set/url";
+	String DISPLAY = "Explanation for code TestCode.";
+	String LANGUAGE = "en";
+	String ERROR_MESSAGE = "This is an error message";
+
+	interface IMyValidationProvider extends IResourceProvider {
+		void addException(String theOperation, String theUrl, String theCode, Exception theException);
+		<P extends IBaseParameters> void addTerminologyResponse(String theOperation, String theUrl, String theCode, P theReturnParams);
+		IBaseParameters addTerminologyResponse(String theOperation, String theUrl, String theCode, FhirContext theFhirContext, String theTerminologyResponseFile);
+	}
+
+	abstract class MyValidationProvider<T extends IDomainResource> implements IMyValidationProvider {
+		private final Map<String, Exception> myExceptionMap = new HashMap<>();
+		private boolean myShouldThrowExceptionForResourceNotFound = true;
+		private final Map<String, IBaseParameters> myTerminologyResponseMap = new HashMap<>();
+		private final Map<String, T> myTerminologyResourceMap = new HashMap<>();
+
+		static String getInputKey(String theOperation, String theUrl, String theCode) {
+			return theOperation + "-" + theUrl + "#" + theCode;
+		}
+
+		public void setShouldThrowExceptionForResourceNotFound(boolean theShouldThrowExceptionForResourceNotFound) {
+			myShouldThrowExceptionForResourceNotFound = theShouldThrowExceptionForResourceNotFound;
+		}
+
+		public void addException(String theOperation, String theUrl, String theCode, Exception theException) {
+			String inputKey = getInputKey(theOperation, theUrl, theCode);
+			myExceptionMap.put(inputKey, theException);
+		}
+
+		abstract Class<? extends IBaseParameters> getParameterType();
+
+		@Override
+		public <P extends IBaseParameters> void addTerminologyResponse(String theOperation, String theUrl, String theCode, P theReturnParams) {
+			myTerminologyResponseMap.put(getInputKey(theOperation, theUrl, theCode), theReturnParams);
+		}
+
+		public IBaseParameters addTerminologyResponse(String theOperation, String theUrl, String theCode, FhirContext theFhirContext, String theTerminologyResponseFile) {
+			IBaseParameters responseParams = ClasspathUtil.loadResource(theFhirContext, getParameterType(), theTerminologyResponseFile);
+			addTerminologyResponse(theOperation, theUrl, theCode, responseParams);
+			return responseParams;
+		}
+
+		protected void addTerminologyResource(String theUrl, T theResource) {
+			myTerminologyResourceMap.put(theUrl, theResource);
+		}
+
+		public abstract T addTerminologyResource(String theUrl);
+
+		protected IBaseParameters getTerminologyResponse(String theOperation, String theUrl, String theCode) throws Exception {
+			String inputKey = getInputKey(theOperation, theUrl, theCode);
+			if (myExceptionMap.containsKey(inputKey)) {
+				throw myExceptionMap.get(inputKey);
+			}
+			IBaseParameters params = myTerminologyResponseMap.get(inputKey);
+			if (params == null) {
+				throw new IllegalStateException("Test setup incomplete. Missing return params for " + inputKey);
+			}
+			return params;
+		}
+
+		protected T getTerminologyResource(UriParam theUrlParam) {
+			if (theUrlParam.isEmpty()) {
+				throw new IllegalStateException("CodeSystem url should not be null.");
+			}
+			String urlValue = theUrlParam.getValue();
+			if (!myTerminologyResourceMap.containsKey(urlValue) && myShouldThrowExceptionForResourceNotFound) {
+				throw new IllegalStateException("Test setup incomplete. CodeSystem not found " + urlValue);
+			}
+			return myTerminologyResourceMap.get(urlValue);
+		}
+
+		@Search
+		public List<T> find(@RequiredParam(name = "url") UriParam theUrlParam) {
+			T resource = getTerminologyResource(theUrlParam);
+			return resource != null ? List.of(resource) : List.of();
+		}
+	}
+
+	interface IMyLookupCodeProvider extends IResourceProvider {
+		void setLookupCodeResult(IValidationSupport.LookupCodeResult theLookupCodeResult);
+	}
+}
diff --git a/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProvidersDstu3.java b/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProvidersDstu3.java
new file mode 100644
index 000000000000..11c5244df414
--- /dev/null
+++ b/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProvidersDstu3.java
@@ -0,0 +1,137 @@
+/*-
+ * #%L
+ * HAPI FHIR Test Utilities
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.test.utilities.validation;
+
+import ca.uhn.fhir.rest.annotation.IdParam;
+import ca.uhn.fhir.rest.annotation.Operation;
+import ca.uhn.fhir.rest.annotation.OperationParam;
+import ca.uhn.fhir.rest.api.server.RequestDetails;
+import jakarta.servlet.http.HttpServletRequest;
+import org.hl7.fhir.dstu3.model.BooleanType;
+import org.hl7.fhir.dstu3.model.CodeSystem;
+import org.hl7.fhir.dstu3.model.CodeType;
+import org.hl7.fhir.dstu3.model.Coding;
+import org.hl7.fhir.dstu3.model.IdType;
+import org.hl7.fhir.dstu3.model.Parameters;
+import org.hl7.fhir.dstu3.model.StringType;
+import org.hl7.fhir.dstu3.model.UriType;
+import org.hl7.fhir.dstu3.model.ValueSet;
+import org.hl7.fhir.instance.model.api.IBaseParameters;
+import org.hl7.fhir.instance.model.api.IBaseResource;
+
+import java.util.List;
+
+public interface IValidationProvidersDstu3 {
+	@SuppressWarnings("unused")
+	class MyCodeSystemProviderDstu3 extends IValidationProviders.MyValidationProvider<CodeSystem> {
+		@Operation(name = "$validate-code", idempotent = true, returnParameters = {
+				@OperationParam(name = "result", type = BooleanType.class, min = 1),
+				@OperationParam(name = "message", type = StringType.class),
+				@OperationParam(name = "display", type = StringType.class)
+		})
+		public IBaseParameters validateCode(
+				HttpServletRequest theServletRequest,
+				@IdParam(optional = true) IdType theId,
+				@OperationParam(name = "url", min = 0, max = 1) UriType theCodeSystemUrl,
+				@OperationParam(name = "code", min = 0, max = 1) CodeType theCode,
+				@OperationParam(name = "display", min = 0, max = 1) StringType theDisplay
+		) throws Exception {
+			String url = theCodeSystemUrl != null ? theCodeSystemUrl.getValue() : null;
+			String code = theCode != null ? theCode.getValue() : null;
+			return getTerminologyResponse("$validate-code", url, code);
+		}
+
+		@Operation(name = "$lookup", idempotent = true, returnParameters= {
+				@OperationParam(name = "name", type = StringType.class, min = 1),
+				@OperationParam(name = "version", type = StringType.class),
+				@OperationParam(name = "display", type = StringType.class, min = 1),
+				@OperationParam(name = "abstract", type = BooleanType.class, min = 1),
+				@OperationParam(name = "property", type = StringType.class, min = 0, max = OperationParam.MAX_UNLIMITED)
+		})
+		public IBaseParameters lookup(
+				HttpServletRequest theServletRequest,
+				@OperationParam(name = "code", max = 1) CodeType theCode,
+				@OperationParam(name = "system",max = 1) UriType theSystem,
+				@OperationParam(name = "coding", max = 1) Coding theCoding,
+				@OperationParam(name = "version", max = 1) StringType theVersion,
+				@OperationParam(name = "displayLanguage", max = 1) CodeType theDisplayLanguage,
+				@OperationParam(name = "property", max = OperationParam.MAX_UNLIMITED) List<CodeType> thePropertyNames,
+				RequestDetails theRequestDetails
+		) throws Exception {
+			String url = theSystem != null ? theSystem.getValue() : null;
+			String code = theCode != null ? theCode.getValue() : null;
+			return getTerminologyResponse("$lookup", url, code);
+		}
+		@Override
+		public Class<? extends IBaseResource> getResourceType() {
+			return CodeSystem.class;
+		}
+		@Override
+		Class<Parameters> getParameterType() {
+			return Parameters.class;
+		}
+		@Override
+		public CodeSystem addTerminologyResource(String theUrl) {
+			CodeSystem codeSystem = new CodeSystem();
+			codeSystem.setId(theUrl.substring(0, theUrl.lastIndexOf("/")));
+			codeSystem.setUrl(theUrl);
+			addTerminologyResource(theUrl, codeSystem);
+			return codeSystem;
+		}
+	}
+
+	@SuppressWarnings("unused")
+	class MyValueSetProviderDstu3 extends IValidationProviders.MyValidationProvider<ValueSet> {
+		@Operation(name = "$validate-code", idempotent = true, returnParameters = {
+				@OperationParam(name = "result", type = BooleanType.class, min = 1),
+				@OperationParam(name = "message", type = StringType.class),
+				@OperationParam(name = "display", type = StringType.class)
+		})
+		public IBaseParameters validateCode(
+				HttpServletRequest theServletRequest,
+				@IdParam(optional = true) IdType theId,
+				@OperationParam(name = "url", min = 0, max = 1) UriType theValueSetUrl,
+				@OperationParam(name = "code", min = 0, max = 1) CodeType theCode,
+				@OperationParam(name = "system", min = 0, max = 1) UriType theSystem,
+				@OperationParam(name = "display", min = 0, max = 1) StringType theDisplay,
+				@OperationParam(name = "valueSet") ValueSet theValueSet
+		) throws Exception {
+			String url = theValueSetUrl != null ? theValueSetUrl.getValue() : null;
+			String code = theCode != null ? theCode.getValue() : null;
+			return getTerminologyResponse("$validate-code", url, code);
+		}
+		@Override
+		public Class<? extends IBaseResource> getResourceType() {
+			return ValueSet.class;
+		}
+		@Override
+		Class<Parameters> getParameterType() {
+			return Parameters.class;
+		}
+		@Override
+		public ValueSet addTerminologyResource(String theUrl) {
+			ValueSet valueSet = new ValueSet();
+			valueSet.setId(theUrl.substring(0, theUrl.lastIndexOf("/")));
+			valueSet.setUrl(theUrl);
+			addTerminologyResource(theUrl, valueSet);
+			return valueSet;
+		}
+	}
+}
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/IValidateCodeProvidersR4.java b/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProvidersR4.java
similarity index 55%
rename from hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/IValidateCodeProvidersR4.java
rename to hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProvidersR4.java
index fd03a8163ffa..87a3dacb1fc2 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/IValidateCodeProvidersR4.java
+++ b/hapi-fhir-test-utilities/src/main/java/ca/uhn/fhir/test/utilities/validation/IValidationProvidersR4.java
@@ -1,12 +1,29 @@
-package org.hl7.fhir.r4.validation;
+/*-
+ * #%L
+ * HAPI FHIR Test Utilities
+ * %%
+ * Copyright (C) 2014 - 2024 Smile CDR, Inc.
+ * %%
+ * Licensed under the Apache License, Version 2.0 (the "License");
+ * you may not use this file except in compliance with the License.
+ * You may obtain a copy of the License at
+ *
+ *      http://www.apache.org/licenses/LICENSE-2.0
+ *
+ * Unless required by applicable law or agreed to in writing, software
+ * distributed under the License is distributed on an "AS IS" BASIS,
+ * WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, either express or implied.
+ * See the License for the specific language governing permissions and
+ * limitations under the License.
+ * #L%
+ */
+package ca.uhn.fhir.test.utilities.validation;
 
-import ca.uhn.fhir.jpa.model.util.JpaConstants;
 import ca.uhn.fhir.rest.annotation.IdParam;
 import ca.uhn.fhir.rest.annotation.Operation;
 import ca.uhn.fhir.rest.annotation.OperationParam;
 import ca.uhn.fhir.rest.api.server.RequestDetails;
 import jakarta.servlet.http.HttpServletRequest;
-import org.hl7.fhir.common.hapi.validation.IValidationProviders;
 import org.hl7.fhir.instance.model.api.IBaseParameters;
 import org.hl7.fhir.instance.model.api.IBaseResource;
 import org.hl7.fhir.r4.model.BooleanType;
@@ -21,38 +38,29 @@
 
 import java.util.List;
 
-public interface IValidateCodeProvidersR4 {
+public interface IValidationProvidersR4 {
 
 	@SuppressWarnings("unused")
-	class MyCodeSystemProviderR4 implements IValidationProviders.IMyCodeSystemProvider {
-		private UriType mySystemUrl;
-		private CodeType myCode;
-		private StringType myDisplay;
-		private Exception myException;
-		private Parameters myReturnParams;
+	class MyCodeSystemProviderR4 extends IValidationProviders.MyValidationProvider<CodeSystem> {
 
-		@Operation(name = "validate-code", idempotent = true, returnParameters = {
+		@Operation(name = "$validate-code", idempotent = true, returnParameters = {
 				@OperationParam(name = "result", type = BooleanType.class, min = 1),
 				@OperationParam(name = "message", type = StringType.class),
 				@OperationParam(name = "display", type = StringType.class)
 		})
-		public Parameters validateCode(
+		public IBaseParameters validateCode(
 				HttpServletRequest theServletRequest,
 				@IdParam(optional = true) IdType theId,
 				@OperationParam(name = "url", min = 0, max = 1) UriType theCodeSystemUrl,
 				@OperationParam(name = "code", min = 0, max = 1) CodeType theCode,
 				@OperationParam(name = "display", min = 0, max = 1) StringType theDisplay
 		) throws Exception {
-			mySystemUrl = theCodeSystemUrl;
-			myCode = theCode;
-			myDisplay = theDisplay;
-			if (myException != null) {
-				throw myException;
-			}
-			return myReturnParams;
+			String url = theCodeSystemUrl != null ? theCodeSystemUrl.getValue() : null;
+			String code = theCode != null ? theCode.getValue() : null;
+			return getTerminologyResponse("$validate-code", url, code);
 		}
 
-		@Operation(name = JpaConstants.OPERATION_LOOKUP, idempotent = true, returnParameters= {
+		@Operation(name = "$lookup", idempotent = true, returnParameters= {
 				@OperationParam(name = "name", type = StringType.class, min = 1),
 				@OperationParam(name = "version", type = StringType.class),
 				@OperationParam(name = "display", type = StringType.class, min = 1),
@@ -69,54 +77,39 @@ public IBaseParameters lookup(
 				@OperationParam(name = "property", max = OperationParam.MAX_UNLIMITED) List<CodeType> thePropertyNames,
 				RequestDetails theRequestDetails
 		) throws Exception {
-			mySystemUrl = theSystem;
-			myCode = theCode;
-			if (myException != null) {
-				throw myException;
-			}
-			return myReturnParams;
+			String url = theSystem != null ? theSystem.getValue() : null;
+			String code = theCode != null ? theCode.getValue() : null;
+			return getTerminologyResponse("$lookup", url, code);
 		}
-
 		@Override
 		public Class<? extends IBaseResource> getResourceType() {
 			return CodeSystem.class;
 		}
 
-		public void setException(Exception theException) {
-			myException = theException;
-		}
-		@Override
-		public void setReturnParams(IBaseParameters theParameters) {
-			myReturnParams = (Parameters) theParameters;
-		}
 		@Override
-		public String getCode() {
-			return myCode != null ? myCode.getValueAsString() : null;
+		Class<Parameters> getParameterType() {
+			return Parameters.class;
 		}
+
 		@Override
-		public String getSystem() {
-			return mySystemUrl != null ? mySystemUrl.getValueAsString() : null;
-		}
-		public String getDisplay() {
-			return myDisplay != null ? myDisplay.getValue() : null;
+		public CodeSystem addTerminologyResource(String theUrl) {
+			CodeSystem codeSystem = new CodeSystem();
+			codeSystem.setId(theUrl.substring(0, theUrl.lastIndexOf("/")));
+			codeSystem.setUrl(theUrl);
+			addTerminologyResource(theUrl, codeSystem);
+			return codeSystem;
 		}
 	}
 
 	@SuppressWarnings("unused")
-	class MyValueSetProviderR4 implements IValidationProviders.IMyValueSetProvider {
-		private Exception myException;
-		private Parameters myReturnParams;
-		private UriType mySystemUrl;
-		private UriType myValueSetUrl;
-		private CodeType myCode;
-		private StringType myDisplay;
+	class MyValueSetProviderR4 extends IValidationProviders.MyValidationProvider<ValueSet> {
 
