HL7.CDA.US.CCDA\Advance Directive Observation - Definitions

This page is part of the CCDA: Consolidated CDA Release (v2.1.0-draft1: CCDA 2.1 Draft) based on FHIR v5.0.0. . For a full list of available versions, see the Directory of published versions

Resource Profile: AdvanceDirectiveObservation - Detailed Descriptions

Active as of 2023-01-16

Definitions for the 2.16.840.1.113883.10.20.22.4.48 resource profile.

Differential Elements Table
Key Elements Table
Snapshot Elements Table

Guidance on how to interpret the contents of this table can be found here.

1. Observation
2. Observation.classCode
Requirements	SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-8648).
Pattern Value	OBS
3. Observation.moodCode
Requirements	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-8649).
Pattern Value	EVN
4. Observation.templateId
Slicing	This element introduces a set of slices on Observation.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root value @ root,
5. Observation.templateId:primary
SliceName	primary
Control	1..1
Requirements	SHALL contain exactly one [1..1] templateId (CONF:1198-8655) such that it
6. Observation.templateId:primary.root
Control	1..1
Requirements	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.48" (CONF:1198-10485).
Pattern Value	2.16.840.1.113883.10.20.22.4.48
7. Observation.templateId:primary.extension
Control	1..1
Requirements	SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32496).
Pattern Value	2015-08-01
8. Observation.id
Control	10..*
Requirements	SHALL contain at least one [1..*] id (CONF:1198-8654).
9. Observation.code
Binding	The codes SHOULD be taken from Advance Directive Type CodeThe codes SHALL be taken from ObservationType; other codes may be used where these codes are not suitable
Requirements	SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Advance Directive Type Code urn:oid:2.16.840.1.113883.1.11.20.2 DYNAMIC (CONF:1198-8651).
10. Observation.code.translation
Control	0..?
Slicing	This element introduces a set of slices on Observation.code.translation. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ code value @ code,
11. Observation.code.translation:advanceDirective
SliceName	advanceDirective
Control	1..1
Requirements	This code SHALL contain exactly one [1..1] translation (CONF:1198-32842) such that it
12. Observation.code.translation:advanceDirective.code
Control	1..1
Requirements	SHALL contain exactly one [1..1] @code="75320-2" Advance directive (CONF:1198-32843).
Pattern Value	75320-2
13. Observation.code.translation:advanceDirective.codeSystem
Control	1..1
Requirements	SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:1198-32844).
Pattern Value	2.16.840.1.113883.6.1
14. Observation.statusCode
Control	10..1
Requirements	SHALL contain exactly one [1..1] statusCode (CONF:1198-8652).
Pattern Value	Completed
15. Observation.statusCode.code
Control	1..1
Requirements	This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1198-19082).
Pattern Value	completed
16. Observation.effectiveTime
Control	10..1
Requirements	SHALL contain exactly one [1..1] effectiveTime (CONF:1198-8656).
17. Observation.effectiveTime.low
Control	1..1
Requirements	This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-28719).
18. Observation.effectiveTime.high
Control	1..1
Requirements	This effectiveTime SHALL contain exactly one [1..1] high (CONF:1198-15521).
Invariants	Defined on this element 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element SHALL have the nullFlavor attribute set to NA (CONF:1198-32449). (: null)
19. Observation.value
Slicing	This element introduces a set of slices on Observation.value. The slices are unordered and Open, and defines no discriminators to differentiate the slices
20. Observation.value:value1
SliceName	value1
Control	1..1
Requirements	SHALL contain exactly one [1..1] value (CONF:1198-30804).
Invariants	Defined on this element 1198-32493: If type CD, then value will be SNOMED-CT 2.16.840.1.113883.6.96 (CONF:1198-32493). (: null)
21. Observation.author
Type	http://hl7.org/fhir/cda/StructureDefinition/Author(AuthorParticipation)
Requirements	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1198-32406).
22. Observation.participant
Slicing	This element introduces a set of slices on Observation.participant. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ participantRole value @ participantRole,
23. Observation.participant:participant1
SliceName	participant1
Control	0..*
Requirements	SHOULD contain zero or more [0..*] participant (CONF:1198-8662) such that it
24. Observation.participant:participant1.typeCode
Control	1..1
Requirements	SHALL contain exactly one [1..1] @typeCode="VRF" Verifier (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8663).
Pattern Value	VRF
25. Observation.participant:participant1.templateId
Control	0..?
Slicing	This element introduces a set of slices on Observation.participant.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root
26. Observation.participant:participant1.templateId:primary
SliceName	primary
Control	1..1
Requirements	SHALL contain exactly one [1..1] templateId (CONF:1198-8664) such that it
27. Observation.participant:participant1.templateId:primary.root
Control	1..1
Requirements	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.1.58" (CONF:1198-10486).
Pattern Value	2.16.840.1.113883.10.20.1.58
28. Observation.participant:participant1.time
Control	0..1
Requirements	SHOULD contain zero or one [0..1] time (CONF:1198-8665).
Invariants	Defined on this element 1198-8666: The data type of Observation/participant/time in a verification SHALL be TS (time stamp) (CONF:1198-8666). (: null)
29. Observation.participant:participant1.participantRole
Control	1..1
Requirements	SHALL contain exactly one [1..1] participantRole (CONF:1198-8825).
30. Observation.participant:participant1.participantRole.code
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Provider Taxonomy
Requirements	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1198-28446).
31. Observation.participant:participant1.participantRole.addr
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/AD(USRealmAddressADUSFIELDED)
Requirements	This participantRole MAY contain zero or more [0..*] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-28451).
32. Observation.participant:participant1.participantRole.playingEntity
Control	0..1
Requirements	This participantRole MAY contain zero or one [0..1] playingEntity (CONF:1198-28428).
33. Observation.participant:participant1.participantRole.playingEntity.name
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/PN(USRealmPersonNamePNUSFIELDED)
Requirements	The playingEntity, if present, MAY contain zero or more [0..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:1198-28454).
34. Observation.participant:participant2
SliceName	participant2
Control	0..*
Requirements	SHOULD contain zero or more [0..*] participant (CONF:1198-8667) such that it
35. Observation.participant:participant2.typeCode
Control	1..1
Requirements	SHALL contain exactly one [1..1] @typeCode="CST" Custodian (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8668).
Pattern Value	CST
36. Observation.participant:participant2.participantRole
Control	1..1
Requirements	SHALL contain exactly one [1..1] participantRole (CONF:1198-8669).
37. Observation.participant:participant2.participantRole.classCode
Control	1..1
Requirements	This participantRole SHALL contain exactly one [1..1] @classCode="AGNT" Agent (CodeSystem: HL7RoleClass urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-8670).
Pattern Value	AGNT
38. Observation.participant:participant2.participantRole.code
Control	0..1
Binding	The codes SHOULD be taken from Personal And Legal Relationship Role Type
Requirements	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Personal And Legal Relationship Role Type urn:oid:2.16.840.1.113883.11.20.12.1 DYNAMIC (CONF:1198-28440).
