HL7.CDA.US.CCDA\Series Act - 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: SeriesAct - Detailed Descriptions

Active as of 2023-01-16

Definitions for the 2.16.840.1.113883.10.20.22.4.63 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. Act
2. Act.classCode
Requirements	SHALL contain exactly one [1..1] @classCode="ACT" Act (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:81-9222).
Pattern Value	ACT
3. Act.moodCode
Requirements	SHALL contain exactly one [1..1] @moodCode="EVN" Event (CodeSystem: HL7ActMood urn:oid:2.16.840.1.113883.5.1001 STATIC) (CONF:81-9223).
Pattern Value	EVN
4. Act.templateId
Slicing	This element introduces a set of slices on Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root
5. Act.templateId:primary
SliceName	primary
Control	1..1
Requirements	SHALL contain exactly one [1..1] templateId (CONF:81-10918) such that it
6. Act.templateId:primary.root
Control	1..1
Requirements	SHALL contain exactly one [1..1] @root="2.16.840.1.113883.10.20.22.4.63" (CONF:81-10919).
Pattern Value	2.16.840.1.113883.10.20.22.4.63
7. Act.id
Control	10..*
Requirements	SHALL contain at least one [1..*] id (CONF:81-9224).
8. Act.id.root
Control	1..1
Requirements	Such ids SHALL contain exactly one [1..1] @root (CONF:81-9225).
9. Act.id.extension
Control	0..0
Requirements	Such ids SHALL NOT contain [0..0] @extension (CONF:81-9226).
10. Act.code
Requirements	SHALL contain exactly one [1..1] code (CONF:81-19166).
11. Act.code.code
Control	1..1
Requirements	This code SHALL contain exactly one [1..1] @code="113015" (CONF:81-19167).
Pattern Value	113015
12. Act.code.codeSystem
Control	0..1
Requirements	This code MAY contain zero or one [0..1] @codeSystem="1.2.840.10008.2.16.4" (CodeSystem: DCM urn:oid:1.2.840.10008.2.16.4) (CONF:81-26461).
Pattern Value	1.2.840.10008.2.16.4
13. Act.code.qualifier
Control	1..1
Requirements	This code SHALL contain exactly one [1..1] qualifier (CONF:81-26462).
14. Act.code.qualifier.name
Control	1..1
Requirements	This qualifier SHALL contain exactly one [1..1] name (CONF:81-26463).
15. Act.code.qualifier.name.code
Control	1..1
Requirements	This name SHALL contain exactly one [1..1] @code="121139" Modality (CONF:81-26464).
Pattern Value	121139
16. Act.code.qualifier.name.codeSystem
Control	1..1
Requirements	This name SHALL contain exactly one [1..1] @codeSystem="1.2.840.10008.2.16.4" (CodeSystem: DCM urn:oid:1.2.840.10008.2.16.4) (CONF:81-26465).
Pattern Value	1.2.840.10008.2.16.4
17. Act.code.qualifier.value
Control	1..1
Requirements	This qualifier SHALL contain exactly one [1..1] value (CONF:81-26466).
18. Act.text
Requirements	MAY contain zero or one [0..1] text (CONF:81-9233).
19. Act.effectiveTime
Requirements	SHOULD contain zero or one [0..1] effectiveTime (CONF:81-9235).
20. Act.entryRelationship
Slicing	This element introduces a set of slices on Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ observation
21. Act.entryRelationship:SOPInstanceObservation
SliceName	SOPInstanceObservation
Control	1..*
Requirements	SHALL contain at least one [1..*] entryRelationship (CONF:81-9237) such that it
22. Act.entryRelationship:SOPInstanceObservation.typeCode
Control	1..1
Requirements	SHALL contain exactly one [1..1] @typeCode="COMP" Component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:81-9238).
Pattern Value	COMP
23. Act.entryRelationship:SOPInstanceObservation.observation
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Observation(SOPInstanceObservation)
Requirements	SHALL contain exactly one [1..1] observationSOP Instance Observation (identifier: urn:oid:2.16.840.1.113883.10.20.6.2.8) (CONF:81-15927).

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

1. Act
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. Act.classCode
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] @classCode="ACT" Act (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:81-9222).
Pattern Value	ACT
3. Act.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:81-9223).
Pattern Value	EVN
4. Act.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 Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root
5. Act.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:81-10918) such that it
6. Act.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="2.16.840.1.113883.10.20.22.4.63" (CONF:81-10919).
Pattern Value	2.16.840.1.113883.10.20.22.4.63
7. Act.id
Control	1..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	SHALL contain at least one [1..*] id (CONF:81-9224).
8. Act.id.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	Such ids SHALL contain exactly one [1..1] @root (CONF:81-9225).