-		@Operation(name = "validate-code", idempotent = true, returnParameters = {
+		@Operation(name = "$validate-code", idempotent = true, returnParameters = {
 				@OperationParam(name = "result", type = BooleanType.class, min = 1),
 				@OperationParam(name = "message", type = StringType.class),
 				@OperationParam(name = "display", type = StringType.class)
 		})
-		public Parameters validateCode(
+		public IBaseParameters validateCode(
 				HttpServletRequest theServletRequest,
 				@IdParam(optional = true) IdType theId,
 				@OperationParam(name = "url", min = 0, max = 1) UriType theValueSetUrl,
@@ -125,41 +118,25 @@ public Parameters validateCode(
 				@OperationParam(name = "display", min = 0, max = 1) StringType theDisplay,
 				@OperationParam(name = "valueSet") ValueSet theValueSet
 		) throws Exception {
-			mySystemUrl = theSystem;
-			myValueSetUrl = theValueSetUrl;
-			myCode = theCode;
-			myDisplay = theDisplay;
-			if (myException != null) {
-				throw myException;
-			}
-			return myReturnParams;
+			String url = theValueSetUrl != null ? theValueSetUrl.getValue() : null;
+			String code = theCode != null ? theCode.getValue() : null;
+			return getTerminologyResponse("$validate-code", url, code);
 		}
-
 		@Override
 		public Class<? extends IBaseResource> getResourceType() {
 			return ValueSet.class;
 		}
-		public void setException(Exception theException) {
-			myException = theException;
-		}
-		@Override
-		public void setReturnParams(IBaseParameters theParameters) {
-			myReturnParams = (Parameters) theParameters;
-		}
 		@Override
-		public String getCode() {
-			return myCode != null ? myCode.getValueAsString() : null;
+		Class<Parameters> getParameterType() {
+			return Parameters.class;
 		}
 		@Override
-		public String getSystem() {
-			return mySystemUrl != null ? mySystemUrl.getValueAsString() : null;
-		}
-		@Override
-		public String getValueSet() {
-			return myValueSetUrl != null ? myValueSetUrl.getValueAsString() : null;
-		}
-		public String getDisplay() {
-			return myDisplay != null ? myDisplay.getValue() : null;
+		public ValueSet addTerminologyResource(String theUrl) {
+			ValueSet valueSet = new ValueSet();
+			valueSet.setId(theUrl.substring(0, theUrl.lastIndexOf("/")));
+			valueSet.setUrl(theUrl);
+			addTerminologyResource(theUrl, valueSet);
+			return valueSet;
 		}
 	}
 }
diff --git a/hapi-fhir-test-utilities/src/test/java/ca/uhn/fhir/test/utilities/UuidUtilsTest.java b/hapi-fhir-test-utilities/src/test/java/ca/uhn/fhir/test/utilities/UuidUtilsTest.java
new file mode 100644
index 000000000000..c7c26bdf1077
--- /dev/null
+++ b/hapi-fhir-test-utilities/src/test/java/ca/uhn/fhir/test/utilities/UuidUtilsTest.java
@@ -0,0 +1,29 @@
+package ca.uhn.fhir.test.utilities;
+
+import org.junit.jupiter.api.Test;
+
+import static org.junit.jupiter.api.Assertions.assertEquals;
+import static org.junit.jupiter.api.Assertions.assertNull;
+
+public class UuidUtilsTest {
+
+	@Test
+	void testFindsUuid() {
+		String xml = "<id value=#cdb6dfa1-74b7-4ea9-88e0-d3afaef8c016/>";
+		String uuid = UuidUtils.findFirstUUID(xml);
+		assertEquals("cdb6dfa1-74b7-4ea9-88e0-d3afaef8c016", uuid);
+	}
+
+	@Test
+	void testFindsFirstUuid() {
+		String xml = "<id value=#cdb6dfa1-74b7-4ea9-88e0-d3afaef8c016/><id value=#da8a08e3-ddf5-4a62-baae-3e8c3ea04687/>";
+		String uuid = UuidUtils.findFirstUUID(xml);
+		assertEquals("cdb6dfa1-74b7-4ea9-88e0-d3afaef8c016", uuid);
+	}
+
+	@Test
+	void testNoUuidReturnsNull() {
+		String xml = "<id value=x />";
+		assertNull(UuidUtils.findFirstUUID(xml));
+	}
+}
diff --git a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/CommonCodeSystemsTerminologyService.java b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/CommonCodeSystemsTerminologyService.java
index 1b12e20ec62e..7a05e197ae63 100644
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/CommonCodeSystemsTerminologyService.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/CommonCodeSystemsTerminologyService.java
@@ -190,7 +190,7 @@ protected CodeValidationResult getValidateCodeResultError(final String theMessag
 		return new CodeValidationResult()
 				.setSeverity(IssueSeverity.ERROR)
 				.setMessage(theMessage)
-				.setCodeValidationIssues(Collections.singletonList(new CodeValidationIssue(
+				.setIssues(Collections.singletonList(new CodeValidationIssue(
 						theMessage,
 						IssueSeverity.ERROR,
 						CodeValidationIssueCode.INVALID,
diff --git a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/InMemoryTerminologyServerValidationSupport.java b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/InMemoryTerminologyServerValidationSupport.java
index 67e553e3d3b7..a617e04c41b7 100644
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/InMemoryTerminologyServerValidationSupport.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/InMemoryTerminologyServerValidationSupport.java
@@ -28,7 +28,6 @@
 import org.hl7.fhir.r5.model.CanonicalType;
 import org.hl7.fhir.r5.model.CodeSystem;
 import org.hl7.fhir.r5.model.Enumerations;
-import org.hl7.fhir.utilities.validation.ValidationMessage;
 
 import java.util.ArrayList;
 import java.util.Collections;
@@ -258,7 +257,7 @@ public CodeValidationResult validateCodeInValueSet(
 					theValidationSupportContext, theValueSet, theCodeSystemUrlAndVersion, theCode);
 		} catch (ExpansionCouldNotBeCompletedInternallyException e) {
 			CodeValidationResult codeValidationResult = new CodeValidationResult();
-			codeValidationResult.setSeverityCode("error");
+			codeValidationResult.setSeverity(IssueSeverity.ERROR);
 
 			String msg = "Failed to expand ValueSet '" + vsUrl + "' (in-memory). Could not validate code "
 					+ theCodeSystemUrlAndVersion + "#" + theCode;
@@ -267,7 +266,7 @@ public CodeValidationResult validateCodeInValueSet(
 			}
 
 			codeValidationResult.setMessage(msg);
-			codeValidationResult.addCodeValidationIssue(e.getCodeValidationIssue());
+			codeValidationResult.addIssue(e.getCodeValidationIssue());
 			return codeValidationResult;
 		}
 
@@ -551,18 +550,18 @@ private CodeValidationResult validateCodeInExpandedValueSet(
 		if (valueSetResult != null) {
 			codeValidationResult = valueSetResult;
 		} else {
-			ValidationMessage.IssueSeverity severity;
+			IValidationSupport.IssueSeverity severity;
 			String message;
 			CodeValidationIssueCode issueCode = CodeValidationIssueCode.CODE_INVALID;
 			CodeValidationIssueCoding issueCoding = CodeValidationIssueCoding.INVALID_CODE;
 			if ("fragment".equals(codeSystemResourceContentMode)) {
-				severity = ValidationMessage.IssueSeverity.WARNING;
+				severity = IValidationSupport.IssueSeverity.WARNING;
 				message = "Unknown code in fragment CodeSystem '"
 						+ getFormattedCodeSystemAndCodeForMessage(
 								theCodeSystemUrlAndVersionToValidate, theCodeToValidate)
 						+ "'";
 			} else {
-				severity = ValidationMessage.IssueSeverity.ERROR;
+				severity = IValidationSupport.IssueSeverity.ERROR;
 				message = "Unknown code '"
 						+ getFormattedCodeSystemAndCodeForMessage(
 								theCodeSystemUrlAndVersionToValidate, theCodeToValidate)
@@ -574,10 +573,9 @@ private CodeValidationResult validateCodeInExpandedValueSet(
 			}
 
 			codeValidationResult = new CodeValidationResult()
-					.setSeverityCode(severity.toCode())
+					.setSeverity(severity)
 					.setMessage(message)
-					.addCodeValidationIssue(new CodeValidationIssue(
-							message, getIssueSeverityFromCodeValidationIssue(severity), issueCode, issueCoding));
+					.addIssue(new CodeValidationIssue(message, severity, issueCode, issueCoding));
 		}
 
 		return codeValidationResult;
@@ -589,19 +587,6 @@ private static String getFormattedCodeSystemAndCodeForMessage(
 				+ theCodeToValidate;
 	}
 
-	private IValidationSupport.IssueSeverity getIssueSeverityFromCodeValidationIssue(
-			ValidationMessage.IssueSeverity theSeverity) {
-		switch (theSeverity) {
-			case ERROR:
-				return IValidationSupport.IssueSeverity.ERROR;
-			case WARNING:
-				return IValidationSupport.IssueSeverity.WARNING;
-			case INFORMATION:
-				return IValidationSupport.IssueSeverity.INFORMATION;
-		}
-		return null;
-	}
-
 	private CodeValidationResult findCodeInExpansion(
 			String theCodeToValidate,
 			String theDisplayToValidate,
@@ -1123,8 +1108,8 @@ private boolean expandValueSetR5IncludeOrExclude(
 							new CodeValidationIssue(
 									theMessage,
 									IssueSeverity.ERROR,
-									CodeValidationIssueCode.OTHER,
-									CodeValidationIssueCoding.OTHER));
+									CodeValidationIssueCode.INVALID,
+									CodeValidationIssueCoding.VS_INVALID));
 				}
 				for (org.hl7.fhir.r5.model.ValueSet.ValueSetExpansionContainsComponent next :
 						subExpansion.getExpansion().getContains()) {
@@ -1376,7 +1361,7 @@ private static CodeValidationResult createResultForDisplayMismatch(
 				.setCodeSystemVersion(theCodeSystemVersion)
 				.setDisplay(theExpectedDisplay);
 		if (issueSeverity != null) {
-			codeValidationResult.setCodeValidationIssues(Collections.singletonList(new CodeValidationIssue(
+			codeValidationResult.setIssues(Collections.singletonList(new CodeValidationIssue(
 					message,
 					theIssueSeverityForCodeDisplayMismatch,
 					CodeValidationIssueCode.INVALID,
diff --git a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/RemoteTerminologyServiceValidationSupport.java b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/RemoteTerminologyServiceValidationSupport.java
index 370f8b423dd2..398eacc52a24 100644
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/RemoteTerminologyServiceValidationSupport.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/RemoteTerminologyServiceValidationSupport.java
@@ -28,6 +28,7 @@
 import org.hl7.fhir.r4.model.Base;
 import org.hl7.fhir.r4.model.CodeSystem;
 import org.hl7.fhir.r4.model.CodeType;
+import org.hl7.fhir.r4.model.CodeableConcept;
 import org.hl7.fhir.r4.model.Coding;
 import org.hl7.fhir.r4.model.OperationOutcome;
 import org.hl7.fhir.r4.model.Parameters;
@@ -631,7 +632,7 @@ private CodeValidationResult createErrorCodeValidationResult(
 		return new CodeValidationResult()
 				.setSeverity(severity)
 				.setMessage(theMessage)
-				.addCodeValidationIssue(new CodeValidationIssue(
+				.addIssue(new CodeValidationIssue(
 						theMessage, severity, theIssueCode, CodeValidationIssueCoding.INVALID_CODE));
 	}
 
@@ -680,13 +681,13 @@ private CodeValidationResult createCodeValidationResult(
 			createCodeValidationIssues(
 							(IBaseOperationOutcome) issuesValue.get(),
 							fhirContext.getVersion().getVersion())
-					.ifPresent(i -> i.forEach(result::addCodeValidationIssue));
+					.ifPresent(i -> i.forEach(result::addIssue));
 		} else {
 			// create a validation issue out of the message
 			// this is a workaround to overcome an issue in the FHIR Validator library
 			// where ValueSet bindings are only reading issues but not messages
 			// @see https://github.com/hapifhir/org.hl7.fhir.core/issues/1766
-			result.addCodeValidationIssue(createCodeValidationIssue(result.getMessage()));
+			result.addIssue(createCodeValidationIssue(result.getMessage()));
 		}
 		return result;
 	}
@@ -717,23 +718,42 @@ public static Optional<Collection<CodeValidationIssue>> createCodeValidationIssu
 
 	private static Collection<CodeValidationIssue> createCodeValidationIssuesR4(OperationOutcome theOperationOutcome) {
 		return theOperationOutcome.getIssue().stream()
-				.map(issueComponent ->
-						createCodeValidationIssue(issueComponent.getDetails().getText()))
+				.map(issueComponent -> {
+					String diagnostics = issueComponent.getDiagnostics();
+					IssueSeverity issueSeverity =
+							IssueSeverity.fromCode(issueComponent.getSeverity().toCode());
+					String issueTypeCode = issueComponent.getCode().toCode();
+					CodeableConcept details = issueComponent.getDetails();
+					CodeValidationIssue issue = new CodeValidationIssue(diagnostics, issueSeverity, issueTypeCode);
+					CodeValidationIssueDetails issueDetails = new CodeValidationIssueDetails(details.getText());
+					details.getCoding().forEach(coding -> issueDetails.addCoding(coding.getSystem(), coding.getCode()));
+					issue.setDetails(issueDetails);
+					return issue;
+				})
 				.collect(Collectors.toList());
 	}
 
 	private static Collection<CodeValidationIssue> createCodeValidationIssuesDstu3(
 			org.hl7.fhir.dstu3.model.OperationOutcome theOperationOutcome) {
 		return theOperationOutcome.getIssue().stream()
-				.map(issueComponent ->
-						createCodeValidationIssue(issueComponent.getDetails().getText()))
+				.map(issueComponent -> {
+					String diagnostics = issueComponent.getDiagnostics();
+					IssueSeverity issueSeverity =
+							IssueSeverity.fromCode(issueComponent.getSeverity().toCode());
+					String issueTypeCode = issueComponent.getCode().toCode();
+					org.hl7.fhir.dstu3.model.CodeableConcept details = issueComponent.getDetails();
+					CodeValidationIssue issue = new CodeValidationIssue(diagnostics, issueSeverity, issueTypeCode);
+					CodeValidationIssueDetails issueDetails = new CodeValidationIssueDetails(details.getText());
+					details.getCoding().forEach(coding -> issueDetails.addCoding(coding.getSystem(), coding.getCode()));
+					issue.setDetails(issueDetails);
+					return issue;
+				})
 				.collect(Collectors.toList());
 	}
 
 	private static CodeValidationIssue createCodeValidationIssue(String theMessage) {
 		return new CodeValidationIssue(
 				theMessage,
-				// assume issue type is OperationOutcome.IssueType#CODEINVALID as it is the only match
 				IssueSeverity.ERROR,
 				CodeValidationIssueCode.INVALID,
 				CodeValidationIssueCoding.INVALID_CODE);
diff --git a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/UnknownCodeSystemWarningValidationSupport.java b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/UnknownCodeSystemWarningValidationSupport.java
index 1898292c4512..265debed058b 100644
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/UnknownCodeSystemWarningValidationSupport.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/UnknownCodeSystemWarningValidationSupport.java
@@ -87,7 +87,7 @@ public CodeValidationResult validateCode(
 			result.setSeverity(null);
 			result.setMessage(null);
 		} else {
-			result.addCodeValidationIssue(new CodeValidationIssue(
+			result.addIssue(new CodeValidationIssue(
 					theMessage,
 					myNonExistentCodeSystemSeverity,
 					CodeValidationIssueCode.NOT_FOUND,
diff --git a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/ValidationSupportUtils.java b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/ValidationSupportUtils.java
index 7321f33d8c8e..7093ab2a7ff1 100644
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/ValidationSupportUtils.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/support/ValidationSupportUtils.java
@@ -11,6 +11,17 @@ public final class ValidationSupportUtils {
 
 	private ValidationSupportUtils() {}
 
+	/**
+	 * This method extracts a code system that can be (potentially) associated with a code when
+	 * performing validation against a ValueSet. This method was created for internal purposes.
+	 * Please use this method with care because it will only cover some
+	 * use-cases (e.g. standard bindings) while for others it may not return correct results or return null.
+	 * An incorrect result could be considered if the resource declares a code with a system, and you're calling
+	 * this method to check a binding against a ValueSet that has nothing to do with that system.
+	 * @param theValueSet the valueSet
+	 * @param theCode the code
+	 * @return the system which can be associated with the code
+	 */
 	public static String extractCodeSystemForCode(IBaseResource theValueSet, String theCode) {
 		if (theValueSet instanceof org.hl7.fhir.dstu3.model.ValueSet) {
 			return extractCodeSystemForCodeDSTU3((org.hl7.fhir.dstu3.model.ValueSet) theValueSet, theCode);
diff --git a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapper.java b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapper.java
index f0f3f41e7f9b..393d8ce1dc54 100644
--- a/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapper.java
+++ b/hapi-fhir-validation/src/main/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapper.java
@@ -62,6 +62,7 @@
 import java.util.Objects;
 import java.util.Set;
 
+import static ca.uhn.fhir.context.support.IValidationSupport.CodeValidationIssueCoding.INVALID_DISPLAY;
 import static java.util.stream.Collectors.collectingAndThen;
 import static java.util.stream.Collectors.toSet;
 import static org.apache.commons.lang3.StringUtils.isBlank;
@@ -296,7 +297,7 @@ private ValidationResult convertValidationResult(
 					theResult.getCodeSystemVersion(),
 					conceptDefinitionComponent,
 					display,
-					getIssuesForCodeValidation(theResult.getCodeValidationIssues()));
+					getIssuesForCodeValidation(theResult.getIssues()));
 		}
 
 		if (retVal == null) {
@@ -307,73 +308,36 @@ private ValidationResult convertValidationResult(
 	}
 
 	private List<OperationOutcome.OperationOutcomeIssueComponent> getIssuesForCodeValidation(
-			List<IValidationSupport.CodeValidationIssue> codeValidationIssues) {
-		List<OperationOutcome.OperationOutcomeIssueComponent> issues = new ArrayList<>();
-
-		for (IValidationSupport.CodeValidationIssue codeValidationIssue : codeValidationIssues) {
-
-			CodeableConcept codeableConcept = new CodeableConcept().setText(codeValidationIssue.getMessage());
-			codeableConcept.addCoding(
-					"http://hl7.org/fhir/tools/CodeSystem/tx-issue-type",
-					getIssueCodingFromCodeValidationIssue(codeValidationIssue),
-					null);
-
-			OperationOutcome.OperationOutcomeIssueComponent issue =
+			List<IValidationSupport.CodeValidationIssue> theIssues) {
+		List<OperationOutcome.OperationOutcomeIssueComponent> issueComponents = new ArrayList<>();
+
+		for (IValidationSupport.CodeValidationIssue issue : theIssues) {
+			OperationOutcome.IssueSeverity severity =
+					OperationOutcome.IssueSeverity.fromCode(issue.getSeverity().getCode());
+			OperationOutcome.IssueType issueType =
+					OperationOutcome.IssueType.fromCode(issue.getType().getCode());
+			String diagnostics = issue.getDiagnostics();
+
+			IValidationSupport.CodeValidationIssueDetails details = issue.getDetails();
+			CodeableConcept codeableConcept = new CodeableConcept().setText(details.getText());
+			details.getCodings().forEach(detailCoding -> codeableConcept
+					.addCoding()
+					.setSystem(detailCoding.getSystem())
+					.setCode(detailCoding.getCode()));
+
+			OperationOutcome.OperationOutcomeIssueComponent issueComponent =
 					new OperationOutcome.OperationOutcomeIssueComponent()
-							.setSeverity(getIssueSeverityFromCodeValidationIssue(codeValidationIssue))
-							.setCode(getIssueTypeFromCodeValidationIssue(codeValidationIssue))
-							.setDetails(codeableConcept);
-			issue.getDetails().setText(codeValidationIssue.getMessage());
-			issue.addExtension()
+							.setSeverity(severity)
+							.setCode(issueType)
+							.setDetails(codeableConcept)
+							.setDiagnostics(diagnostics);
+			issueComponent
+					.addExtension()
 					.setUrl("http://hl7.org/fhir/StructureDefinition/operationoutcome-message-id")
 					.setValue(new StringType("Terminology_PassThrough_TX_Message"));
-			issues.add(issue);
-		}
-		return issues;
-	}
-
-	private String getIssueCodingFromCodeValidationIssue(IValidationSupport.CodeValidationIssue codeValidationIssue) {
-		switch (codeValidationIssue.getCoding()) {
-			case VS_INVALID:
-				return "vs-invalid";
-			case NOT_FOUND:
-				return "not-found";
-			case NOT_IN_VS:
-				return "not-in-vs";
-			case INVALID_CODE:
-				return "invalid-code";
-			case INVALID_DISPLAY:
-				return "invalid-display";
-		}
-		return null;
-	}
-
-	private OperationOutcome.IssueType getIssueTypeFromCodeValidationIssue(
-			IValidationSupport.CodeValidationIssue codeValidationIssue) {
-		switch (codeValidationIssue.getCode()) {
-			case NOT_FOUND:
-				return OperationOutcome.IssueType.NOTFOUND;
-			case CODE_INVALID:
-				return OperationOutcome.IssueType.CODEINVALID;
-			case INVALID:
-				return OperationOutcome.IssueType.INVALID;
-		}
-		return null;
-	}
-
-	private OperationOutcome.IssueSeverity getIssueSeverityFromCodeValidationIssue(
-			IValidationSupport.CodeValidationIssue codeValidationIssue) {
-		switch (codeValidationIssue.getSeverity()) {
-			case FATAL:
-				return OperationOutcome.IssueSeverity.FATAL;
-			case ERROR:
-				return OperationOutcome.IssueSeverity.ERROR;
-			case WARNING:
-				return OperationOutcome.IssueSeverity.WARNING;
-			case INFORMATION:
-				return OperationOutcome.IssueSeverity.INFORMATION;
+			issueComponents.add(issueComponent);
 		}
-		return null;
+		return issueComponents;
 	}
 