39. Observation.participant:participant2.participantRole.addr
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/AD(USRealmAddressADUSFIELDED)
Requirements	This participantRole SHOULD contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8671).
40. Observation.participant:participant2.participantRole.telecom
Control	0..*
Requirements	This participantRole SHOULD contain zero or more [0..*] telecom (CONF:1198-8672).
41. Observation.participant:participant2.participantRole.playingEntity
Control	1..1
Requirements	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-8824).
42. Observation.participant:participant2.participantRole.playingEntity.code
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Agent Qualifier
Requirements	This playingEntity SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Agent Qualifier urn:oid:2.16.840.1.113883.11.20.9.51 DYNAMIC (CONF:1198-28444).
43. Observation.participant:participant2.participantRole.playingEntity.name
Control	1..1
Requirements	This playingEntity SHALL contain exactly one [1..1] name (CONF:1198-8673).
44. Observation.reference
Slicing	This element introduces a set of slices on Observation.reference. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ externalDocument value @ externalDocument,
45. Observation.reference:reference1
SliceName	reference1
Control	1..*
Requirements	SHOULD contain at least one [1..*] reference (CONF:1198-8692) such that it
46. Observation.reference:reference1.typeCode
Control	1..1
Requirements	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-8694).
Pattern Value	REFR
47. Observation.reference:reference1.externalDocument
Control	1..1
Requirements	SHALL contain exactly one [1..1] externalDocument (CONF:1198-8693).
48. Observation.reference:reference1.externalDocument.id
Control	1..*
Requirements	This externalDocument SHALL contain at least one [1..*] id (CONF:1198-8695).
49. Observation.reference:reference1.externalDocument.text
Control	0..1
Requirements	This externalDocument MAY contain zero or one [0..1] text (CONF:1198-8696).
50. Observation.reference:reference1.externalDocument.text.reference
Control	0..1
Requirements	The text, if present, MAY contain zero or one [0..1] reference (CONF:1198-8697).
Invariants	Defined on this element 1198-8698: The URL of a referenced advance directive document MAY be present, and SHALL be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). (: null) 1198-8699: If a URL is referenced, then it SHOULD have a corresponding linkHTML element in narrative block (CONF:1198-8699). (: null)

Guidance on how to interpret the contents of this table can be found here.

1. Observation
Definition	Base definition for all types defined in FHIR type system.
Control	10..1*
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
2. Observation.classCode
Control	1..1
Binding	The codes SHALL be taken from ActClassObservation
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-8648).
Pattern Value	OBS
3. Observation.moodCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-8649).
Pattern Value	EVN
4. Observation.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Slicing	This element introduces a set of slices on Observation.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root value @ root,
5. Observation.templateId:primary
SliceName	primary
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	SHALL contain exactly one [1..1] templateId (CONF:1198-8655) such that it
6. Observation.templateId:primary.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.48" (CONF:1198-10485).
Pattern Value	2.16.840.1.113883.10.20.22.4.48
7. Observation.templateId:primary.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32496).
Pattern Value	2015-08-01
8. Observation.id
Definition	The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Control	10..*1
Type	http://hl7.org/fhir/cda/StructureDefinition/IIid
Requirements	SHALL contain at least one [1..*] id (CONF:1198-8654).
Comments	Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
9. Observation.code
Definition	Describes what was observed. Sometimes this is called the observation "name".
Control	1..1
Binding	The codes SHOULD be taken from Advance Directive Type CodeFor example codes, see LOINCCodes
Type	http://hl7.org/fhir/cda/StructureDefinition/CDCodeableConcept
XML Representation	The type of this property is determined using the xsi:type attribute.
Requirements	SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Advance Directive Type Code urn:oid:2.16.840.1.113883.1.11.20.2 DYNAMIC (CONF:1198-8651). Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names	Name
Comments	All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
10. Observation.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
XML Representation	The type of this property is determined using the xsi:type attribute.
Slicing	This element introduces a set of slices on Observation.code.translation. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ code value @ code,
11. Observation.code.translation:advanceDirective
SliceName	advanceDirective
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
XML Representation	The type of this property is determined using the xsi:type attribute.
Requirements	This code SHALL contain exactly one [1..1] translation (CONF:1198-32842) such that it
12. Observation.code.translation:advanceDirective.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @code="75320-2" Advance directive (CONF:1198-32843).
Pattern Value	75320-2
13. Observation.code.translation:advanceDirective.codeSystem
Definition	Specifies the code system that defines the code.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:1198-32844).
Pattern Value	2.16.840.1.113883.6.1
14. Observation.statusCode
Control	1..1
Binding	The codes SHALL be taken from ActStatus
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
Requirements	SHALL contain exactly one [1..1] statusCode (CONF:1198-8652).
Pattern Value	Completed
15. Observation.statusCode.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1198-19082).
Pattern Value	completed
16. Observation.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
17. Observation.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
18. Observation.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
19. Observation.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
20. Observation.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
21. Observation.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/CR
22. Observation.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
XML Representation	The type of this property is determined using the xsi:type attribute.
23. Observation.effectiveTime
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/IVL-TS
Requirements	SHALL contain exactly one [1..1] effectiveTime (CONF:1198-8656).
24. Observation.effectiveTime.low
Definition	This is the low limit of the interval.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/TS
Requirements	This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-28719).
25. Observation.effectiveTime.high
Definition	This is the high limit of the interval.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/TS
Requirements	This effectiveTime SHALL contain exactly one [1..1] high (CONF:1198-15521).
Invariants	Defined on this element 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element SHALL have the nullFlavor attribute set to NA (CONF:1198-32449). (: null)
26. Observation.value
Control	0..*
Type	Choice of: http://hl7.org/fhir/cda/StructureDefinition/BL, http://hl7.org/fhir/cda/StructureDefinition/ED, http://hl7.org/fhir/cda/StructureDefinition/ST, http://hl7.org/fhir/cda/StructureDefinition/CD, http://hl7.org/fhir/cda/StructureDefinition/CV, http://hl7.org/fhir/cda/StructureDefinition/CE, http://hl7.org/fhir/cda/StructureDefinition/SC, http://hl7.org/fhir/cda/StructureDefinition/II, http://hl7.org/fhir/cda/StructureDefinition/TEL, http://hl7.org/fhir/cda/StructureDefinition/AD, http://hl7.org/fhir/cda/StructureDefinition/EN, http://hl7.org/fhir/cda/StructureDefinition/INT, http://hl7.org/fhir/cda/StructureDefinition/REAL, http://hl7.org/fhir/cda/StructureDefinition/PQ, http://hl7.org/fhir/cda/StructureDefinition/MO, http://hl7.org/fhir/cda/StructureDefinition/TS, http://hl7.org/fhir/cda/StructureDefinition/IVL-PQ, http://hl7.org/fhir/cda/StructureDefinition/IVL-TS, http://hl7.org/fhir/cda/StructureDefinition/PIVL-TS, http://hl7.org/fhir/cda/StructureDefinition/EIVL-TS, http://hl7.org/fhir/cda/StructureDefinition/SXPR-TS, http://hl7.org/fhir/cda/StructureDefinition/RTO-PQ-PQ
XML Representation	The type of this property is determined using the xsi:type attribute.