9. Act.id.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	Such ids SHALL NOT contain [0..0] @extension (CONF:81-9226).
10. Act.code
Control	1..1
Binding	The codes SHALL be taken from v3 Code System ActCode; other codes may be used where these codes are not suitable
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
Requirements	SHALL contain exactly one [1..1] code (CONF:81-19166).
11. Act.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	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	This code SHALL contain exactly one [1..1] @code="113015" (CONF:81-19167).
Pattern Value	113015
12. Act.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.
Requirements	This code MAY contain zero or one [0..1] @codeSystem="1.2.840.10008.2.16.4" (CodeSystem: DCM urn:oid:1.2.840.10008.2.16.4) (CONF:81-26461).
Pattern Value	1.2.840.10008.2.16.4
13. Act.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CR
Requirements	This code SHALL contain exactly one [1..1] qualifier (CONF:81-26462).
14. Act.code.qualifier.name
Definition	Specifies the manner in which the concept role value contributes to the meaning of a code phrase. For example, if SNOMED RT defines a concept "leg", a role relation "has-laterality", and another concept "left", the concept role relation allows to add the qualifier "has-laterality: left" to a primary code "leg" to construct the meaning "left leg". In this example "has-laterality" is the CR.name.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CV
Requirements	This qualifier SHALL contain exactly one [1..1] name (CONF:81-26463).
15. Act.code.qualifier.name.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 name SHALL contain exactly one [1..1] @code="121139" Modality (CONF:81-26464).
Pattern Value	121139
16. Act.code.qualifier.name.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	This name SHALL contain exactly one [1..1] @codeSystem="1.2.840.10008.2.16.4" (CodeSystem: DCM urn:oid:1.2.840.10008.2.16.4) (CONF:81-26465).
Pattern Value	1.2.840.10008.2.16.4
17. Act.code.qualifier.name.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
18. Act.code.qualifier.name.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.
19. Act.code.qualifier.value
Definition	The concept that modifies the primary code of a code phrase through the role relation. For example, if SNOMED RT defines a concept "leg", a role relation "has-laterality", and another concept "left", the concept role relation allows adding the qualifier "has-laterality: left" to a primary code "leg" to construct the meaning "left leg". In this example "left" is the CR.value.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
Requirements	This qualifier SHALL contain exactly one [1..1] value (CONF:81-26466).
20. Act.text
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
Requirements	MAY contain zero or one [0..1] text (CONF:81-9233).
21. Act.effectiveTime
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/IVL-TS
Requirements	SHOULD contain zero or one [0..1] effectiveTime (CONF:81-9235).
22. Act.entryRelationship
Control	0..*
Type	Element
Invariants	Defined on this element act-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) 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 Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ observation
23. Act.entryRelationship.typeCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
24. Act.entryRelationship.contextConductionInd
Control	1..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	true
25. Act.entryRelationship:SOPInstanceObservation
SliceName	SOPInstanceObservation
Control	1..*
Type	Element
Requirements	SHALL contain at least one [1..*] entryRelationship (CONF:81-9237) such that it
Invariants	Defined on this element act-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) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Act.entryRelationship:SOPInstanceObservation.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="COMP" Component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:81-9238).
Pattern Value	COMP
27. Act.entryRelationship:SOPInstanceObservation.contextConductionInd
Control	1..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	true
28. Act.entryRelationship:SOPInstanceObservation.observation
Definition	Base definition for all types defined in FHIR type system.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Observation(SOPInstanceObservation)
Requirements	SHALL contain exactly one [1..1] observationSOP Instance Observation (identifier: urn:oid:2.16.840.1.113883.10.20.6.2.8) (CONF:81-15927).
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
29. Act.entryRelationship:SOPInstanceObservation.regionOfInterest
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/RegionOfInterest
30. Act.entryRelationship:SOPInstanceObservation.observationMedia
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/ObservationMedia
31. Act.entryRelationship:SOPInstanceObservation.substanceAdministration
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/SubstanceAdministration
32. Act.entryRelationship:SOPInstanceObservation.supply
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Supply
33. Act.entryRelationship:SOPInstanceObservation.procedure
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Procedure
34. Act.entryRelationship:SOPInstanceObservation.encounter
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Encounter
35. Act.entryRelationship:SOPInstanceObservation.organizer
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Organizer
36. Act.entryRelationship:SOPInstanceObservation.act
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Act

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

1. Act
Definition	Base definition for all types defined in FHIR type system.
Control	1..1
2. Act.classCode
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] @classCode="ACT" Act (CodeSystem: HL7ActClass urn:oid:2.16.840.1.113883.5.6 STATIC) (CONF:81-9222).