 	@Override
@@ -851,25 +815,22 @@ private IValidationSupport.CodeValidationResult validateCodeInValueSet(
 				.getRootValidationSupport()
 				.validateCodeInValueSet(
 						myValidationSupportContext, theValidationOptions, theSystem, theCode, theDisplay, theValueSet);
-		if (result != null) {
+		if (result != null && theSystem != null) {
 			/* We got a value set result, which could be successful, or could contain errors/warnings. The code
 			might also be invalid in the code system, so we will check that as well and add those issues
 			to our result.
 			*/
 			IValidationSupport.CodeValidationResult codeSystemResult =
 					validateCodeInCodeSystem(theValidationOptions, theSystem, theCode, theDisplay);
-			final boolean valueSetResultContainsInvalidDisplay = result.getCodeValidationIssues().stream()
-					.anyMatch(codeValidationIssue -> codeValidationIssue.getCoding()
-							== IValidationSupport.CodeValidationIssueCoding.INVALID_DISPLAY);
+			final boolean valueSetResultContainsInvalidDisplay = result.getIssues().stream()
+					.anyMatch(VersionSpecificWorkerContextWrapper::hasInvalidDisplayDetailCode);
 			if (codeSystemResult != null) {
-				for (IValidationSupport.CodeValidationIssue codeValidationIssue :
-						codeSystemResult.getCodeValidationIssues()) {
+				for (IValidationSupport.CodeValidationIssue codeValidationIssue : codeSystemResult.getIssues()) {
 					/* Value set validation should already have checked the display name. If we get INVALID_DISPLAY
 					issues from code system validation, they will only repeat what was already caught.
 					*/
-					if (codeValidationIssue.getCoding() != IValidationSupport.CodeValidationIssueCoding.INVALID_DISPLAY
-							|| !valueSetResultContainsInvalidDisplay) {
-						result.addCodeValidationIssue(codeValidationIssue);
+					if (!hasInvalidDisplayDetailCode(codeValidationIssue) || !valueSetResultContainsInvalidDisplay) {
+						result.addIssue(codeValidationIssue);
 					}
 				}
 			}
@@ -877,6 +838,10 @@ private IValidationSupport.CodeValidationResult validateCodeInValueSet(
 		return result;
 	}
 
+	private static boolean hasInvalidDisplayDetailCode(IValidationSupport.CodeValidationIssue theIssue) {
+		return theIssue.hasIssueDetailCode(INVALID_DISPLAY.getCode());
+	}
+
 	private IValidationSupport.CodeValidationResult validateCodeInCodeSystem(
 			ConceptValidationOptions theValidationOptions, String theSystem, String theCode, String theDisplay) {
 		return myValidationSupportContext
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/ILookupCodeTest.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/ILookupCodeTest.java
index bb7eaf1c17ba..eac448ad0ebd 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/ILookupCodeTest.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/ILookupCodeTest.java
@@ -9,6 +9,7 @@
 import ca.uhn.fhir.context.support.IValidationSupport.StringConceptProperty;
 import ca.uhn.fhir.context.support.LookupCodeRequest;
 import ca.uhn.fhir.rest.server.exceptions.InternalErrorException;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
 import org.hl7.fhir.instance.model.api.IBaseDatatype;
 import org.junit.jupiter.api.Test;
 
@@ -21,12 +22,12 @@
 import static ca.uhn.fhir.context.support.IValidationSupport.TYPE_STRING;
 import static java.util.stream.IntStream.range;
 import static org.assertj.core.api.Assertions.assertThat;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.CODE;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.CODE_SYSTEM;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.CODE_SYSTEM_NAME;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.CODE_SYSTEM_VERSION;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.DISPLAY;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.LANGUAGE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM_NAME;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM_VERSION;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.DISPLAY;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.LANGUAGE;
 import static org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport.createConceptProperty;
 import static org.junit.jupiter.api.Assertions.assertEquals;
 import static org.junit.jupiter.api.Assertions.assertFalse;
@@ -189,8 +190,6 @@ default void verifyLookupCodeResult(LookupCodeRequest theRequest, LookupCodeResu
 
 		// verify
 		assertNotNull(outcome);
-		assertEquals(theRequest.getCode(), getLookupCodeProvider().getCode());
-		assertEquals(theRequest.getSystem(), getLookupCodeProvider().getSystem());
 		assertEquals(theExpectedResult.isFound(), outcome.isFound());
 		assertEquals(theExpectedResult.getErrorMessage(), outcome.getErrorMessage());
 		assertEquals(theExpectedResult.getCodeSystemDisplayName(), outcome.getCodeSystemDisplayName());
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IRemoteTerminologyLookupCodeTest.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IRemoteTerminologyLookupCodeTest.java
index 5ba79bd3e6f9..95c4fd7d3b97 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IRemoteTerminologyLookupCodeTest.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IRemoteTerminologyLookupCodeTest.java
@@ -2,6 +2,7 @@
 
 import ca.uhn.fhir.context.support.IValidationSupport.LookupCodeResult;
 import ca.uhn.fhir.context.support.LookupCodeRequest;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
 import org.junit.jupiter.api.Test;
 
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IRemoteTerminologyValidateCodeTest.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IRemoteTerminologyValidateCodeTest.java
index cb6bb02ac072..21c5d0dc5e74 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IRemoteTerminologyValidateCodeTest.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IRemoteTerminologyValidateCodeTest.java
@@ -1,17 +1,76 @@
 package org.hl7.fhir.common.hapi.validation;
 
+import ca.uhn.fhir.context.FhirVersionEnum;
 import ca.uhn.fhir.context.support.IValidationSupport;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
 import org.hl7.fhir.instance.model.api.IBaseOperationOutcome;
+import org.junit.jupiter.api.Test;
 
 import java.util.Collection;
 import java.util.List;
 import java.util.Optional;
 
+import static org.assertj.core.api.Assertions.assertThat;
+import static org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport.createCodeValidationIssues;
+
 public interface IRemoteTerminologyValidateCodeTest extends IValidateCodeTest {
 	default List<IValidationSupport.CodeValidationIssue> getCodeValidationIssues(IBaseOperationOutcome theOperationOutcome) {
 		// this method should be removed once support for issues is fully implemented across all validator types
 		Optional<Collection<IValidationSupport.CodeValidationIssue>> issues = RemoteTerminologyServiceValidationSupport.createCodeValidationIssues(theOperationOutcome, getService().getFhirContext().getVersion().getVersion());
 		return issues.map(theCodeValidationIssues -> theCodeValidationIssues.stream().toList()).orElseGet(List::of);
 	}
+
+	@Test
+	default void createCodeValidationIssues_withCodeSystemOutcomeForInvalidCode_returnsAsExpected() {
+		IBaseOperationOutcome outcome = getCodeSystemInvalidCodeOutcome();
+		FhirVersionEnum versionEnum = getService().getFhirContext().getVersion().getVersion();
+		Optional<Collection<IValidationSupport.CodeValidationIssue>> issuesOptional = createCodeValidationIssues(outcome, versionEnum);
+		assertThat(issuesOptional).isPresent();
+		assertThat(issuesOptional.get()).hasSize(1);
+		IValidationSupport.CodeValidationIssue issue = issuesOptional.get().iterator().next();
+		assertThat(issue.getType().getCode()).isEqualTo("code-invalid");
+		assertThat(issue.getSeverity().getCode()).isEqualTo("error");
+		assertThat(issue.getDetails().getCodings()).hasSize(1);
+		IValidationSupport.CodeValidationIssueCoding issueCoding = issue.getDetails().getCodings().get(0);
+		assertThat(issueCoding.getSystem()).isEqualTo("http://hl7.org/fhir/tools/CodeSystem/tx-issue-type");
+		assertThat(issueCoding.getCode()).isEqualTo("invalid-code");
+		assertThat(issue.getDetails().getText()).isEqualTo("Unknown code 'CODE' in the CodeSystem 'http://code.system/url' version '1.0.0'");
+		assertThat(issue.getDiagnostics()).isNull();
+	}
+
+	@Test
+	default void createCodeValidationIssues_withValueSetOutcomeForInvalidCode_returnsAsExpected() {
+		IBaseOperationOutcome outcome = getValueSetInvalidCodeOutcome();
+		FhirVersionEnum versionEnum = getService().getFhirContext().getVersion().getVersion();
+		Optional<Collection<IValidationSupport.CodeValidationIssue>> issuesOptional = createCodeValidationIssues(outcome, versionEnum);
+		assertThat(issuesOptional).isPresent();
+		assertThat(issuesOptional.get()).hasSize(2);
+		IValidationSupport.CodeValidationIssue issue = issuesOptional.get().iterator().next();
+		assertThat(issue.getType().getCode()).isEqualTo("code-invalid");
+		assertThat(issue.getSeverity().getCode()).isEqualTo("error");
+		assertThat(issue.getDetails().getCodings()).hasSize(1);
+		IValidationSupport.CodeValidationIssueCoding issueCoding = issue.getDetails().getCodings().get(0);
+		assertThat(issueCoding.getSystem()).isEqualTo("http://hl7.org/fhir/tools/CodeSystem/tx-issue-type");
+		assertThat(issueCoding.getCode()).isEqualTo("not-in-vs");
+		assertThat(issue.getDetails().getText()).isEqualTo("The provided code 'http://code.system/url#CODE' was not found in the value set 'http://value.set/url%7C1.0.0'");
+		assertThat(issue.getDiagnostics()).isNull();
+	}
+
+	@Test
+	default void createCodeValidationIssues_withValueSetOutcomeWithCustomDetailCode_returnsAsExpected() {
+		IBaseOperationOutcome outcome = getValueSetCustomDetailCodeOutcome();
+		FhirVersionEnum versionEnum = getService().getFhirContext().getVersion().getVersion();
+		Optional<Collection<IValidationSupport.CodeValidationIssue>> issuesOptional = createCodeValidationIssues(outcome, versionEnum);
+		assertThat(issuesOptional).isPresent();
+		assertThat(issuesOptional.get()).hasSize(1);
+		IValidationSupport.CodeValidationIssue issue = issuesOptional.get().iterator().next();
+		assertThat(issue.getType().getCode()).isEqualTo("processing");
+		assertThat(issue.getSeverity().getCode()).isEqualTo("information");
+		assertThat(issue.getDetails().getCodings()).hasSize(1);
+		IValidationSupport.CodeValidationIssueCoding issueCoding = issue.getDetails().getCodings().get(0);
+		assertThat(issueCoding.getSystem()).isEqualTo("http://example.com/custom-issue-type");
+		assertThat(issueCoding.getCode()).isEqualTo("valueset-is-draft");
+		assertThat(issue.getDetails().getText()).isNull();
+		assertThat(issue.getDiagnostics()).isEqualTo("The ValueSet status is marked as draft.");
+	}
 }
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IValidateCodeTest.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IValidateCodeTest.java
index 52dbf1177a86..53411b440fe6 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IValidateCodeTest.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IValidateCodeTest.java
@@ -4,6 +4,9 @@
 import ca.uhn.fhir.context.support.IValidationSupport.CodeValidationResult;
 import ca.uhn.fhir.rest.server.exceptions.InvalidRequestException;
 import ca.uhn.fhir.rest.server.exceptions.ResourceNotFoundException;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
+import ca.uhn.fhir.util.ClasspathUtil;
+import org.hl7.fhir.dstu3.model.OperationOutcome;
 import org.hl7.fhir.instance.model.api.IBaseOperationOutcome;
 import org.hl7.fhir.instance.model.api.IBaseParameters;
 import org.hl7.fhir.instance.model.api.IBaseResource;
@@ -16,12 +19,13 @@
 import java.util.stream.Stream;
 
 import static ca.uhn.fhir.context.support.IValidationSupport.IssueSeverity.ERROR;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.CODE;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.CODE_SYSTEM;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.CODE_SYSTEM_VERSION;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.DISPLAY;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.ERROR_MESSAGE;
-import static org.hl7.fhir.common.hapi.validation.IValidationProviders.VALUE_SET_URL;
+import static ca.uhn.fhir.jpa.model.util.JpaConstants.OPERATION_VALIDATE_CODE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM_VERSION;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.DISPLAY;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.ERROR_MESSAGE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.VALUE_SET_URL;
 import static org.junit.jupiter.api.Assertions.assertEquals;
 import static org.junit.jupiter.api.Assertions.assertFalse;
 import static org.junit.jupiter.api.Assertions.assertNotNull;
@@ -31,21 +35,35 @@
 
 public interface IValidateCodeTest {
 
-	IValidationProviders.IMyCodeSystemProvider getCodeSystemProvider();
-	IValidationProviders.IMyValueSetProvider getValueSetProvider();
+	IValidationProviders.IMyValidationProvider getCodeSystemProvider();
+	IValidationProviders.IMyValidationProvider getValueSetProvider();
 	IValidationSupport getService();
 	IBaseParameters createParameters(Boolean theResult, String theDisplay, String theMessage, IBaseResource theIssuesResource);
 	String getCodeSystemError();
 	String getValueSetError();
 	IBaseOperationOutcome getCodeSystemInvalidCodeOutcome();
 	IBaseOperationOutcome getValueSetInvalidCodeOutcome();
+	IBaseOperationOutcome getValueSetCustomDetailCodeOutcome();
+
+	default IBaseOperationOutcome getCodeSystemInvalidCodeOutcome(Class<? extends IBaseOperationOutcome> theResourceClass) {
+		return getOutcome(theResourceClass, "/terminology/OperationOutcome-CodeSystem-invalid-code.json");
+	}
+	default IBaseOperationOutcome getValueSetInvalidCodeOutcome(Class<? extends IBaseOperationOutcome> theResourceClass) {
+		return getOutcome(theResourceClass, "/terminology/OperationOutcome-ValueSet-invalid-code.json");
+	}
+	default IBaseOperationOutcome getValueSetCustomDetailCodeOutcome(Class<? extends IBaseOperationOutcome> theResourceClass) {
+		return getOutcome(theResourceClass, "/terminology/OperationOutcome-ValueSet-custom-issue-detail.json");
+	}
+	default IBaseOperationOutcome getOutcome(Class<? extends IBaseOperationOutcome> theResourceClass, String theFile) {
+		return ClasspathUtil.loadResource(getService().getFhirContext(), theResourceClass, theFile);
+	}
 
 	default void createCodeSystemReturnParameters(Boolean theResult, String theDisplay, String theMessage, IBaseResource theIssuesResource) {
-		getCodeSystemProvider().setReturnParams(createParameters(theResult, theDisplay, theMessage, theIssuesResource));
+		getCodeSystemProvider().addTerminologyResponse(OPERATION_VALIDATE_CODE, CODE_SYSTEM, CODE, createParameters(theResult, theDisplay, theMessage, theIssuesResource));
 	}
 
 	default void createValueSetReturnParameters(Boolean theResult, String theDisplay, String theMessage, IBaseResource theIssuesResource) {
-		getValueSetProvider().setReturnParams(createParameters(theResult, theDisplay, theMessage, theIssuesResource));
+		getValueSetProvider().addTerminologyResponse(OPERATION_VALIDATE_CODE, VALUE_SET_URL, CODE, createParameters(theResult, theDisplay, theMessage, theIssuesResource));
 	}
 
 	@Test
@@ -91,8 +109,8 @@ default void validateCode_codeSystemAndValueSetUrlAreIncorrect_returnsValidation
 																																	String theValidationMessage,
 																																	String theCodeSystem,
 																																	String theValueSetUrl) {
-		getCodeSystemProvider().setException(theException);
-		getValueSetProvider().setException(theException);
+		getCodeSystemProvider().addException(OPERATION_VALIDATE_CODE, theCodeSystem, CODE, theException);
+		getValueSetProvider().addException(OPERATION_VALIDATE_CODE, theValueSetUrl, CODE, theException);
 		CodeValidationResult outcome = getService().validateCode(null, null, theCodeSystem, CODE, DISPLAY, theValueSetUrl);
 
 		verifyErrorResultFromException(outcome, theValidationMessage, theServerMessage);
@@ -105,7 +123,7 @@ default void verifyErrorResultFromException(CodeValidationResult outcome, String
 		for (String message : theMessages) {
 			assertTrue(outcome.getMessage().contains(message));
 		}
-		assertFalse(outcome.getCodeValidationIssues().isEmpty());
+		assertFalse(outcome.getIssues().isEmpty());
 	}
 