Slicing	This element introduces a set of slices on Observation.value. The slices are unordered and Open, and defines no discriminators to differentiate the slices
27. Observation.value:value1
SliceName	value1
Control	1..1
Type	Choice of: http://hl7.org/fhir/cda/StructureDefinition/BL, http://hl7.org/fhir/cda/StructureDefinition/ED, http://hl7.org/fhir/cda/StructureDefinition/ST, http://hl7.org/fhir/cda/StructureDefinition/CD, http://hl7.org/fhir/cda/StructureDefinition/CV, http://hl7.org/fhir/cda/StructureDefinition/CE, http://hl7.org/fhir/cda/StructureDefinition/SC, http://hl7.org/fhir/cda/StructureDefinition/II, http://hl7.org/fhir/cda/StructureDefinition/TEL, http://hl7.org/fhir/cda/StructureDefinition/AD, http://hl7.org/fhir/cda/StructureDefinition/EN, http://hl7.org/fhir/cda/StructureDefinition/INT, http://hl7.org/fhir/cda/StructureDefinition/REAL, http://hl7.org/fhir/cda/StructureDefinition/PQ, http://hl7.org/fhir/cda/StructureDefinition/MO, http://hl7.org/fhir/cda/StructureDefinition/TS, http://hl7.org/fhir/cda/StructureDefinition/IVL-PQ, http://hl7.org/fhir/cda/StructureDefinition/IVL-TS, http://hl7.org/fhir/cda/StructureDefinition/PIVL-TS, http://hl7.org/fhir/cda/StructureDefinition/EIVL-TS, http://hl7.org/fhir/cda/StructureDefinition/SXPR-TS, http://hl7.org/fhir/cda/StructureDefinition/RTO-PQ-PQ
XML Representation	The type of this property is determined using the xsi:type attribute.
Requirements	SHALL contain exactly one [1..1] value (CONF:1198-30804).
Invariants	Defined on this element 1198-32493: If type CD, then value will be SNOMED-CT 2.16.840.1.113883.6.96 (CONF:1198-32493). (: null)
28. Observation.author
Definition	Base definition for all types defined in FHIR type system.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Author(AuthorParticipation)
Requirements	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1198-32406).
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Observation.participant
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Participant2
Slicing	This element introduces a set of slices on Observation.participant. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ participantRole value @ participantRole,
30. Observation.participant:participant1
SliceName	participant1
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Participant2
Requirements	SHOULD contain zero or more [0..*] participant (CONF:1198-8662) such that it
31. Observation.participant:participant1.typeCode
Control	1..1
Binding	The codes SHALL be taken from ParticipationType
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @typeCode="VRF" Verifier (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8663).
Pattern Value	VRF
32. Observation.participant:participant1.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Slicing	This element introduces a set of slices on Observation.participant.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root
33. Observation.participant:participant1.templateId:primary
SliceName	primary
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	SHALL contain exactly one [1..1] templateId (CONF:1198-8664) such that it
34. Observation.participant:participant1.templateId:primary.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.1.58" (CONF:1198-10486).
Pattern Value	2.16.840.1.113883.10.20.1.58
35. Observation.participant:participant1.time
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/IVL-TS
Requirements	SHOULD contain zero or one [0..1] time (CONF:1198-8665).
Invariants	Defined on this element 1198-8666: The data type of Observation/participant/time in a verification SHALL be TS (time stamp) (CONF:1198-8666). (: null)
36. Observation.participant:participant1.participantRole
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ParticipantRole
Requirements	SHALL contain exactly one [1..1] participantRole (CONF:1198-8825).
37. Observation.participant:participant1.participantRole.classCode
Control	1..1
Binding	The codes SHALL be taken from RoleClassRoot
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	ROL
38. Observation.participant:participant1.participantRole.code
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Provider Taxonomy
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
Requirements	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1198-28446).
39. Observation.participant:participant1.participantRole.addr
Definition	Mailing and home or office addresses. A sequence of address parts, such as street or post office Box, city, postal code, country, etc.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/AD(USRealmAddressADUSFIELDED)
Requirements	This participantRole MAY contain zero or more [0..*] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-28451).
Invariants	Defined on this element 81-7296: SHALL NOT have mixed content except for white space (CONF:81-7296). (: null) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
40. Observation.participant:participant1.participantRole.playingEntity
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/PlayingEntity
Requirements	This participantRole MAY contain zero or one [0..1] playingEntity (CONF:1198-28428).
41. Observation.participant:participant1.participantRole.playingEntity.classCode
Control	1..1
Binding	The codes SHALL be taken from EntityClassRoot
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	ENT
42. Observation.participant:participant1.participantRole.playingEntity.determinerCode
Control	1..1
Binding	The codes SHALL be taken from EntityDeterminer
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	INSTANCE
Fixed Value	INSTANCE
43. Observation.participant:participant1.participantRole.playingEntity.name
Definition	A name for a person. A sequence of name parts, such as given name or family name, prefix, suffix, etc. Examples for person name values are "Jim Bob Walton, Jr.", "Adam Everyman", etc. A person name may be as simple as a character string or may consist of several person name parts, such as, "Jim", "Bob", "Walton", and "Jr.". PN differs from EN because the qualifier type cannot include LS (Legal Status).
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/PN(USRealmPersonNamePNUSFIELDED)
Requirements	The playingEntity, if present, MAY contain zero or more [0..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:1198-28454).
Invariants	Defined on this element 81-9371: The content of name SHALL be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). (: null) 81-9372: The string SHALL NOT contain name parts (CONF:81-9372). (: null) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. Observation.participant:participant2
SliceName	participant2
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Participant2
Requirements	SHOULD contain zero or more [0..*] participant (CONF:1198-8667) such that it
45. Observation.participant:participant2.typeCode
Control	1..1
Binding	The codes SHALL be taken from ParticipationType
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @typeCode="CST" Custodian (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8668).
Pattern Value	CST
46. Observation.participant:participant2.participantRole
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ParticipantRole
Requirements	SHALL contain exactly one [1..1] participantRole (CONF:1198-8669).
47. Observation.participant:participant2.participantRole.classCode
Control	1..1
Binding	The codes SHALL be taken from RoleClassRoot
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	This participantRole SHALL contain exactly one [1..1] @classCode="AGNT" Agent (CodeSystem: HL7RoleClass urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-8670).
Default Value	ROL
Pattern Value	AGNT
48. Observation.participant:participant2.participantRole.code
Control	0..1
Binding	The codes SHOULD be taken from Personal And Legal Relationship Role Type
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
Requirements	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Personal And Legal Relationship Role Type urn:oid:2.16.840.1.113883.11.20.12.1 DYNAMIC (CONF:1198-28440).
