This page is part of the CCDA: Consolidated CDA Release (v3.0.0-ballot: CCDA 3.0 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions
Official URL: http://hl7.org/cda/us/ccda/StructureDefinition/PlannedCoverage | Version: 3.0.0-ballot | |||
Draft as of 2023-12-21 | Computable Name: PlannedCoverage | |||
Other Identifiers: id: urn:oid:2.16.840.1.113883.10.20.22.4.129 |
This template represents the insurance coverage intended to cover an act or procedure.
Usage:
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Act
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:planned-coverage | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.129 | |
@extension | 0..0 | |||
@classCode | 1..1 | cs | Fixed Value: ACT | |
@moodCode | 1..1 | cs | Fixed Value: INT | |
id | 1..* | II | ||
code | 1..1 | CD | ||
@code | 1..1 | cs | Required Pattern: 48768-6 | |
@codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
statusCode | 1..1 | CS | ||
@code | 1..1 | cs | Fixed Value: active | |
author | 0..* | AuthorParticipation | Base for all types and resources | |
Slices for entryRelationship | 1..* | EntryRelationship | Slice: Unordered, Open by exists:act | |
entryRelationship:entryRelationship1 | 1..1 | EntryRelationship | ||
@typeCode | 1..1 | cs | Fixed Value: COMP | |
act | 1..1 | Act | ||
@classCode | 1..1 | cs | Fixed Value: ACT | |
@moodCode | 1..1 | cs | Fixed Value: INT | |
id | 1..* | II | These act/identifiers are unique identifiers for the policy or program providing the coverage. | |
code | 1..1 | CD | Binding: Payer Type (required) | |
statusCode | 1..1 | CS | ||
@code | 1..1 | cs | Fixed Value: active | |
Documentation for this format |
Path | Conformance | ValueSet |
Act.entryRelationship:entryRelationship1.act.code | required | PayerType |
Id | Grade | Path(s) | Details | Requirements |
should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:planned-coverage | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.129 | |
@classCode | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
@moodCode | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: INT | |
id | 1..* | II | ||
code | 1..1 | CD | Binding: v3 Code System ActCode (example) | |
@code | 1..1 | cs | Required Pattern: 48768-6 | |
@codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
statusCode | 1..1 | CS | Binding: ActStatus (required) | |
@code | 1..1 | cs | Fixed Value: active | |
author | 0..* | AuthorParticipation | Base for all types and resources | |
Slices for entryRelationship | 1..* | EntryRelationship | Slice: Unordered, Open by exists:act | |
entryRelationship:entryRelationship1 | 1..1 | EntryRelationship | ||
@typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP | |
act | 1..1 | Act | ||
@classCode | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
@moodCode | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: INT | |
id | 1..* | II | These act/identifiers are unique identifiers for the policy or program providing the coverage. | |
code | 1..1 | CD | Binding: Payer Type (required) | |
statusCode | 1..1 | CS | Binding: ActStatus (required) | |
@code | 1..1 | cs | Fixed Value: active | |
Documentation for this format |
Path | Conformance | ValueSet / Code |
Act.classCode | required | Fixed Value: ACT |
Act.moodCode | required | Fixed Value: INT |
Act.code | example | ActCode |
Act.statusCode | required | ActStatus |
Act.entryRelationship:entryRelationship1.typeCode | required | Fixed Value: COMP |
Act.entryRelationship:entryRelationship1.act.classCode | required | Fixed Value: ACT |
Act.entryRelationship:entryRelationship1.act.moodCode | required | Fixed Value: INT |
Act.entryRelationship:entryRelationship1.act.code | required | PayerType |
Act.entryRelationship:entryRelationship1.act.statusCode | required | ActStatus |
Id | Grade | Path(s) | Details | Requirements |
should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Path | Conformance | ValueSet / Code |
Act.nullFlavor | required | CDANullFlavor |
Act.typeId.nullFlavor | required | CDANullFlavor |
Act.templateId:planned-coverage.nullFlavor | required | CDANullFlavor |
Act.classCode | required | Fixed Value: ACT |
Act.moodCode | required | Fixed Value: INT |
Act.code | example | ActCode |