 	@Test
@@ -130,11 +148,7 @@ default void validateCode_withValueSetSuccess_returnsCorrectly() {
 		assertEquals(DISPLAY, outcome.getDisplay());
 		assertNull(outcome.getSeverity());
 		assertNull(outcome.getMessage());
-		assertTrue(outcome.getCodeValidationIssues().isEmpty());
-
-		assertEquals(CODE, getValueSetProvider().getCode());
-		assertEquals(DISPLAY, getValueSetProvider().getDisplay());
-		assertEquals(VALUE_SET_URL, getValueSetProvider().getValueSet());
+		assertTrue(outcome.getIssues().isEmpty());
 	}
 
 	@Test
@@ -147,9 +161,7 @@ default void validateCode_withCodeSystemSuccess_returnsCorrectly() {
 		assertEquals(DISPLAY, outcome.getDisplay());
 		assertNull(outcome.getSeverity());
 		assertNull(outcome.getMessage());
-		assertTrue(outcome.getCodeValidationIssues().isEmpty());
-
-		assertEquals(CODE, getCodeSystemProvider().getCode());
+		assertTrue(outcome.getIssues().isEmpty());
 	}
 
 	@Test
@@ -165,10 +177,7 @@ default void validateCode_withCodeSystemProvidingMinimalInputs_ReturnsSuccess()
 		assertNull(outcome.getDisplay());
 		assertNull(outcome.getSeverity());
 		assertNull(outcome.getMessage());
-		assertTrue(outcome.getCodeValidationIssues().isEmpty());
-
-		assertEquals(CODE, getCodeSystemProvider().getCode());
-		assertEquals(CODE_SYSTEM, getCodeSystemProvider().getSystem());
+		assertTrue(outcome.getIssues().isEmpty());
 	}
 
 	@Test
@@ -184,15 +193,11 @@ default void validateCode_withCodeSystemSuccessWithMessageValue_returnsCorrectly
 		assertEquals(DISPLAY, outcome.getDisplay());
 		assertNull(outcome.getSeverity());
 		assertNull(outcome.getMessage());
-		assertTrue(outcome.getCodeValidationIssues().isEmpty());
-
-		assertEquals(CODE, getCodeSystemProvider().getCode());
-		assertEquals(DISPLAY, getCodeSystemProvider().getDisplay());
-		assertEquals(CODE_SYSTEM, getCodeSystemProvider().getSystem());
+		assertTrue(outcome.getIssues().isEmpty());
 	}
 
 	@Test
-	default void validateCode_withCodeSystemError_returnsCorrectly() {
+	default void validateCode_withCodeSystemErrorWithDiagnosticsWithIssues_returnsCorrectly() {
 		IBaseOperationOutcome invalidCodeOutcome = getCodeSystemInvalidCodeOutcome();
 		createCodeSystemReturnParameters(false, null, ERROR_MESSAGE, invalidCodeOutcome);
 
@@ -204,12 +209,12 @@ default void validateCode_withCodeSystemError_returnsCorrectly() {
 		// assertEquals(CODE, outcome.getCode());
 		assertEquals(ERROR, outcome.getSeverity());
 		assertEquals(getCodeSystemError(), outcome.getMessage());
-		assertFalse(outcome.getCodeValidationIssues().isEmpty());
+		assertFalse(outcome.getIssues().isEmpty());
 		verifyIssues(invalidCodeOutcome, outcome);
 	}
 
 	@Test
-	default void validateCode_withCodeSystemErrorAndIssues_returnsCorrectly() {
+	default void validateCode_withCodeSystemErrorWithDiagnosticsWithoutIssues_returnsCorrectly() {
 		createCodeSystemReturnParameters(false, null, ERROR_MESSAGE, null);
 
 		CodeValidationResult outcome = getService()
@@ -223,10 +228,32 @@ default void validateCode_withCodeSystemErrorAndIssues_returnsCorrectly() {
 		assertNull(outcome.getDisplay());
 		assertEquals(ERROR, outcome.getSeverity());
 		assertEquals(expectedError, outcome.getMessage());
-		assertFalse(outcome.getCodeValidationIssues().isEmpty());
-		assertEquals(1, outcome.getCodeValidationIssues().size());
-		assertEquals(expectedError, outcome.getCodeValidationIssues().get(0).getMessage());
-		assertEquals(ERROR, outcome.getCodeValidationIssues().get(0).getSeverity());
+		assertFalse(outcome.getIssues().isEmpty());
+		assertEquals(1, outcome.getIssues().size());
+		assertEquals(expectedError, outcome.getIssues().get(0).getDiagnostics());
+		assertEquals(ERROR, outcome.getIssues().get(0).getSeverity());
+	}
+
+	@Test
+	default void validateCode_withCodeSystemErrorWithoutDiagnosticsWithIssues_returnsCorrectly() {
+		IBaseOperationOutcome invalidCodeOutcome = getCodeSystemInvalidCodeOutcome();
+		createCodeSystemReturnParameters(false, null, null, invalidCodeOutcome);
+
+		CodeValidationResult outcome = getService()
+				.validateCode(null, null, CODE_SYSTEM, CODE, null, null);
+
+		String expectedError = getCodeSystemError();
+		assertNotNull(outcome);
+		assertEquals(CODE_SYSTEM, outcome.getCodeSystemName());
+		assertEquals(CODE_SYSTEM_VERSION, outcome.getCodeSystemVersion());
+		// assertEquals(CODE, outcome.getCode());
+		assertNull(outcome.getDisplay());
+		assertEquals(ERROR, outcome.getSeverity());
+		assertNull(outcome.getMessage());
+		assertFalse(outcome.getIssues().isEmpty());
+		assertEquals(1, outcome.getIssues().size());
+		assertNull(outcome.getIssues().get(0).getDiagnostics());
+		assertEquals(ERROR, outcome.getIssues().get(0).getSeverity());
 	}
 
 	@Test
@@ -242,10 +269,7 @@ default void validateCode_withValueSetProvidingMinimalInputsSuccess_returnsCorre
 		assertNull(outcome.getDisplay());
 		assertNull(outcome.getSeverity());
 		assertNull(outcome.getMessage());
-		assertTrue(outcome.getCodeValidationIssues().isEmpty());
-
-		assertEquals(CODE, getValueSetProvider().getCode());
-		assertEquals(VALUE_SET_URL, getValueSetProvider().getValueSet());
+		assertTrue(outcome.getIssues().isEmpty());
 	}
 
 	@Test
@@ -261,11 +285,7 @@ default void validateCode_withValueSetSuccessWithMessage_returnsCorrectly() {
 		assertEquals(DISPLAY, outcome.getDisplay());
 		assertNull(outcome.getSeverity());
 		assertNull(outcome.getMessage());
-		assertTrue(outcome.getCodeValidationIssues().isEmpty());
-
-		assertEquals(CODE, getValueSetProvider().getCode());
-		assertEquals(DISPLAY, getValueSetProvider().getDisplay());
-		assertEquals(VALUE_SET_URL, getValueSetProvider().getValueSet());
+		assertTrue(outcome.getIssues().isEmpty());
 	}
 
 	@Test
@@ -283,13 +303,9 @@ default void validateCode_withValueSetError_returnsCorrectly() {
 		assertEquals(DISPLAY, outcome.getDisplay());
 		assertEquals(ERROR, outcome.getSeverity());
 		assertEquals(expectedError, outcome.getMessage());
-		assertEquals(1, outcome.getCodeValidationIssues().size());
-		assertEquals(expectedError, outcome.getCodeValidationIssues().get(0).getMessage());
-		assertEquals(ERROR, outcome.getCodeValidationIssues().get(0).getSeverity());
-
-		assertEquals(CODE, getValueSetProvider().getCode());
-		assertEquals(DISPLAY, getValueSetProvider().getDisplay());
-		assertEquals(VALUE_SET_URL, getValueSetProvider().getValueSet());
+		assertEquals(1, outcome.getIssues().size());
+		assertEquals(expectedError, outcome.getIssues().get(0).getDiagnostics());
+		assertEquals(ERROR, outcome.getIssues().get(0).getSeverity());
 	}
 
 	@Test
@@ -306,24 +322,28 @@ default void validateCode_withValueSetErrorWithIssues_returnsCorrectly() {
 		assertEquals(DISPLAY, outcome.getDisplay());
 		assertEquals(ERROR, outcome.getSeverity());
 		assertEquals(getValueSetError(), outcome.getMessage());
-		assertFalse(outcome.getCodeValidationIssues().isEmpty());
+		assertFalse(outcome.getIssues().isEmpty());
 		verifyIssues(invalidCodeOutcome, outcome);
-
-		assertEquals(CODE, getValueSetProvider().getCode());
-		assertEquals(DISPLAY, getValueSetProvider().getDisplay());
-		assertEquals(VALUE_SET_URL, getValueSetProvider().getValueSet());
 	}
 
 	default void verifyIssues(IBaseOperationOutcome theOperationOutcome, CodeValidationResult theResult) {
 		List<IValidationSupport.CodeValidationIssue> issues = getCodeValidationIssues(theOperationOutcome);
-		assertEquals(issues.size(), theResult.getCodeValidationIssues().size());
+		assertEquals(issues.size(), theResult.getIssues().size());
 		for (int i = 0; i < issues.size(); i++) {
 			IValidationSupport.CodeValidationIssue expectedIssue = issues.get(i);
-			IValidationSupport.CodeValidationIssue actualIssue = theResult.getCodeValidationIssues().get(i);
-			assertEquals(expectedIssue.getCode(), actualIssue.getCode());
+			IValidationSupport.CodeValidationIssue actualIssue = theResult.getIssues().get(i);
+			assertEquals(expectedIssue.getType().getCode(), actualIssue.getType().getCode());
 			assertEquals(expectedIssue.getSeverity(), actualIssue.getSeverity());
-			assertEquals(expectedIssue.getCoding(), actualIssue.getCoding());
-			assertEquals(expectedIssue.getMessage(), actualIssue.getMessage());
+			assertEquals(expectedIssue.getDetails().getText(), actualIssue.getDetails().getText());
+			assertEquals(expectedIssue.getDetails().getCodings().size(), actualIssue.getDetails().getCodings().size());
+			for (int index = 0; index < expectedIssue.getDetails().getCodings().size(); index++) {
+				IValidationSupport.CodeValidationIssueCoding expectedCoding = expectedIssue.getDetails().getCodings().get(index);
+				IValidationSupport.CodeValidationIssueCoding actualCoding = actualIssue.getDetails().getCodings().get(index);
+				assertEquals(expectedCoding.getSystem(), actualCoding.getSystem());
+				assertEquals(expectedCoding.getCode(), actualCoding.getCode());
+			}
+			assertEquals(expectedIssue.getDetails().getText(), actualIssue.getDetails().getText());
+			assertEquals(expectedIssue.getDiagnostics(), actualIssue.getDiagnostics());
 		}
 	}
 
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IValidationProviders.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IValidationProviders.java
deleted file mode 100644
index 1537f8e5c00b..000000000000
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/IValidationProviders.java
+++ /dev/null
@@ -1,39 +0,0 @@
-package org.hl7.fhir.common.hapi.validation;
-
-import ca.uhn.fhir.context.support.IValidationSupport;
-import ca.uhn.fhir.rest.server.IResourceProvider;
-import org.hl7.fhir.instance.model.api.IBaseParameters;
-
-public interface IValidationProviders {
-	String CODE_SYSTEM = "http://code.system/url";
-	String CODE_SYSTEM_VERSION = "1.0.0";
-	String CODE_SYSTEM_NAME = "Test Code System";
-	String CODE = "CODE";
-	String VALUE_SET_URL = "http://value.set/url";
-	String DISPLAY = "Explanation for code TestCode.";
-	String LANGUAGE = "en";
-	String ERROR_MESSAGE = "This is an error message";
-
-	interface IMyCodeSystemProvider extends IResourceProvider {
-		String getCode();
-		String getSystem();
-		String getDisplay();
-		void setException(Exception theException);
-		void setReturnParams(IBaseParameters theParameters);
-	}
-
-	interface IMyLookupCodeProvider extends IResourceProvider {
-		String getCode();
-		String getSystem();
-		void setLookupCodeResult(IValidationSupport.LookupCodeResult theLookupCodeResult);
-	}
-
-	interface IMyValueSetProvider extends IResourceProvider {
-		String getCode();
-		String getSystem();
-		String getDisplay();
-		String getValueSet();
-		void setException(Exception theException);
-		void setReturnParams(IBaseParameters theParameters);
-	}
-}
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapperTest.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapperTest.java
index 57aae8d96f99..cbc79fadc981 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapperTest.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/common/hapi/validation/validator/VersionSpecificWorkerContextWrapperTest.java
@@ -7,7 +7,6 @@
 import ca.uhn.fhir.fhirpath.BaseValidationTestWithInlineMocks;
 import ca.uhn.fhir.i18n.HapiLocalizer;
 import ca.uhn.hapi.converters.canonical.VersionCanonicalizer;
-
 import org.hl7.fhir.r5.model.Resource;
 import org.hl7.fhir.r5.model.StructureDefinition;
 import org.hl7.fhir.r5.model.StructureDefinition.StructureDefinitionKind;
@@ -16,17 +15,18 @@
 import org.junit.jupiter.api.Test;
 import org.mockito.quality.Strictness;
 
+import java.util.List;
+
 import static org.assertj.core.api.Assertions.assertThat;
 import static org.mockito.ArgumentMatchers.any;
 import static org.mockito.ArgumentMatchers.eq;
 import static org.mockito.Mockito.mock;
+import static org.mockito.Mockito.never;
 import static org.mockito.Mockito.times;
 import static org.mockito.Mockito.verify;
 import static org.mockito.Mockito.when;
 import static org.mockito.Mockito.withSettings;
 
-import java.util.List;
-
 public class VersionSpecificWorkerContextWrapperTest extends BaseValidationTestWithInlineMocks {
 
 	final byte[] EXPECTED_BINARY_CONTENT_1 = "dummyBinaryContent1".getBytes();
@@ -80,7 +80,7 @@ public void cacheResource_normally_executesWithoutException() {
 	}
 
 	@Test
-	public void validateCode_normally_resolvesCodeSystemFromValueSet() {
+	public void validateCode_codeInValueSet_resolvesCodeSystemFromValueSet() {
 		// setup
 		IValidationSupport validationSupport = mockValidationSupport();
 		ValidationSupportContext mockContext = mockValidationSupportContext(validationSupport);
@@ -90,8 +90,7 @@ public void validateCode_normally_resolvesCodeSystemFromValueSet() {
 		ValueSet valueSet = new ValueSet();
 		valueSet.getCompose().addInclude().setSystem("http://codesystems.com/system").addConcept().setCode("code0");
 		valueSet.getCompose().addInclude().setSystem("http://codesystems.com/system2").addConcept().setCode("code2");
-		when(validationSupport.fetchResource(eq(ValueSet.class), eq("http://somevalueset"))).thenReturn(valueSet);
-		when(validationSupport.validateCodeInValueSet(any(), any(), any(), any(), any(), any())).thenReturn(new IValidationSupport.CodeValidationResult());
+		when(validationSupport.validateCodeInValueSet(any(), any(), any(), any(), any(), any())).thenReturn(mock(IValidationSupport.CodeValidationResult.class));
 
 		// execute
 		wrapper.validateCode(new ValidationOptions(), "code0", valueSet);
@@ -101,6 +100,26 @@ public void validateCode_normally_resolvesCodeSystemFromValueSet() {
 		verify(validationSupport, times(1)).validateCode(any(), any(), eq("http://codesystems.com/system"), eq("code0"), any(), any());
 	}
 