49. Observation.participant:participant2.participantRole.addr
Definition	Mailing and home or office addresses. A sequence of address parts, such as street or post office Box, city, postal code, country, etc.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/AD(USRealmAddressADUSFIELDED)
Requirements	This participantRole SHOULD contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8671).
Invariants	Defined on this element 81-7296: SHALL NOT have mixed content except for white space (CONF:81-7296). (: null) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
50. Observation.participant:participant2.participantRole.telecom
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/TEL
Requirements	This participantRole SHOULD contain zero or more [0..*] telecom (CONF:1198-8672).
51. Observation.participant:participant2.participantRole.playingEntity
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/PlayingEntity
Requirements	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-8824).
52. Observation.participant:participant2.participantRole.playingEntity.classCode
Control	1..1
Binding	The codes SHALL be taken from EntityClassRoot
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	ENT
53. Observation.participant:participant2.participantRole.playingEntity.determinerCode
Control	1..1
Binding	The codes SHALL be taken from EntityDeterminer
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	INSTANCE
Fixed Value	INSTANCE
54. Observation.participant:participant2.participantRole.playingEntity.code
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Agent Qualifier
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
Requirements	This playingEntity SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Agent Qualifier urn:oid:2.16.840.1.113883.11.20.9.51 DYNAMIC (CONF:1198-28444).
55. Observation.participant:participant2.participantRole.playingEntity.name
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/EN
Requirements	This playingEntity SHALL contain exactly one [1..1] name (CONF:1198-8673).
56. Observation.reference
Control	0..*
Type	Element
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing	This element introduces a set of slices on Observation.reference. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ externalDocument value @ externalDocument,
57. Observation.reference.typeCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
58. Observation.reference:reference1
SliceName	reference1
Control	1..*
Type	Element
Requirements	SHOULD contain at least one [1..*] reference (CONF:1198-8692) such that it
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
59. Observation.reference:reference1.typeCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-8694).
Pattern Value	REFR
60. Observation.reference:reference1.externalDocument
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalDocument
Requirements	SHALL contain exactly one [1..1] externalDocument (CONF:1198-8693).
61. Observation.reference:reference1.externalDocument.classCode
Control	1..1
Binding	The codes SHALL be taken from ActClassDocument
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	DOC
62. Observation.reference:reference1.externalDocument.moodCode
Control	1..1
Binding	The codes SHALL be taken from ActMood
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	EVN
Fixed Value	EVN
63. Observation.reference:reference1.externalDocument.id
Control	1..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	This externalDocument SHALL contain at least one [1..*] id (CONF:1198-8695).
64. Observation.reference:reference1.externalDocument.text
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
Requirements	This externalDocument MAY contain zero or one [0..1] text (CONF:1198-8696).
65. Observation.reference:reference1.externalDocument.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/TEL
Requirements	The text, if present, MAY contain zero or one [0..1] reference (CONF:1198-8697).
Invariants	Defined on this element 1198-8698: The URL of a referenced advance directive document MAY be present, and SHALL be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). (: null) 1198-8699: If a URL is referenced, then it SHOULD have a corresponding linkHTML element in narrative block (CONF:1198-8699). (: null)

Guidance on how to interpret the contents of this table can be found here.

1. Observation
Definition	Base definition for all types defined in FHIR type system.
Control	1..1
2. Observation.classCode
Control	1..1
Binding	The codes SHALL be taken from ActClassObservation
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @classCode="OBS" Observation (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:1198-8648).
Pattern Value	OBS
3. Observation.moodCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:1198-8649).
Pattern Value	EVN
4. Observation.negationInd
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
5. Observation.realmCode
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
6. Observation.typeId
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
7. Observation.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Slicing	This element introduces a set of slices on Observation.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root value @ root,
8. Observation.templateId:primary
SliceName	primary
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	SHALL contain exactly one [1..1] templateId (CONF:1198-8655) such that it
9. Observation.templateId:primary.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
10. Observation.templateId:primary.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
11. Observation.templateId:primary.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
12. Observation.templateId:primary.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.48" (CONF:1198-10485).
Pattern Value	2.16.840.1.113883.10.20.22.4.48
13. Observation.templateId:primary.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @extension="2015-08-01" (CONF:1198-32496).
Pattern Value	2015-08-01
14. Observation.id
Control	1..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	SHALL contain at least one [1..*] id (CONF:1198-8654).
15. Observation.code
Control	1..1
Binding	The codes SHOULD be taken from Advance Directive Type Code
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
XML Representation	The type of this property is determined using the xsi:type attribute.
Requirements	SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Advance Directive Type Code urn:oid:2.16.840.1.113883.1.11.20.2 DYNAMIC (CONF:1198-8651).
16. Observation.code.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
17. Observation.code.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
18. Observation.code.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
19. Observation.code.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
20. Observation.code.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
21. Observation.code.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
22. Observation.code.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `valueSet`.
23. Observation.code.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `valueSetVersion`.
24. Observation.code.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
25. Observation.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CR
26. Observation.code.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
XML Representation	The type of this property is determined using the xsi:type attribute.
Slicing	This element introduces a set of slices on Observation.code.translation. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ code value @ code,
27. Observation.code.translation:advanceDirective
SliceName	advanceDirective
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
XML Representation	The type of this property is determined using the xsi:type attribute.
Requirements	This code SHALL contain exactly one [1..1] translation (CONF:1198-32842) such that it
28. Observation.code.translation:advanceDirective.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
29. Observation.code.translation:advanceDirective.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @code="75320-2" Advance directive (CONF:1198-32843).
Pattern Value	75320-2
30. Observation.code.translation:advanceDirective.codeSystem
Definition	Specifies the code system that defines the code.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @codeSystem="2.16.840.1.113883.6.1" (CodeSystem: LOINC urn:oid:2.16.840.1.113883.6.1) (CONF:1198-32844).
Pattern Value	2.16.840.1.113883.6.1
31. Observation.code.translation:advanceDirective.codeSystemName
Definition	The common name of the coding system.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
32. Observation.code.translation:advanceDirective.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
33. Observation.code.translation:advanceDirective.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
34. Observation.code.translation:advanceDirective.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `valueSet`.
35. Observation.code.translation:advanceDirective.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `valueSetVersion`.
36. Observation.code.translation:advanceDirective.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
37. Observation.code.translation:advanceDirective.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CR
38. Observation.code.translation:advanceDirective.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
XML Representation	The type of this property is determined using the xsi:type attribute.
39. Observation.derivationExpr
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ST
40. Observation.text
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
XML Representation	The type of this property is determined using the xsi:type attribute.
41. Observation.statusCode
Control	1..1
Binding	The codes SHALL be taken from ActStatus
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
Requirements	SHALL contain exactly one [1..1] statusCode (CONF:1198-8652).
Pattern Value	Completed
42. Observation.statusCode.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
43. Observation.statusCode.code
Definition	The plain code symbol defined by the code system. For example, "784.0" is the code symbol of the ICD-9 code "784.0" for headache.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	This statusCode SHALL contain exactly one [1..1] @code="completed" Completed (CodeSystem: HL7ActStatus urn:oid:2.16.840.1.113883.5.14 STATIC) (CONF:1198-19082).