Act.code.nullFlavor | required | CDANullFlavor |
Act.text.nullFlavor | required | CDANullFlavor |
Act.text.compression | required | CDACompressionAlgorithm |
Act.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm |
Act.text.mediaType | example | MediaType |
Act.text.representation | required | BinaryDataEncoding |
Act.statusCode | required | ActStatus |
Act.statusCode.nullFlavor | required | CDANullFlavor |
Act.priorityCode | example | ActPriority |
Act.languageCode | required | AllLanguages |
Act.entryRelationship:entryRelationship1.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.typeId.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.typeCode | required | Fixed Value: COMP |
Act.entryRelationship:entryRelationship1.act.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.act.typeId.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.act.classCode | required | Fixed Value: ACT |
Act.entryRelationship:entryRelationship1.act.moodCode | required | Fixed Value: INT |
Act.entryRelationship:entryRelationship1.act.code | required | PayerType |
Act.entryRelationship:entryRelationship1.act.statusCode | required | ActStatus |
Act.entryRelationship:entryRelationship1.act.statusCode.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.act.priorityCode | example | ActPriority |
Act.entryRelationship:entryRelationship1.act.languageCode | required | AllLanguages |
Id | Grade | Path(s) | Details | Requirements |
should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
This structure is derived from Act
Summary
Mandatory: 14 elements
Fixed Value: 7 elements
Prohibited: 1 element
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Differential View
This structure is derived from Act
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:planned-coverage | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.129 | |
@extension | 0..0 | |||
@classCode | 1..1 | cs | Fixed Value: ACT | |
@moodCode | 1..1 | cs | Fixed Value: INT | |
id | 1..* | II | ||
code | 1..1 | CD | ||
@code | 1..1 | cs | Required Pattern: 48768-6 | |
@codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
statusCode | 1..1 | CS | ||
@code | 1..1 | cs | Fixed Value: active | |
author | 0..* | AuthorParticipation | Base for all types and resources | |
Slices for entryRelationship | 1..* | EntryRelationship | Slice: Unordered, Open by exists:act | |
entryRelationship:entryRelationship1 | 1..1 | EntryRelationship | ||
@typeCode | 1..1 | cs | Fixed Value: COMP | |
act | 1..1 | Act | ||
@classCode | 1..1 | cs | Fixed Value: ACT | |
@moodCode | 1..1 | cs | Fixed Value: INT | |
id | 1..* | II | These act/identifiers are unique identifiers for the policy or program providing the coverage. | |
code | 1..1 | CD | Binding: Payer Type (required) | |
statusCode | 1..1 | CS | ||
@code | 1..1 | cs | Fixed Value: active | |
Documentation for this format |
Path | Conformance | ValueSet |
Act.entryRelationship:entryRelationship1.act.code | required | PayerType |
Id | Grade | Path(s) | Details | Requirements |
should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Key Elements View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Act | C | 1..1 | Act | XML Namespace: urn:hl7-org:v3 Elements defined in Ancestors: @nullFlavor, realmCode, typeId, templateId, @classCode, @moodCode, @negationInd, id, code, text, statusCode, effectiveTime, priorityCode, languageCode, subject, specimen, performer, author, informant, participant, entryRelationship, reference, precondition, sdtcPrecondition2, sdtcInFulfillmentOf1 Base for all types and resources Instances of this type are validated by templateId Logical Container: ClinicalDocument (CDA Class) should-text-ref-value: SHOULD contain text/reference/@value |
Slices for templateId | 1..* | II | Slice: Unordered, Open by value:root | |
templateId:planned-coverage | 1..1 | II | ||
@root | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.10.20.22.4.129 | |
@classCode | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
@moodCode | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: INT | |
id | 1..* | II | ||
code | 1..1 | CD | Binding: v3 Code System ActCode (example) | |
@code | 1..1 | cs | Required Pattern: 48768-6 | |
@codeSystem | 1..1 | oid, uuid, ruid | Required Pattern: 2.16.840.1.113883.6.1 | |