+	@Test
+	public void validateCode_codeNotInValueSet_doesNotResolveSystem() {
+		// setup
+		IValidationSupport validationSupport = mockValidationSupport();
+		ValidationSupportContext mockContext = mockValidationSupportContext(validationSupport);
+		VersionCanonicalizer versionCanonicalizer = new VersionCanonicalizer(FhirContext.forR5Cached());
+		VersionSpecificWorkerContextWrapper wrapper = new VersionSpecificWorkerContextWrapper(mockContext, versionCanonicalizer);
+
+		ValueSet valueSet = new ValueSet();
+		valueSet.getCompose().addInclude().setSystem("http://codesystems.com/system").addConcept().setCode("code0");
+		valueSet.getCompose().addInclude().setSystem("http://codesystems.com/system2").addConcept().setCode("code2");
+
+		// execute
+		wrapper.validateCode(new ValidationOptions(), "code1", valueSet);
+
+		// verify
+		verify(validationSupport, times(1)).validateCodeInValueSet(any(), any(), eq(null), eq("code1"), any(), any());
+		verify(validationSupport, never()).validateCode(any(), any(), any(), any(), any(), any());
+	}
+
 	@Test
 	public void isPrimitive_primitive() {
 		// setup
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu2/hapi/validation/FhirInstanceValidatorDstu2Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu2/hapi/validation/FhirInstanceValidatorDstu2Test.java
index da73c0be8000..5a53ba0ac3d4 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu2/hapi/validation/FhirInstanceValidatorDstu2Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu2/hapi/validation/FhirInstanceValidatorDstu2Test.java
@@ -4,7 +4,6 @@
 import ca.uhn.fhir.context.support.ConceptValidationOptions;
 import ca.uhn.fhir.context.support.DefaultProfileValidationSupport;
 import ca.uhn.fhir.context.support.IValidationSupport;
-import ca.uhn.fhir.context.support.ValidationSupportContext;
 import ca.uhn.fhir.fhirpath.BaseValidationTestWithInlineMocks;
 import ca.uhn.fhir.model.dstu2.composite.PeriodDt;
 import ca.uhn.fhir.model.dstu2.resource.Parameters;
@@ -28,10 +27,7 @@
 import org.hl7.fhir.dstu2.model.QuestionnaireResponse;
 import org.hl7.fhir.dstu2.model.QuestionnaireResponse.QuestionnaireResponseStatus;
 import org.hl7.fhir.dstu2.model.StringType;
-import org.hl7.fhir.dstu3.model.CodeSystem;
-import org.hl7.fhir.utilities.validation.ValidationMessage;
 import org.junit.jupiter.api.AfterAll;
-import org.junit.jupiter.api.BeforeAll;
 import org.junit.jupiter.api.BeforeEach;
 import org.junit.jupiter.api.Disabled;
 import org.junit.jupiter.api.Test;
@@ -41,9 +37,7 @@
 
 import java.io.IOException;
 import java.util.ArrayList;
-import java.util.HashMap;
 import java.util.HashSet;
-import java.util.Optional;
 import java.util.Set;
 
 import static org.assertj.core.api.Assertions.assertThat;
@@ -100,7 +94,7 @@ public IValidationSupport.CodeValidationResult answer(InvocationOnMock theInvoca
 				if (myValidConcepts.contains(system + "___" + code)) {
 					retVal = new IValidationSupport.CodeValidationResult().setCode(code);
 				} else if (myValidSystems.contains(system)) {
-					return new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage("Unknown code");
+					return new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage("Unknown code");
 				} else {
 					retVal = null;
 				}
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/FhirInstanceValidatorDstu3Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/FhirInstanceValidatorDstu3Test.java
index ad6276f2761a..cfbeca68626a 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/FhirInstanceValidatorDstu3Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/FhirInstanceValidatorDstu3Test.java
@@ -58,7 +58,6 @@
 import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor;
 import org.hl7.fhir.r5.utils.validation.IValidatorResourceFetcher;
 import org.hl7.fhir.r5.utils.validation.constants.ReferenceValidationPolicy;
-import org.hl7.fhir.utilities.validation.ValidationMessage;
 import org.junit.jupiter.api.AfterAll;
 import org.junit.jupiter.api.BeforeEach;
 import org.junit.jupiter.api.Disabled;
@@ -229,10 +228,10 @@ public IValidationSupport.CodeValidationResult answer(InvocationOnMock theInvoca
 					retVal = new IValidationSupport.CodeValidationResult().setCode(code);
 				} else if (myValidSystems.contains(system)) {
 					final String message = "Unknown code (for '" + system + "#" + code + "')";
-					retVal = new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage(message).setCodeValidationIssues(Collections.singletonList(new IValidationSupport.CodeValidationIssue(message, IValidationSupport.IssueSeverity.ERROR, IValidationSupport.CodeValidationIssueCode.CODE_INVALID, IValidationSupport.CodeValidationIssueCoding.INVALID_CODE)));
+					retVal = new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage(message).setIssues(Collections.singletonList(new IValidationSupport.CodeValidationIssue(message, IValidationSupport.IssueSeverity.ERROR, IValidationSupport.CodeValidationIssueCode.CODE_INVALID, IValidationSupport.CodeValidationIssueCoding.INVALID_CODE)));
 				} else if (myValidSystemsNotReturningIssues.contains(system)) {
 					final String message = "Unknown code (for '" + system + "#" + code + "')";
-					retVal = new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage(message);
+					retVal = new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage(message);
 				} else if (myCodeSystems.containsKey(system)) {
 					CodeSystem cs = myCodeSystems.get(system);
 					Optional<ConceptDefinitionComponent> found = cs.getConcept().stream().filter(t -> t.getCode().equals(code)).findFirst();
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/IValidateCodeProvidersDstu3.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/IValidateCodeProvidersDstu3.java
deleted file mode 100644
index 0c639e310ee2..000000000000
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/IValidateCodeProvidersDstu3.java
+++ /dev/null
@@ -1,159 +0,0 @@
-package org.hl7.fhir.dstu3.hapi.validation;
-
-import ca.uhn.fhir.jpa.model.util.JpaConstants;
-import ca.uhn.fhir.rest.annotation.IdParam;
-import ca.uhn.fhir.rest.annotation.Operation;
-import ca.uhn.fhir.rest.annotation.OperationParam;
-import ca.uhn.fhir.rest.api.server.RequestDetails;
-import jakarta.servlet.http.HttpServletRequest;
-import org.hl7.fhir.common.hapi.validation.IValidationProviders;
-import org.hl7.fhir.dstu3.model.BooleanType;
-import org.hl7.fhir.dstu3.model.CodeSystem;
-import org.hl7.fhir.dstu3.model.CodeType;
-import org.hl7.fhir.dstu3.model.Coding;
-import org.hl7.fhir.dstu3.model.IdType;
-import org.hl7.fhir.dstu3.model.Parameters;
-import org.hl7.fhir.dstu3.model.StringType;
-import org.hl7.fhir.dstu3.model.UriType;
-import org.hl7.fhir.dstu3.model.ValueSet;
-import org.hl7.fhir.instance.model.api.IBaseParameters;
-import org.hl7.fhir.instance.model.api.IBaseResource;
-
-import java.util.List;
-
-public interface IValidateCodeProvidersDstu3 {
-	@SuppressWarnings("unused")
-	class MyCodeSystemProviderDstu3 implements IValidationProviders.IMyCodeSystemProvider {
-		private UriType mySystemUrl;
-		private CodeType myCode;
-		private StringType myDisplay;
-		private Exception myException;
-		private Parameters myReturnParams;
-
-		@Operation(name = "validate-code", idempotent = true, returnParameters = {
-				@OperationParam(name = "result", type = org.hl7.fhir.dstu3.model.BooleanType.class, min = 1),
-				@OperationParam(name = "message", type = org.hl7.fhir.dstu3.model.StringType.class),
-				@OperationParam(name = "display", type = org.hl7.fhir.dstu3.model.StringType.class)
-		})
-		public org.hl7.fhir.dstu3.model.Parameters validateCode(
-				HttpServletRequest theServletRequest,
-				@IdParam(optional = true) org.hl7.fhir.dstu3.model.IdType theId,
-				@OperationParam(name = "url", min = 0, max = 1) org.hl7.fhir.dstu3.model.UriType theCodeSystemUrl,
-				@OperationParam(name = "code", min = 0, max = 1) org.hl7.fhir.dstu3.model.CodeType theCode,
-				@OperationParam(name = "display", min = 0, max = 1) org.hl7.fhir.dstu3.model.StringType theDisplay
-		) throws Exception {
-			mySystemUrl = theCodeSystemUrl;
-			myCode = theCode;
-			myDisplay = theDisplay;
-			if (myException != null) {
-				throw myException;
-			}
-			return myReturnParams;
-		}
-
-		@Operation(name = JpaConstants.OPERATION_LOOKUP, idempotent = true, returnParameters= {
-				@OperationParam(name = "name", type = org.hl7.fhir.dstu3.model.StringType.class, min = 1),
-				@OperationParam(name = "version", type = org.hl7.fhir.dstu3.model.StringType.class),
-				@OperationParam(name = "display", type = org.hl7.fhir.dstu3.model.StringType.class, min = 1),
-				@OperationParam(name = "abstract", type = org.hl7.fhir.dstu3.model.BooleanType.class, min = 1),
-				@OperationParam(name = "property", type = org.hl7.fhir.dstu3.model.StringType.class, min = 0, max = OperationParam.MAX_UNLIMITED)
-		})
-		public IBaseParameters lookup(
-				HttpServletRequest theServletRequest,
-				@OperationParam(name = "code", max = 1) org.hl7.fhir.dstu3.model.CodeType theCode,
-				@OperationParam(name = "system",max = 1) org.hl7.fhir.dstu3.model.UriType theSystem,
-				@OperationParam(name = "coding", max = 1) Coding theCoding,
-				@OperationParam(name = "version", max = 1) org.hl7.fhir.dstu3.model.StringType theVersion,
-				@OperationParam(name = "displayLanguage", max = 1) org.hl7.fhir.dstu3.model.CodeType theDisplayLanguage,
-				@OperationParam(name = "property", max = OperationParam.MAX_UNLIMITED) List<org.hl7.fhir.dstu3.model.CodeType> thePropertyNames,
-				RequestDetails theRequestDetails
-		) {
-			myCode = theCode;
-			return myReturnParams;
-		}
-
-		@Override
-		public Class<? extends IBaseResource> getResourceType() {
-			return CodeSystem.class;
-		}
-
-		public void setException(Exception theException) {
-			myException = theException;
-		}
-		@Override
-		public void setReturnParams(IBaseParameters theParameters) {
-			myReturnParams = (Parameters) theParameters;
-		}
-		@Override
-		public String getCode() {
-			return myCode != null ? myCode.getValueAsString() : null;
-		}
-		@Override
-		public String getSystem() {
-			return mySystemUrl != null ? mySystemUrl.getValueAsString() : null;
-		}
-		public String getDisplay() {
-			return myDisplay != null ? myDisplay.getValue() : null;
-		}
-	}
-
-	@SuppressWarnings("unused")
-	class MyValueSetProviderDstu3 implements IValidationProviders.IMyValueSetProvider {
-		private Exception myException;
-		private Parameters myReturnParams;
-		private UriType mySystemUrl;
-		private UriType myValueSetUrl;
-		private CodeType myCode;
-		private StringType myDisplay;
-
-		@Operation(name = "validate-code", idempotent = true, returnParameters = {
-				@OperationParam(name = "result", type = BooleanType.class, min = 1),
-				@OperationParam(name = "message", type = org.hl7.fhir.dstu3.model.StringType.class),
-				@OperationParam(name = "display", type = org.hl7.fhir.dstu3.model.StringType.class)
-		})
-		public Parameters validateCode(
-				HttpServletRequest theServletRequest,
-				@IdParam(optional = true) IdType theId,
-				@OperationParam(name = "url", min = 0, max = 1) org.hl7.fhir.dstu3.model.UriType theValueSetUrl,
-				@OperationParam(name = "code", min = 0, max = 1) CodeType theCode,
-				@OperationParam(name = "system", min = 0, max = 1) UriType theSystem,
-				@OperationParam(name = "display", min = 0, max = 1) StringType theDisplay,
-				@OperationParam(name = "valueSet") org.hl7.fhir.dstu3.model.ValueSet theValueSet
-		) throws Exception {
-			mySystemUrl = theSystem;
-			myValueSetUrl = theValueSetUrl;
-			myCode = theCode;
-			myDisplay = theDisplay;
-			if (myException != null) {
-				throw myException;
-			}
-			return myReturnParams;
-		}
-		@Override
-		public Class<? extends IBaseResource> getResourceType() {
-			return ValueSet.class;
-		}
-		public void setException(Exception theException) {
-			myException = theException;
-		}
-		@Override
-		public void setReturnParams(IBaseParameters theParameters) {
-			myReturnParams = (Parameters) theParameters;
-		}
-		@Override
-		public String getCode() {
-			return myCode != null ? myCode.getValueAsString() : null;
-		}
-		@Override
-		public String getSystem() {
-			return mySystemUrl != null ? mySystemUrl.getValueAsString() : null;
-		}
-		@Override
-		public String getValueSet() {
-			return myValueSetUrl != null ? myValueSetUrl.getValueAsString() : null;
-		}
-		public String getDisplay() {
-			return myDisplay != null ? myDisplay.getValue() : null;
-		}
-	}
-}
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/QuestionnaireResponseValidatorDstu3Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/QuestionnaireResponseValidatorDstu3Test.java
index 7804b9df10f2..57591b31e763 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/QuestionnaireResponseValidatorDstu3Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/QuestionnaireResponseValidatorDstu3Test.java
@@ -41,7 +41,6 @@
 import org.hl7.fhir.dstu3.model.UriType;
 import org.hl7.fhir.dstu3.model.ValueSet;
 import org.hl7.fhir.instance.model.api.IBaseResource;
-import org.hl7.fhir.utilities.validation.ValidationMessage;
 import org.junit.jupiter.api.AfterAll;
 import org.junit.jupiter.api.BeforeAll;
 import org.junit.jupiter.api.BeforeEach;
@@ -56,6 +55,8 @@
 import java.util.List;
 import java.util.stream.Collectors;
 
+import static ca.uhn.fhir.context.support.IValidationSupport.IssueSeverity.ERROR;
+import static ca.uhn.fhir.context.support.IValidationSupport.IssueSeverity.WARNING;
 import static org.assertj.core.api.Assertions.assertThat;
 import static org.hl7.fhir.dstu3.model.Questionnaire.QuestionnaireItemType.BOOLEAN;
 import static org.hl7.fhir.dstu3.model.Questionnaire.QuestionnaireItemType.CHOICE;
@@ -224,7 +225,7 @@ public void testCodedAnswer() {
 		when(myValSupport.validateCodeInValueSet(any(), any(), eq("http://codesystems.com/system"), eq("code0"), any(), nullable(ValueSet.class)))
 			.thenReturn(new IValidationSupport.CodeValidationResult().setCode("code0"));
 		when(myValSupport.validateCodeInValueSet(any(), any(), eq("http://codesystems.com/system"), eq("code1"), any(), nullable(ValueSet.class)))
-			.thenReturn(new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage("Unknown code"));
+			.thenReturn(new IValidationSupport.CodeValidationResult().setSeverity(ERROR).setMessage("Unknown code"));
 
 		CodeSystem codeSystem = new CodeSystem();
 		codeSystem.setContent(CodeSystemContentMode.COMPLETE);
@@ -246,7 +247,7 @@ public void testCodedAnswer() {
 		when(myValSupport.validateCode(any(), any(), eq("http://codesystems.com/system"), eq("code0"), any(), nullable(String.class)))
 			.thenReturn(new IValidationSupport.CodeValidationResult().setCode(CODE_ICC_SCHOOLTYPE_PT));
 		when(myValSupport.validateCode(any(), any(), eq("http://codesystems.com/system"), eq("code1"), any(), nullable(String.class)))
-			.thenReturn(new IValidationSupport.CodeValidationResult().setSeverityCode("warning").setMessage("Unknown code: http://codesystems.com/system / code1"));
+			.thenReturn(new IValidationSupport.CodeValidationResult().setSeverity(WARNING).setMessage("Unknown code: http://codesystems.com/system / code1"));
 
 
 		QuestionnaireResponse qa;
@@ -1034,7 +1035,7 @@ public void testOpenchoiceAnswer() {
 		when(myValSupport.validateCode(any(), any(), eq("http://codesystems.com/system"), eq("code0"), any(), nullable(String.class)))
 			.thenReturn(new IValidationSupport.CodeValidationResult().setCode("code0"));
 		when(myValSupport.validateCode(any(), any(), eq("http://codesystems.com/system"), eq("code1"), any(), nullable(String.class)))
-			.thenReturn(new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage("Unknown code"));
+			.thenReturn(new IValidationSupport.CodeValidationResult().setSeverity(ERROR).setMessage("Unknown code"));
 
 		CodeSystem codeSystem = new CodeSystem();
 		codeSystem.setContent(CodeSystemContentMode.COMPLETE);
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyLookupCodeDstu3Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyLookupCodeDstu3Test.java
index 6e98c4b31a94..56bc892c3d41 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyLookupCodeDstu3Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyLookupCodeDstu3Test.java
@@ -12,9 +12,9 @@
 import ca.uhn.fhir.rest.server.exceptions.InvalidRequestException;
 import ca.uhn.fhir.rest.server.exceptions.ResourceNotFoundException;
 import ca.uhn.fhir.test.utilities.server.RestfulServerExtension;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
 import jakarta.servlet.http.HttpServletRequest;
 import org.hl7.fhir.common.hapi.validation.IRemoteTerminologyLookupCodeTest;
-import org.hl7.fhir.common.hapi.validation.IValidationProviders;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
 import org.hl7.fhir.dstu3.model.BooleanType;
 import org.hl7.fhir.dstu3.model.CodeSystem;
@@ -164,8 +164,6 @@ void lookupCode_withCodeSystemWithDesignation_returnsCorrectDesignation(final IV
 
 	@SuppressWarnings("unused")
 	static class MyLookupCodeProviderDstu3 implements IValidationProviders.IMyLookupCodeProvider {
-		private UriType mySystemUrl;
-		private CodeType myCode;
 		private LookupCodeResult myLookupCodeResult;
 
 		@Override
@@ -190,8 +188,6 @@ public IBaseParameters lookup(
 			@OperationParam(name= " property", max = OperationParam.MAX_UNLIMITED) List<StringType> thePropertyNames,
 			RequestDetails theRequestDetails
 		) {
-			myCode = theCode;
-			mySystemUrl = theSystem;
 			if (theSystem == null) {
 				throw new InvalidRequestException(MessageFormat.format(MESSAGE_RESPONSE_INVALID, theCode));
 			}
@@ -205,15 +201,5 @@ public IBaseParameters lookup(
 		public Class<? extends IBaseResource> getResourceType() {
 			return CodeSystem.class;
 		}
-
-		@Override
-		public String getCode() {
-			return myCode != null ? myCode.getValueAsString() : null;
-		}
-
-		@Override
-		public String getSystem() {
-			return mySystemUrl != null ? mySystemUrl.getValueAsString() : null;
-		}
 	}
 }
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyLookupCodeWithResponseFileDstu3Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyLookupCodeWithResponseFileDstu3Test.java
index 48a99f260d0b..4817542ef4dd 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyLookupCodeWithResponseFileDstu3Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyLookupCodeWithResponseFileDstu3Test.java
@@ -5,13 +5,10 @@
 import ca.uhn.fhir.context.support.LookupCodeRequest;
 import ca.uhn.fhir.rest.client.interceptor.LoggingInterceptor;
 import ca.uhn.fhir.test.utilities.server.RestfulServerExtension;
-import ca.uhn.fhir.util.ClasspathUtil;
-import org.hl7.fhir.common.hapi.validation.IValidationProviders;
+import ca.uhn.fhir.test.utilities.validation.IValidationProvidersDstu3;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
-import org.hl7.fhir.dstu3.model.Parameters;
 import org.hl7.fhir.dstu3.model.StringType;
 import org.hl7.fhir.instance.model.api.IBaseParameters;
-import org.hl7.fhir.instance.model.api.IBaseResource;
 import org.junit.jupiter.api.AfterEach;
 import org.junit.jupiter.api.BeforeEach;
 import org.junit.jupiter.api.Test;
@@ -19,13 +16,15 @@
 
 import java.util.List;
 