Pattern Value	completed
44. Observation.statusCode.codeSystem
Definition	Specifies the code system that defines the code.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
45. Observation.statusCode.codeSystemName
Definition	The common name of the coding system.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
46. Observation.statusCode.codeSystemVersion
Definition	If applicable, a version descriptor defined specifically for the given code system.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
47. Observation.statusCode.displayName
Definition	A name or title for the code, under which the sending system shows the code value to its users.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
48. Observation.statusCode.sdtcValueSet
Definition	The valueSet extension adds an attribute for elements with a CD dataType which indicates the particular value set constraining the coded concept.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `valueSet`.
49. Observation.statusCode.sdtcValueSetVersion
Definition	The valueSetVersion extension adds an attribute for elements with a CD dataType which indicates the version of the particular value set constraining the coded concept.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `valueSetVersion`.
50. Observation.statusCode.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
51. Observation.statusCode.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/CR
52. Observation.statusCode.translation
Definition	A set of other concept descriptors that translate this concept descriptor into other code systems.
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
XML Representation	The type of this property is determined using the xsi:type attribute.
53. Observation.effectiveTime
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/IVL-TS
Requirements	SHALL contain exactly one [1..1] effectiveTime (CONF:1198-8656).
54. Observation.effectiveTime.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
55. Observation.effectiveTime.value
Definition	A quantity specifying a point on the axis of natural time. A point in time is most often represented as a calendar expression.
Control	0..1
Type	dateTime
XML Representation	In the XML format, this property is represented as an attribute.
56. Observation.effectiveTime.inclusive
Definition	Specifies whether the limit is included in the interval (interval is closed) or excluded from the interval (interval is open).
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
57. Observation.effectiveTime.operator
Definition	A code specifying whether the set component is included (union) or excluded (set-difference) from the set, or other set operations with the current set component and the set as constructed from the representation stream up to the current point.
Control	0..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
58. Observation.effectiveTime.low
Definition	This is the low limit of the interval.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/TS
Requirements	This effectiveTime SHALL contain exactly one [1..1] low (CONF:1198-28719).
59. Observation.effectiveTime.high
Definition	This is the high limit of the interval.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/TS
Requirements	This effectiveTime SHALL contain exactly one [1..1] high (CONF:1198-15521).
Invariants	Defined on this element 1198-32449: If the Advance Directive does not have a specified ending time, the <high> element SHALL have the nullFlavor attribute set to NA (CONF:1198-32449). (: )
60. Observation.effectiveTime.width
Definition	The difference between high and low boundary. The purpose of distinguishing a width property is to handle all cases of incomplete information symmetrically. In any interval representation only two of the three properties high, low, and width need to be stated and the third can be derived.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/PQ
61. Observation.effectiveTime.center
Definition	The arithmetic mean of the interval (low plus high divided by 2). The purpose of distinguishing the center as a semantic property is for conversions of intervals from and to point values.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/TS
62. Observation.priorityCode
Control	0..1
Binding	The codes SHALL be taken from ActPriority; other codes may be used where these codes are not suitable
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
63. Observation.repeatNumber
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/IVL-INT
64. Observation.languageCode
Control	0..1
Binding	The codes SHALL be taken from HumanLanguage
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
65. Observation.value
Control	0..*
Type	Choice of: http://hl7.org/fhir/cda/StructureDefinition/BL, http://hl7.org/fhir/cda/StructureDefinition/ED, http://hl7.org/fhir/cda/StructureDefinition/ST, http://hl7.org/fhir/cda/StructureDefinition/CD, http://hl7.org/fhir/cda/StructureDefinition/CV, http://hl7.org/fhir/cda/StructureDefinition/CE, http://hl7.org/fhir/cda/StructureDefinition/SC, http://hl7.org/fhir/cda/StructureDefinition/II, http://hl7.org/fhir/cda/StructureDefinition/TEL, http://hl7.org/fhir/cda/StructureDefinition/AD, http://hl7.org/fhir/cda/StructureDefinition/EN, http://hl7.org/fhir/cda/StructureDefinition/INT, http://hl7.org/fhir/cda/StructureDefinition/REAL, http://hl7.org/fhir/cda/StructureDefinition/PQ, http://hl7.org/fhir/cda/StructureDefinition/MO, http://hl7.org/fhir/cda/StructureDefinition/TS, http://hl7.org/fhir/cda/StructureDefinition/IVL-PQ, http://hl7.org/fhir/cda/StructureDefinition/IVL-TS, http://hl7.org/fhir/cda/StructureDefinition/PIVL-TS, http://hl7.org/fhir/cda/StructureDefinition/EIVL-TS, http://hl7.org/fhir/cda/StructureDefinition/SXPR-TS, http://hl7.org/fhir/cda/StructureDefinition/RTO-PQ-PQ
XML Representation	The type of this property is determined using the xsi:type attribute.
Slicing	This element introduces a set of slices on Observation.value. The slices are unordered and Open, and defines no discriminators to differentiate the slices
66. Observation.value:value1
SliceName	value1
Control	1..1
Type	Choice of: http://hl7.org/fhir/cda/StructureDefinition/BL, http://hl7.org/fhir/cda/StructureDefinition/ED, http://hl7.org/fhir/cda/StructureDefinition/ST, http://hl7.org/fhir/cda/StructureDefinition/CD, http://hl7.org/fhir/cda/StructureDefinition/CV, http://hl7.org/fhir/cda/StructureDefinition/CE, http://hl7.org/fhir/cda/StructureDefinition/SC, http://hl7.org/fhir/cda/StructureDefinition/II, http://hl7.org/fhir/cda/StructureDefinition/TEL, http://hl7.org/fhir/cda/StructureDefinition/AD, http://hl7.org/fhir/cda/StructureDefinition/EN, http://hl7.org/fhir/cda/StructureDefinition/INT, http://hl7.org/fhir/cda/StructureDefinition/REAL, http://hl7.org/fhir/cda/StructureDefinition/PQ, http://hl7.org/fhir/cda/StructureDefinition/MO, http://hl7.org/fhir/cda/StructureDefinition/TS, http://hl7.org/fhir/cda/StructureDefinition/IVL-PQ, http://hl7.org/fhir/cda/StructureDefinition/IVL-TS, http://hl7.org/fhir/cda/StructureDefinition/PIVL-TS, http://hl7.org/fhir/cda/StructureDefinition/EIVL-TS, http://hl7.org/fhir/cda/StructureDefinition/SXPR-TS, http://hl7.org/fhir/cda/StructureDefinition/RTO-PQ-PQ
XML Representation	The type of this property is determined using the xsi:type attribute.
Requirements	SHALL contain exactly one [1..1] value (CONF:1198-30804).