Pattern Value	ACT
3. Act.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:81-9223).
Pattern Value	EVN
4. Act.realmCode
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
5. Act.typeId
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/II
6. Act.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 Act.templateId. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ root
7. Act.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:81-10918) such that it
8. Act.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.
9. Act.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.
10. Act.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.
11. Act.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="2.16.840.1.113883.10.20.22.4.63" (CONF:81-10919).
Pattern Value	2.16.840.1.113883.10.20.22.4.63
12. Act.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.
13. Act.id
Control	1..*
Type	http://hl7.org/fhir/cda/StructureDefinition/II
Requirements	SHALL contain at least one [1..*] id (CONF:81-9224).
14. Act.id.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.
15. Act.id.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.
16. Act.id.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.
17. Act.id.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	Such ids SHALL contain exactly one [1..1] @root (CONF:81-9225).
18. Act.id.extension
Definition	A character string as a unique identifier within the scope of the identifier root.
Control	0..0
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	Such ids SHALL NOT contain [0..0] @extension (CONF:81-9226).
19. Act.code
Control	1..1
Binding	The codes SHALL be taken from v3 Code System ActCode; other codes may be used where these codes are not suitable
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
Requirements	SHALL contain exactly one [1..1] code (CONF:81-19166).
20. Act.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.
21. Act.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	1..1
Type	string
XML Representation	In the XML format, this property is represented as an attribute.
Requirements	This code SHALL contain exactly one [1..1] @code="113015" (CONF:81-19167).
Pattern Value	113015
22. Act.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.
Requirements	This code MAY contain zero or one [0..1] @codeSystem="1.2.840.10008.2.16.4" (CodeSystem: DCM urn:oid:1.2.840.10008.2.16.4) (CONF:81-26461).
Pattern Value	1.2.840.10008.2.16.4
23. Act.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.
24. Act.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.
25. Act.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.
26. Act.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`.
27. Act.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`.
28. Act.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
29. Act.code.qualifier
Definition	Specifies additional codes that increase the specificity of the the primary code.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CR
Requirements	This code SHALL contain exactly one [1..1] qualifier (CONF:81-26462).
30. Act.code.qualifier.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.
31. Act.code.qualifier.inverted
Definition	Indicates if the sense of the role name is inverted. This can be used in cases where the underlying code system defines inversion but does not provide reciprocal pairs of role names. By default, inverted is false.
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
32. Act.code.qualifier.name
Definition	Specifies the manner in which the concept role value contributes to the meaning of a code phrase. For example, if SNOMED RT defines a concept "leg", a role relation "has-laterality", and another concept "left", the concept role relation allows to add the qualifier "has-laterality: left" to a primary code "leg" to construct the meaning "left leg". In this example "has-laterality" is the CR.name.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CV
Requirements	This qualifier SHALL contain exactly one [1..1] name (CONF:81-26463).
33. Act.code.qualifier.name.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.
34. Act.code.qualifier.name.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 name SHALL contain exactly one [1..1] @code="121139" Modality (CONF:81-26464).
Pattern Value	121139
35. Act.code.qualifier.name.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	This name SHALL contain exactly one [1..1] @codeSystem="1.2.840.10008.2.16.4" (CodeSystem: DCM urn:oid:1.2.840.10008.2.16.4) (CONF:81-26465).
Pattern Value	1.2.840.10008.2.16.4
36. Act.code.qualifier.name.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.
37. Act.code.qualifier.name.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.
38. Act.code.qualifier.name.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.
39. Act.code.qualifier.name.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`.
40. Act.code.qualifier.name.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`.
41. Act.code.qualifier.name.originalText
Definition	The text or phrase used as the basis for the coding.
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
42. Act.code.qualifier.name.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
43. Act.code.qualifier.name.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.
44. Act.code.qualifier.value
Definition	The concept that modifies the primary code of a code phrase through the role relation. For example, if SNOMED RT defines a concept "leg", a role relation "has-laterality", and another concept "left", the concept role relation allows adding the qualifier "has-laterality: left" to a primary code "leg" to construct the meaning "left leg". In this example "left" is the CR.value.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/CD
Requirements	This qualifier SHALL contain exactly one [1..1] value (CONF:81-26466).
45. Act.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.
46. Act.negationInd
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
47. Act.text
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ED
Requirements	MAY contain zero or one [0..1] text (CONF:81-9233).
48. Act.statusCode
Control	0..1
Binding	The codes SHALL be taken from ActStatus
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
49. Act.effectiveTime
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/IVL-TS
Requirements	SHOULD contain zero or one [0..1] effectiveTime (CONF:81-9235).