+import static ca.uhn.fhir.jpa.model.util.JpaConstants.OPERATION_LOOKUP;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM;
 import static org.junit.jupiter.api.Assertions.assertEquals;
 import static org.junit.jupiter.api.Assertions.assertNotNull;
-import static org.junit.jupiter.api.Assertions.assertTrue;
 
 public class RemoteTerminologyLookupCodeWithResponseFileDstu3Test {
 	private static final FhirContext ourCtx = FhirContext.forDstu3Cached();
-	private IValidateCodeProvidersDstu3.MyCodeSystemProviderDstu3 myCodeSystemProvider;
+	private IValidationProvidersDstu3.MyCodeSystemProviderDstu3 myCodeSystemProvider;
 	@RegisterExtension
 	public static RestfulServerExtension ourRestfulServerExtension = new RestfulServerExtension(ourCtx);
 
@@ -36,7 +35,7 @@ public void before() {
 		String baseUrl = "http://localhost:" + ourRestfulServerExtension.getPort();
 		mySvc = new RemoteTerminologyServiceValidationSupport(ourCtx, baseUrl);
 		mySvc.addClientInterceptor(new LoggingInterceptor(false).setLogRequestSummary(true).setLogResponseSummary(true));
-		myCodeSystemProvider = new IValidateCodeProvidersDstu3.MyCodeSystemProviderDstu3();
+		myCodeSystemProvider = new IValidationProvidersDstu3.MyCodeSystemProviderDstu3();
 		ourRestfulServerExtension.getRestfulServer().registerProviders(myCodeSystemProvider);
 	}
 
@@ -47,13 +46,10 @@ public void after() {
 	}
 	@Test
 	void lookupCode_withParametersOutput_convertsCorrectly() {
-		String paramsAsString = ClasspathUtil.loadResource("/terminology/CodeSystem-lookup-output-with-subproperties.json");
-		IBaseResource baseResource = ourCtx.newJsonParser().parseResource(paramsAsString);
-		assertTrue(baseResource instanceof Parameters);
-		Parameters resultParameters = (Parameters) baseResource;
-		myCodeSystemProvider.setReturnParams(resultParameters);
+		String outputFile ="/terminology/CodeSystem-lookup-output-with-subproperties.json";
+		IBaseParameters resultParameters = myCodeSystemProvider.addTerminologyResponse(OPERATION_LOOKUP, CODE_SYSTEM, CODE, ourCtx, outputFile);
 
-		LookupCodeRequest request = new LookupCodeRequest(IValidationProviders.CODE_SYSTEM, IValidationProviders.CODE, null, List.of("interfaces"));
+		LookupCodeRequest request = new LookupCodeRequest(CODE_SYSTEM, CODE, null, List.of("interfaces"));
 
 		// test
 		IValidationSupport.LookupCodeResult outcome = mySvc.lookupCode(null, request);
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyValidateCodeDstu3Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyValidateCodeDstu3Test.java
index af4f39f09262..2f573ad3e5fc 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyValidateCodeDstu3Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/dstu3/hapi/validation/RemoteTerminologyValidateCodeDstu3Test.java
@@ -4,16 +4,18 @@
 import ca.uhn.fhir.rest.client.api.ServerValidationModeEnum;
 import ca.uhn.fhir.rest.client.interceptor.LoggingInterceptor;
 import ca.uhn.fhir.test.utilities.server.RestfulServerExtension;
-import ca.uhn.fhir.util.ClasspathUtil;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
+import ca.uhn.fhir.test.utilities.validation.IValidationProvidersDstu3;
 import org.hl7.fhir.common.hapi.validation.IRemoteTerminologyValidateCodeTest;
-import org.hl7.fhir.common.hapi.validation.IValidationProviders;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
 import org.hl7.fhir.dstu3.model.BooleanType;
+import org.hl7.fhir.dstu3.model.CodeSystem;
 import org.hl7.fhir.dstu3.model.OperationOutcome;
 import org.hl7.fhir.dstu3.model.Parameters;
 import org.hl7.fhir.dstu3.model.Resource;
 import org.hl7.fhir.dstu3.model.StringType;
 import org.hl7.fhir.dstu3.model.UriType;
+import org.hl7.fhir.dstu3.model.ValueSet;
 import org.hl7.fhir.instance.model.api.IBaseOperationOutcome;
 import org.hl7.fhir.instance.model.api.IBaseResource;
 import org.junit.jupiter.api.AfterEach;
@@ -22,6 +24,11 @@
 
 import java.util.List;
 
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM_VERSION;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.ERROR_MESSAGE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.VALUE_SET_URL;
 import static org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport.ERROR_CODE_UNKNOWN_CODE_IN_CODE_SYSTEM;
 import static org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport.ERROR_CODE_UNKNOWN_CODE_IN_VALUE_SET;
 
@@ -38,8 +45,8 @@ public class RemoteTerminologyValidateCodeDstu3Test implements IRemoteTerminolog
 	private static final FhirContext ourCtx = FhirContext.forDstu3Cached();
 	@RegisterExtension
 	public static RestfulServerExtension ourRestfulServerExtension = new RestfulServerExtension(ourCtx);
-	private IValidateCodeProvidersDstu3.MyCodeSystemProviderDstu3 myCodeSystemProvider;
-	private IValidateCodeProvidersDstu3.MyValueSetProviderDstu3 myValueSetProvider;
+	private IValidationProviders.MyValidationProvider<CodeSystem> myCodeSystemProvider;
+	private IValidationProviders.MyValidationProvider<ValueSet> myValueSetProvider;
 	private RemoteTerminologyServiceValidationSupport mySvc;
 	private String myCodeSystemError, myValueSetError;
 
@@ -48,14 +55,14 @@ public void before() {
 		String baseUrl = "http://localhost:" + ourRestfulServerExtension.getPort();
 		myCodeSystemError = ourCtx.getLocalizer().getMessage(
 				RemoteTerminologyServiceValidationSupport.class,
-				ERROR_CODE_UNKNOWN_CODE_IN_CODE_SYSTEM, IValidationProviders.CODE_SYSTEM, IValidationProviders.CODE, baseUrl, IValidationProviders.ERROR_MESSAGE);
+				ERROR_CODE_UNKNOWN_CODE_IN_CODE_SYSTEM, CODE_SYSTEM, CODE, baseUrl, ERROR_MESSAGE);
 		myValueSetError = ourCtx.getLocalizer().getMessage(
 				RemoteTerminologyServiceValidationSupport.class,
-				ERROR_CODE_UNKNOWN_CODE_IN_VALUE_SET, IValidationProviders.CODE_SYSTEM, IValidationProviders.CODE, IValidationProviders.VALUE_SET_URL, baseUrl, IValidationProviders.ERROR_MESSAGE);
+				ERROR_CODE_UNKNOWN_CODE_IN_VALUE_SET, CODE_SYSTEM, CODE, VALUE_SET_URL, baseUrl, ERROR_MESSAGE);
 		mySvc = new RemoteTerminologyServiceValidationSupport(ourCtx, baseUrl);
 		mySvc.addClientInterceptor(new LoggingInterceptor(false).setLogRequestSummary(true).setLogResponseSummary(true));
-		myCodeSystemProvider = new IValidateCodeProvidersDstu3.MyCodeSystemProviderDstu3();
-		myValueSetProvider = new IValidateCodeProvidersDstu3.MyValueSetProviderDstu3();
+		myCodeSystemProvider = new IValidationProvidersDstu3.MyCodeSystemProviderDstu3();
+		myValueSetProvider = new IValidationProvidersDstu3.MyValueSetProviderDstu3();
 		ourRestfulServerExtension.getRestfulServer().registerProviders(myCodeSystemProvider, myValueSetProvider);
 	}
 
@@ -82,45 +89,40 @@ public String getValueSetError() {
 	}
 
 	@Override
-	public IValidateCodeProvidersDstu3.MyCodeSystemProviderDstu3 getCodeSystemProvider() {
+	public IValidationProviders.IMyValidationProvider getCodeSystemProvider() {
 		return myCodeSystemProvider;
 	}
 
 	@Override
-	public IValidateCodeProvidersDstu3.MyValueSetProviderDstu3 getValueSetProvider() {
+	public IValidationProviders.IMyValidationProvider getValueSetProvider() {
 		return myValueSetProvider;
 	}
 
 	@Override
 	public IBaseOperationOutcome getCodeSystemInvalidCodeOutcome() {
-		return ClasspathUtil.loadResource(getService().getFhirContext(), OperationOutcome.class, "/terminology/OperationOutcome-CodeSystem-invalid-code.json");
+		return getCodeSystemInvalidCodeOutcome(OperationOutcome.class);
 	}
 
 	@Override
 	public IBaseOperationOutcome getValueSetInvalidCodeOutcome() {
-		return ClasspathUtil.loadResource(getService().getFhirContext(), OperationOutcome.class, "/terminology/OperationOutcome-ValueSet-invalid-code.json");
+		return getValueSetInvalidCodeOutcome(OperationOutcome.class);
+	}
+
+	@Override
+	public IBaseOperationOutcome getValueSetCustomDetailCodeOutcome() {
+		return getValueSetCustomDetailCodeOutcome(OperationOutcome.class);
 	}
 
 	@Override
 	public Parameters createParameters(Boolean theResult, String theDisplay, String theMessage, IBaseResource theIssuesResource) {
 		Parameters parameters = new Parameters();
 		parameters.addParameter().setName("result").setValue(new BooleanType(theResult));
-		parameters.addParameter().setName("code").setValue(new StringType(IValidationProviders.CODE));
-		parameters.addParameter().setName("system").setValue(new UriType(IValidationProviders.CODE_SYSTEM));
-		parameters.addParameter().setName("version").setValue(new StringType(IValidationProviders.CODE_SYSTEM_VERSION));
+		parameters.addParameter().setName("code").setValue(new StringType(CODE));
+		parameters.addParameter().setName("system").setValue(new UriType(CODE_SYSTEM));
+		parameters.addParameter().setName("version").setValue(new StringType(CODE_SYSTEM_VERSION));
 		parameters.addParameter().setName("display").setValue(new StringType(theDisplay));
 		parameters.addParameter().setName("message").setValue(new StringType(theMessage));
 		parameters.addParameter().setName("issues").setResource((Resource) theIssuesResource);
 		return parameters;
 	}
-
-	@Override
-	public void createCodeSystemReturnParameters(Boolean theResult, String theDisplay, String theMessage, IBaseResource theIssuesResource) {
-		myCodeSystemProvider.setReturnParams(createParameters(theResult, theDisplay, theMessage, theIssuesResource));
-	}
-
-	@Override
-	public void createValueSetReturnParameters(Boolean theResult, String theDisplay, String theMessage, IBaseResource theIssuesResource) {
-		myValueSetProvider.setReturnParams(createParameters(theResult, theDisplay, theMessage, theIssuesResource));
-	}
 }
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/utils/FhirPathEngineR4Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/utils/FhirPathEngineR4Test.java
index 15bbc3a8bf35..1c2382b6aac1 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/utils/FhirPathEngineR4Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/utils/FhirPathEngineR4Test.java
@@ -54,6 +54,7 @@ public void testCrossResourceBoundaries() throws FHIRException {
 
 		List<Base> value;
 
+
 		value = ourCtx.newFhirPath().evaluate(o, "Observation.specimen", Base.class);
 		assertThat(value).hasSize(1);
 		value = ourCtx.newFhirPath().evaluate(o, "Observation.specimen.resolve()", Base.class);
@@ -65,6 +66,9 @@ public void testCrossResourceBoundaries() throws FHIRException {
 		assertEquals("2011-01-01", ((DateTimeType) value.get(0)).getValueAsString());
 	}
 
+
+
+
 	@Test
 	public void testComponentCode() {
 		String path = "(Observation.component.value.ofType(FHIR.Quantity)) ";
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/FhirInstanceValidatorR4Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/FhirInstanceValidatorR4Test.java
index d03c3aa974d8..fb46f7f80089 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/FhirInstanceValidatorR4Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/FhirInstanceValidatorR4Test.java
@@ -307,10 +307,10 @@ public IValidationSupport.CodeValidationResult answer(InvocationOnMock theInvoca
 					retVal = new IValidationSupport.CodeValidationResult().setCode(code);
 				} else if (myValidSystems.contains(system)) {
 					final String message = "Unknown code (for '" + system + "#" + code + "')";
-					retVal = new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage(message).setCodeValidationIssues(Collections.singletonList(new IValidationSupport.CodeValidationIssue(message, IValidationSupport.IssueSeverity.ERROR, IValidationSupport.CodeValidationIssueCode.CODE_INVALID, IValidationSupport.CodeValidationIssueCoding.INVALID_CODE)));
+					retVal = new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage(message).setIssues(Collections.singletonList(new IValidationSupport.CodeValidationIssue(message, IValidationSupport.IssueSeverity.ERROR, IValidationSupport.CodeValidationIssueCode.CODE_INVALID, IValidationSupport.CodeValidationIssueCoding.INVALID_CODE)));
 				} else if (myValidSystemsNotReturningIssues.contains(system)) {
 					final String message = "Unknown code (for '" + system + "#" + code + "')";
-					retVal = new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage(message);
+					retVal = new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage(message);
 				} else {
 					retVal = myDefaultValidationSupport.validateCode(new ValidationSupportContext(myDefaultValidationSupport), options, system, code, display, valueSetUrl);
 				}
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyLookupCodeR4Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyLookupCodeR4Test.java
index d67966df6d46..382f621f547e 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyLookupCodeR4Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyLookupCodeR4Test.java
@@ -11,9 +11,10 @@
 import ca.uhn.fhir.rest.server.exceptions.InvalidRequestException;
 import ca.uhn.fhir.rest.server.exceptions.ResourceNotFoundException;
 import ca.uhn.fhir.test.utilities.server.RestfulServerExtension;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
+import ca.uhn.fhir.test.utilities.validation.IValidationProvidersR4;
 import jakarta.servlet.http.HttpServletRequest;
 import org.hl7.fhir.common.hapi.validation.IRemoteTerminologyLookupCodeTest;
-import org.hl7.fhir.common.hapi.validation.IValidationProviders;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
 import org.hl7.fhir.instance.model.api.IBaseDatatype;
 import org.hl7.fhir.instance.model.api.IBaseParameters;
@@ -52,7 +53,7 @@ public class RemoteTerminologyLookupCodeR4Test implements IRemoteTerminologyLook
 	@RegisterExtension
 	public static RestfulServerExtension ourRestfulServerExtension = new RestfulServerExtension(ourCtx);
 	private final RemoteTerminologyServiceValidationSupport mySvc = new RemoteTerminologyServiceValidationSupport(ourCtx);
-	private IValidateCodeProvidersR4.MyCodeSystemProviderR4 myCodeSystemProvider;
+	private IValidationProvidersR4.MyCodeSystemProviderR4 myCodeSystemProvider;
 	private MyLookupCodeProviderR4 myLookupCodeProviderR4;
 
 	@BeforeEach
@@ -60,7 +61,7 @@ public void before() {
 		String baseUrl = "http://localhost:" + ourRestfulServerExtension.getPort();
 		mySvc.setBaseUrl(baseUrl);
 		mySvc.addClientInterceptor(new LoggingInterceptor(true));
-		myCodeSystemProvider = new IValidateCodeProvidersR4.MyCodeSystemProviderR4();
+		myCodeSystemProvider = new IValidationProvidersR4.MyCodeSystemProviderR4();
 		myLookupCodeProviderR4 = new MyLookupCodeProviderR4();
 		ourRestfulServerExtension.getRestfulServer().registerProviders(myCodeSystemProvider, myLookupCodeProviderR4);
 	}
@@ -166,8 +167,6 @@ void lookupCode_withCodeSystemWithDesignation_returnsCorrectDesignation(final IV
 
 	@SuppressWarnings("unused")
 	static class MyLookupCodeProviderR4 implements IValidationProviders.IMyLookupCodeProvider {
-		private UriType mySystemUrl;
-		private CodeType myCode;
 		private LookupCodeResult myLookupCodeResult;
 
 		@Override
@@ -192,8 +191,6 @@ public IBaseParameters lookup(
 			@OperationParam(name = "property", max = OperationParam.MAX_UNLIMITED) List<CodeType> thePropertyNames,
 			RequestDetails theRequestDetails
 		) {
-			myCode = theCode;
-			mySystemUrl = theSystem;
 			if (theSystem == null) {
 				throw new InvalidRequestException(MessageFormat.format(MESSAGE_RESPONSE_INVALID, theCode));
 			}
@@ -206,15 +203,5 @@ public IBaseParameters lookup(
 		public Class<? extends IBaseResource> getResourceType() {
 			return CodeSystem.class;
 		}
-
-		@Override
-		public String getCode() {
-			return myCode != null ? myCode.getValueAsString() : null;
-		}
-
-		@Override
-		public String getSystem() {
-			return mySystemUrl != null ? mySystemUrl.getValueAsString() : null;
-		}
 	}
 }
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyLookupCodeWithResponseFileR4Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyLookupCodeWithResponseFileR4Test.java
index 37eba91d0ca1..a0896bd8c4e7 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyLookupCodeWithResponseFileR4Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyLookupCodeWithResponseFileR4Test.java
@@ -5,12 +5,9 @@
 import ca.uhn.fhir.context.support.LookupCodeRequest;
 import ca.uhn.fhir.rest.client.interceptor.LoggingInterceptor;
 import ca.uhn.fhir.test.utilities.server.RestfulServerExtension;
-import ca.uhn.fhir.util.ClasspathUtil;
-import org.hl7.fhir.common.hapi.validation.IValidationProviders;
+import ca.uhn.fhir.test.utilities.validation.IValidationProvidersR4;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
 import org.hl7.fhir.instance.model.api.IBaseParameters;
-import org.hl7.fhir.instance.model.api.IBaseResource;
-import org.hl7.fhir.r4.model.Parameters;
 import org.hl7.fhir.r4.model.StringType;
 import org.junit.jupiter.api.AfterEach;
 import org.junit.jupiter.api.BeforeEach;
@@ -19,13 +16,15 @@
 
 import java.util.List;
 