Invariants	Defined on this element 1198-32493: If type CD, then value will be SNOMED-CT 2.16.840.1.113883.6.96 (CONF:1198-32493). (: )
67. Observation.interpretationCode
Control	0..*
Binding	The codes SHALL be taken from ObservationInterpretation
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
68. Observation.methodCode
Control	0..*
Binding	The codes SHALL be taken from ObservationMethod; other codes may be used where these codes are not suitable
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
69. Observation.targetSiteCode
Definition	Drawn from concept domain ActSite
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
70. Observation.subject
Control	0..1
Type	Element
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
71. Observation.subject.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Summary	false
72. Observation.subject.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control	0..*
Type	Extension
Summary	false
Alternate Names	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing	This element introduces a set of slices on Observation.subject.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
73. Observation.subject.typeCode
Control	1..1
Binding	The codes SHALL be taken from ParticipationTargetSubject
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	SBJ
Fixed Value	SBJ
74. Observation.subject.contextControlCode
Control	1..1
Binding	The codes SHALL be taken from ContextControl
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	OP
Fixed Value	OP
75. Observation.subject.awarenessCode
Control	0..1
Binding	The codes SHALL be taken from TargetAwareness; other codes may be used where these codes are not suitable
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
76. Observation.subject.relatedSubject
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/RelatedSubject
77. Observation.specimen
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Specimen
78. Observation.performer
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Performer2
79. Observation.author
Definition	Base definition for all types defined in FHIR type system.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Author(AuthorParticipation)
Requirements	SHOULD contain zero or more [0..*] Author Participation (identifier: urn:oid:2.16.840.1.113883.10.20.22.4.119) (CONF:1198-32406).
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
80. Observation.informant
Control	0..*
Type	Element
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
81. Observation.informant.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Summary	false
82. Observation.informant.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control	0..*
Type	Extension
Summary	false
Alternate Names	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing	This element introduces a set of slices on Observation.informant.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
83. Observation.informant.typeCode
Control	1..1
Binding	The codes SHALL be taken from ParticipationInformationGenerator
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	INF
Fixed Value	INF
84. Observation.informant.contextControlCode
Control	1..1
Binding	The codes SHALL be taken from ContextControl
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	OP
Fixed Value	OP
85. Observation.informant.assignedEntity
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/AssignedEntity
86. Observation.informant.relatedEntity
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/RelatedEntity
87. Observation.participant
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Participant2
Slicing	This element introduces a set of slices on Observation.participant. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ participantRole value @ participantRole,
88. Observation.participant:participant1
SliceName	participant1
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Participant2
Requirements	SHOULD contain zero or more [0..*] participant (CONF:1198-8662) such that it
89. Observation.participant:participant1.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
90. Observation.participant:participant1.typeCode
Control	1..1
Binding	The codes SHALL be taken from ParticipationType
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @typeCode="VRF" Verifier (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8663).
Pattern Value	VRF
91. Observation.participant:participant1.contextControlCode
Control	0..1
Binding	The codes SHALL be taken from ContextControl
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Fixed Value	OP
92. Observation.participant:participant1.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
93. Observation.participant:participant1.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
94. Observation.participant:participant1.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Slicing	This element introduces a set of slices on Observation.participant.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root
95. Observation.participant:participant1.templateId:primary
SliceName	primary
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	SHALL contain exactly one [1..1] templateId (CONF:1198-8664) such that it
96. Observation.participant:participant1.templateId:primary.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
97. Observation.participant:participant1.templateId:primary.assigningAuthorityName
Definition	A human readable name or mnemonic for the assigning authority. The Assigning Authority Name has no computational value. The purpose of a Assigning Authority Name is to assist an unaided human interpreter of an II value to interpret the authority. Note: no automated processing must depend on the assigning authority name to be present in any form.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
98. Observation.participant:participant1.templateId:primary.displayable
Definition	Specifies if the identifier is intended for human display and data entry (displayable = true) as opposed to pure machine interoperation (displayable = false).
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
99. Observation.participant:participant1.templateId:primary.root
Definition	A unique identifier that guarantees the global uniqueness of the instance identifier. The root alone may be the entire instance identifier.
Control	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.1.58" (CONF:1198-10486).
Pattern Value	2.16.840.1.113883.10.20.1.58
100. Observation.participant:participant1.templateId:primary.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
101. Observation.participant:participant1.sdtcFunctionCode
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
XML Representation	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `functionCode`.
102. Observation.participant:participant1.time
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/IVL-TS
Requirements	SHOULD contain zero or one [0..1] time (CONF:1198-8665).
Invariants	Defined on this element 1198-8666: The data type of Observation/participant/time in a verification SHALL be TS (time stamp) (CONF:1198-8666). (: )
103. Observation.participant:participant1.awarenessCode
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
104. Observation.participant:participant1.participantRole
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ParticipantRole
Requirements	SHALL contain exactly one [1..1] participantRole (CONF:1198-8825).
105. Observation.participant:participant1.participantRole.classCode
Control	1..1
Binding	The codes SHALL be taken from RoleClassRoot
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	ROL
106. Observation.participant:participant1.participantRole.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
107. Observation.participant:participant1.participantRole.id
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
108. Observation.participant:participant1.participantRole.sdtcIdentifiedBy
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/IdentifiedBy
XML Representation	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `identifiedBy`.
109. Observation.participant:participant1.participantRole.code
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Provider Taxonomy
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
Requirements	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Provider Taxonomy urn:oid:2.16.840.1.114222.4.11.1066 DYNAMIC (CONF:1198-28446).
110. Observation.participant:participant1.participantRole.addr
Definition	Mailing and home or office addresses. A sequence of address parts, such as street or post office Box, city, postal code, country, etc.
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/AD(USRealmAddressADUSFIELDED)
Requirements	This participantRole MAY contain zero or more [0..*] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-28451).
Invariants	Defined on this element 81-7296: SHALL NOT have mixed content except for white space (CONF:81-7296). (: ) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
111. Observation.participant:participant1.participantRole.telecom
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/TEL
112. Observation.participant:participant1.participantRole.playingDevice
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Device
113. Observation.participant:participant1.participantRole.playingEntity
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/PlayingEntity
Requirements	This participantRole MAY contain zero or one [0..1] playingEntity (CONF:1198-28428).
114. Observation.participant:participant1.participantRole.playingEntity.classCode
Control	1..1
Binding	The codes SHALL be taken from EntityClassRoot
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	ENT
115. Observation.participant:participant1.participantRole.playingEntity.determinerCode
Control	1..1
Binding	The codes SHALL be taken from EntityDeterminer
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	INSTANCE
Fixed Value	INSTANCE
116. Observation.participant:participant1.participantRole.playingEntity.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
117. Observation.participant:participant1.participantRole.playingEntity.code
Control	0..1
Binding	The codes SHALL be taken from EntityCode; other codes may be used where these codes are not suitable
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
118. Observation.participant:participant1.participantRole.playingEntity.quantity
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/PQ
119. Observation.participant:participant1.participantRole.playingEntity.name
Definition	A name for a person. A sequence of name parts, such as given name or family name, prefix, suffix, etc. Examples for person name values are "Jim Bob Walton, Jr.", "Adam Everyman", etc. A person name may be as simple as a character string or may consist of several person name parts, such as, "Jim", "Bob", "Walton", and "Jr.". PN differs from EN because the qualifier type cannot include LS (Legal Status).