50. Act.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
51. Act.languageCode
Control	0..1
Binding	The codes SHALL be taken from HumanLanguage
Type	http://hl7.org/fhir/cda/StructureDefinition/CS
52. Act.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()))
53. Act.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
54. Act.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 Act.subject.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
55. Act.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
56. Act.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
57. Act.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
58. Act.subject.relatedSubject
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/RelatedSubject
59. Act.specimen
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Specimen
60. Act.performer
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Performer2
61. Act.author
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Author
62. Act.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()))
63. Act.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
64. Act.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 Act.informant.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
65. Act.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
66. Act.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
67. Act.informant.assignedEntity
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/AssignedEntity
68. Act.informant.relatedEntity
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/RelatedEntity
69. Act.participant
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Participant2
70. Act.entryRelationship
Control	0..*
Type	Element
Invariants	Defined on this element act-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) 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 Act.entryRelationship. The slices are unordered and Open, and can be differentiated using the following discriminators: profile @ observation
71. Act.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
72. Act.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 Act.entryRelationship.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
73. Act.entryRelationship.typeCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
74. Act.entryRelationship.inversionInd
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
75. Act.entryRelationship.contextConductionInd
Control	1..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	true
76. Act.entryRelationship.sequenceNumber
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/INT
77. Act.entryRelationship.negationInd
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
78. Act.entryRelationship.seperatableInd
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/BL
79. Act.entryRelationship.observation
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Observation
80. Act.entryRelationship.regionOfInterest
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/RegionOfInterest
81. Act.entryRelationship.observationMedia
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ObservationMedia
82. Act.entryRelationship.substanceAdministration
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/SubstanceAdministration
83. Act.entryRelationship.supply
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Supply
84. Act.entryRelationship.procedure
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Procedure
85. Act.entryRelationship.encounter
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Encounter
86. Act.entryRelationship.organizer
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Organizer
87. Act.entryRelationship.act
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Act
88. Act.entryRelationship:SOPInstanceObservation
SliceName	SOPInstanceObservation
Control	1..*
Type	Element
Requirements	SHALL contain at least one [1..*] entryRelationship (CONF:81-9237) such that it
Invariants	Defined on this element act-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) ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
89. Act.entryRelationship:SOPInstanceObservation.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
90. Act.entryRelationship:SOPInstanceObservation.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 Act.entryRelationship.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
91. Act.entryRelationship:SOPInstanceObservation.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="COMP" Component (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002 STATIC) (CONF:81-9238).
Pattern Value	COMP
92. Act.entryRelationship:SOPInstanceObservation.inversionInd
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
93. Act.entryRelationship:SOPInstanceObservation.contextConductionInd
Control	1..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
Default Value	true
94. Act.entryRelationship:SOPInstanceObservation.sequenceNumber
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/INT
95. Act.entryRelationship:SOPInstanceObservation.negationInd
Control	0..1
Type	boolean
XML Representation	In the XML format, this property is represented as an attribute.
96. Act.entryRelationship:SOPInstanceObservation.seperatableInd
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/BL
97. Act.entryRelationship:SOPInstanceObservation.observation
Definition	Base definition for all types defined in FHIR type system.
Control	1..1
Type	http://hl7.org/fhir/cda/StructureDefinition/Observation(SOPInstanceObservation)
Requirements	SHALL contain exactly one [1..1] observationSOP Instance Observation (identifier: urn:oid:2.16.840.1.113883.10.20.6.2.8) (CONF:81-15927).
Invariants	Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
98. Act.entryRelationship:SOPInstanceObservation.regionOfInterest
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/RegionOfInterest
99. Act.entryRelationship:SOPInstanceObservation.observationMedia
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/ObservationMedia
100. Act.entryRelationship:SOPInstanceObservation.substanceAdministration
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/SubstanceAdministration
101. Act.entryRelationship:SOPInstanceObservation.supply
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Supply
102. Act.entryRelationship:SOPInstanceObservation.procedure
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Procedure
103. Act.entryRelationship:SOPInstanceObservation.encounter
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Encounter
104. Act.entryRelationship:SOPInstanceObservation.organizer
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Organizer
105. Act.entryRelationship:SOPInstanceObservation.act
Control	0..0
Type	http://hl7.org/fhir/cda/StructureDefinition/Act
106. Act.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()))
107. Act.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
108. Act.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 Act.reference.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
109. Act.reference.typeCode
Control	1..1
Type	code
XML Representation	In the XML format, this property is represented as an attribute.
110. Act.reference.seperatableInd
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/BL
111. Act.reference.externalAct
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalAct
112. Act.reference.externalObservation
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalObservation
113. Act.reference.externalProcedure
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalProcedure
114. Act.reference.externalDocument
Control	0..1
Type	http://hl7.org/fhir/cda/StructureDefinition/ExternalDocument
115. Act.precondition
Control	0..*
Type	http://hl7.org/fhir/cda/StructureDefinition/Precondition