Existing Wording
The version specific identifier SHOULD be provided whenever there are potentially significant changes in meaning across multiple releases of a code system.

Proposed Wording
The version specific identifier MUST be provided whenever there are potentially significant changes in meaning across multiple releases of a code system.

Grahame's Comments
hah, no one does this. Does Russ do this for LOINC everywhere in CDA? (in fact, does everybody?) We cannot legislate things people won't do. Also, this could become retrospectively true - a release is made with a signfiicant change, and now all systems are in violation because of something that happened after they were implemneted. No, SHOULD is right here

Disposition
Not persuasive

Disposition Comment
Not all systems are capable of knowing the version-specific identifier, nor will they necessarily be in a position to know that significant changes of meaning will have occurred. Thus SHALL isn't reasonable