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/PN(USRealmPersonNamePNUSFIELDED)
Requirements	The playingEntity, if present, MAY contain zero or more [0..*] US Realm Person Name (PN.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.1.1) (CONF:1198-28454).
Invariants	Defined on this element 81-9371: The content of name SHALL be either a conformant Patient Name (PTN.US.FIELDED), or a string (CONF:81-9371). (: ) 81-9372: The string SHALL NOT contain name parts (CONF:81-9372). (: ) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
120. Observation.participant:participant1.participantRole.playingEntity.desc
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
121. Observation.participant:participant1.participantRole.scopingEntity
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Entity
122. Observation.participant:participant2
SliceName	participant2
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Participant2
Requirements	SHOULD contain zero or more [0..*] participant (CONF:1198-8667) such that it
123. Observation.participant:participant2.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
124. Observation.participant:participant2.typeCode
Control	1..1
Binding	The codes SHALL be taken from ParticipationType
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @typeCode="CST" Custodian (CodeSystem: HL7ParticipationType urn:oid:2.16.840.1.113883.5.90 STATIC) (CONF:1198-8668).
Pattern Value	CST
125. Observation.participant:participant2.contextControlCode
Control	0..1
Binding	The codes SHALL be taken from ContextControl
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Fixed Value	OP
126. Observation.participant:participant2.realmCode
Definition	When valued in an instance, this attribute signals the imposition of realm-specific constraints. The value of this attribute identifies the realm in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
127. Observation.participant:participant2.typeId
Definition	When valued in an instance, this attribute signals the imposition of constraints defined in an HL7-specified message type. This might be a common type (also known as CMET in the messaging communication environment), or content included within a wrapper. The value of this attribute provides a unique identifier for the type in question.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
128. Observation.participant:participant2.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
129. Observation.participant:participant2.sdtcFunctionCode
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
XML Representation	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `functionCode`.
130. Observation.participant:participant2.time
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/IVL-TS
131. Observation.participant:participant2.awarenessCode
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
132. Observation.participant:participant2.participantRole
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ParticipantRole
Requirements	SHALL contain exactly one [1..1] participantRole (CONF:1198-8669).
133. Observation.participant:participant2.participantRole.classCode
Control	1..1
Binding	The codes SHALL be taken from RoleClassRoot
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	This participantRole SHALL contain exactly one [1..1] @classCode="AGNT" Agent (CodeSystem: HL7RoleClass urn:oid:2.16.840.1.113883.5.110 STATIC) (CONF:1198-8670).
Default Value	ROL
Pattern Value	AGNT
134. Observation.participant:participant2.participantRole.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
135. Observation.participant:participant2.participantRole.id
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
136. Observation.participant:participant2.participantRole.sdtcIdentifiedBy
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/IdentifiedBy
XML Representation	In the XML format, this property has the namespace `urn:hl7-org:sdtc`.In the XML format, this property has the actual name `identifiedBy`.
137. Observation.participant:participant2.participantRole.code
Control	0..1
Binding	The codes SHOULD be taken from Personal And Legal Relationship Role Type
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
Requirements	This participantRole SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Personal And Legal Relationship Role Type urn:oid:2.16.840.1.113883.11.20.12.1 DYNAMIC (CONF:1198-28440).
138. Observation.participant:participant2.participantRole.addr
Definition	Mailing and home or office addresses. A sequence of address parts, such as street or post office Box, city, postal code, country, etc.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/AD(USRealmAddressADUSFIELDED)
Requirements	This participantRole SHOULD contain zero or one [0..1] US Realm Address (AD.US.FIELDED) (identifier: urn:oid:2.16.840.1.113883.10.20.22.5.2) (CONF:1198-8671).
Invariants	Defined on this element 81-7296: SHALL NOT have mixed content except for white space (CONF:81-7296). (: ) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
139. Observation.participant:participant2.participantRole.telecom
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/TEL
Requirements	This participantRole SHOULD contain zero or more [0..*] telecom (CONF:1198-8672).
140. Observation.participant:participant2.participantRole.playingDevice
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Device
141. Observation.participant:participant2.participantRole.playingEntity
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/PlayingEntity
Requirements	This participantRole SHALL contain exactly one [1..1] playingEntity (CONF:1198-8824).
142. Observation.participant:participant2.participantRole.playingEntity.classCode
Control	1..1
Binding	The codes SHALL be taken from EntityClassRoot
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	ENT
143. Observation.participant:participant2.participantRole.playingEntity.determinerCode
Control	1..1
Binding	The codes SHALL be taken from EntityDeterminer
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	INSTANCE
Fixed Value	INSTANCE
144. Observation.participant:participant2.participantRole.playingEntity.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
145. Observation.participant:participant2.participantRole.playingEntity.code
Control	0..1
Binding	The codes SHOULD be taken from Healthcare Agent Qualifier
Type	http://hl7.org/fhir/cda/StructureDefinition/CE
Requirements	This playingEntity SHOULD contain zero or one [0..1] code, which SHOULD be selected from ValueSet Healthcare Agent Qualifier urn:oid:2.16.840.1.113883.11.20.9.51 DYNAMIC (CONF:1198-28444).
146. Observation.participant:participant2.participantRole.playingEntity.quantity
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/PQ
147. Observation.participant:participant2.participantRole.playingEntity.name
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/EN
Requirements	This playingEntity SHALL contain exactly one [1..1] name (CONF:1198-8673).
148. Observation.participant:participant2.participantRole.playingEntity.desc
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
149. Observation.participant:participant2.participantRole.scopingEntity
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Entity
150. Observation.entryRelationship
Control	0..*
Type	Element
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) obs-er-1: Only one of observation, regionOfInterest, observationMedia, substanceAdministration, supply, procedure, encounter, organizer, and act (: (observation \| regionOfInterest \| observationMedia \| substanceAdministration \| supply \| procedure \| encounter \| organizer \| act).count() = 1)
151. Observation.entryRelationship.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Summary	false
152. Observation.entryRelationship.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control	0..*
Type	Extension
Summary	false
Alternate Names	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing	This element introduces a set of slices on Observation.entryRelationship.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
153. Observation.entryRelationship.typeCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
154. Observation.entryRelationship.inversionInd
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
155. Observation.entryRelationship.contextConductionInd
Control	1..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	true
156. Observation.entryRelationship.sequenceNumber
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/INT
157. Observation.entryRelationship.negationInd
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
158. Observation.entryRelationship.seperatableInd
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/BL
159. Observation.entryRelationship.observation
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Observation
160. Observation.entryRelationship.regionOfInterest
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/RegionOfInterest
161. Observation.entryRelationship.observationMedia
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ObservationMedia
162. Observation.entryRelationship.substanceAdministration
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/SubstanceAdministration
163. Observation.entryRelationship.supply
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Supply
164. Observation.entryRelationship.procedure
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Procedure
165. Observation.entryRelationship.encounter
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Encounter
166. Observation.entryRelationship.organizer
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Organizer
167. Observation.entryRelationship.act
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Act
168. Observation.reference
Control	0..*
Type	Element
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
Slicing	This element introduces a set of slices on Observation.reference. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ externalDocument value @ externalDocument,
169. Observation.reference.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Summary	false
170. Observation.reference.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control	0..*
Type	Extension
Summary	false
Alternate Names	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing	This element introduces a set of slices on Observation.reference.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
171. Observation.reference.typeCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
172. Observation.reference.seperatableInd
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/BL
173. Observation.reference.externalAct
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalAct
174. Observation.reference.externalObservation
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalObservation
175. Observation.reference.externalProcedure
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalProcedure
176. Observation.reference.externalDocument
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalDocument
177. Observation.reference:reference1
SliceName	reference1
Control	1..*
Type	Element
Requirements	SHOULD contain at least one [1..*] reference (CONF:1198-8692) such that it
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
178. Observation.reference:reference1.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Summary	false
179. Observation.reference:reference1.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control	0..*
Type	Extension
Summary	false
Alternate Names	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing	This element introduces a set of slices on Observation.reference.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