+import static ca.uhn.fhir.jpa.model.util.JpaConstants.OPERATION_LOOKUP;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM;
 import static org.junit.jupiter.api.Assertions.assertEquals;
 import static org.junit.jupiter.api.Assertions.assertNotNull;
-import static org.junit.jupiter.api.Assertions.assertTrue;
 
 public class RemoteTerminologyLookupCodeWithResponseFileR4Test {
 	private static final FhirContext ourCtx = FhirContext.forR4Cached();
-	private IValidateCodeProvidersR4.MyCodeSystemProviderR4 myCodeSystemProvider;
+	private IValidationProvidersR4.MyCodeSystemProviderR4 myCodeSystemProvider;
 	@RegisterExtension
 	public static RestfulServerExtension ourRestfulServerExtension = new RestfulServerExtension(ourCtx);
 
@@ -36,7 +35,7 @@ public void before() {
 		String baseUrl = "http://localhost:" + ourRestfulServerExtension.getPort();
 		mySvc = new RemoteTerminologyServiceValidationSupport(ourCtx, baseUrl);
 		mySvc.addClientInterceptor(new LoggingInterceptor(false).setLogRequestSummary(true).setLogResponseSummary(true));
-		myCodeSystemProvider = new IValidateCodeProvidersR4.MyCodeSystemProviderR4();
+		myCodeSystemProvider = new IValidationProvidersR4.MyCodeSystemProviderR4();
 		ourRestfulServerExtension.getRestfulServer().registerProviders(myCodeSystemProvider);
 	}
 
@@ -48,13 +47,10 @@ public void after() {
 
 	@Test
 	void lookupCode_withParametersOutput_convertsCorrectly() {
-		String paramsAsString = ClasspathUtil.loadResource("/terminology/CodeSystem-lookup-output-with-subproperties.json");
-		IBaseResource baseResource = ourCtx.newJsonParser().parseResource(paramsAsString);
-		assertTrue(baseResource instanceof Parameters);
-		Parameters resultParameters = (Parameters) baseResource;
-		myCodeSystemProvider.setReturnParams(resultParameters);
+		String outputFile ="/terminology/CodeSystem-lookup-output-with-subproperties.json";
+		IBaseParameters resultParameters = myCodeSystemProvider.addTerminologyResponse(OPERATION_LOOKUP, CODE_SYSTEM, CODE, ourCtx, outputFile);
 
-		LookupCodeRequest request = new LookupCodeRequest(IValidationProviders.CODE_SYSTEM, IValidationProviders.CODE, null, List.of("interfaces"));
+		LookupCodeRequest request = new LookupCodeRequest(CODE_SYSTEM, CODE, null, List.of("interfaces"));
 
 		// test
 		IValidationSupport.LookupCodeResult outcome = mySvc.lookupCode(null, request);
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyValidateCodeR4Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyValidateCodeR4Test.java
index 08f6c251869d..ffd8045a8a53 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyValidateCodeR4Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4/validation/RemoteTerminologyValidateCodeR4Test.java
@@ -2,8 +2,8 @@
 
 import ca.uhn.fhir.context.FhirContext;
 import ca.uhn.fhir.context.support.ConceptValidationOptions;
-import ca.uhn.fhir.context.support.IValidationSupport;
 import ca.uhn.fhir.context.support.IValidationSupport.CodeValidationResult;
+import ca.uhn.fhir.jpa.model.util.JpaConstants;
 import ca.uhn.fhir.parser.IJsonLikeParser;
 import ca.uhn.fhir.rest.client.api.IClientInterceptor;
 import ca.uhn.fhir.rest.client.api.IHttpRequest;
@@ -13,11 +13,11 @@
 import ca.uhn.fhir.rest.server.exceptions.InvalidRequestException;
 import ca.uhn.fhir.rest.server.exceptions.ResourceNotFoundException;
 import ca.uhn.fhir.test.utilities.server.RestfulServerExtension;
-import ca.uhn.fhir.util.ClasspathUtil;
+import ca.uhn.fhir.test.utilities.validation.IValidationProviders;
+import ca.uhn.fhir.test.utilities.validation.IValidationProvidersR4;
 import ca.uhn.fhir.util.ParametersUtil;
 import com.google.common.collect.Lists;
 import org.hl7.fhir.common.hapi.validation.IRemoteTerminologyValidateCodeTest;
-import org.hl7.fhir.common.hapi.validation.IValidationProviders;
 import org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport;
 import org.hl7.fhir.instance.model.api.IBaseOperationOutcome;
 import org.hl7.fhir.instance.model.api.IBaseResource;
@@ -39,6 +39,12 @@
 import java.util.List;
 import java.util.stream.Stream;
 
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.CODE_SYSTEM_VERSION;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.DISPLAY;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.ERROR_MESSAGE;
+import static ca.uhn.fhir.test.utilities.validation.IValidationProviders.VALUE_SET_URL;
 import static org.assertj.core.api.Assertions.assertThat;
 import static org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport.ERROR_CODE_UNKNOWN_CODE_IN_CODE_SYSTEM;
 import static org.hl7.fhir.common.hapi.validation.support.RemoteTerminologyServiceValidationSupport.ERROR_CODE_UNKNOWN_CODE_IN_VALUE_SET;
@@ -61,8 +67,8 @@ public class RemoteTerminologyValidateCodeR4Test implements IRemoteTerminologyVa
 	private static final FhirContext ourCtx = FhirContext.forR4Cached();
 	@RegisterExtension
 	public static RestfulServerExtension ourRestfulServerExtension = new RestfulServerExtension(ourCtx);
-	private IValidateCodeProvidersR4.MyCodeSystemProviderR4 myCodeSystemProvider;
-	private IValidateCodeProvidersR4.MyValueSetProviderR4 myValueSetProvider;
+	private IValidationProviders.IMyValidationProvider myCodeSystemProvider;
+	private IValidationProviders.IMyValidationProvider myValueSetProvider;
 	private RemoteTerminologyServiceValidationSupport mySvc;
 	private String myCodeSystemError, myValueSetError;
 
@@ -71,14 +77,14 @@ public void before() {
 		String baseUrl = "http://localhost:" + ourRestfulServerExtension.getPort();
 		myCodeSystemError = ourCtx.getLocalizer().getMessage(
 				RemoteTerminologyServiceValidationSupport.class,
-				ERROR_CODE_UNKNOWN_CODE_IN_CODE_SYSTEM, IValidationProviders.CODE_SYSTEM, IValidationProviders.CODE, baseUrl, IValidationProviders.ERROR_MESSAGE);
+				ERROR_CODE_UNKNOWN_CODE_IN_CODE_SYSTEM, CODE_SYSTEM, CODE, baseUrl, ERROR_MESSAGE);
 		myValueSetError = ourCtx.getLocalizer().getMessage(
 				RemoteTerminologyServiceValidationSupport.class,
-				ERROR_CODE_UNKNOWN_CODE_IN_VALUE_SET, IValidationProviders.CODE_SYSTEM, IValidationProviders.CODE, IValidationProviders.VALUE_SET_URL, baseUrl, IValidationProviders.ERROR_MESSAGE);
+				ERROR_CODE_UNKNOWN_CODE_IN_VALUE_SET, CODE_SYSTEM, CODE, VALUE_SET_URL, baseUrl, ERROR_MESSAGE);
 		mySvc = new RemoteTerminologyServiceValidationSupport(ourCtx, baseUrl);
 		mySvc.addClientInterceptor(new LoggingInterceptor(false).setLogRequestSummary(true).setLogResponseSummary(true));
-		myCodeSystemProvider = new IValidateCodeProvidersR4.MyCodeSystemProviderR4();
-		myValueSetProvider = new IValidateCodeProvidersR4.MyValueSetProviderR4();
+		myCodeSystemProvider = new IValidationProvidersR4.MyCodeSystemProviderR4();
+		myValueSetProvider = new IValidationProvidersR4.MyValueSetProviderR4();
 		ourRestfulServerExtension.getRestfulServer().registerProviders(myCodeSystemProvider, myValueSetProvider);
 	}
 
@@ -95,12 +101,12 @@ public RemoteTerminologyServiceValidationSupport getService() {
 	}
 
 	@Override
-	public IValidationProviders.IMyCodeSystemProvider getCodeSystemProvider() {
+	public IValidationProviders.IMyValidationProvider getCodeSystemProvider() {
 		return myCodeSystemProvider;
 	}
 
 	@Override
-	public IValidationProviders.IMyValueSetProvider getValueSetProvider() {
+	public IValidationProviders.IMyValidationProvider getValueSetProvider() {
 		return myValueSetProvider;
 	}
 
@@ -116,51 +122,40 @@ public String getValueSetError() {
 
 	@Override
 	public IBaseOperationOutcome getCodeSystemInvalidCodeOutcome() {
-		return ClasspathUtil.loadResource(getService().getFhirContext(), OperationOutcome.class, "/terminology/OperationOutcome-CodeSystem-invalid-code.json");
+		return getCodeSystemInvalidCodeOutcome(OperationOutcome.class);
 	}
 
 	@Override
 	public IBaseOperationOutcome getValueSetInvalidCodeOutcome() {
-		return ClasspathUtil.loadResource(getService().getFhirContext(), OperationOutcome.class, "/terminology/OperationOutcome-ValueSet-invalid-code.json");
+		return getValueSetInvalidCodeOutcome(OperationOutcome.class);
 	}
 
 	@Override
-	public List<IValidationSupport.CodeValidationIssue> getCodeValidationIssues(IBaseOperationOutcome theOperationOutcome) {
-		return ((OperationOutcome)theOperationOutcome).getIssue().stream()
-				.map(issueComponent -> new IValidationSupport.CodeValidationIssue(
-						issueComponent.getDetails().getText(),
-						IValidationSupport.IssueSeverity.ERROR,
-						/* assume issue type is OperationOutcome.IssueType#CODEINVALID as it is the only match */
-						IValidationSupport.CodeValidationIssueCode.INVALID,
-						IValidationSupport.CodeValidationIssueCoding.INVALID_CODE))
-				.toList();
+	public IBaseOperationOutcome getValueSetCustomDetailCodeOutcome() {
+		return getValueSetCustomDetailCodeOutcome(OperationOutcome.class);
 	}
 
 	@Test
 	void validateCodeInValueSet_success() {
-		createValueSetReturnParameters(true, IValidationProviders.DISPLAY, null, null);
+		createValueSetReturnParameters(true, DISPLAY, null, null);
 
 		ValueSet valueSet = new ValueSet();
-		valueSet.setUrl(IValidationProviders.VALUE_SET_URL);
+		valueSet.setUrl(VALUE_SET_URL);
 
-		CodeValidationResult outcome = mySvc.validateCodeInValueSet(null, new ConceptValidationOptions(), IValidationProviders.CODE_SYSTEM, IValidationProviders.CODE, IValidationProviders.DISPLAY, valueSet);
+		CodeValidationResult outcome = mySvc.validateCodeInValueSet(null, new ConceptValidationOptions(), CODE_SYSTEM, CODE, DISPLAY, valueSet);
 		assertNotNull(outcome);
-		assertEquals(IValidationProviders.CODE, outcome.getCode());
-		assertEquals(IValidationProviders.DISPLAY, outcome.getDisplay());
+		assertEquals(CODE, outcome.getCode());
+		assertEquals(DISPLAY, outcome.getDisplay());
 		assertNull(outcome.getSeverity());
 		assertNull(outcome.getMessage());
-
-		assertEquals(IValidationProviders.CODE, myValueSetProvider.getCode());
-		assertEquals(IValidationProviders.DISPLAY, myValueSetProvider.getDisplay());
-		assertEquals(IValidationProviders.VALUE_SET_URL, myValueSetProvider.getValueSet());
 	}
 
 	@Override
 	public Parameters createParameters(Boolean theResult, String theDisplay, String theMessage, IBaseResource theIssuesResource) {
 		Parameters parameters = new Parameters()
-				.addParameter("code", IValidationProviders.CODE)
-				.addParameter("system", IValidationProviders.CODE_SYSTEM)
-				.addParameter("version", IValidationProviders.CODE_SYSTEM_VERSION)
+				.addParameter("code", CODE)
+				.addParameter("system", CODE_SYSTEM)
+				.addParameter("version", CODE_SYSTEM_VERSION)
 				.addParameter("display", theDisplay)
 				.addParameter("message", theMessage);
 		if (theResult != null) {
@@ -181,16 +176,16 @@ class ExtractCodeSystemFromValueSet {
 
 		@Test
 		void validateCodeInValueSet_uniqueComposeInclude() {
-			createValueSetReturnParameters(true, IValidationProviders.DISPLAY, null, null);
+			createValueSetReturnParameters(true, DISPLAY, null, null);
 
 			ValueSet valueSet = new ValueSet();
-			valueSet.setUrl(IValidationProviders.VALUE_SET_URL);
+			valueSet.setUrl(VALUE_SET_URL);
 			String systemUrl = "http://hl7.org/fhir/ValueSet/administrative-gender";
 			valueSet.setCompose(new ValueSet.ValueSetComposeComponent().setInclude(
 					Collections.singletonList(new ValueSet.ConceptSetComponent().setSystem(systemUrl)) ));
 
 			CodeValidationResult outcome = mySvc.validateCodeInValueSet(null,
-					new ConceptValidationOptions().setInferSystem(true), null, IValidationProviders.CODE, IValidationProviders.DISPLAY, valueSet);
+					new ConceptValidationOptions().setInferSystem(true), null, CODE, DISPLAY, valueSet);
 
 			// validate service doesn't return error message (as when no code system is present)
 			assertNotNull(outcome);
@@ -211,16 +206,16 @@ public static Stream<Arguments> getRemoteTerminologyServerExceptions() {
 			@ParameterizedTest
 			@MethodSource(value = "getRemoteTerminologyServerExceptions")
 			void validateCodeInValueSet_systemNotPresent_returnsValidationResultWithError(Exception theException, String theServerMessage) {
-				myValueSetProvider.setException(theException);
-				createValueSetReturnParameters(true, IValidationProviders.DISPLAY, null, null);
+				getValueSetProvider().addException("$validate-code", VALUE_SET_URL, CODE, theException);
+				createValueSetReturnParameters(true, DISPLAY, null, null);
 
 				ValueSet valueSet = new ValueSet();
-				valueSet.setUrl(IValidationProviders.VALUE_SET_URL);
+				valueSet.setUrl(VALUE_SET_URL);
 				valueSet.setCompose(new ValueSet.ValueSetComposeComponent().setInclude(
 						Lists.newArrayList(new ValueSet.ConceptSetComponent(), new ValueSet.ConceptSetComponent())));
 
 				CodeValidationResult outcome = mySvc.validateCodeInValueSet(null,
-						new ConceptValidationOptions().setInferSystem(true), null, IValidationProviders.CODE, IValidationProviders.DISPLAY, valueSet);
+						new ConceptValidationOptions().setInferSystem(true), null, CODE, DISPLAY, valueSet);
 
 				String unknownCodeForValueSetError = "Unknown code \"null#CODE\" for ValueSet with URL \"http://value.set/url\". The Remote Terminology server http://";
 				verifyErrorResultFromException(outcome, unknownCodeForValueSetError, theServerMessage);
@@ -230,11 +225,11 @@ void validateCodeInValueSet_systemNotPresent_returnsValidationResultWithError(Ex
 			@ParameterizedTest
 			@MethodSource(value = "getRemoteTerminologyServerExceptions")
 			void validateCodeInValueSet_systemPresentCodeNotPresent_returnsValidationResultWithError(Exception theException, String theServerMessage) {
-				myValueSetProvider.setException(theException);
-				createValueSetReturnParameters(true, IValidationProviders.DISPLAY, null, null);
+				getValueSetProvider().addException(JpaConstants.OPERATION_VALIDATE_CODE, VALUE_SET_URL, CODE, theException);
+				createValueSetReturnParameters(true, DISPLAY, null, null);
 
 				ValueSet valueSet = new ValueSet();
-				valueSet.setUrl(IValidationProviders.VALUE_SET_URL);
+				valueSet.setUrl(VALUE_SET_URL);
 				String systemUrl = "http://hl7.org/fhir/ValueSet/administrative-gender";
 				String systemUrl2 = "http://hl7.org/fhir/ValueSet/other-valueset";
 				valueSet.setCompose(new ValueSet.ValueSetComposeComponent().setInclude(
@@ -243,7 +238,7 @@ void validateCodeInValueSet_systemPresentCodeNotPresent_returnsValidationResultW
 								new ValueSet.ConceptSetComponent().setSystem(systemUrl2))));
 
 				CodeValidationResult outcome = mySvc.validateCodeInValueSet(null,
-						new ConceptValidationOptions().setInferSystem(true), null, IValidationProviders.CODE, IValidationProviders.DISPLAY, valueSet);
+						new ConceptValidationOptions().setInferSystem(true), null, CODE, DISPLAY, valueSet);
 
 				String unknownCodeForValueSetError = "Unknown code \"null#CODE\" for ValueSet with URL \"http://value.set/url\". The Remote Terminology server http://";
 				verifyErrorResultFromException(outcome, unknownCodeForValueSetError, theServerMessage);
@@ -252,10 +247,10 @@ void validateCodeInValueSet_systemPresentCodeNotPresent_returnsValidationResultW
 
 			@Test
 			void validateCodeInValueSet_systemPresentCodePresentValidatesOKNoVersioned() {
-				createValueSetReturnParameters(true, IValidationProviders.DISPLAY, null, null);
+				createValueSetReturnParameters(true, DISPLAY, null, null);
 
 				ValueSet valueSet = new ValueSet();
-				valueSet.setUrl(IValidationProviders.VALUE_SET_URL);
+				valueSet.setUrl(VALUE_SET_URL);
 				String systemUrl = "http://hl7.org/fhir/ValueSet/administrative-gender";
 				String systemUrl2 = "http://hl7.org/fhir/ValueSet/other-valueset";
 				valueSet.setCompose(new ValueSet.ValueSetComposeComponent().setInclude(
@@ -264,14 +259,14 @@ void validateCodeInValueSet_systemPresentCodePresentValidatesOKNoVersioned() {
 								new ValueSet.ConceptSetComponent().setSystem(systemUrl2).setConcept(
 										Lists.newArrayList(
 												new ValueSet.ConceptReferenceComponent().setCode("not-the-code"),
-												new ValueSet.ConceptReferenceComponent().setCode(IValidationProviders.CODE) )
+												new ValueSet.ConceptReferenceComponent().setCode(CODE) )
 								)) ));
 