text | 0..1 | ED | SHOULD reference the portion of section narrative text corresponding to this entry | |
reference | C | 0..1 | TEL | value-starts-octothorpe: If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative |
statusCode | 1..1 | CS | Binding: ActStatus (required) | |
@code | 1..1 | cs | Fixed Value: active | |
author | 0..* | AuthorParticipation | Base for all types and resources | |
Slices for entryRelationship | 1..* | EntryRelationship | Slice: Unordered, Open by exists:act | |
entryRelationship:entryRelationship1 | 1..1 | EntryRelationship | ||
@typeCode | 1..1 | cs | Binding: x_ActRelationshipEntryRelationship (required) Fixed Value: COMP | |
act | 1..1 | Act | ||
@classCode | 1..1 | cs | Binding: XActClassDocumentEntryAct (2.0.0) (required) Fixed Value: ACT | |
@moodCode | 1..1 | cs | Binding: XDocumentActMood (2.0.0) (required) Fixed Value: INT | |
id | 1..* | II | These act/identifiers are unique identifiers for the policy or program providing the coverage. | |
code | 1..1 | CD | Binding: Payer Type (required) | |
statusCode | 1..1 | CS | Binding: ActStatus (required) | |
@code | 1..1 | cs | Fixed Value: active | |
Documentation for this format |
Path | Conformance | ValueSet / Code |
Act.classCode | required | Fixed Value: ACT |
Act.moodCode | required | Fixed Value: INT |
Act.code | example | ActCode |
Act.statusCode | required | ActStatus |
Act.entryRelationship:entryRelationship1.typeCode | required | Fixed Value: COMP |
Act.entryRelationship:entryRelationship1.act.classCode | required | Fixed Value: ACT |
Act.entryRelationship:entryRelationship1.act.moodCode | required | Fixed Value: INT |
Act.entryRelationship:entryRelationship1.act.code | required | PayerType |
Act.entryRelationship:entryRelationship1.act.statusCode | required | ActStatus |
Id | Grade | Path(s) | Details | Requirements |
should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
Snapshot View
Path | Conformance | ValueSet / Code |
Act.nullFlavor | required | CDANullFlavor |
Act.typeId.nullFlavor | required | CDANullFlavor |
Act.templateId:planned-coverage.nullFlavor | required | CDANullFlavor |
Act.classCode | required | Fixed Value: ACT |
Act.moodCode | required | Fixed Value: INT |
Act.code | example | ActCode |
Act.code.nullFlavor | required | CDANullFlavor |
Act.text.nullFlavor | required | CDANullFlavor |
Act.text.compression | required | CDACompressionAlgorithm |
Act.text.integrityCheckAlgorithm | required | IntegrityCheckAlgorithm |
Act.text.mediaType | example | MediaType |
Act.text.representation | required | BinaryDataEncoding |
Act.statusCode | required | ActStatus |
Act.statusCode.nullFlavor | required | CDANullFlavor |
Act.priorityCode | example | ActPriority |
Act.languageCode | required | AllLanguages |
Act.entryRelationship:entryRelationship1.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.typeId.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.typeCode | required | Fixed Value: COMP |
Act.entryRelationship:entryRelationship1.act.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.act.typeId.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.act.classCode | required | Fixed Value: ACT |
Act.entryRelationship:entryRelationship1.act.moodCode | required | Fixed Value: INT |
Act.entryRelationship:entryRelationship1.act.code | required | PayerType |
Act.entryRelationship:entryRelationship1.act.statusCode | required | ActStatus |
Act.entryRelationship:entryRelationship1.act.statusCode.nullFlavor | required | CDANullFlavor |
Act.entryRelationship:entryRelationship1.act.priorityCode | example | ActPriority |
Act.entryRelationship:entryRelationship1.act.languageCode | required | AllLanguages |
Id | Grade | Path(s) | Details | Requirements |
should-text-ref-value | warning | Act | SHOULD contain text/reference/@value : text.reference.value.exists() | |
value-starts-octothorpe | error | Act.text.reference | If reference/@value is present, it SHALL begin with a '#' and SHALL point to its corresponding narrative : value.exists() implies value.startsWith('#') |
This structure is derived from Act
Summary
Mandatory: 14 elements
Fixed Value: 7 elements
Prohibited: 1 element
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices: