diff --git a/src/converter/choice-handler.ts b/src/converter/choice-handler.ts
index e612384..7f88cd5 100644
--- a/src/converter/choice-handler.ts
+++ b/src/converter/choice-handler.ts
@@ -24,6 +24,84 @@ function canonicalToName(url: string): string {
   return parts[parts.length - 1];
 }
 
+function isChoiceTypeSlicingRoot(element: StructureDefinitionElement): boolean {
+  if (!element.path.endsWith('[x]') || element.sliceName) return false;
+  const discriminator = element.slicing?.discriminator;
+  return (
+    !!discriminator &&
+    discriminator.length === 1 &&
+    discriminator[0].type === 'type' &&
+    discriminator[0].path.trim() === '$this'
+  );
+}
+
+/**
+ * Collapse type slicing on choice elements ($this type discriminator) into the
+ * plain choice representation: the sliced element becomes the choice declaration
+ * (accumulating every variant in `choices` and keeping the slicing metadata so
+ * open/closed rules survive), and each slice becomes a regular typed variant
+ * element. Children of a slice are re-parented under its variant element.
+ */
+export function collapseChoiceTypeSlicing(
+  elements: StructureDefinitionElement[],
+): StructureDefinitionElement[] {
+  const result: StructureDefinitionElement[] = [];
+  let i = 0;
+
+  while (i < elements.length) {
+    const element = elements[i];
+    if (!isChoiceTypeSlicingRoot(element)) {
+      result.push(element);
+      i++;
+      continue;
+    }
+
+    const rootPath = element.path;
+    const basePath = rootPath.replace(/\[x\]$/, '');
+    const fieldName = basePath.split('.').pop() || '';
+    const { slicing, type, ...rootRest } = element;
+
+    const choices = (type || []).map((t) => fieldName + capitalize(canonicalToName(t.code)));
+    const slicedVariants = new Set<string>();
+    const collapsed: StructureDefinitionElement[] = [];
+    let variantPath: string | undefined;
+
+    let j = i + 1;
+    for (; j < elements.length && elements[j].path.startsWith(rootPath); j++) {
+      const el = elements[j];
+      if (el.path === rootPath && el.sliceName && el.type?.length === 1) {
+        const typeName = capitalize(canonicalToName(el.type[0].code));
+        const variantName = fieldName + typeName;
+        variantPath = basePath + typeName;
+        if (!choices.includes(variantName)) choices.push(variantName);
+        slicedVariants.add(variantName);
+        const { sliceName, ...sliceRest } = el;
+        collapsed.push({ ...sliceRest, path: variantPath, choiceOf: fieldName });
+      } else if (el.path.startsWith(`${rootPath}.`) && variantPath) {
+        collapsed.push({ ...el, path: variantPath + el.path.slice(rootPath.length) });
+      } else {
+        collapsed.push(el);
+        variantPath = undefined;
+      }
+    }
+
+    result.push({ ...rootRest, path: basePath, choices, _choiceSlicing: slicing });
+
+    // Explicit root types without a matching slice keep plain variant elements,
+    // mirroring expandChoiceElement for unsliced choice elements.
+    for (const t of type || []) {
+      const typeName = capitalize(canonicalToName(t.code));
+      if (slicedVariants.has(fieldName + typeName)) continue;
+      const { binding, ...variantRest } = rootRest;
+      result.push({ ...variantRest, path: basePath + typeName, type: [t], choiceOf: fieldName });
+    }
+    result.push(...collapsed);
+    i = j;
+  }
+
+  return result;
+}
+
 export function expandChoiceElement(
   element: StructureDefinitionElement,
 ): StructureDefinitionElement[] {
diff --git a/src/converter/index.ts b/src/converter/index.ts
index 09b7197..85130ea 100644
--- a/src/converter/index.ts
+++ b/src/converter/index.ts
@@ -1,5 +1,9 @@
 import { calculateActions } from './action-calculator.js';
-import { expandChoiceElement, isChoiceElement } from './choice-handler.js';
+import {
+  collapseChoiceTypeSlicing,
+  expandChoiceElement,
+  isChoiceElement,
+} from './choice-handler.js';
 import { transformElement } from './element-transformer.js';
 import { enrichPath, parsePath } from './path-parser.js';
 import { applyActions } from './stack-processor.js';
@@ -185,7 +189,7 @@ export function translate(
   }
 
   const header = buildResourceHeader(structureDefinition, context);
-  const elements = getDifferential(structureDefinition);
+  const elements = collapseChoiceTypeSlicing(getDifferential(structureDefinition));
 
   // Note: Root element constraints are not included in the output
 
@@ -217,8 +221,16 @@ export function translate(
     const actions = calculateActions(prevPath, enrichedPath);
 
     // Transform element
-    const transformedElement = transformElement(element, structureDefinition);
-    const elementWithIndex: Record<string, unknown> = { ...transformedElement, index: index++ };
+    const transformedElement = transformElement(element, structureDefinition) as Record<
+      string,
+      unknown
+    >;
+    // Slicing metadata from collapsed choice type slicing becomes plain slicing
+    // on the choice declaration (rules/discriminator, no slices)
+    const { _choiceSlicing, ...transformedRest } = transformedElement;
+    const elementWithIndex: Record<string, unknown> = _choiceSlicing
+      ? { ...transformedRest, slicing: _choiceSlicing, index: index++ }
+      : { ...transformedRest, index: index++ };
 
     // Apply actions
     stack = applyActions(stack, actions, elementWithIndex);
diff --git a/test/unit/converter.test.ts b/test/unit/converter.test.ts
index b679244..84fe596 100644
--- a/test/unit/converter.test.ts
+++ b/test/unit/converter.test.ts
@@ -998,4 +998,69 @@ describe('Converter Algorithm Tests', () => {
       });
     });
   });
+
+  describe('choice type slicing', () => {
+    // Mirrors profiles like KBV_PR_Base_Condition_Diagnosis (kbv.basis), which
+    // slice a choice element by type ($this discriminator) with open rules to
+    // attach per-variant constraints without restricting the choice.
+    const openOnsetSlicing: Partial<StructureDefinitionElement>[] = [
+      {
+        path: 'Test.onset[x]',
+        slicing: { discriminator: [{ type: 'type', path: '$this' }], rules: 'open' },
+      },
+      {
+        path: 'Test.onset[x]',
+        sliceName: 'onsetPeriod',
+        min: 0,
+        max: '1',
+        type: [{ code: 'Period' }],
+      },
+      {
+        path: 'Test.onset[x]',
+        sliceName: 'onsetAge',
+        min: 0,
+        max: '1',
+        type: [{ code: 'Age' }],
+      },
+    ];
+
+    it('keeps every declared slice variant as a choice', () => {
+      const result = translate(createTestStructureDefinition(openOnsetSlicing));
+
+      expect(result.elements?.onset?.choices).toEqual(['onsetPeriod', 'onsetAge']);
+      expect(result.elements?.onsetPeriod).toMatchObject({ type: 'Period', choiceOf: 'onset' });
+      expect(result.elements?.onsetAge).toMatchObject({ type: 'Age', choiceOf: 'onset' });
+    });
+
+    it('preserves open slicing rules and discriminator on the choice element', () => {
+      const result = translate(createTestStructureDefinition(openOnsetSlicing));
+
+      expect(result.elements?.onset?.slicing?.rules).toBe('open');
+      expect(result.elements?.onset?.slicing?.discriminator).toEqual([
+        { type: 'type', path: '$this' },
+      ]);
+    });
+
+    it('preserves closed slicing rules on the choice element', () => {
+      // Closed type slicing (e.g. KBV Apgar Score value[x]) forbids variants
+      // without a slice, so consumers must be able to see rules: closed.
+      const result = translate(
+        createTestStructureDefinition([
+          {
+            path: 'Test.value[x]',
+            slicing: { discriminator: [{ type: 'type', path: '$this' }], rules: 'closed' },
+            type: [{ code: 'CodeableConcept' }],
+          },
+          {
+            path: 'Test.value[x]',
+            sliceName: 'valueCodeableConcept',
+            max: '1',
+            type: [{ code: 'CodeableConcept' }],
+          },
+        ]),
+      );
+
+      expect(result.elements?.value?.slicing?.rules).toBe('closed');
+    });
+  });
 });