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For ItemDef elements that reference a CodeList element containing CodeListItem child elements, ItemData values must match a CodedValue attribute.

The CodedValue must be an acceptable value of the DataType of the containing CodeList.

The CodeListItems within a single CodeList must not have duplicate CodedValues (as interpreted by the CodeList's DataType).

If Rank is provided for any CodeListItem in a CodeList, it must be provided for all and values must be unique.

Note: the Rank attribute may be used where the relative value corresponding to an enumeration cannot or should not be determined by its lexical order. For example, if you have a list of enumerated text values including "Low", "Medium", and "High" and wish to assign these relative numeric values 1, 2, and 3 respectively, you should include a Rank attribute for each CodeListItem defined. Without the applied rank attribute, the normal lexical ordering would be "High", "Low", and "Medium".

OrderNumber must be a positive integer.
If OrderNumber is provided for any CodeListItem, it must be provided for all and values must be unique.

Note: the OrderNumber values provide an ordering on the CodeListItems (within a containing CodeList) for use whenever a list of CodeList Items is presented to a user. They do not imply anything about event scheduling, time ordering, or data correctness.