 				TestClientInterceptor requestInterceptor = new TestClientInterceptor();
 				mySvc.addClientInterceptor(requestInterceptor);
 
 				CodeValidationResult outcome = mySvc.validateCodeInValueSet(null,
-						new ConceptValidationOptions().setInferSystem(true), null, IValidationProviders.CODE, IValidationProviders.DISPLAY, valueSet);
+						new ConceptValidationOptions().setInferSystem(true), null, CODE, DISPLAY, valueSet);
 
 				assertNotNull(outcome);
 				assertEquals(systemUrl2, requestInterceptor.getCapturedSystemParameter());
@@ -280,10 +275,10 @@ void validateCodeInValueSet_systemPresentCodePresentValidatesOKNoVersioned() {
 
 			@Test
 			void validateCodeInValueSet_systemPresentCodePresentValidatesOKVersioned() {
-				createValueSetReturnParameters(true, IValidationProviders.DISPLAY, null, null);
+				createValueSetReturnParameters(true, DISPLAY, null, null);
 
 				ValueSet valueSet = new ValueSet();
-				valueSet.setUrl(IValidationProviders.VALUE_SET_URL);
+				valueSet.setUrl(VALUE_SET_URL);
 				String systemUrl = "http://hl7.org/fhir/ValueSet/administrative-gender";
 				String systemVersion = "3.0.2";
 				String systemUrl2 = "http://hl7.org/fhir/ValueSet/other-valueset";
@@ -294,14 +289,14 @@ void validateCodeInValueSet_systemPresentCodePresentValidatesOKVersioned() {
 								new ValueSet.ConceptSetComponent().setSystem(systemUrl2).setVersion(system2Version).setConcept(
 										Lists.newArrayList(
 												new ValueSet.ConceptReferenceComponent().setCode("not-the-code"),
-												new ValueSet.ConceptReferenceComponent().setCode(IValidationProviders.CODE) )
+												new ValueSet.ConceptReferenceComponent().setCode(CODE) )
 								)) ));
 
 				TestClientInterceptor requestInterceptor = new TestClientInterceptor();
 				mySvc.addClientInterceptor(requestInterceptor);
 
 				CodeValidationResult outcome = mySvc.validateCodeInValueSet(null,
-						new ConceptValidationOptions().setInferSystem(true), null, IValidationProviders.CODE, IValidationProviders.DISPLAY, valueSet);
+						new ConceptValidationOptions().setInferSystem(true), null, CODE, DISPLAY, valueSet);
 
 				assertNotNull(outcome);
 				assertEquals(systemUrl2 + "|" + system2Version, requestInterceptor.getCapturedSystemParameter());
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4b/validation/FhirInstanceValidatorR4BTest.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4b/validation/FhirInstanceValidatorR4BTest.java
index ca55a41bf4c2..d5035a8048ef 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4b/validation/FhirInstanceValidatorR4BTest.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r4b/validation/FhirInstanceValidatorR4BTest.java
@@ -31,6 +31,7 @@
 import org.hl7.fhir.instance.model.api.IBaseResource;
 import org.hl7.fhir.r4b.conformance.ProfileUtilities;
 import org.hl7.fhir.r4b.context.IWorkerContext;
+import org.hl7.fhir.r4b.fhirpath.FHIRPathEngine;
 import org.hl7.fhir.r4b.hapi.ctx.HapiWorkerContext;
 import org.hl7.fhir.r4b.model.AllergyIntolerance;
 import org.hl7.fhir.r4b.model.Base;
@@ -61,7 +62,6 @@
 import org.hl7.fhir.r4b.model.ValueSet;
 import org.hl7.fhir.r4b.model.ValueSet.ValueSetExpansionComponent;
 import org.hl7.fhir.r4b.terminologies.ValueSetExpander;
-import org.hl7.fhir.r4b.fhirpath.FHIRPathEngine;
 import org.hl7.fhir.r5.test.utils.ClassesLoadedFlags;
 import org.hl7.fhir.r5.utils.validation.IValidationPolicyAdvisor;
 import org.hl7.fhir.r5.utils.validation.IValidatorResourceFetcher;
@@ -203,7 +203,7 @@ public IValidationSupport.CodeValidationResult answer(InvocationOnMock theInvoca
 					retVal = new IValidationSupport.CodeValidationResult().setCode(code);
 				} else if (myValidSystems.contains(system)) {
 					final String message = "Unknown code (for '" + system + "#" + code + "')";
-					return new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage(message).setCodeValidationIssues(Collections.singletonList(new IValidationSupport.CodeValidationIssue(message, IValidationSupport.IssueSeverity.ERROR, IValidationSupport.CodeValidationIssueCode.CODE_INVALID, IValidationSupport.CodeValidationIssueCoding.INVALID_CODE)));
+					return new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage(message).setIssues(Collections.singletonList(new IValidationSupport.CodeValidationIssue(message, IValidationSupport.IssueSeverity.ERROR, IValidationSupport.CodeValidationIssueCode.CODE_INVALID, IValidationSupport.CodeValidationIssueCoding.INVALID_CODE)));
 				} else {
 					retVal = myDefaultValidationSupport.validateCode(new ValidationSupportContext(myDefaultValidationSupport), options, system, code, display, valueSetUrl);
 				}
diff --git a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r5/validation/FhirInstanceValidatorR5Test.java b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r5/validation/FhirInstanceValidatorR5Test.java
index f0ea48686e17..abcb0f947046 100644
--- a/hapi-fhir-validation/src/test/java/org/hl7/fhir/r5/validation/FhirInstanceValidatorR5Test.java
+++ b/hapi-fhir-validation/src/test/java/org/hl7/fhir/r5/validation/FhirInstanceValidatorR5Test.java
@@ -48,7 +48,6 @@
 import org.hl7.fhir.r5.utils.validation.IValidatorResourceFetcher;
 import org.hl7.fhir.r5.utils.validation.constants.BestPracticeWarningLevel;
 import org.hl7.fhir.r5.utils.validation.constants.ReferenceValidationPolicy;
-import org.hl7.fhir.utilities.validation.ValidationMessage;
 import org.hl7.fhir.utilities.xhtml.XhtmlNode;
 import org.junit.jupiter.api.AfterAll;
 import org.junit.jupiter.api.BeforeEach;
@@ -200,10 +199,10 @@ public IValidationSupport.CodeValidationResult answer(InvocationOnMock theInvoca
 					retVal = new IValidationSupport.CodeValidationResult().setCode(code);
 				} else if (myValidSystems.contains(system)) {
 					String theMessage = "Unknown code (for '" + system + "#" + code + "')";
-					retVal = new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage(theMessage).setCodeValidationIssues(Collections.singletonList(new IValidationSupport.CodeValidationIssue(theMessage, IValidationSupport.IssueSeverity.ERROR, IValidationSupport.CodeValidationIssueCode.CODE_INVALID, IValidationSupport.CodeValidationIssueCoding.INVALID_CODE)));
+					retVal = new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage(theMessage).setIssues(Collections.singletonList(new IValidationSupport.CodeValidationIssue(theMessage, IValidationSupport.IssueSeverity.ERROR, IValidationSupport.CodeValidationIssueCode.CODE_INVALID, IValidationSupport.CodeValidationIssueCoding.INVALID_CODE)));
 				} else if (myValidSystemsNotReturningIssues.contains(system)) {
 					final String message = "Unknown code (for '" + system + "#" + code + "')";
-					retVal = new IValidationSupport.CodeValidationResult().setSeverityCode(ValidationMessage.IssueSeverity.ERROR.toCode()).setMessage(message);
+					retVal = new IValidationSupport.CodeValidationResult().setSeverity(IValidationSupport.IssueSeverity.ERROR).setMessage(message);
 				} else {
 					retVal = myDefaultValidationSupport.validateCode(new ValidationSupportContext(myDefaultValidationSupport), options, system, code, display, valueSetUrl);
 				}
diff --git a/hapi-fhir-validation/src/test/resources/terminology/OperationOutcome-ValueSet-custom-issue-detail.json b/hapi-fhir-validation/src/test/resources/terminology/OperationOutcome-ValueSet-custom-issue-detail.json
new file mode 100644
index 000000000000..0823a430cf83
--- /dev/null
+++ b/hapi-fhir-validation/src/test/resources/terminology/OperationOutcome-ValueSet-custom-issue-detail.json
@@ -0,0 +1,22 @@
+{
+  "resourceType": "OperationOutcome",
+  "issue": [
+    {
+      "severity": "information",
+      "code": "processing",
+      "details": {
+        "coding": [
+          {
+            "system": "http://example.com/custom-issue-type",
+            "code": "valueset-is-draft"
+          }
+        ]
+      },
+      "diagnostics": "The ValueSet status is marked as draft.",
+      "location": [
+        "Bundle",
+        "Line[1] Col[2]"
+      ]
+    }
+  ]
+}
\ No newline at end of file
diff --git a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/Configuration.java b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/Configuration.java
index 3fd0a49aa5e2..640bde8c9943 100644
--- a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/Configuration.java
+++ b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/Configuration.java
@@ -4,7 +4,7 @@
 import ca.uhn.fhir.context.FhirVersionEnum;
 import ca.uhn.fhir.i18n.Msg;
 import ca.uhn.fhir.tinder.parser.BaseStructureSpreadsheetParser;
-import org.apache.commons.lang.WordUtils;
+import org.apache.commons.text.WordUtils;
 
 import java.io.File;
 import java.io.IOException;
diff --git a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/TinderGenericSingleFileMojo.java b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/TinderGenericSingleFileMojo.java
index e5a2816340fb..08fc8f2d7bbb 100644
--- a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/TinderGenericSingleFileMojo.java
+++ b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/TinderGenericSingleFileMojo.java
@@ -7,7 +7,7 @@
 import ca.uhn.fhir.tinder.parser.BaseStructureParser;
 import ca.uhn.fhir.tinder.parser.DatatypeGeneratorUsingSpreadsheet;
 import ca.uhn.fhir.tinder.parser.TargetType;
-import org.apache.commons.lang.WordUtils;
+import org.apache.commons.text.WordUtils;
 import org.apache.maven.model.Resource;
 import org.apache.maven.plugin.AbstractMojo;
 import org.apache.maven.plugin.MojoExecutionException;
diff --git a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/TinderJpaRestServerMojo.java b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/TinderJpaRestServerMojo.java
index 4503b47061f9..4f2fe43f8f6c 100644
--- a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/TinderJpaRestServerMojo.java
+++ b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/TinderJpaRestServerMojo.java
@@ -6,7 +6,7 @@
 import ca.uhn.fhir.tinder.parser.BaseStructureSpreadsheetParser;
 import ca.uhn.fhir.tinder.parser.ResourceGeneratorUsingModel;
 import ca.uhn.fhir.util.ClasspathUtil;
-import org.apache.commons.lang.WordUtils;
+import org.apache.commons.text.WordUtils;
 import org.apache.maven.plugin.AbstractMojo;
 import org.apache.maven.plugin.MojoExecutionException;
 import org.apache.maven.plugin.MojoFailureException;
diff --git a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/ant/TinderGeneratorTask.java b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/ant/TinderGeneratorTask.java
index 9819edcc795b..c8304187c85b 100644
--- a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/ant/TinderGeneratorTask.java
+++ b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/ant/TinderGeneratorTask.java
@@ -33,7 +33,7 @@
 import ca.uhn.fhir.tinder.parser.BaseStructureSpreadsheetParser;
 import ca.uhn.fhir.tinder.parser.DatatypeGeneratorUsingSpreadsheet;
 import ca.uhn.fhir.tinder.parser.TargetType;
-import org.apache.commons.lang.WordUtils;
+import org.apache.commons.text.WordUtils;
 import org.apache.maven.plugin.MojoFailureException;
 import org.apache.tools.ant.BuildException;
 import org.apache.tools.ant.Task;
diff --git a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/model/BaseElement.java b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/model/BaseElement.java
index 8de25b933767..69c30538f573 100644
--- a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/model/BaseElement.java
+++ b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/model/BaseElement.java
@@ -8,8 +8,8 @@
 import java.util.List;
 import java.util.Map;
 
-import static org.apache.commons.lang.StringUtils.defaultString;
-import static org.apache.commons.lang.StringUtils.isNotBlank;
+import static org.apache.commons.lang3.StringUtils.defaultString;
+import static org.apache.commons.lang3.StringUtils.isNotBlank;
 
 public abstract class BaseElement {
 
diff --git a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/model/SearchParameter.java b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/model/SearchParameter.java
index 7ac33c816932..fe8233c02b97 100644
--- a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/model/SearchParameter.java
+++ b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/model/SearchParameter.java
@@ -1,7 +1,7 @@
 package ca.uhn.fhir.tinder.model;
 
-import org.apache.commons.lang.WordUtils;
 import org.apache.commons.lang3.StringUtils;
+import org.apache.commons.text.WordUtils;
 
 import java.util.ArrayList;
 import java.util.Collections;
diff --git a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/parser/BaseStructureParser.java b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/parser/BaseStructureParser.java
index 68b28b0b96bd..9e465ad18cf8 100644
--- a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/parser/BaseStructureParser.java
+++ b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/parser/BaseStructureParser.java
@@ -25,9 +25,9 @@
 import com.google.common.base.Charsets;
 import org.apache.commons.io.FileUtils;
 import org.apache.commons.io.IOUtils;
-import org.apache.commons.lang.WordUtils;
 import org.apache.commons.lang3.ObjectUtils;
 import org.apache.commons.lang3.StringUtils;
+import org.apache.commons.text.WordUtils;
 import org.apache.maven.plugin.MojoFailureException;
 import org.apache.velocity.VelocityContext;
 import org.apache.velocity.app.VelocityEngine;
@@ -56,8 +56,8 @@
 import java.util.TreeMap;
 import java.util.TreeSet;
 
-import static org.apache.commons.lang.StringUtils.defaultString;
-import static org.apache.commons.lang.StringUtils.isNotBlank;
+import static org.apache.commons.lang3.StringUtils.defaultString;
+import static org.apache.commons.lang3.StringUtils.isNotBlank;
 
 public abstract class BaseStructureParser {
 
diff --git a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/parser/ResourceGeneratorUsingModel.java b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/parser/ResourceGeneratorUsingModel.java
index 734a35822ab9..0f90505d77bd 100644
--- a/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/parser/ResourceGeneratorUsingModel.java
+++ b/hapi-tinder-plugin/src/main/java/ca/uhn/fhir/tinder/parser/ResourceGeneratorUsingModel.java
@@ -6,7 +6,7 @@
 import ca.uhn.fhir.rest.api.RestSearchParameterTypeEnum;
 import ca.uhn.fhir.tinder.model.Resource;
 import ca.uhn.fhir.tinder.model.SearchParameter;
-import org.apache.commons.lang.WordUtils;
+import org.apache.commons.text.WordUtils;
 import org.apache.maven.plugin.MojoFailureException;
 
 import java.io.File;
diff --git a/pom.xml b/pom.xml
index 31b2d0c455fe..9b19056b43d8 100644
--- a/pom.xml
+++ b/pom.xml
@@ -999,8 +999,8 @@
 		<!-- Before Bumping: See note above about dbcp2 -->
 		<commons_pool2_version>2.12.0</commons_pool2_version>
 		<commons_text_version>1.10.0</commons_text_version>
-		<commons_io_version>2.11.0</commons_io_version>
-		<commons_lang3_version>3.14.0</commons_lang3_version>
+		<commons_io_version>2.17.0</commons_io_version>
+		<commons_lang3_version>3.17.0</commons_lang3_version>
 		<com_jamesmurty_utils_version>1.2</com_jamesmurty_utils_version>
 		<error_prone_core_version>2.23.0</error_prone_core_version>
 		<mockito_version>5.8.0</mockito_version>
@@ -1013,15 +1013,15 @@
 		<jaxb_runtime_version>4.0.4</jaxb_runtime_version>
 		<jena_version>4.9.0</jena_version>
 		<jersey_version>3.0.3</jersey_version>
-		<jetty_version>12.0.9</jetty_version>
+		<jetty_version>12.0.14</jetty_version>
 		<jsr305_version>3.0.2</jsr305_version>
 		<junit_version>5.10.1</junit_version>
 		<flexmark_version>0.64.8</flexmark_version>
 		<flyway_version>9.4.0</flyway_version>
-		<hibernate_version>6.4.1.Final</hibernate_version>
+		<hibernate_version>6.4.10.Final</hibernate_version>
 		<logback_version>1.4.14</logback_version>
 		<!-- Update lucene version when you update hibernate-search version - These go together! -->
-		<hibernate_search_version>7.0.0.Final</hibernate_search_version>
+		<hibernate_search_version>7.0.1.Final</hibernate_search_version>
 		<!-- Update lucene version when you update hibernate-search version - These go together! -->
 		<lucene_version>9.8.0</lucene_version>
 		<hamcrest_version>2.2</hamcrest_version>
@@ -1046,8 +1046,8 @@
 		<swagger_version>2.2.22</swagger_version>
 		<slf4j_version>2.0.13</slf4j_version>
 		<log4j_to_slf4j_version>2.19.0</log4j_to_slf4j_version>
-		<spring_version>6.1.8</spring_version>
-		<spring_data_bom_version>2023.1.6</spring_data_bom_version>
+		<spring_version>6.1.14</spring_version>
+		<spring_data_bom_version>2024.0.5</spring_data_bom_version>
 		<spring_batch_version>4.3.10</spring_batch_version>
 		<spring_boot_version>3.2.6</spring_boot_version>
 		<spring_retry_version>2.0.6</spring_retry_version>
@@ -1063,7 +1063,7 @@
 		<ucum_version>1.0.8</ucum_version>
 
 		<!-- Clinical Reasoning & CQL Support -->
-		<clinical-reasoning.version>3.13.0</clinical-reasoning.version>
+		<clinical-reasoning.version>3.13.1</clinical-reasoning.version>
 
 		<!-- Site properties -->
 		<fontawesomeVersion>5.4.1</fontawesomeVersion>
@@ -1673,7 +1673,7 @@
 			<dependency>
 				<groupId>org.apache.velocity</groupId>
 				<artifactId>velocity-engine-core</artifactId>
-				<version>2.3</version>
+				<version>2.4.1</version>
 			</dependency>
 			<dependency>
 				<groupId>org.awaitility</groupId>