180. Observation.reference:reference1.typeCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:1198-8694).
Pattern Value	REFR
181. Observation.reference:reference1.seperatableInd
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/BL
182. Observation.reference:reference1.externalAct
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalAct
183. Observation.reference:reference1.externalObservation
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalObservation
184. Observation.reference:reference1.externalProcedure
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalProcedure
185. Observation.reference:reference1.externalDocument
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalDocument
Requirements	SHALL contain exactly one [1..1] externalDocument (CONF:1198-8693).
186. Observation.reference:reference1.externalDocument.classCode
Control	1..1
Binding	The codes SHALL be taken from ActClassDocument
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	DOC
187. Observation.reference:reference1.externalDocument.moodCode
Control	1..1
Binding	The codes SHALL be taken from ActMood
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	EVN
Fixed Value	EVN
188. Observation.reference:reference1.externalDocument.templateId
Definition	When valued in an instance, this attribute signals the imposition of a set of template-defined constraints. The value of this attribute provides a unique identifier for the templates in question
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
189. Observation.reference:reference1.externalDocument.id
Control	1..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	This externalDocument SHALL contain at least one [1..*] id (CONF:1198-8695).
190. Observation.reference:reference1.externalDocument.code
Control	0..1
Binding	The codes SHALL be taken from FHIRDocumentTypeCodes; other codes may be used where these codes are not suitable
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
191. Observation.reference:reference1.externalDocument.text
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
Requirements	This externalDocument MAY contain zero or one [0..1] text (CONF:1198-8696).
192. Observation.reference:reference1.externalDocument.text.nullFlavor
Definition	If a value is an exceptional value (NULL-value), this specifies in what way and why proper information is missing.
Control	0..1
Binding	The codes SHALL be taken from NullFlavor
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
193. Observation.reference:reference1.externalDocument.text.charset
Definition	For character-based encoding types, this property specifies the character set and character encoding used. The charset shall be identified by an Internet Assigned Numbers Authority (IANA) Charset Registration [] in accordance with RFC 2978 [].
Control	0..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
194. Observation.reference:reference1.externalDocument.text.compression
Definition	Indicates whether the raw byte data is compressed, and what compression algorithm was used.
Control	0..1
Binding	The codes SHALL be taken from CompressionAlgorithm
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
195. Observation.reference:reference1.externalDocument.text.integrityCheck
Definition	The integrity check is a short binary value representing a cryptographically strong checksum that is calculated over the binary data. The purpose of this property, when communicated with a reference is for anyone to validate later whether the reference still resolved to the same data that the reference resolved to when the encapsulated data value with reference was created.
Control	0..1
Type	base64Binary
XML Representation	In the XML format, this property is represented as an attribute.
196. Observation.reference:reference1.externalDocument.text.integrityCheckAlgorithm
Definition	Specifies the algorithm used to compute the integrityCheck value. The cryptographically strong checksum algorithm Secure Hash Algorithm-1 (SHA-1) is currently the industry standard. It has superseded the MD5 algorithm only a couple of years ago, when certain flaws in the security of MD5 were discovered. Currently the SHA-1 hash algorithm is the default choice for the integrity check algorithm. Note that SHA-256 is also entering widespread usage.
Control	0..1
Binding	The codes SHALL be taken from IntegrityCheckAlgorithm
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
197. Observation.reference:reference1.externalDocument.text.language
Definition	For character based information the language property specifies the human language of the text.
Control	0..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
198. Observation.reference:reference1.externalDocument.text.mediaType
Definition	Identifies the type of the encapsulated data and identifies a method to interpret or render the data.
Control	0..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
199. Observation.reference:reference1.externalDocument.text.representation
Control	0..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
200. Observation.reference:reference1.externalDocument.text.data[x]
Definition	Data that is primarily intended for human interpretation or for further machine processing is outside the scope of HL7. This includes unformatted or formatted written language, multimedia data, or structured information as defined by a different standard (e.g., XML-signatures.)
Control	0..1
Type	Choice of: string, base64Binary
[x] Note	See Choice of Data Types for further information about how to use [x]
XML Representation	In the XML format, this property is represented as unadorned text.
201. Observation.reference:reference1.externalDocument.text.reference
Definition	A telecommunication address (TEL), such as a URL for HTTP or FTP, which will resolve to precisely the same binary data that could as well have been provided as inline data.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/TEL
Requirements	The text, if present, MAY contain zero or one [0..1] reference (CONF:1198-8697).
Invariants	Defined on this element 1198-8698: The URL of a referenced advance directive document MAY be present, and SHALL be represented in Observation/reference/ExternalDocument/text/reference (CONF:1198-8698). (: ) 1198-8699: If a URL is referenced, then it SHOULD have a corresponding linkHTML element in narrative block (CONF:1198-8699). (: )
202. Observation.reference:reference1.externalDocument.text.thumbnail
Definition	An abbreviated rendition of the full data. A thumbnail requires significantly fewer resources than the full data, while still maintaining some distinctive similarity with the full data. A thumbnail is typically used with by-reference encapsulated data. It allows a user to select data more efficiently before actually downloading through the reference.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
203. Observation.reference:reference1.externalDocument.setId
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
204. Observation.reference:reference1.externalDocument.versionNumber
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/INT
205. Observation.precondition
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Precondition
206. Observation.referenceRange
Control	0..*
Type	Element
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
207. Observation.referenceRange.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control	0..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Summary	false
208. Observation.referenceRange.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Control	0..*
Type	Extension
Summary	false
Alternate Names	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing	This element introduces a set of slices on Observation.referenceRange.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
209. Observation.referenceRange.typeCode
Control	1..1
Binding	The codes SHALL be taken from ActRelationshipPertains
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	REFV
Fixed Value	REFV
210. Observation.referenceRange.observationRange
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ObservationRange